Application: ieMR Advanced quick reference guide 02.12.2021 - 1 -

Single Injection Neuraxial Opioids

(Spinal (intrathecal), epidural and caudal morphine or hydromorphone) Quick reference guide

Anaesthetists

1. Search and load the Epidural Infusion and Neuraxial PowerPlan, go to the Single Injection Neuraxial phase.

2. Right click and Modify CAUTION order to stipulate time and date of first allowable opioid.

3. Initiate and Sign this phase of the powerplan.

Note: If ordering a bolus only PCA/NCA deselect (untick) the vital signs, pain assessment and naloxone orders – complete these within the PCA/NCA powerplan.

Post Anaesthesia Care Unit (PACU) Registered Nurses

1. Navigate to Single injection nerve block, found in Interactive View – Lines and Devices.

2. Single Injection Nerve Block Site – tick either Spinal anaesthetic or Epidural/caudal.

3. Drug Administered – tick opioid and local anaesthetic used.

4. Next opiate administration as per APS appears when morphine or hydromorphone is selected. Complete the time to next opioid field as per the anaesthetist handover or “Caution” order.

5. Complete Paraesthesia and Bromage assessment at least ONCE in PACU.

6. Ensure Sedation score, Respiratory rate and Nausea/Vomiting is completed.

Application: ieMR Advanced quick reference guide 02.12.2021 - 2 -

Ward Registered Nurses

Note: See CHQ-PROC-01008 Single Injection Neuraxial Opioid for observation details and frequency

1. Complete vital signs as per normal processes. Sedation assessment can also be documented via the Managing Deterioration power form.

2. Complete Pain Assessment and Single injection nerve block Observations. Single Injection Nerve Block is found in Interactive View – Lines and Devices, above Pain Infusions.

a. Click the tasks in Care Compass for quick access to these.

3. Ensure Single injection Nerve Block Site and Drug Administered fields have been completed at least ONCE. If not, complete as per PACU Registered Nurse steps 1-4 on the previous page.

4. Ensure Sedation score is completed hourly

5. Assess and document Nausea/Vomiting, Pruritus, and Urinary retention if there are any signs/reports of these.

6. Document Paraesthesia and Bromage (left & right)

Note: Where there is blue text follow the link for alerts and refernce text.