- Outlines the specific responsibilities of the multidisciplinary healthcare team in relation to epidural practice.
- Reviews the issues of risk benefit analysis and informed consent.
- Provides an overview of the physiology of acute pain, epidural catheter insertion procedure and the pharmacodynamics and pharmacokinetics of the commonest classes of drugs.
- Describes the equipment required to use safe and effective delivery of epidural solution to patients.
- Provides an overview of the nature and frequency of the observations required for close monitoring of patients.
- Offers a practical guide to the removal of the catheter.
Clinical governance and competency–based training are also addressed, and a framework provided to fit the training into the Agenda for Change Knowledge and Skills framework.
List of Tables.
1 Responsibilities of the Multidisciplinary Acute Pain Team (Carolyn Middleton).
2 Patient Selection (Lynda Jenkins).
3 Insertion and Epidural Catheter Management (Carolyn Middleton).
4 Physiology of Pain, Pharmacodynamics and Pharmacokinetics of Local Anaesthetic and Opioid Drugs (Carolyn Middleton).
5 Epidural Delivery Systems (Carolyn Middleton and Lynda Jenkins).
6 Epidurals in Obstetrics (Carolyn Middleton).
7 Epidurals in Paediatric Practice (Carolyn Middleton).
8 Patient Observations (Carolyn Middleton).
9 Discontinuation and Removal of the Epidural Catheter (Carolyn Middleton).
10 Troubleshooting (Dee Comerford).
11 Education and Training (Carolyn Middleton).
12 Clinical Governance and Clinical Audit (Rachel Swinglehurst).