Coolstick, A Cool Trick: Can We Do Away With The Spray?

Introduction

Ethyl chloride is a local anaesthetic spray which provides a cold sensation to check the level of sensory block in neuraxial and regional anaesthetic blocks. Its use is common practice in Obstetrics at New Cross Hospital.

The Problem

Large volume usage of ethyl chloride spray has both environmental and financial implications including:

      costing nearly £1000 per month on average.

The Solution

The Coolstick is a non-toxic alternative; a one-time purchase cold metal stick which is kept in the fridge and can be cleaned after each use. It costs just £80 per stick.

Aim

To reduce and eliminate the use of ethyl chloride and replace it with a sustainable, reusable alternative to check the level of sensory blockade.

Methods

We surveyed 37 anaesthetics doctors in maternity theatres

over 4 weeks across 4 domains seen in Figure 2.

Discussion

Overall, feedback has been extremely positive with 97% of doctors finding that using the Coolstick alone can provide a confident sensory level, and 100% acceptance by the patient.

The Coolstick was found to be readily available for all, easy to use, and gave reproducible results.

Challenges: Providing adequate training to staff regarding proper storage and cleaning of Coolsticks.

Language barrier with patients was the main reason reported for needing to counter-check with the spray.

Conclusions and Recommendation: The Coolsticks are a long-term, financially viable and sustainable solution, which should replace all use of ethyl chloride spray.

Next Steps: We will re-audit, and implement the use of Coolsticks into labour ward, orthopaedic and emergency theatres.