191 posters, 5 topics, 20 sessions, 393 authors, 116 institutions
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Obstetric Anaesthesia Annual Scientific Meeting 2023
18 - 19 May, 2023 | EICC Edinburgh
5814392
Standardisation of PDPH data collection and documentation
Poster Presenter
Authors
Part of Topic
Quality Improvement
Standardisation of PDPH data collection and documentation
Riddhi Rathod1, Boopathi Sivarajan1, Rajan Mane2
1 Senior Clinical Fellow 2 Consultant Anaesthetist
Introduction
Post dural puncture headache is a major complication of neuroaxial anaesthesia.
Our maternity unit is one of the largest in the country with 8500 deliveries per year.
Majority of the cases are done regional anaesthesia, hence we decided to investigate the data over the last decade about the dural puncture headaches and their management in our maternity unit.
The Aim of the study was to understand the quality of data, management strategies used over the last decade
Method
Retrospective analysis of data collected from handwritten registers of n= 304 cases of post dural puncture headaches associated with regional techniques between 2007-2019. Reaudit done from Jan 2020 - march 2023 total cases n= 25
Data was categorised under various subgroups (symptoms, type of regional technique, duration of epidural catheter in-situ, imaging and management conservative v/s blood patch).
Analysis of 304 cases showed median age = 20-29yrs.
Headache and neck pain/ stiffness were the most common presenting symptoms. Headache was found in 264 (304) patients and neck pain was dominant complaint in 40 (304) patients other symptoms described were photophobia, nausea, vomiting, dizziness, seizure. 25 patients had missing data about their symptoms.
Reaudit : Headache 14(25) patients, neck pain 11(25) and other associated symptoms described photophobia, tinnitus, vomiting.
Epidural blood patch was successful in 87% of the cases in the first attempt
conclusion
We needed to improve the quality of data collection, increase uniformity of data collection as we had missed data. Hence, we devised a standardised data collection sheet which includes initial assessment, follow up and epidural blood patch. This QI helps as a comprehensive tool for data collection of all complications of neuroaxial blocks.
We have mitigated the issues of poor handwriting, improved time management during documentation, a more uniform method of documentation, easy to use and is a useful tool for future audits and projects and a format for electronic data collection.
References
1. A Comprehensive Update on the Treatment and Management of Postdural Puncture Headache. Riki Patel, Ivan Urits, Vwaire Orhurhu et al 2020 Apr 22;24(6):24.doi: 10.1007/s11916-020-00860-0.
2. Postdural puncture headache. Kyung-Hwa Kwak. Korean J Anesthesiol.2017 Apr; 70(2): 136–143.