Regional SIA
North Bristol NHS Trust (Southmead Hospital) is a large trauma centre, with over 100 FTE anaesthetists, many of whom have an interest in regional anaesthesia (RA). We have many services whose patients benefit from RA (Elective and Trauma orthopaedics, plastics, vascular, renal, and general surgery) which ensure that there are plenty of opportunities to learn RA. A new orthopaedic treatment centre is due to open shortly and will expand this even further.
Ultrasound guided techniques are now standard, and catheter techniques are occasionally used in both the acute and chronic pain settings. Lists for which awake surgery under peripheral nerve blockade include hand surgery, vascular and vascular access surgery. Blocks that you can expect exposure to include all Plan A blocks and:
- Brachial plexus (Axillary, Supra and infraclavicular approaches)
- Cervical plexus
- Forearm approaches to peripheral nerves
- Trunk blocks including TAP, quadratus lumborum and rectus sheath
- Paravertebral/ESP
- Popliteal/proximal approaches to sciatic nerve
- Femoral, adductor canal and saphenous nerve
- Ankle block
Catheter techniques include:
- Femoral/fascial iliaca
- Epidural/Rectus sheath
- Erector spinae (for our expanding rib fracture service)
- Brachial plexus (particular for complex arm injuries)
Other than clinical experience there are ample opportunities to get involved with academic work to supplement your CV, including:
- Audit and QI
- Presentations
- Teaching; including on regular “Plan A block day” and Bristol RA course.
- Research
- Advice and support for the European Diploma in Regional Anaesthesia and MSC in RA
We have recently acquired an AI based needle trainer which allows for self-directed scanning and needling practice.
There are general service provision duties as part of this post and the on call, however once up to speed you will find plenty of use for RA skills (including rib fractures). For scheduled lists, the department will endeavour to give regional fellows priority for lists on which blocks are likely.
Historically this placement was 6 months FTE (occasionally including other modules), however shorter modules are now permitted within the new curriculum. In this case, it is advised this be paired with a complimentary specialty (e.g orthopaedics/vascular) so the learning outcomes can be tailored appropriately.
SIA Lead