Obstetric Anesthesia Core Knowledge Modules-Spinal Placement Checklist

Spinal Placement Checklist

Pdf Summary

The checklist reviews the sequence for spinal anesthesia, from the preprocedural timeout through positioning for surgery. Confirm informed consent, answer questions, verify the patient’s identity, allergies, and planned block, and include the patient and obstetric nurse in the timeout. Apply monitors and maintain communication throughout.<br /><br />Palpate the iliac crests to estimate L4 and identify the intended interspace. Prepare the back and establish a sterile field, keeping equipment organized and sharps positioned safely. Open glass ampules away from the sterile tray and use a filter straw to draw medication. Keep spinal medication separate from lidocaine for skin infiltration. The demonstrated spinal needle is a 25-gauge, 3.5-inch Whitacre.<br /><br />Recheck landmarks before insertion. Explain the local anesthetic injection, create a superficial skin wheal with 1% lidocaine, and use care with needle depth. Place the introducer, then advance the spinal needle with steady control. After the dural “pop,” remove the stylet and confirm cerebrospinal fluid (CSF) return. Follow the demonstrated aspiration and slow injection steps while keeping the needle stable, then remove the needle and introducer together.<br /><br />Finally, remove the drape, clean the back, assist with positioning—including left uterine displacement for obstetric patients—and continue monitoring as the team prepares for surgery.

Keywords

spinal anesthesia

preprocedural timeout

informed consent

patient identification

sterile field

lumbar landmarks

Whitacre needle

cerebrospinal fluid

local anesthetic

obstetric positioning