Lab 5- Testing of dermatomes PDF

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Summary

Lab 5...

Description

Testing of Dermatomes Equipment: 

Ice Pack or frozen saline tube.

Procedure: 

Explain to the patient how epidural analgesia works and why the cold test is necessary (the numb feeling from the epidural may be similar to that left behind after local anaesthetics used in dental treatment).

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Maintain patient dignity by performing the test in privacy, as areas of the body will need to be exposed.

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Remove any clothing that may restrict the assessment.

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Place the ice/cold pack on the patient’s face/shoulder to demonstrate the coldness in an area that should not be affected by the blockade. .

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Start at the upper anterior chest and work downwards in 5 cm intervals until the patient states that it does NOT feel as cold as – this is the top dermatome level.

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Continue downwards until the patient states it feels cold again – the level above this is the bottom dermatome level.

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Document at what levels (upper and lower dermatome) the patient reported altered sensation to cold as per the dermatome chart e.g. T4-T8.

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Repeat the procedure on the opposite side of the body to determine if the block is unilateral or bilateral.

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Document each side separately, e.g. Left: T10-L1, Right: T10-T12.

References: Fraser Health Authority (2012). Self-Learning Package – Pain Physiology & Assessment, Patient Controlled Analagesia, Epidural & Spinal Analgesia, Nerve Block Catheters. British Columbia, Canada. King Edward Memorial Hospital (2010). Testing of dermatomes (Section B – Clinical Guidelines). Perth, Western Australia. Sugden, A., & Cox, F. (2006). How to assess epidural blockage. Nursing Times, 102(11), 26.

Last revised winter 2017...