Components of a Save Application

The RemiPCA SAFE Network © provides the following safety components for participating hospitals:

1. Standards for the use of remifentanil PCA in the delivery room:
   The current application standards (standardised operating procedure SOP) merge from the experience gained from the network data, the current literature, and input form national and international experts. The SOP is evaluated and updated annually. The current SOP "best practice" is provided to all participating hospitals and is the underlying base for a safe application of this procedure. The responsibility for a careful application of remifentanil PCA for labour remains with the individual hospital and their specialists.
    
   
2. RemiPCA Registry©:
   Each participating hospital submits all application data (outcome data) encrypted via the online questionnaire directly onto the RemiPCA registry. For auditing and benchmarking the hospital can extract a standardised documentation of their own outcome data (hospital audit). The overall data of the RemiPCA Registry are evaluated on regular basis. This evaluation is used to review the method as a whole and to gain important insights into efficacy, adverse effects for mother and child, rare serious events and the satisfaction of the parturients and the midwives (process audit). The experience from the overall data, which are based on a large case load, is continuously incorporated into the SOP of remifentanil PCA (collaborative learning).
    
   
3. RemiPCA Alert©:
   As soon as a serious incident, such as ventilation or cardiopulmonary resuscitation of the mother or cardiopulmonary resuscitation of the new-born, occurred and is submitted to the registry, this alarm system is activated. The RemiPCA Alert provides fast information about serious events and helps to quickly initiate process adjustments if there is a connection to remifentanil PCA. Therefor it increases the awareness of severe incidents in all participating hospitals, although serious events are extremely rare.
    
   
4. www.remipca.org:
   The website gives information about the RemiPCA SAFE Network and provides access to the password-protected area for participating hospitals. The protected area contains the online questionnaire, the possibility to download your own data either as raw data or a ready available evaluation and the valid guidelines (SOP).
    
   

Current Results

The following graphs show live from the RemiPCA Registry© the total number of documented Remifentanil PCA applications . In addition they show pain reduction sores, side effects as well as satisfaction of the parturients. The participating hospitals have access to more detailed results through the password-protected area on the website.

Participating Hospitals

The RemiPCA SAFE Network is joined by hospitals that apply remifentanil PCA for labour in a standardized way, wish to continuously improve these standards and support actively the safety of this analgesic method.

The following hospitals participate in the RemiPCA SAFE Network© and thus establish this dynamic process of continuous quality management. Thank you very much, for your contribution!

Map of Hospitals with Quality-Controlled Remifentanil PCA

List of Hospitals with Quality-Controlled Remifentanil PCA

• Australia
• Ballarat Health Services, Ballarat
• Royal Prince Alfred Hospital - Women and Babies`Executive Unit, Camperdown
• Royal Hobart Hospital, Hobart TAS
• CH
• Hirslanden Klinik Aarau, Aarau
• Kantonspital Aarau, Aarau
• Zuger Kantonspital, Baar
• Universitätsspital Basel, Basel
• Ospedale Regionale Bellinzona e Valli, Bellinzona
• Salem-Spital, Bern 25
• Hirslanden Klinik Linde, Biel
• Spitalzentrum Biel AG, Biel
• Spital Bülach AG, Bülach
• Spital Emmental Burgdorf, Burgdorf
• Kantonsspital Graubünden, Chur
• Kantonsspital Frauenfeld, Frauenfeld
• Hôpitaux Universitaires Genève, Genève
• Spital Herisau, Herisau
• See-Spital Horgen, Horgen
• Spital Langenthal, Langenthal
• Centre Hospitalier Universitaire Vaudois, Lausanne
• Ospedale Regionale di Lugano, Lugano
• Luzerner Kantonsspital Luzern, Luzern
• Hirslanden Klinik St. Anna, Luzern
• Kantonspital Münsterlingen, Münsterlingen
• Privatklinik Villa im Park, Rothrist
• Spital Oberengadin, Samedan
• Spital Limmattal, Schlieren
• Hôpital du Valais, Site Sion, Sion
• Spital Thun, Thun
• GZO Spital Wetzikon, Wetzikon
• Kantonsspital Winterthur, Winterthur
• Klinik Im Park, Zürich
• Stadtspital Triemli, Zürich
• Privatklinik Bethanien, Zürich
• Klinik Hirslanden, Zürich
• Qatar
• Sidra Medicine, Ar-Rayyan
• Singapore
• KK Women`s and Children`s Hospital, Singapore
• UK
• Norfolk and Norwich University Hospitals, Norwich
• University Hospital Southampton, Southampton

The Procedure

Remifentanil PCA is a new method to ease labour pain. Remifentanil (Ultiva®) is an ultra-short-acting, very strong μ-opioid. It is metabolized by non-specific plasma and tissue esterases in both adults and neonates. The ultrashort half-life of remifentanil is responsible for its excellent controllability. There is no accumulation in case of impaired renal or hepatic function therefor no adjustment of dosing is necess