Patient Feedback Please use this form to leave feedback about your experience of ward 39 and the hand surgery unit.DateSelect the date you underwent your procedure Date Format: DD slash MM slash YYYY Admission typeWere you admitted for a planned / elective operation, or were you admitted to have urgent surgery ?please selectPlanned / ElectiveUrgent / TraumaAnaesthesia typeplease selectLocal anaesthesiaRegional anaesthesia (nerve block)General anaesthesiaChoose whether you had:1. Local anaesthesia - an injection very close to the site of the surgery, usually done by the surgeon in theatre2. Regional anaesthesia - an injection around the collar bone or arm pit to make the whole arm numb, usually done by an anaesthetist before going into theatre3. General anaesthesia - being made fully unconscious for the whole operationHow good was the pain relief from your nerve block? 1 (bad) - 5 (good)please select...12345How good was the pain relief from your local anaesthetic? 1 (bad) - 5 (good)please select...12345Give your pain relief an overall rating 1 (bad) - 5 (good)please select...12345Would you have a nerve block again?YesNoSedationDid you also have sedation during your operation ? (being made sleepy and drowsy but still able to communicate throughout)NoYesDid you have any side effects? nausea / vomiting shivering sore throat damage to lips / teeth dizziness confusion / memory impairment Did you stay overnight?NoYesWhich ward did you stay on?20404447Park SuiteUnsureCommentsPlease leave your feedback here. Feel free to tell us what you think went well, and how you think we could do better. If you had regional anaesthesia (nerve block), we would be keen to know how you felt about the procedure and how the experience could be better. We would like your comments to remain anonymous, so please do NOT provide your name, hospital number, address, or other personal information. If you wish to make a complaint, please use this LINK.