ANZCA Bulletin - June 2009 - Australian and New Zealand College ...

More documents

Recommendations

Info

Quality and SafetyContinuedAnaphylaxis toChlorhexidineIn a recent edition of the British Journalof Anaesthesia, Parkes et al provide areport on three cases of anaphylaxis tochlorhexidine 1 . In all three reports theanaphylactic reaction followed the use ofurethral lubricant in the operating theatreand the authors noted that there may bea delayed presentation of cardiovascularcollapse and skin manifestations whichin these cases occurred some time afteradmission to the recovery area.A number of early reports of anaphylaxis tochlorhexidine were reported in urologicaljournals and two reports in Anaesthesia andIntensive Care in 1994 2 and 1995 3 all relatedto the use of urethral lubricants.Of interest is a case report which concerns amale undergoing a neck dissection and freeflap who developed marked hypotensionand tachycardia one hour after induction.A urinary catheter was being inserted atthe time and latex allergy was consideredbut proved negative. The patient made anuneventful recovery and skin testing wasunremarkable. The possibility of sensitivityto chlorhexidine was not considered atthis time.One year later the patient developed anerythematous rash over his entire bodyduring the insertion of intra-arterialand central venous lines (PICC line). Noanaesthetic drugs had been administeredbut the surgery did not proceed. Skin testingrevealed strongly positive reactions to boththe lignocaine-chlorhexidine lubricant usedfor the urinary catheter insertion and forthe subsequent use of chlorhexidine skinpreparation for the invasive monitoring.Anaesthetists are reminded that whenthere is unexplained cardiovascularcollapse, especially in the recovery area,the possibility of anaphylactic reactionsto chlorhexidine should be considered aschlorhexidine is present in a wide varietyof agents used in healthcare as well as inthe community.References1. Parkes AW, Harper N, HerwadkarA, Pumphrey R Anaphylaxis to thechlorhexidine component of Instillagel: acase series. Br J Anaesth 2009; 102: 65-682. Russ BR, Maddem PJ. Anaphylacticreaction to chlorhexidine in urinarycatheter lubricant. Anaesth IntensiveCare 1994; 22611-23. Parker F, Foran S. Chlorhexidine catheterlubricant anaphylaxis. Anaesth IntensiveCare 1995; 23:126Dr Fred RosewarneVictoriaQuality and SafetyCommittee membershipThe Quality and Safety Committee is justone of 12 committees of ANZCA that reportsto the ANZCA Council. While both myselfand Dr Elizabeth Feeney, President, ASA,are observers at the College Council, weare full members of the Quality and SafetyCommittee and therefore have an activerole on this important group.This means that opinions from outsidea direct college framework that reflectthe views of the respective societies’memberships can be expressed andparticularly from the NZSA point of viewthere is an additional New Zealand voiceon the committee. Not all practisinganaesthetists are Fellows but via this forumit is possible for them to have a say in theCollege’s activities.The committee is responsible for advisingand informing Council in matters of bothquality assurance and safety and also reportissues of concern directly to ANZCA fellowsvia the Bulletin or the website, giving allpractising anaesthetists up-to-date andtimely information that may seriously affectpractice. The discussions of the committeeare wide ranging and encompass all aspectsof quality and safety in anaesthesia suchas the Australia and New Zealand TripartiteAnaesthetic Data Committee process andthe preparation of appropriate guidelines.It is an interesting and enjoyable committeeto take part in, and its work is veryimportant for the patients of New Zealandand Australia.Dr Andrew Warmington, President,New Zealand Society of Anaesthetists (NZSA)Auckland, New Zealand48The ANZCA Bulletin June 2009
Changes to medicaloxygen connections– re-visitedThe March 2009 edition of the ANZCABulletin published an article by ProfessorJohn Russell regarding the recentamendment to AS2473.3 and the subsequentupcoming changes to medical oxygenconnections which are to be converted byall suppliers on a state-by-state basis overthe next two years.The College has received correspondencefrom the Australia and New ZealandIndustrial Gas Association (ANZIGA),regarding the schedule, and the informationis outlined opposite.Important changes to medical gas cylindersANZIGA recently wrote to you in regard to two important changes that are goingto occur to medical gas cylinders in the near future:• The changes to medical oxygen valve outlets as required by Australian StandardAS2473.3; and• The requirement that all medical gas cylinders have a white body with thecolour on the shoulder indicating the type of gasThis letter is to remind you that all large medical oxygen cylinders (D, E and G sizesincluding bundles/packs) will be supplied with a different valve outlet, called a pinindexed valve outlet, and will also be coloured white from the time indicated below:DateSeptember 2009February 2010May 2010August 2010February 2011June 2011LocationNorthern TerritorySouth AustraliaWestern AustraliaQueenslandNew South Wales/ACTVictoria/TasmaniaThis means that in your state or territory, from the date indicated above, large medicalcylinders will be available only with pin index valves. For example in NorthernTerritory from September 2009, large medial cylinders will only besupplied with pin index valves.Prior to the changeover time in your state or territory, you will need to arrange fora replacement medical oxygen regulator in order to be able to connect to the newvalve outlet. It is recommended you contact your regulator supplier or medicalgas supplier for assistance with your requirements. Users of medical oxygen withmanifold systems will need to have their manifold connections and/or flexibleconnections changed prior to the change-over date.Please contact ANZIGA or your medical gas suppler if you require further information, at:ANZIGALevel 1, Unit 7, Skipping Girl Place651 Victoria St, Abbotsford, Vic 3067Telephone: +61 3 9426 3812Email: office@anziga.orgThe ANZCA Bulletin June 2009 49
Page 3 and 4: 12 27 20 36ContentsThe ANZCA Bullet
Page 5 and 6: NewsSafety of AnaesthesiaReportThe
Page 7 and 8: Simulation-based sedationcourse for
Page 9 and 10: anzca Research AwardThe Lennard Tra
Page 11 and 12: Annual General MeetingminutesMinute
Page 13 and 14: 4. Declaration of the PollsCouncil
Page 15 and 16: Snapshot1657 Full registrants 152 F
Page 17 and 18: The ANZCA Bulletin June 2009 15
Page 19 and 20: The College Ceremony; Dr James Sart
Page 21 and 22: ASM photo galleries and videosof th
Page 23 and 24: Leading the debate onthe future of
Page 25 and 26: BroadeningrolesDr Vanessa BeavisWe
Page 27 and 28: “Commencing medical students are
Page 29 and 30: An anaesthetist-ledPerioperativeCar
Page 31 and 32: advertisementThe ANZCA Bulletin Jun
Page 33 and 34: Hobart AnaesthesiaGroupThe Hobart A
Page 35 and 36: Mater Private Hospital,SydneyOver t
Page 37 and 38: large number of anaesthetic colleag
Page 39 and 40: and we often split that into two si
Page 41 and 42: DC: As someone who’s slightly fur
Page 43 and 44: profileDr Vanessa Beavis:From South
Page 45 and 46: philanthropyThe ANZCA FoundationAn
Page 47 and 48: advertisementRoyal Melbourne Hospit
Page 49: Trauma, surgery,obstetrics and blee
Page 53 and 54: Wai Ka MingLaurent Anthony WallaceP
Page 55 and 56: ANZCACurriculum ReviewThe Why, Who,
Page 57 and 58: advertisement142_ANT_Agilia_HP_Ad d
Page 59 and 60: The CanMEDS Roles are typicallyrepr
Page 61 and 62: fellowship affairsContinuing Profes
Page 63 and 64: Australian and New Zealand College
Page 65 and 66: Essential guide to generic skills /
Page 67 and 68: RegionsAustralian CapitalTerritoryT
Page 69 and 70: RegionsContinuedQueenslandThe Facul
Page 71 and 72: Western AustraliaThe WA 2009 Autumn
Page 73 and 74: April 2009Stefan Andre LOMBAARDChri
Page 75 and 76: advertisementASURA 2009Australasian
Page 77 and 78: advertisementPRACTICAL AIRWAYMANAGE
Page 79 and 80: Joint Faculty of Intensive Care Med
Page 85 and 86: Faculty of Pain MedicineDean’s Me
Page 87 and 88: Faculty of Pain MedicineOrganisatio
Page 89 and 90: Faculty of Pain MedicineThe symposi
Page 91 and 92: Dr Carolyn Arnold, A/Prof Leigh Atk
Page 93 and 94: Faculty of Pain MedicineDean’s Re
Page 95 and 96: Faculty of Pain MedicineHonorary Fe
Page 97 and 98: FELLOWSHIP AFFAIRSProfessionaldocum
Page 99 and 100: Australian and New Zealand Collegeo
Page 101:
October 16-182009 Fpm Spring Meetin
Page 104:
Christchurch 2010
show all

ANZCA Bulletin - June 2009 - Australian and New Zealand College ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?