Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Pain management and postoperative carePARACETAMOL – For mild pain or moderate in combination with NSAID. Giveregularly for 24-48 hours Use weight related doses when possible. Minimum 4hours between doses. Maximum 4g in 24 hoursAge Birth to 3months3 monthsto 12years.12years to16years ifless than50kg12 to 16years if50kg ormoreCommentsEnsure doses arepracticable tomeasureMaximumdose per 24hoursOral loadingdoseOralmaintenancedoseRectalloading doseRectalmaintenancedose60mg /kg20mg/kg20mg/kg8 hourly30mg/kg20mg/kg8 hourly90mg/kgfor48hoursthen60mg/kgMax 4g20mg/kgMax 1g15mg/kg4-6 hourlyMax 1g40mg/kgMax 1g20mg/kg4-6hourlyMax 1g4g1g500 mg -1g 4-6hourly1g500mg-1g 4-6hourlyLiquid 120mg in5mL under 6yearsmust be used ondischargeLiquid 250mg/5mLover 6 years (under6 – may use onward if smallervolume beneficial)Suppositories – donot cut or break.Round dose butmust not exceeddaily maximum Donot use rectal usein febrileneutropeniaNo single dose toexceed 1g.Minimum interval4hours .Maximumdose in 24 hours4gSupps available as60mg, 120mg,240mg, 1g102 Anaesthetists Handbook January 2010
Pain management and postoperative careNSAIDS – For mild pain or moderate in combination with paracetamol. Giveregularly for 24 – 48 hours. Give with food / milk if possibleDo not prescribe more than one NSAIDIBUPROFEN1 month to 6months> 5kg weight6 months to 16years Comments – Ensuredoses are practicableto measureOraldosePrescription byRegistrar orabove only5mg/kg 6- 8hourly5mg/kg 6-8 hourlyMax single dose600mgMaximum daily dose2.4gDICLOFENACOraldoseNotrecommended1mg/kg up to 3times a day. Maxsingle dose 50mgMaximum dose3mg/kg/24 hours upto 150mgRectaldose3mg/kg/24hours(150mg) maximumsingle dose not toexceed 2mg/kgRound doses toavailablesuppositories.Do not cutsuppositoriesDo not exceed dailymaximum12.5mg/25mg/50mg/100mg availableAnaesthetists Handbook January 2010 103
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Department of AnaesthesiaAnaestheti
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Document control for approved clini
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ContentsTrauma list anaesthetist (t
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ContentsStudy leave 81Junior doctor
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ContentsIndications for investigati
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ContentsRenal patients - clinical g
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Introduction and scope of guideline
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Introduction and scope of guideline
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Airway assessmentManaging difficult
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Managing difficult airways• Flexi
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Managing difficult airways• Manuj
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Resuscitation - advanced life suppo
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Resuscitation - advanced life suppo
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Duties of the on call anaesthetists
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Getting senior helpGetting senior h
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On call casesGetting senior helpYou
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Supervision for sick patientsGettin
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Calling the senior resident anaesth
Page 51 and 52: Perianaesthesia Care Unit (PACU)PAC
Page 53 and 54: PACUThe surgical team responsible f
Page 55 and 56: PACU6. Oxygen and intravenous thera
Page 57 and 58: Integration with the critical care
Page 59 and 60: Inter-hospital transfersInter-hospi
Page 61 and 62: Inter-hospital transfersConsultant
Page 63 and 64: Signing onAdministrative issuesYour
Page 65 and 66: Administrative issuesMobile phones
Page 67 and 68: Administrative issuesobstetrics, we
Page 69 and 70: Administrative issuesMain theatre r
Page 71 and 72: CLWrota processes• To complete ca
Page 73 and 74: Security rules:• Do not put confi
Page 75 and 76: Education and trainingthe Royal Col
Page 77 and 78: Education and trainingthe necessary
Page 79 and 80: Education and trainingarrive in the
Page 81 and 82: Education and traininginformation c
Page 83 and 84: Education and trainingexamination i
Page 85 and 86: Education and trainingAll consultan
Page 87 and 88: Presenting at seminars• Bring har
Page 89 and 90: Presenting at seminarsDOI advise yo
Page 91 and 92: Clinical adverse event reportingCli
Page 93 and 94: Clinical auditClinical audit[Apprai
Page 95 and 96: Clinical auditYour presentation sho
Page 97 and 98: Pain management and postoperative c
Page 101: Pain management and postoperative c
Page 121 and 122: Signs and symptomsAgitation, anxiet
Page 123 and 124: Epidural anaesthesia and analgesiaP
Page 125 and 126: Epidural anaesthesia and analgesiai
Page 127 and 128: Epidural anaesthesia and analgesiaS
Page 129 and 130: IndicationsEpidural anaesthesia and
Page 131 and 132: Epidural anaesthesia and analgesiaH
Page 133 and 134: Assessment and treatment optionsEpi
Page 135 and 136: Epidural anaesthesia and analgesia3
Page 137 and 138: Epidural anaesthesia and analgesia
Page 139 and 140: Epidural anaesthesia and analgesiaA
Page 141 and 142: Epidural anaesthesia and analgesiaG
Page 143 and 144: Allergies and adverse drug reaction
Page 149 and 150: Awareness during anaesthesiaPrevent
Page 151 and 152: Fractured neck of femur:management
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Fractured neck of femurGuidelines f
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Management of patients with diabete
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Patients who take insulinManagement
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Preoperative assessment and investi
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Indications for investigationsFull
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SevofluraneSevoflurane[Dr Mark Port
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Sevofluranemust be considered on it
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Gabapentin in acute painSide-effect
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Blood and blood productsBlood and b
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Blood and blood productsWhen the un
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Blood and blood productsCross match
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Blood and blood productsBlood Cool
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Blood and blood productsHaematology
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Blood and blood products25322 so th
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Blood and blood productsfactors, ha
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Day case anaesthesia6. Social crite
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ENT anaesthesiaENT anaesthesia{Dr C
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ENT anaesthesiaIntraoperative• In
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Miscellaneous issuesMiscellaneous i
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Miscellaneous issuesideally be cont
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Miscellaneous issuesinstruction man
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Miscellaneous issuesRemifentanilRem
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Miscellaneous issuesCentral neuraxi
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Miscellaneous issuesAnalgesia Fenta
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Miscellaneous issues• Diclofenac
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Miscellaneous issues• Associated
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Miscellaneous issues• Everyone wi
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Miscellaneous issues• If fasting
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Miscellaneous issueslabour ward ana
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Miscellaneous issuesThere is no cli
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Patient monitoring in and out of th
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Miscellaneous issuessuch as Hartman
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Miscellaneous issues• Abdominal a
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Miscellaneous issuesPrevention of p
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Miscellaneous issuesDifferent clini
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Recovery and patient handoverMiscel
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For afternoon list (pm)Diabetic Pat
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Miscellaneous issuestake part in th
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Miscellaneous issuesSee page 37 for
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Waiting list initiatives[Appraised
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Major Incident ProcedureStaff assem
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Major Incident Procedure• In coop
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Finding your way round theUniversit
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• Coffee room.• Quiet room (fiv
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Anaesthesia department lead clinici
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Trust organisational structureTrust
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Telephone numbersLabour ward……
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IndexIndexAabsence, 68adenotonsille
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Indexemergency department, 222emerg
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Indexmortality review, 93MRI scansa
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Indexstudy leave, 81applications, 6
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NotesAnaesthetists Handbook January
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NotesAnaesthetists Handbook January
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