Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Pain management and postoperative careAdminister cyclizine 50 mg i.m. (ori.v. in 10 mL given slowly), andreview the effect after 60 minutes.Satisfactory control ofPONV?YesNoAdministerprochlorperazine 12.5mg i.m. or 25 mg p.r.,and review the effectafter 60 minutes.Prescribe regular cyclizine50 mg i.m. (or i.v. in 10mL given slowly) for 24hours and review.Satisfactory control ofPONV?YesNoSingle intravenous dose ofondansetron 4 mg.Reconsider causes and seek furthersenior medical or pain team advicePrescribeprochlorperazine12.5 mg i.m. 8-hourly regularlyfor 24 hours andreview.118 Anaesthetists Handbook January 2010
Pain management and postoperative careManaging opiate usersGuidelines on the management of opiate users admitted to hospitalPrescribing for drug usersIn order to ensure safe prescribing for patients who are receivingmethadone or buprenorphine (Subutex) for opiate dependency it isessential that communication with the Community Drug Team (CDT),GP, or dispensing community pharmacy is established when patientsare admitted and discharged from hospital.Emergency admissionsDoctors must ensure that the patient is a registered methadone orbuprenorphine user and this must be confirmed with the CDT, GP orpatient’s community pharmacy before methadone or buprenorphine isprescribed. If it is not possible to confirm this medication must not beprescribed and the guidelines should be followed for themanagement of opiate withdrawal symptoms.Doctors must be satisfied that a full assessment of the patient,including drug history, has taken place and that the correct dose hasbeen established and verified before prescribing methadone orbuprenorphine. Doctors must also be aware of other substances ofabuse that the patient may report to be taking. This also needs to beconfirmed with the CDT, GP or community pharmacy. If this cannotbe confirmed treat symptomatically.If the patient requires analgesia for further advice contact the PainTeam on bleep 2492 or 2493 or ward pharmacist.Planned admissionsDoctors and nursing staff must be satisfied that the dose and time ofthe last dose of methadone or buprenorphine taken by the patienthas been confirmed by the CDT, prescribing GP or communitypharmacy prior to administration of subsequent medication to thepatient.Anaesthetists Handbook January 2010 119
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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
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Perianaesthesia Care Unit (PACU)PAC
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PACUThe surgical team responsible f
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PACU6. Oxygen and intravenous thera
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Integration with the critical care
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Inter-hospital transfersInter-hospi
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Inter-hospital transfersConsultant
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Signing onAdministrative issuesYour
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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 117: 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
Page 153 and 154: Fractured neck of femurGuidelines f
Page 155 and 156: Management of patients with diabete
Page 157 and 158: Patients who take insulinManagement
Page 163 and 164: Preoperative assessment and investi
Page 165 and 166: Preoperative assessment and investi
Page 167 and 168: Indications for investigationsFull
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Preoperative assessment and investi
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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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