Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Management of patients with diabetes mellitus• Ensure the meal was eaten, if not be vigilant for hypoglycaemia.• Institute finger stick glucose monitoring pre meal and pre bed.Contact the Diabetic Team (bleeps 1243 or 4086; extension 25567)in the normal working day or the on call medical registrar for advice ifyou have ANY concerns.162 Anaesthetists Handbook January 2010
Preoperative assessment and investigationsPreoperative assessment andinvestigations[Appraised by Dr John La Rosa, January 2010]The Pre Anaesthetic Assessment Centre (PAAC) has beenestablished as part of the Surgical Patients’ Pathway Program(SPPP). The PAAC is there to assess fitness for anaesthesia. It is notthere to assess or action any other aspects of preoperativeassessment.Appropriate tests – ECG, chest X-ray, and blood tests etc. – areordered as appropriate when they attend. Anaesthetists are availablefor:• Final decision-making.• Providing anaesthetic information.• Advice on patient optimisation, further tests and referral to otherspecialists.Eventually, all elective patients will be assessed in this way. PAACcurrently covers orthopaedic surgery, general surgery, urology, daysurgery and neurosurgery. Check the notes for pre-screening forms.The lead consultant anaesthetist is Dr John La Rosa. The PAAC is inthe main outpatients department on the ground floor – clinic 4.Operational policyThe operational policy was written by Dr Glynn Evans (clinicaldirector) and Dr John La Rosa, with Mr Paul Steel (outpatientservices manager) in January 2007. Relevant sections arereproduced below revised for practice changes in 2008.Anaesthetists Handbook January 2010 163
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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
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Administrative issuesobstetrics, we
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Administrative issuesMain theatre r
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CLWrota processes• To complete ca
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Security rules:• Do not put confi
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Education and trainingthe Royal Col
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Education and trainingthe necessary
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Education and trainingarrive in the
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Education and traininginformation c
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Education and trainingexamination i
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Education and trainingAll consultan
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Presenting at seminars• Bring har
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Presenting at seminarsDOI advise yo
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Clinical adverse event reportingCli
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Clinical auditClinical audit[Apprai
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Clinical auditYour presentation sho
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Pain management and postoperative c
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Page 111 and 112: 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
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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 159 and 160: Management of patients with diabete
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Page 165 and 166: Preoperative assessment and investi
Page 167 and 168: Indications for investigationsFull
Page 169 and 170: Preoperative assessment and investi
Page 171 and 172: SevofluraneSevoflurane[Dr Mark Port
Page 173 and 174: Sevofluranemust be considered on it
Page 175 and 176: Gabapentin in acute painSide-effect
Page 177 and 178: Blood and blood productsBlood and b
Page 179 and 180: Blood and blood productsWhen the un
Page 181 and 182: Blood and blood productsCross match
Page 183 and 184: Blood and blood productsBlood Cool
Page 185 and 186: Blood and blood productsHaematology
Page 187 and 188: Blood and blood products25322 so th
Page 189 and 190: Blood and blood productsfactors, ha
Page 191 and 192: Day case anaesthesia6. Social crite
Page 193 and 194: ENT anaesthesiaENT anaesthesia{Dr C
Page 195 and 196: ENT anaesthesiaIntraoperative• In
Page 197 and 198: Miscellaneous issuesMiscellaneous i
Page 199 and 200: Miscellaneous issuesideally be cont
Page 201 and 202: Miscellaneous issuesinstruction man
Page 203 and 204: Miscellaneous issuesRemifentanilRem
Page 205 and 206: Miscellaneous issuesCentral neuraxi
Page 207 and 208: Miscellaneous issuesAnalgesia Fenta
Page 209 and 210: Miscellaneous issues• Diclofenac
Page 211 and 212: 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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