Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Managing difficult airwaysModified Mallampati’s classificationConducted with the patient sitting upright, opening the mouth as faras is possible and maximally protruding the tongue. Allocate a classbased on what you see at the back of the mouth.Class 1: Faucial pillars, soft palate and uvula seen.Class 2: Faucial pillars and soft palate seen. Base of tongue masksuvula.Class 3: Only soft palate visibleClass 4: Even soft palate not visible.Difficult airway trolleyYou will find the following equipment in the difficult airway trolleys.You should familiarise yourself with this equipment and also withtechniques for maintaining oxygenation. As soon as you experiencedifficulty with airway maintenance or tracheal intubation you shouldask for the difficult intubation trolley.• Curved blade laryngoscope: McCoy.• Straight blade laryngoscopes: Miller or Henderson.• Frova tracheal introducer or gum elastic bougie.• Laryngeal Mask Airway.• iLMA.• MicroLaryngoscopy Tracheal tube (MLT).• Jet ventilation catheter : 13 G / 14 G• Manujet III jet ventilation device and catheters.• QuickTrach emergency cricothyrotomy devices.• Aintree catheter (for fibreoptic intubation via LMA).18 Anaesthetists Handbook January 2010
Managing difficult airways• Flexible intubating fibreoptic laryngoscope is available in alltheatre locations except in day case surgical theatres.• Cook airway exchange catheter (in ENT/maxillofacial theatre fornasal ETT exchange).Algorithm for managementAlgorithms for different scenarios are available at www.das.uk.com(the Difficult Airway Society). You should educate yourself in their useas part of your CEPD. The following algorithm is a compositeappropriate to most situations, which you should study before havingto use it in an emergency situation.Anaesthetists Handbook January 2010 19
Page 1 and 2: Department of AnaesthesiaAnaestheti
Page 3 and 4: Document control for approved clini
Page 5 and 6: ContentsTrauma list anaesthetist (t
Page 7 and 8: ContentsStudy leave 81Junior doctor
Page 9 and 10: ContentsIndications for investigati
Page 11 and 12: ContentsRenal patients - clinical g
Page 13 and 14: Introduction and scope of guideline
Page 15 and 16: Introduction and scope of guideline
Page 17: Airway assessmentManaging difficult
Page 21 and 22: Managing difficult airways• Manuj
Page 23 and 24: Resuscitation - advanced life suppo
Page 25 and 26: Resuscitation - advanced life suppo
Page 27 and 28: Duties of the on call anaesthetists
Page 43 and 44: Getting senior helpGetting senior h
Page 45 and 46: On call casesGetting senior helpYou
Page 47 and 48: Supervision for sick patientsGettin
Page 49 and 50: 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
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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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Signs and symptomsAgitation, anxiet
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Epidural anaesthesia and analgesiaP
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Epidural anaesthesia and analgesiai
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Epidural anaesthesia and analgesiaS
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IndicationsEpidural anaesthesia and
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Epidural anaesthesia and analgesiaH
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Assessment and treatment optionsEpi
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Epidural anaesthesia and analgesia3
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Epidural anaesthesia and analgesia
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Epidural anaesthesia and analgesiaA
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Epidural anaesthesia and analgesiaG
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Allergies and adverse drug reaction
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Awareness during anaesthesiaPrevent
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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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