Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Day case anaesthesia• Sickle cell disease (trait is acceptable).• Pregnancy (except for local anaesthesia or for pregnancyrelatedprocedures).Spinal anaesthesia in day surgical patientsSpinal anaesthesia in day surgical patients is associated with a highincidence of post dural puncture headache and urinary retention.Apart from delaying discharge this can cause undue distress andresult in significant morbidity to the patient.You should only use spinal anaesthesia if there is a strong clinicalindication and only after discussion with a consultant anaesthetist.192 Anaesthetists Handbook January 2010
ENT anaesthesiaENT anaesthesia{Dr Cyprian Mendonca and Mr Darius Rejali, July 2007; appraised byDr Mendonca, January 2010]These are guidelines for management of pain and prevention ofpostoperative nausea and vomiting in patients undergoingtonsillectomy and adenotonsillectomy.Tonsillectomy is the most commonly performed ENT procedure inchildren. There is a high incidence of postoperative pain, nausea andvomiting (as high as 54%) and post-operative pain followingtonsillectomy varies with the method of surgery, administeredanalgesics and individual patient factors. Previous audit (no. 356) hasrevealed that 37% of patients suffer from moderate pain during thepostoperative period on return to the ward. Optimising perioperativeantiemetic prophylaxis and analgesia are important factors inpreventing morbidity, prolonged hospital stay and enhancing patientsatisfaction.Paediatric tonsillectomyFor paediatric tonsillectomy, use your familiar anaesthetic techniquewith the following modifications.Preoperative• Clear fluids allowed up to two hours preoperatively (a child canhave a drink of clear fluid ~10 mL kg -1 , maximum 100 mL twohours preoperatively).• Consider premedication with paracetamol (20 mg kg -1 oral) +ibuprofen (5 mg kg -1 ).Intraoperative• Induction: propofol (or inhalational induction if indicated) +fentanyl (suggested dose is 0.5 –1.0 µg kg -1 ).• Dexamethasone 0.1 mg kg -1 (intravenous).Anaesthetists Handbook January 2010 193
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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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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
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 167 and 168: Indications for investigationsFull
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: Day case anaesthesia6. Social crite
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
Page 213 and 214: Miscellaneous issues• Everyone wi
Page 215 and 216: Miscellaneous issues• If fasting
Page 217 and 218: Miscellaneous issueslabour ward ana
Page 219 and 220: Miscellaneous issuesThere is no cli
Page 221 and 222: Patient monitoring in and out of th
Page 223 and 224: Miscellaneous issuessuch as Hartman
Page 225 and 226: Miscellaneous issues• Abdominal a
Page 227 and 228: Miscellaneous issuesPrevention of p
Page 229 and 230: Miscellaneous issuesDifferent clini
Page 231 and 232: Recovery and patient handoverMiscel
Page 233 and 234: For afternoon list (pm)Diabetic Pat
Page 235 and 236: Miscellaneous issuestake part in th
Page 237 and 238: Miscellaneous issuesSee page 37 for
Page 239 and 240: Waiting list initiatives[Appraised
Page 241 and 242: 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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