Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Miscellaneous issues• Female gender.• Non-smoker.• History of PONV or motion sickness.• Perioperative use of opioids.• Oral or ENT surgery.• Laparoscopic surgery.• Squint surgery.• Prolonged surgery (> 60 minutes).Low-risk (0-2 points) Medium risk (3points)High risk (> 3 points)General measuresonly.If harm may resultfrom PONV e.g.craniotomy, jawwiring, vascularsurgery, then givedexamethasone 4-8mg i.v.RecordsGeneral measuresplus…Dexamethasone 4-8mg i.v.Cyclizine 50 mg i.v.(Use granisetron orondansetron wheresedatingantihistamines arecontraindicated.)General measuresplus…Dexamethasone4-8 mg i.v.Ondansetron8 mg i.v.[Appraised by Dr Falguni Choksey, January 2010]It is a normal professional requirement to keep medical records andin particular complete an anaesthesia record sheet (the ‘pink chart’).228 Anaesthetists Handbook January 2010
Miscellaneous issuesDifferent clinical areas might have different records needing to becompleted.We are continually audited against chart standards for CNSTpurposes. You should make sure that your name, grade and GMCnumber are legibly printed on every patient record that you complete.Repeated audits have shown that records are completed poorly withmandatory items often omitted. This leaves you open to criticism andvulnerable to a potential court case.Items that are often missed out are:• Using black ink.• The name and grade of the anaesthetist in block letters.• Estimated blood loss.• Intraoperative and postoperative fluids.• Postoperative oxygen prescription.• Postoperative instructions for recovery staff.• Details of handover to another anaesthetist.Remember to include on the record details of:• Your GMC number.• Any discussion with senior colleagues and their names.• Care discussed with StR3+ if ASA 3, or consultant if ASA 4 orASA 5.• Name of responsible consultant.• Discussion and decisions about levels of monitoring.• Discussion and decisions about postoperative care.Please make sure that you are aware of the standard of recordkeeping expected of you (based on RCA & AAGBI guidelines).We audit anaesthesia records on a random basis. The results are aregular item in clinical audit meetings.Anaesthetists Handbook January 2010 229
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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
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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
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
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: Miscellaneous issuesPrevention of p
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
Page 243 and 244: Major Incident Procedure• In coop
Page 245 and 246: Finding your way round theUniversit
Page 247 and 248: • Coffee room.• Quiet room (fiv
Page 249 and 250: Anaesthesia department lead clinici
Page 251 and 252: Trust organisational structureTrust
Page 253 and 254: Telephone numbersLabour ward……
Page 255 and 256: IndexIndexAabsence, 68adenotonsille
Page 257 and 258: Indexemergency department, 222emerg
Page 259 and 260: Indexmortality review, 93MRI scansa
Page 261 and 262: Indexstudy leave, 81applications, 6
Page 263 and 264: NotesAnaesthetists Handbook January
Page 265: NotesAnaesthetists Handbook January
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