Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Resuscitation – advanced life supportResuscitation – advanced lifesupport[Appraised by Dr Alistair Brookes, January 2009]Your responsibilities• Ensure you are familiar with the resuscitation equipment withinyour clinical areas – see page 74.• All anaesthetists are required to attend an ALS update annually.It would be beneficial if you are a current ALS provider• Fill in appropriate records as below.Use of biphasic defibrillatorsThe Trust uses biphasic defibrillators on both sites. The energysetting for defibrillation is 150 J and escalating energy settings of100 J, 150 J and 200 J for synchronised cardioversion. To refresh thememory of your update course:• Connect the multifunction defibrillator pads to the patient.• Turn on the machine with dial 1.• Charge (if appropriate) with button 2.• Perform safety checks (‘clear…’).• Discharge with button 3.The current guidelines are athttp://www.resus.org.uk/pages/guide.htm.RecordsAll in-hospital adult cardiac arrests must be documented in the CPRrecord books which can be found on all cardiac arrest trolleys. Theyellow sheet must be filed in the medical notes and the pink sheetreturned to the Resuscitation and Clinical Skills Department.22 Anaesthetists Handbook January 2010
Resuscitation – advanced life supportThis form must be filled in regardless of whether the cardiac arrestteams were called or attended. This includes cardiac arrests intheatres (that are not a planned part of the procedure). You shouldalso write a separate record in the anaesthesia chart.AlgorithmsThe figure on the next page is the algorithm for Adult Advanced LifeSupport 2005, published by the Resuscitation Council (UK).Anaesthetists Handbook January 2010 23
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 and 18: Airway assessmentManaging difficult
Page 19 and 20: Managing difficult airways• Flexi
Page 21: Managing difficult airways• Manuj
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
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
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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
Page 93 and 94:
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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Page 147 and 148:
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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
Page 265:
NotesAnaesthetists Handbook January
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