Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Getting senior helpIf you are uncertain as to whether you need advice or you needthe consultant to come in, or if you feel that you are notconfident to handle the situation on your own, ask theconsultant to come in and help you.Routine casesOn accompanied lists, the senior anaesthetist to whom you areattached is your supervisor. Any problems, including those that mayarise before the start of the list, should be raised with them.On solo lists, you should discuss problems with the senior residentanaesthetist or the general consultant on call. If a problem willnecessitate assistance during the list, make sure that this is arrangedfar enough in advance with the Anaesthesia Office and with anysenior staff who will be helping you.DocumentationIn all cases that you seek senior help you must make a note in thepatient record (cross-referenced between the anaesthesia record andcontinuity sheets as appropriate). This note should detail thediscussion, any relevant points and must record any decisions made.Referral to the senior resident anaesthetistAs a general rule, if you are working as a sole anaesthetist and needhelp, you should refer problems to the senior resident anaesthetist.During normal hours, you may be asked to refer the problem to anearby consultant. In particular, you must call before you cancel orpostpone any elective or routine patient, for whatever reason.You must make a note as above. In addition, you should recordpostponements and cancellations on the handover form.46 Anaesthetists Handbook January 2010
Supervision for sick patientsGetting senior helpAssess patients carefully and assign an ASA grade. The table showsthe minimum seniority of anaesthetist needed for routine and urgentcases. There is no distinction between general or regionalanaesthesia, and sedation. In dire emergency with sick patients, callfor senior help and offer what help you can.ASA 3 • StR2 after discussion with senior residentStR• Specialty registrar (year 3 onwards)ASA 4 or 5 • StR (year 4) after discussion with seniorresident StR or consultant• StR (year 5-7)• Inform the relevant consultant on call ofevery caseAnaesthetists Handbook January 2010 47
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 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: On call casesGetting senior helpYou
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
Page 75 and 76: Education and trainingthe Royal Col
Page 77 and 78: Education and trainingthe necessary
Page 79 and 80: Education and trainingarrive in the
Page 81 and 82: Education and traininginformation c
Page 83 and 84: Education and trainingexamination i
Page 85 and 86: Education and trainingAll consultan
Page 87 and 88: Presenting at seminars• Bring har
Page 89 and 90: Presenting at seminarsDOI advise yo
Page 91 and 92: Clinical adverse event reportingCli
Page 93 and 94: Clinical auditClinical audit[Apprai
Page 95 and 96: Clinical auditYour presentation sho
Page 97 and 98:
Pain management and postoperative c
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Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
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Signs and symptomsAgitation, anxiet
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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
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Epidural anaesthesia and analgesiaH
Page 133 and 134:
Assessment and treatment optionsEpi
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Epidural anaesthesia and analgesia3
Page 137 and 138:
Epidural anaesthesia and analgesia
Page 139 and 140:
Epidural anaesthesia and analgesiaA
Page 141 and 142:
Epidural anaesthesia and analgesiaG
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Allergies and adverse drug reaction
Page 145 and 146:
Page 147 and 148:
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:
Page 161 and 162:
Page 163 and 164:
Preoperative assessment and investi
Page 165 and 166:
Page 167 and 168:
Indications for investigationsFull
Page 169 and 170:
Page 171 and 172:
SevofluraneSevoflurane[Dr Mark Port
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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
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Blood and blood products25322 so th
Page 189 and 190:
Blood and blood productsfactors, ha
Page 191 and 192:
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
Page 205 and 206:
Miscellaneous issuesCentral neuraxi
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Miscellaneous issuesAnalgesia Fenta
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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
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Patient monitoring in and out of th
Page 223 and 224:
Miscellaneous issuessuch as Hartman
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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
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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
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……
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IndexIndexAabsence, 68adenotonsille
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Indexemergency department, 222emerg
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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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