Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Clinical adverse event reporting• Aspiration of gastric contents.• Failed intubation.• Oesophageal intubation.Equipment• Anaesthetic machine malfunction or failure.• Monitor malfunction or failure.• Ventilator or breathing system problem.• Drug or fluid delivery system problem.Organisational• Non-availability of a needed intensive care or high dependencybed.• Failure of communication.• Delays in obtaining essential preoperative tests.• Inappropriate grade of anaesthetists in relation to the complexityof the case.• Inappropriate pressure to proceed or relief not available.There is an opportunity on the day of the clinical audit meeting todiscuss anonymously a significant or interesting event related to aclinical case or the system of delivering care. Contact the consultantleads on this for further information:• Dr Falguni Choksey.• Dr Keith Clayton.• Dr Rati Danha.• Dr Jon Echebarria.• Dr Krish Ramachandran.92 Anaesthetists Handbook January 2010
Clinical auditClinical audit[Appraised by Dr S. Krishnamoorthy, January 2006]The department actively takes part in clinical audit and you will berequired to participate in the development, data collection andpresentation of audit projects as determined by the department.There is a regular meetings programme, with meetings taking placefor a morning or an afternoon in ten months of the year. The dayrotates through the week. Each meeting has certain commonelements – clinical adverse events, mortality review – and is usuallythemed to a subspecialty. A number of meetings are held jointly witha department of surgeons.The audit programme is usually determined at least a year inadvance, with subspecialties appearing in rotation. Each subspecialtyhas a lead auditor who will coordinate the projects conducted andpresented. If you have a good idea for a worthwhile audit, then spacecan usually be made.Getting helpIf you wish to conduct a project in a specific subspecialty, you shouldsee the lead auditor for that subspecialty. The Departmental AuditCoordinator (currently Dr Krishnamoorthy) will be able to discussideas for projects.The clinical audit and effectiveness officer, will be able to advise andhelp on the execution and presentation of projects.For help with presentation materials see page 86.The clinical audit and effectiveness department produces a resourcepack available on paper and e-copy. You may find this useful whenthinking about or preparing a project.Anaesthetists Handbook January 2010 93
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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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Page 41 and 42: 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
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: Clinical adverse event reportingCli
Page 95 and 96: Clinical auditYour presentation sho
Page 97 and 98: Pain management and postoperative c
Page 121 and 122: Signs and symptomsAgitation, anxiet
Page 123 and 124: 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
Page 131 and 132: Epidural anaesthesia and analgesiaH
Page 133 and 134: Assessment and treatment optionsEpi
Page 135 and 136: 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
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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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