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important to involve those who take part in regular interdepartmental audit. This will include A&E personnel, anaesthetists, paramedics, etc. Participation of the neurosciences unit in such audit is particularly valuable. The quality of transfer should be audited, and critical incidents recorded. Such information is invaluable in refining and improving local transfer protocols. Appropriate audit tools for transfer are available from the Royal College of Anaesthetists.[20] 16
SECTION X - RESOURCE IMPLICATIONS FOR T R A N S F E R OF PATIENTS WITH BRAIN INJURIES Without adequate resources it is not possible to have a good quality transfer service. Each organisation that provides acute healthcare should recognise that this requires specific funding which should be considered in discussions with purchasers. Resources include staff and equipment that may be similar to, and shared with, those used for other secondary transfers including the movement of ICU patients within the hospital. It should be recognised that there are significant resource implications to the transferring hospital on-call anaesthetic team. Hospitals involved in transfer of patients with brain injuries should set aside a budget for this work. The budget will include the capital equipment, the cost of which will depend upon its complexity and the demand placed upon it, as well as the cost of servicing, maintenance, insurance and renewal/upgrading at appropriate intervals. Portable equipment will need regular battery replacement and will have a shorter life than static equipment. There must be adequate provision for clothing and personal insurance. The responsibilities of the designated consultant for transfers include logistics, training, audit and liaison between the parties involved and may require dedicated programmed activities in job plans. Rotas of doctors and nurses must take account of this work and allow staff of adequate seniority to be released from other duties. Retrieval teams have been set up in some regions eg Northern Ireland [21] and are of particular importance in paediatric practice.[22] However, the speed of transfer required for head injuries may not permit a team to travel from the neuroscience centre. In addition, on a rare occasion two transfers may be required simultaneously, hence the referring hospitals will have to maintain the capability to transfer transfer patients with a time-critical lesion. This means that any unit potentially admitting children with head trauma should have a contingency to undertake such a transfer and have an appropriate kit with paediatric equipment ready for use. In an ideal world the funding of suitably situated retrieval teams would not be an issue. 17
Page 1 and 2: Recommendations for the Safe Transf
Page 3 and 4: CONTENTS Section I Summary and Reco
Page 5 and 6: SECTION II - BACKGROUND In 1996 the
Page 7 and 8: SECTION IV - ORGANISATION AND COMMU
Page 9 and 10: SECTION V - STAFFING REQUIREMENTS A
Page 11 and 12: A p p ropriate re s p i ra t o ry s
Page 13 and 14: SECTION VII - THE TRANSFER The tran
Page 15 and 16: SECTION VIII - EQUIPMENT AND DRUGS
Page 17: SECTION IX - EDUCATION AND TRAINING
Page 21 and 22: APPENDIX I INDICATIONS FOR INTUBATI
Page 23 and 24: APPENDIX III ADDITIONAL INFORMATION
Page 25 and 26: AAGBI SAFETY GUIDELINE Suspected An
Page 27 and 28: GUIDELINES Suspected Anaphylactic R
Page 29 and 30: Suspected anaphylactic reactions as
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Anaesthesia 2016, 71, 1503 Correcti
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Membership of the working party Dr
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1. Summary 1.1 Safety, quality and
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3. Responsibility of anaesthetists
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3.4 The Trust - Medical Devices Man
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4. Standards 4.1 Medical Devices Di
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5. Responsibility of manufacturers
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6. Choosing and trialling equipment
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equipment officer is encouraged to
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EU procurement thresholds Threshold
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When negotiating a purchasing agree
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9. Shared equipment Many types of e
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Third party servicing is another op
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11. Replacement 11.1 Planned equipm
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number of re-uses (e.g. re-usable L
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Where new equipment is purchased th
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14. Incident reporting and investig
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available from www.hse.gov.uk 14.4
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DB DoH EBME EC EU FRCA HN HSE IEC I
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8. OPSI. Statutory Instrument 2006
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Eire Tel: 00353 1 676 4971 Website:
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Peri-operative management of the ob
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Guidelines Peri-operative managemen
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Recommendations 1 Every hospital sh
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35 30 25 Prevalance (%) 20 15 10 5
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is an increased incidence of prolon
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Figure 2 Relationship between total
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techniques, and when used with neur
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Table 5 The STOP-BANG screening que
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Intra-operative care Preparation of
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Figure 3 Ramping position for obese
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eturn of airway reflexes with desfl
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Table 6 Dosing schedule for thrombo
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A review and meta-analysis by the S
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numbers of staff are needed to roll
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Table 7 Equipment for managing obes
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11. Schneider HJ, Glaesmer H, Klots
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44. Edholm D, Kullberg J, Haenni A,
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75. McKay RE, Malhotra A, Cakmakkay
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21 Portland Place, London, W1B 1PY
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This guideline was originally publi
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Anaesthesia 2015 Barker et al. | Gu
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Out of Hours Activity (Anaesthesia)
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Considerations for anaesthetists Th
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OAA / AAGBI Guidelines for Obstetri
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Contents 1. Key recommendations 2 2
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2. Introduction This is the third v
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Recommendations Medical staff The t
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appointed directly from other count
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Peripartum care Pre-operative asses
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Intravenous patient-controlled opio
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depression. In the absence of contr
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of clinical deterioration, as recom
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5. Training and education Each obst
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• Skills and drills training: ana
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• The midwife caring for a woman
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7. Support services, equipment, fac
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Equipment for PCA must be available
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8. The future The delivery of healt
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The following national guidelines s
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19. Obstetric Anaesthetists’ Asso
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At the first meeting held on 9 th M
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Methods to estimate/establish publi
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Recommendations The WP recommends:
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Anaesthesia, 2007, 62, pages 1199-1
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Anaesthesia, 2007, 62, pages 1199-1
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OPTION 3 - PRESUMED CONSENT. ‘Pre
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Power of Attorney) while requiring
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Needle-stick injury and HIV testing
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egain capacity, and the absence of
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treatment if it was understood that
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Management of hypertension before e
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AAGBI Safety Guideline Management o
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Malignant Hyperthermia Crisis Task
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MEMBERSHIP OF THE WORKING PARTY Dr
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Section 1 Recommendations 1. Transf
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Section 3 Introduction In 1997 it w
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This process may require many telep
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Section 6 Accompanying the patient
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Section 7 Monitoring, drugs and equ
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heavily congested areas, but not al
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APPENDIX 1 Departure checklist Do a
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13. Bercault N, Wolf M, Runge I, Fl
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21 Portland Place, London W1B 1PY T
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Membership of the Working Party Dr
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Infection control in anaesthesia An
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AAGBI SAFETY GUIDELINE Immediate Po
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Guidelines Immediate post-anaesthes
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Whitaker et al. | Guidelines: Immed
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The Royal College of Anaesthetists
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Contents ❚ Foreword 4 Introductio
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Introduction ❚ The Good Anaesthet
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Related guidelines and sources of i
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Domain A: knowledge, skills and per
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Domain B: safety and quality Attrib
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Domain C: communication, partnershi
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Domain D: maintaining trust Attribu
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Day Case and Short Stay Surgery 2 P
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GUIDELINES Day case and short stay
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Guidelines: Day case and short stay
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