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Barker et al. | Guidelines on peri-operative management of diabetes Anaesthesia 2015 Appendix 1 Example of a variable-rate intravenous insulin infusion prescription. Glucose concentration is usually measured in capillary blood. Glucose concentration; 1 mmol.l Standard rate (use unless otherwise indicated) No basal insulin < 4 0.5 IU.h 1 + give 100 ml glucose 20% intravenously 4.1–6.0 0.5 IU.h 1 + consider 50 ml glucose 20% intravenously Basal insulin continued No basal insulin STOP + give 100 ml glucose 20% intravenously STOP + consider 50 ml glucose 20% intravenously Reduced rate (e.g. insulin-sensitive patients (i.e. < 24 IU.day 1 )) 0.2 IU.h 1 + give 100 ml glucose 20% intravenously 0.2 IU.h 1 + give 50 ml glucose 20% intravenously Basal insulin continued No basal insulin STOP + give 100 ml glucose 20% intravenously STOP + consider 50 ml glucose 20% intravenously Increased rate (e.g. insulin-resistant patients (i.e. > 100 IU.day 1 )) 0.5 IU.h 1 + give 100 ml glucose 20% intravenously 0.5 IU.h 1 + give 50 ml glucose 20% intravenously Basal insulin continued STOP + give 100 ml glucose 20% intravenously STOP + consider 6.1–8.0 1 IU.h 1 1 IU.h 1 0.5 IU.h 1 0.5 IU.h 1 2 IU.h 1 2 IU.h 1 8.1–12.0 2 IU.h 1 2 IU.h 1 1 IU.h 1 1 IU.h 1 4 IU.h 1 4 IU.h 1 12.1–16.0 4 IU.h 1 4 IU.h 1 2 IU.h 1 2 IU.h 1 6 IU.h 1 6 IU.h 1 16.1–20.0 5 IU.h 1 5 IU.h 1 3 IU.h 1 3 IU.h 1 7 IU.h 1 7 IU.h 1 20.1–24.0 6 IU.h 1 6 IU.h 1 4 IU.h 1 4 IU.h 1 8 IU.h 1 8 IU.h 1 > 24.1 8 IU.h 1 8 IU.h 1 6 IU.h 1 6 IU.h 1 10 IU.h 1 10 IU.h 1 > 24.1 Ensure insulin is running and that the measured blood glucose concentration is not artefactual 50 ml glucose 20% intravenously © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland 13
Anaesthesia 2015 Barker et al. | Guidelines on peri-operative management of diabetes Appendix 2 Example of a variable-rate intravenous insulin infusion regimen observation chart. Reproduced by kind permission of the Norfolk and Norwich University Hospitals NHS Foundation Trust. BLOOD GLUCOSE MONITORING CHART (adults, not pregnant) B Paent Name: Hospital Number: Date of birth: Consultant: Date (dd/mm/yyyy): Time: Blood glucose reading (mmol/L) OR PATIENT LABEL A SINGLE reading in a RED area requires acon TWO consecuve readings in the AMBER areas require acon This is the ACCEPTABLE glucose range This is the IDEAL glucose target range Ward: Blood glucose readings (mmol/L) Ketone levels Diabetes Inpatient Specialist Nurse bleep - 0407 - available Monday to Friday 9am to 5pm Urine Blood 30 25 20 15 10 5 0 ++++ +++ ++ + Nil ALL ACTION TAKEN MUST BE DOCUMENTED IN THE HOSPITAL NOTES Inials 14 © 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists of Great Britain and Ireland
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Recommendations for the Safe Transf
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CONTENTS Section I Summary and Reco
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SECTION II - BACKGROUND In 1996 the
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SECTION IV - ORGANISATION AND COMMU
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SECTION V - STAFFING REQUIREMENTS A
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A p p ropriate re s p i ra t o ry s
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SECTION VII - THE TRANSFER The tran
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SECTION VIII - EQUIPMENT AND DRUGS
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SECTION IX - EDUCATION AND TRAINING
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SECTION X - RESOURCE IMPLICATIONS F
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APPENDIX I INDICATIONS FOR INTUBATI
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APPENDIX III ADDITIONAL INFORMATION
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AAGBI SAFETY GUIDELINE Suspected An
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GUIDELINES Suspected Anaphylactic R
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Suspected anaphylactic reactions as
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Storage of Drugs in Anaesthetic Roo
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Storage of Drugs in Anaesthetic Roo
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This guideline was originally publi
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Anaesthesia 2015 Checketts et al. |
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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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Page 165 and 166: Out of Hours Activity (Anaesthesia)
Page 167 and 168: Considerations for anaesthetists Th
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Page 179 and 180: Peripartum care Pre-operative asses
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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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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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The Association of Anaesthetists of
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