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centre. This level of training can only be delivered in centres that allow the trainee the opportunity to develop the skills required to manage the delivery suite and undertake complex obstetric cases whilst building and consolidating knowledge of obstetric anaesthesia, obstetrics and neonatology • Less than full-time (LTFT) trainees: at each level of training, LTFT trainees should be given an appropriate period of training in obstetric anaesthesia, proportionate to the percentage of whole time equivalent worked. Assessment Completion of the IACOA is mandatory for all core trainees before being allowed to work in an obstetric unit without direct supervision. Achieving the IACOA, however, does not signal the completion of the basic level unit of training in obstetric anaesthesia. Supervision All trainees should be supervised directly by a trainer present on delivery suite until the IACOA is completed. In addition, a joint OAA/ RCoA survey in 2010 [5] recommended that: • The IACOA should be used in conjunction with a local system of review that satisfies local clinical governance arrangements before a trainee works without immediate supervision • No trainee who feels unprepared to start obstetric on-call (regardless of completion of IACOA) should be expected to join the on-call rota unless directly supervised. Departments should make provision for this eventuality where rotas are written a long time in advance • All trainees who have completed their basic obstetric training should have some opportunity to cover the labour ward without immediate supervision, so that they are confident to take on this responsibility once they are appointed to an ST3 post. The first two of the above recommendations should also apply to non-trainee anaesthetists. All trainee and non-trainee anaesthetists working without direct supervision on delivery suite must have a named supervising consultant and both parties must be happy with the level of supervision available. In addition, they must know how to contact the supervising consultant in the event of an emergency. Simulation Simulation-based educational techniques can be used to assist all anaesthetists to develop the skills and attributes required to work safely and efficiently within the multidisciplinary obstetric team, including: • Technical skill development using part-task simulators e.g. epidural, cricothyroidotomy [39] • Reinforcement of emergency drills e.g. failed intubation [40] • Teaching and assessing clinical skills when clinical opportunities are limited e.g. general anaesthesia for caesarean section • Maternal and neonatal resuscitation [40] • Teamwork training emphasising non-technical skills [9] 18
• Skills and drills training: anaesthetists should help organise and participate in regular multidisciplinary drills covering delivery suite emergencies such as major obstetric haemorrhage, maternal collapse and failed intubation [41]. These drills should be followed by debriefing and feedback so that lessons can be learned at both an individual and a systems level. Continuing professional development All anaesthetists involved in the delivery of obstetric anaesthetic services should undertake appropriate continuing professional development activities in line with revalidation guidelines. 19
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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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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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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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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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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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