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Lipid emulsion, dantrolene and sugammadex may all be useful in anaesthetic emergencies. These should be immediately available on the delivery suite and location of these drugs should be clearly identified. Local anaesthetic and opioid solutions intended for epidural use should be available and stored separately from intravenous fluids to minimise the risk of accidental intravenous administration of such fluids. All units that care for high-risk patients should be able to access level-2 HDU care on site (see Section 4). Accommodation All consultant obstetric units should include dedicated office space for the sole use of the anaesthesia team on the delivery suite, or close enough for the resident anaesthetist to be able to work there between cases. This space should have adequate information technology facilities for both trainee and trained staff to be able to deal with emails, complete mandatory online training, access journals and search engines via the internet, complete portfolios and enter audit-related data. Local multidisciplinary evidence-based guidelines must be available in the office. The office space, facilities and furniture should comply with the standards recommended by AAGBI guidelines [53]. A library of specialist reference books/journals should be available. There should be a separate anaesthetic consultants’ office available to allow teaching, assessment and appraisal, that complies with AAGBI guidelines [53]. A communal rest-room in the delivery suite should be provided to enable staff of all specialities to meet. A seminar room(s) must be available for training, teaching and multidisciplinary meetings. We strongly support the provision of an on-call room containing a bed as there is good evidence that even short periods of sleep improve performance during nightshift work (regardless of the length of the shift) [8, 54]. Where a consultant is required to be resident, appropriate on-call accommodation should be provided [55]. 26
8. The future The delivery of healthcare constantly needs to evolve to meet the challenges of a changing population and deliver high-quality care; obstetric anaesthesia is no exception to this. Changes in healthcare encompass both organisational and clinical aspects. Developments that the Working Party supports include: • An aspiration to develop a 24-hour consultant-delivered anaesthesia service in the maternity unit, with the instigation of twilight and weekend sessions as an initial step • An expanded role of the obstetric anaesthetist as a ‘peripartum physician’ – in particular, more antenatal involvement in the management of women with high-risk/complicated pregnancies • Developing relationships between the maternity team and other specialities in the hospital setting, e.g. medical specialities such as cardiology, with maternity units receiving support from a named cardiologist • More extensive use of near-patient testing in the maternity unit • Development of safe and effective alternatives to regional analgesia in labour • Outcome-based research on the impact of intrapartum analgesia and anaesthesia on mother and baby • Further research into increased levels of anaesthetic safety • Development of enhanced recovery programmes in obstetrics • Confirmation at Department of Health level of the uninterrupted continuation of the Confidential Enquiries into maternal death and morbidity with more timely and frequent reports • Promoting equitable provision of anaesthetic services by ensuring anaesthetic representation on commissioning bodies. 27
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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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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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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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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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