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Membership of the Working Party Dr Leslie Gemmell Dr Richard Birks Dr Patrick Radford Professor Don Jeffries CBE Dr Geoffrey Ridgway Mr Douglas McIvor Chairman, Honorary Secretary Elect President Elect Royal College of Anaesthetists Emeritus Professor of Virology, University of London Consultant Microbiologist Medicines and Healthcare Products Regulatory Authority Ex officio Dr David Whitaker Dr William Harrop-Griffiths Dr Iain Wilson Dr Ian Johnston Dr David Bogod President Honorary Secretary Honorary Treasurer Honorary Membership Secretary Editor-in-Chief, Anaesthesia This guideline was originally published in Anaesthesia. If you wish to refer to this guideline, please use the following reference: Anaesthesia 2008, 63; 1027-36
Anaesthesia, 2008, 63, pages 1027–1036 doi:10.1111/j.1365-2044.2008.05657.x ..................................................................................................................................................................................................................... GUIDELINES Infection Control in Anaesthesia Association of Anaesthetists of Great Britain and Ireland Membership of the Working Party: Gemmell L, Chair; Birks R, President Elect; Radford P, Royal College of Anaesthetists representative; Jeffries D, National Institute for Health and Clinical Excellence; Ridgway G, consultant microbiologist; McIvor D, Medicines and Healthcare Products Regulatory Authority; Executive Officers of AAGBI, ex officio This is a consensus document produced by expert members of a Working Party established by the Association of Anaesthetists of Great Britain and Ireland (AAGBI). It updates and replaces previous guidance published in 2002. 1.0. Summary (1) A named consultant in each department of anaesthesia should liaise with Trust Infection Control Teams and Occupational Health Departments to ensure that relevant specialist standards are established and monitored in all areas of anaesthetic practice. (2) Precautions against the transmission of infection between patient and anaesthetist or between patients should be a routine part of anaesthetic practice. In particular, anaesthetists must ensure that hand hygiene becomes an indispensable part of their clinical culture. (3) Anaesthetists must comply with local theatre infection control policies including the safe use and disposal of sharps. (4) Anaesthetic equipment is a potential vector for transmission of disease. Policies should be documented to ensure that nationally recommended decontamination practices are followed and audited for all reusable anaesthetic equipment. (5) Single use equipment should be utilised where appropriate but a sterile supplies department (SSD) should process reusable items. (6) An effective, new bacterial ⁄ viral breathing circuit filter should be used for every patient and a local policy developed for the re-use of breathing circuits in line with manufacturer’s instructions. The AAGBI recommends that anaesthetic departments should consider changing anaesthetic circuits on a daily basis in line with daily cleaning protocols. (7) Appropriate infection control precautions should be established for each anaesthetic procedure, to include maximal barrier precautions for the insertion of central venous catheters, spinal and epidural procedures and any invasive procedures in high risk patients. 2.0. Introduction The Association of Anaesthetists of Great Britain and Ireland (AAGBI) published guidelines in 2002 on problems relating to infection control in anaesthetic practice. In addition to AAGBI Officers and Council members, representation included the Royal College of Anaesthetists and the Medicines and Healthcare Products Regulatory Authority (MHRA). This is an updated version of that guidance document. Healthcare organisations now have a legal responsibility to implement changes to reduce healthcare associated infections (HCAIs). The Health Act 2006 provided the Healthcare Commission with statutory powers to enforce compliance with the Code of Practice for the Prevention and Control of Healthcare Associated Infection (The Code). The Code provides a framework for NHS Bodies to plan and implement structures and systems aimed at prevention of HCAIs. The Code sets out criteria that mandate NHS bodies, including Acute Trusts, and which ensure that patients are cared for in a clean environment. Anaesthetists should be in the forefront of ensuring that their patients are cared for in the safest possible environment. Further advice can be obtained from the Department of Health (DOH) website http://www. clean-safe-care.nhs.uk. Ó 2008 The Authors Journal compilation Ó 2008 The Association of Anaesthetists of Great Britain and Ireland 1027
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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 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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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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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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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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