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Whitaker et al. | Guidelines: Immediate post-anaesthesia recovery Anaesthesia 2013 • Need for cardiovascular support (inotropes, vasoconstrictors, anti-arrhythmics) Return to the operating theatre before discharge from PACU • Inadequate reversal of neuromuscular blocking drugs. Reports of such incidents should be accompanied by clinical information that will allow further analysis. The PACU is also a useful area in which to monitor compliance with Trust initiatives that seek to improve patient care and safety. These might include: Compliance with WHO checklist performance Administration of antibiotics Thrombo-embolic prophylaxis Compliance with analgesic and anti-emetic protocols • Completion of postoperative instructions relating to oxygen therapy, pain therapy, fluid management, wound and drain management, restarting of oral intake and other elements of early postoperative care. Competing interests DKW is a Past President of the AAGBI and is currently Chairman of the European Board of Anaesthesiology Safety Committee, and a member of the European Board of Anaesthesiology/European Society of Anaesthesiology Patient Safety Task Force. No external funding or competing interests declared. Acknowledgement The Working Party is very grateful to Dr K. Wilkinson for providing help and advice, particularly on the care of children. References 1. Association of Anaesthetists of Great Britain & Ireland. Immediate Postanaesthetic Recovery. London: AAGBI, 2002. 2. Vimlatia L, Gilsanzb F, Goldikc Z. Quality and safety guidelines of postanaesthesia care Working Party on Post Anaesthesia Care (approved by the European Board and Section of Anaesthesiology, Union Europeénne des Médecins Spećialistes). European Journal of Anaesthesiology 2009; 26: 715–21. 3. Royal College of Anaesthetists. Implementing and Ensuring Safe Sedation Practice for Healthcare Procedures in Adults. http://www.rcoa.ac.uk/system/files/PUB- SafeSedPrac.pdf (accessed 03/12/2012). 4. NHS Estates. Health Building Note 26, Facilities for Surgical Procedures: volume 1. London: The Stationery Office, 2004. © 2013 The Association of Anaesthetists of Great Britain and Ireland 15
Anaesthesia 2013 Whitaker et al. | Guidelines: Immediate post-anaesthesia recovery 5. Health Facilities Scotland. Scottish Health Planning Note 00-07: Resilience Planning for the Healthcare Estate. http://www.hfs.scot.nhs.uk/publications/1253180726- SHPN%2000-07%20Final.pdf (accessed 03/12/2012). 6. Association of Anaesthetists of Great Britain and Ireland. Recommendations for Standards of Monitoring During Anaesthesia and Recovery. http://www.aagbi.org/ sites/default/files/standardsofmonitoring07.pdf (accessed 03/12/2012). 7. Association of Anaesthetists of Great Britain and Ireland. AAGBI safety statement: the use of capnography outside the operating theatre. http://www.aagbi.org/ sites/default/files/Safety%20Statement%20-%20The%20use%20of%20capnography%20outside%20the%20operating%20theatre%20May%202011_0.pdf (accessed 03/12/2012). 8. European Section and Board of Anaesthesiology UEMS. EBA Recommendation for the Use of Capnography. http://www.eba-uems.eu/resources/PDFS/EBA-UEMS-recommendation-for-use-of-Capnography.pdf (accessed 03/12/2012). 9. Royal College of Anaesthetists. Major Complications of Airway Management in the UK, 4th National Audit Project. http://www.rcoa.ac.uk/system/files/CSQ-NAP4- Full.pdf (accessed 03/12/2012). 10. Association of Anaesthetists of Great Britain and Ireland. Guidance on the 2003 (New) Contract and Job Planning for Consultant Anaesthetists. http://www.aagbi. org/sites/default/files/jobplanning05.pdf (accessed 03/12/2012). 11. Association of Anaesthetists of Great Britain and Ireland. UK National Core Competencies for Post-anaesthesia Care. http://www.aagbi.org/sites/default/files/corecompetencies2013.pdf (in press). 12. Association of Anaesthetists of Great Britain and Ireland. The Anaesthesia Team 3. London: AAGBI, 2010 http://www.aagbi.org/sites/default/files/anaesthesia_ team_2010_0.pdf (accessed 03/12/2012). 13. Kluger MT, Bullock MFM. Recovery room incidents: a review of 419 reports from the anaesthetic incident monitoring study (AIMS). Anaesthesia 2002; 57: 1060–6. 14. NHS. Guidance on the Standard for Patient Identifiers for Identity Bands. http:// www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60136&type=full&- servicetype=Attachment (accessed 03/12/2012). 15. National Institute for Health and Clinical Excellence. Management of Inadvertent Perioperative Hypothermia in Adults. http://www.nice.org.uk/CG065 (accessed 03/12/2012). 16. Association of Anaesthetists of Great Britain and Ireland. Management of Severe Local Anaesthetic Toxicity. http://www.aagbi.org/sites/default/files/la_toxicity_ 2010_0.pdf (accessed 03/12/2012). 17. Royal College of Anaesthetists. Guidance on the Provision of Paediatric Anaesthetic Services. http://www.rcoa.ac.uk/system/files/CSQ-GPAS8-Paeds_0.pdf (accessed 03/12/2012). 18. Royal College of Anaesthetists. Child Protection and the Anaesthetist: Safeguarding Children in the Operating Theatre. http://www.rcoa.ac.uk/system/files/PUB-Child- Protection.pdf (accessed 03/12/2012). 19. Royal College of Anaesthetists. Safeguarding Children and Young People: Roles and Competencies for Health Care Staff. http://www.rcoa.ac.uk/system/files/PUB-Safeguarding-Children_0.pdf (accessed 03/12/2012). 16 © 2013 The 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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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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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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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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Guidelines: Day case and short stay
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