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Domain A: knowledge, skills and performance Attribute 2: apply knowledge and experience to practice Standards ➣➣ In providing care an anaesthetist must recognise and work within the limits of their competence. ❏❏ When a problem arises outside their area of competence an anaesthetist must seek help from a suitable colleague. ❏❏ An anaesthetist must act promptly and appropriately when anaesthetic complications arise and be familiar with the operation of resuscitation equipment and current resuscitation guidelines. ❏❏ An anaesthetist must take urgent appropriate action if a patient has suffered harm through misadventure or for any other reason. ❏❏ An anaesthetist must use safe, regularly maintained equipment which has been checked before use, and use equipment and techniques with which he or she is familiar. ➣➣ An anaesthetist must adequately assess the patient’s condition. ❏❏ An anaesthetist must assess the patient before anaesthesia and devise an appropriate plan of anaesthetic management. ➣➣ An anaesthetist must provide or arrange advice, investigations or treatment where necessary. ❏❏ An anaesthetist must prescribe drugs or treatment, including repeat prescriptions, safely and appropriately. ❏❏ An anaesthetist must take steps to alleviate pain and distress whether or not a cure may be possible. ❏❏ An anaesthetist must provide effective treatments based on the best available evidence. ❏❏ An anaesthetist should consider appropriate local or nationally agreed guidelines when planning an anaesthetic. ❏❏ An anaesthetist must consult colleagues, or refer patients to colleagues, when this is in the patient’s best interest. ➣➣ If they are involved in teaching, an anaesthetist must apply the skills, attitudes and practice of a competent teacher/trainer. ❏❏ An anaesthetist should support the College Tutor in the teaching and clinical supervision of anaesthetic trainees. ❏❏ An anaesthetist should participate actively in the professional development of trainees. ❏❏ An anaesthetist should participate in the assessment of trainees, having undertaken the necessary training. ❏❏ An anaesthetist should contribute to the teaching of medical and other students. ❏❏ An anaesthetist should adopt a multidisciplinary approach to learning and teaching. ❏❏ An anaesthetist should help to foster a culture of lifelong learning. Page 10 | The Good Anaesthetist | Standards of Practice for Career Grade Anaesthetists
Domain A: knowledge, skills and performance Attribute 2: apply knowledge and experience to practice Explanatory notes Patients rely on anaesthetists to utilise and apply their expert knowledge and experience when making professional judgements, dealing with complex situations and solving clinical problems. However, on the other hand, given the rate of scientific and technological advances in medicine the majority of patients do not expect anaesthetists to be the fountain of all knowledge. In return for this recognition, anaesthetists must work within the limits of their competence; and where appropriate consult or seek advice from other sources or refer patients to colleagues, including those from other specialties, who do have the necessary experience and expertise. An environment where patient care prospers is one where all members of the healthcare team can learn from one another. Anaesthetists must therefore share their knowledge, skills and expertise by engaging in the education, training and professional development of colleagues. This educational role also includes undertaking reliable and honest formative assessment of students and trainees; providing constructive feedback to them as appropriate. Related guidelines and sources of information The General Medical Council ›› Good practice in prescribing medicines: supplementary guidance, 2008. ›› Withholding and withdrawing life-prolonging treatments: good practice in decision making, 2006. The Royal College of Anaesthetists ›› Cardiopulmonary resuscitation: standards for clinical practice and training, 2004. ›› Good practice in the management of continuous epidural analgesia in the hospital setting, 2004. ›› Local anaesthesia for intraocular surgery, 2001. The Association of Anaesthetists of Great Britain and Ireland ›› Checking anaesthetic equipment (3rd edition), 2004. ›› Day surgery (2nd edition), 2005. ›› Do not attempt resuscitation (DNAR) decisions in the peri-operative period, 2009. ›› Guidelines for the management of a malignant hyperthermia crisis, 2007. ›› Peri-operative management of the morbidly obese patient, 2007. ›› Pre-hospital anaesthesia. AAGBI safety guideline, 2009. ›› Pre-operative assessment: the role of the anaesthetist, 2001. ›› Safe management of anaesthetic related equipment, 2009. ›› Suspected anaphylactic reactions associated with anaesthesia (4th edition). AAGBI safety guideline, 2009. Prepared by the Joint Committee on Good Practice | Page 11
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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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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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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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