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Anaesthesia 2012 Hartle et al. | Checking anaesthetic equipment .................................................................................................. 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 has been seen and approved by the AAGBI Council. This article is accompanied by an Editorial. See page 571 of this issue. You can respond to this article at http://www.anaesthesiacorrespondence.com Accepted: 18 March 2012 • What other guideline statements are available on this topic? Guidelines on checking anaesthetic equipment have been published by the Association of Anaesthetists of Great Britain and Ireland (AAGBI), and amongst others, the American Society of Anesthesiologists, the Australian and New Zealand College of Anaesthetists and the World Federation of Societies of Anesthesiologists. • Why was this guideline developed? The increasing sophistication and diversity of anaesthesia workstations made the AAGBI’s existing guideline less universally applicable. Incidents reported to the Medicines and Healthcare products Regulatory Agency (MHRA), National Patient Safety Agency (NPSA) and AAGBI also highlighted priority checks that would avoid harm. • How does this statement differ from existing guidelines? The checklist specifies outcomes rather than processes and covers all the equipment necessary to conduct safe anaesthesia, not just the anaesthesia workstation. It has been written by Officers and Council members of the AAGBI in conjunction with representatives of the Royal College of Anaesthetists (RCoA), MHRA, NPSA and manufacturers. It was modified after a consultation with the membership of the AAGBI and industry. It has been trialled and modified in simulator settings on different machines. It has been endorsed by the Chief Medical Officers of England, Scotland, Wales and Northern Ireland. • Why does this statement differ from existing guidelines? The guideline reflects anaesthetic practice and staffing in the UK and Ireland and is applicable to any anaesthetic machine, including those yet to be developed. The pre-use check to ensure the correct functioning of anaesthetic equipment is essential to patient safety. The importance of this pre-use check is recognised worldwide and the check has been included in the 2 Anaesthesia ª 2012 The Association of Anaesthetists of Great Britain and Ireland
Hartle et al. | Checking anaesthetic equipment Anaesthesia 2012 World Health Organization’s Surgical Safety Checklist [1]. The AAGBI published the third edition of Checking Anaesthetic Equipment in 2004, and this has gained widespread acceptance in the profession. Changes in anaesthetic equipment and introduction of microprocessor-controlled technology necessitate continued revision of this document. This new edition of the safety guideline updates the procedures recommended in 2004 and places greater emphasis on checking all of the equipment required. A Working Party was established in 2009 comprising Officers and Council Members of the AAGBI and representatives of the Group of Anaesthetists in Training (GAT), RCoA, MHRA and the British Association of Anaesthetic and Respiratory Equipment Manufacturers Association (BAREMA). The Working Party reviewed the 2004 guideline, together with guidelines published by other organisations, and in addition reviewed incidents reported to the MHRA and the National Reporting and Learning Service (NRLS) of the NPSA [2]. The accompanying Checklist for Anaesthetic Equipment 2012 has been completely reformatted (Fig. 1). There are two new checklists – the first to be completed at the start of every operating session, the second a short set of checks before each case. The detail of how to perform these checks is given in this safety guideline. The first draft was circulated to the membership of the AAGBI and to manufacturers for comments, and the guideline amended in the light of these. Several versions of the checklist were trialled in simulators using different machines. The final version of the checklist was then submitted for further usability tests in simulators. The guideline and checklists have been endorsed by the Chief Medical Officers of England, Scotland, Wales and Northern Ireland. The principles set out in previous guidelines have governed amendments in this new edition. It must be emphasised that failure to check the anaesthetic machine and ⁄ or the breathing system features as a major contributory factor in many anaesthetic misadventures, including some that have resulted in hypoxic brain damage or death. The RCoA recognises the importance of these safety checks, and knowledge of them may be tested as part of the FRCA examination [3]. The anaesthetist has a primary responsibility to understand the function of the anaesthetic equipment and to check it before use Anaesthetists must not use equipment unless they have been trained to use it and are competent to do so [4]. The NHS Clinical Negligence Scheme for Trusts and NHS Quality Improvement Scotland require that hospitals ensure all personnel are trained to use and to check relevant equipment Anaesthesia ª 2012 The Association of Anaesthetists of Great Britain and Ireland 3
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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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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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Anaesthesia, 2007, 62, pages 1199-1
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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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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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