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11. References 1. American Society of Anaesthetists Committee on Ethics, 2001. Ethical guidelines for the anesthesia care of patients with do-notresuscitate orders or other directives that limit treatment. www. asahq.org/publicationsAndServices/standards/09.html (accessed 01/08/08). 2. Canadian Anesthesiologists’ Society Committee on Ethics, 2002. Peri-operative status of ‘do not resuscitate’ (DNR) orders and other directives regarding treatment. www.cas.ca/members/ sign_in/guidelines/do_not_resuscitate/ (accessed 01/08/08). 3. Resuscitation Council, Decisions Relating to Cardiopulmonary Resuscitation. A Joint Statement from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing, London: 2007. www.resus.org.uk/pages/DNAR.htm (accessed 18/11/08). 4. McBrien ME and Heyburn G. Anaesthesia 2006; 61: 625–7. 5. Consent for Anaesthesia, 2nd edition 2006. London, The Association of Anaesthetists of Great Britain and Ireland. www. <strong>aagbi</strong>.org/publications/guidelines/docs/consent06.pdf (accessed 01/08/08). 6. General Medical Council. Consent: patients and doctors making decisions together, 2008. www.gmc-uk.org/news/articles/ Consent_guidance.pdf (accessed 01/08/08). 7. Medical Council of Ireland. A Guide to Ethical Conduct and Behaviour, Sixth Edition, 2004. www.medicalcouncil.ie/ professional/ethics.asp (accessed 18/11/08). 8. Mental Capacity Act 2005. http://www.opsi.gov.uk/ACTS/ acts2005/ukpga_20050009_en_1 (accessed 29.1.09). 9. Adults with Incapacity (Scotland) Act 2000. http://www.opsi.gov. uk/legislation/scotland/acts2000/asp_20000004_en_1 (accessed 29.1.09). 25
10. Human Rights Act 1998. http://www.opsi.gov.uk/ACTS/acts1998/ ukpga_19980042_en_1 (accessed 29.1.09). 11. Beauchamp TL, Childress JF. Principles of Biomedical Ethics, 5th edn. Oxford: Oxford University Press, 2001. 12. General Medical Council. Withholding and withdrawing life prolonging treatments: Good practice in decision-making, 2002. www.gmc-uk.org/guidance/current/library/witholding_ lifeprolonging_guidance.asp#67 (accessed 18/09/08). 13. White SM, Baldwin TJ. The Human Rights Act, 1998: implications for anaesthesia and intensive care. Anaesthesia 2002; 57: 882–8. 14. White SM, Baldwin TJ. The Mental Capacity Act 2005 – implications for anaesthesia and critical care. Anaesthesia 2006; 61: 381-9. 15. Irish Council for Bioethics. Is it time for advance healthcare directives? Opinion, 2007. www.bioethics.ie/uploads/docs/ AdvanceDirectiveReport.pdf (accessed 18/11/08). 16. Butler MW, Saaidin N, Sheikh AA, Fennell JS. Dissatisfaction with do not attempt resuscitation orders: A nationwide study of Irish consultant physician practices. Irish Medical Journal 2006; 99: 208-210. 17. Olsson GL, Hallen B. Cardiac arrest during anaesthesia. A computer-aided study in 250,543 anaesthetics. Acta Anaesthesiologica Scandinavica 1988; 32(8): 653–64. 18. Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Medicine 2007; 33: 237-45. 19. General Medical Council. Good medical practice, 2006. www.gmc-uk.org/guidance/good_medical_practice/index.asp (accessed 01/08/08). 26
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Staff and Associate Specialist Grad
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Staff and Associate Specialist Grad
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CONTENTS Section 1 Introduction 4 S
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2. Recommendations The AAGBI strong
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Associate Specialists should ensure
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Appointment is limited to those pri
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5. The AAGBI and the SAS anaestheti
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Where the SAS doctor and the named
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Discretionary points and optional p
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Useful websites The Association of
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APPENDIX 2 Update on the new SAS gr
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Supporting Professional Activities
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23
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Storage of Drugs in Anaesthetic Roo
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Storage of Drugs in Anaesthetic Roo
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Propofol ..........................
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The measurement of adult blood pres
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Anaesthesia 2016, 71, 326-337 Guide
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Anaesthesia 2016, 71, 326-337 Manag
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Anaesthesia 2016, 71, 326-337 made,
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21 Portland Place, London, W1B 1PY
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Membership of the working party (De
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1. Introduction This document prese
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There is at present no specific bod
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using ultrasound in a clinical situ
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up to individual departments to tra
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3. Recommended essential ultrasound
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initial assessment of practical ski
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4. Regional anaesthesia and pain me
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Terminal peripheral nerves of the a
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Interpersonal and communications sk
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5. Vascular procedures The use of u
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Level 2 pathology Ultrasonic appear
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6. Thoracic ultrasound The use of p
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Pathology Level 1 pathology Pleural
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Assessment checklist - thoracic ult
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Curriculum for abdominal ultrasound
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Assessment checklist - abdominal ul
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Curriculum for echocardiography Bas
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Technique of pericardiocentesis, in
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Level 2 accreditation A proportion
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15. The British Medical Ultrasound
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Appendix 1 RCoA Direct Observation
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intensive care society care when it
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GROUP OF ANAESTHETISTS IN TRAINING
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CONTENTS Who should read this? 05 I
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OPERATING THEATRE WORK Safe care of
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majority of currently advertised co
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TRAINING AND EXAMS Entry to basic t
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LESS THAN FULL TIME TRAINING If you
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USEFUL CONTACTS Group of Anaestheti
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Group of Anaesthetists in Training
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Membership of the working party Con
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The practical changes were that a c
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was undertaken in standard or premi
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For most consultants, the majority
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6. Leave of all sorts Annual leave
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Maternity leave, domestic, personal
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Changes to the frequency of on-call
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to give him the flexibility to atte
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Job planning is by agreement, not d
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elated and other specialty activiti
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Each individual consultant anaesthe
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although NHDs may be flexible in ti
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15. References 1) British Medical A
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Workload for Consultant Anaesthetis
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Contents 1. Key points 3 2. Introd
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2. Introduction The 2008 (Connaught
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Terms and conditions Appointment an
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If a consultant remains in the hosp
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Consultants eligible to hold contra
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consultants once the overall ratio
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5. Consultant work schedule Introdu
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internal activities, (ii) external
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Recommendations • The consultant
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• Consider his/her need for addit
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7. Academic consultants All terms o
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following statements: (i) “Traine
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9. The European Working Time Direct
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for junior doctors in the 48-hour w
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Medical Council • Medical Council
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Implementation. Guidance to health
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Consultant anaesthetist with a spec
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Appendix 3. Non-clinical Activities
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Research • Research meetings •
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• Access to confidential telephon
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42
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AAGBI SAFETY GUIDELINE UPDATE Safet
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GUIDELINES Safety in magnetic reson
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Safety in magnetic resonance units
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Malignant Hyperthermia Crisis AAGBI
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Recommended Contents of Malignant H
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PROVISION OF ANAESTHETIC SERVICES I
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Contents Page Section I Summary 1 S
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Section II: Introduction Magnetic r
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MR compatible pulse oximeters must
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Scavenging of anaesthetic gases The
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Gauss (G) see Tesla. Gauss is a uni
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Section X: References 1. Health Bui
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Association of Anaesthetists of Gre
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Three principle methods of achievin
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3. Testing could take place with th
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Appendices: 1. Needlestuck 2. Analy
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Editorial Anaesthesia, 2007, 62, pa
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Analysis of Benefits and Harms of C
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AAGBI Needlestick Injuries Working
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AAGBI NEEDLESTICK INJURIES WORKING
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when asking for the family’s posi
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Needle-stick Injuries from a Patien
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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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Membership of the working party (de
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from the occupational health depart
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those whose complex problems cannot
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5. There should be arrangements in
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European Directive 2010/32/EU speci
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5c. Manual handling and back care M
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Associated risks to the fetus 1. Ph
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When making a referral to the occup
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• modifying instructions or refer
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16. The Workwell model: an integrat
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Definitions The times that can be c
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Members of the working party: Dr Ka
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This guideline was originally publi
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operatively. The advice presented i
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Table 1 World Health Organization c
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Sleep-disordered breathing describe
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Table 2 The four most useful terms
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Table 3 Suggested initial dosing sc
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score 4-5 on the OS-MRS are more li
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indicator and when greater than 60
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adipose tissue, standard doses of l
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trolled, ventilation. The addition
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Routine discharge criteria are met
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Sedation Pre-operative evaluation f
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an increased decision-to-delivery i
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mended in all patients who have a g
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This is designed as an aide memoire
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28. Parkin L, Sweetland S, Balkwill
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the epidural space in obese parturi
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project’ (2010). 2011. http://www
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AAGBI SAFETY GUIDELINE Peri-operati
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Anaesthesia 2014, 69 (Suppl. 1), 81
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Griffiths et al. | Guidelines: Peri
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Perioperative fasting in adults and
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Membership of the working party (de
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1. Recommendations This guidance ha
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2. Introduction Preparing a patient
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3. Before planned admission Pre-ope
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Pathologies that predictably progre
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• Have balanced the pros and cons
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tool for survival prediction in add
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4. After planned admission Anaesthe
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ecommendations for optimisation in
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6. Children and young people Childr
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competent minor to refuse treatment
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comorbidity and complexity of the s
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It is extremely important that adeq
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9. Older P, Hall A, Hader R. Cardio
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Appendices 1. Fasting guidelines in
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Post-operative resumption of oral i
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Appendix 3 Surgical severity (from
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Appendix 5 Systemic disease (from N
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Regional Anaesthesia and Patients w
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Guidelines Regional anaesthesia and
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W. Harrop-Griffiths et al. | Guidel
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Anaesthesia 2016 Bodenham et al. |
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AAGBI SAFETY GUIDELINE Safe Managem
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Contents 1. Summary 2 2. Introducti
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2. Introduction The Association of
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3.3 Duties of the equipment officer
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In addition to items for which the
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that can conduct electricity direct
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Regulations, including those transp
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6.3 Assessing equipment and the fin
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7. Public sector procurement regula
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More guidance on the application ca
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8. Commissioning new equipment The
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10. Maintenance 10.1 Planned preven
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For ‘in-house’ departments, qua
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12. Disposal 12.1 General Unreliabl
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13. User training 13.1 General Anae
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anaesthetic simulators already play
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implications for patients or users
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15. Audit 15.1 Internal This is par
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References 1. Association of Anaest
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Useful numbers and websites For rep
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All AAGBI guidelines are reviewed t
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eyond its initial application. In o
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sion: the Royal College of Anaesthe
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Despite chlorhexidine’s proven ef
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the duration of antimicrobial activ
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21. Henschen A, Olson L. Chlorhexid
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MEMBERSHIP OF THE WORKING PARTY Pro
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SUMMARY OF THE RECOMMENDATIONS 1. L
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SECTION 2. MEDICINES ACT 1968 The M
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In order of preference, the supply
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SECTION 4. GUIDELINES The developme
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(d) Controlled drugs coming into th
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SECTION 6. SOLUTIONS FOR INFUSION O
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SECTION 7. DISPOSAL OF CONTROLLED D
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REFERENCES Report of a Working Part
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Practical advice from the GAT Commi
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Contents Foreword 4 1. Introduction
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Introduction Anaesthetics has tradi
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JOIN THE ASSOCIATION OF ANAESTHETIS
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co-ordinator or secretary. It alway
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Equipment competencies - You may be
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summarise your training, assessment
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The current training programme, ove
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Foundation doctor (two years) (Or a
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• Whether the case was discussed
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move to intermediate level training
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is to confirm the possession of the
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to gain the complementary specialty
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history-taking, physical examinatio
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But, it does not help to answer the
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Anaesthetic training in Scotland Au
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Professionalism and accountability
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The BMA Counselling Service for doc
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MMC Modernising Medical Careers SAS
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38 39
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Inter-hospital transfer of the crit
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1. SUMMARY OF RECOMMENDATIONS 1. A
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available, and without immediate tr
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6. THE TRANSFER ITSELF The anaesthe
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4. No other anaesthesia-accompanied
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21 Portland Place, London W1B 1PY T
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Guidelines: Day case and short stay
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Page 689 and 690: Barker et al. | Guidelines on peri-
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Page 703 and 704: Membership of the working party Dr
Page 705 and 706: 1. Recommendations 1. Management of
Page 707 and 708: 2. Introduction In the past, decisi
Page 709 and 710: 3. Definitions Do not attempt resus
Page 711 and 712: 4. Ethical framework Advance decisi
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Page 715 and 716: If an advance decision does not mee
Page 717 and 718: 6. Why is it necessary to review a
Page 719 and 720: 7. How to review a DNAR decision It
Page 721 and 722: Option one: The DNAR decision is to
Page 723 and 724: 8. Conflict resolution When dealing
Page 725 and 726: 9. Duration of the DNAR management
Page 727: At the end of the decision making p
Page 731 and 732: Appendix 1 DNAR management consent
Page 733 and 734: DNAR management option agreed: Opti
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Page 739 and 740: Membership of the working party (De
Page 741 and 742: 1. Summary The vast majority of ana
Page 743 and 744: Opioid abuse The incidence of non-a
Page 745 and 746: Availability The fact that anaesthe
Page 747 and 748: Warning signs of drug abuse [6, 27]
Page 749 and 750: Where the individual is a trainee,
Page 751 and 752: There is a real possibility of self
Page 753 and 754: 7. Treatment, support and monitorin
Page 755 and 756: Monitoring Mandatory biochemical mo
Page 757 and 758: to label all anaesthetists with opi
Page 759 and 760: 11. Booth JV et al. Substance abuse
Page 761 and 762: 33. Foll B Le, Gallo A, Strat Y Le,
Page 763 and 764: Dependence syndrome (addiction) The
Page 765 and 766: Appendix 2: Sources of support More
Page 767 and 768: Royal Medical Benevolent Fund (RMBF
Page 769 and 770: 2.4 To foster a climate that will e
Page 771 and 772: the OHS who will refer for treatmen
Page 773 and 774: Appendix 4: Identifying unsafe drin
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Contents Page 1 Introduction 2 2 Sc
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3 Patient selection and consent 3.1
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5.2 The tip of the epidural cathete
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8 Patient monitoring 8.1 Patients m
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9.4 Hourly assessments are recommen
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References 1 Good practice in the m
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INSIDE BACK COVER - TO BE LEFT BLAN
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Fatigue and Anaesthetists Published
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Contents 1. Preface 2 2. Recommenda
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2. Recommendations • In keeping w
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Most adults require eight hours of
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5. What are the risks? Performance
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7. References 1. Fatigue Risk Manag
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30. Lockley SW, Barger LK, Ayas NT,
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Appendix 2 Sample Sleep Diary Date
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Membership Questionnaire 2 (Health
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Anaesthesia 2011 Griffiths et al. |
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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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Good Practice Guide 2006 Foreword
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Good Practice Guide 2006 Chapter 1
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Good Practice Guide 2006 A further
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Good Practice Guide 2006 11 1.3.2.2
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Good Practice Guide 2006 13 and hea
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Good Practice Guide 2006 15 6, 15-1
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Good Practice Guide 2006 17 2.4 Pro
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Good Practice Guide 2006 19 Para 48
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Good Practice Guide 2006 21 Chapter
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Good Practice Guide 2006 23 5.1 Loc
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Good Practice Guide 2006 25 Each de
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Good Practice Guide 2006 29 However
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Good Practice Guide 2006 31 ❚ ❚
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Good Practice Guide 2006 35 Anaesth
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Good Practice Guide 2006 39 overall
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Good Practice Guide 2006 41 Fitness
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Good Practice Guide 2006 43 Referra
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Good Practice Guide 2006 45 42 Effi
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Good Practice Guide 2006 47 Provisi
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Good Practice Guide 2006 49 Appendi
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Good Practice Guide 2006 51 Intensi
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Good Practice Guide 2006 53 Knowled
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Good Practice Guide 2006 55 Knowled
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Design and layout by The Royal Coll
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publications highlighting complicat
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y which patients undergo such surge
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event (Table 2) [11]. All hip fract
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The Association of Anaesthetists of
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CONTENTS Glossary of terms 3 Introd
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PCA pCO2 PDP PONV PPE QIS RAE RCN R
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The clinical components are: • As
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Articulates role within peri-operat
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COMPETENCY 3: CLINICAL LEADERSHIP C
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4.4 Demonstrate and promote the del
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5.3 Understands features of oxygen
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COMPETENCY 6: ASSESSMENT AND MANAGE
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COMPETENCY 8: ASSESSMENT OF LEVEL O
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9.3 Perform charting of physiologic
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COMPETENCY 11: APPLIED KNOWLEDGE OF
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COMPETENCY 12: MANAGEMENT OF POSTOP
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COMPETENCY 13: RECOVERY EMERGENCIES
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13.10 Short term management of a pa
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14.7 Urinary catheters and bladder
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Members of the Working Party Dr W H
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Key Points • Independent practice
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indemnity subscription, have more c
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Anaesthetists practising in the pri
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an elective list; it would not be a
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Some of these documents will need t
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Investigations by the Inland Revenu
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Indemnity for Independent Practice
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Independent Medicolegal Practice Me
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Moving on There are also organisati
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Independent Practice in Pain Medici
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Independent Practice in Intensive C
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Accurate records of procedures unde
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Chambers and Group Practice For ana
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treasurer, but the arrangements of
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30
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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 Interhospita
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CONTENTS Section 1 Recommendations
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Section 2 Background The AAGBI Coun
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Section 4 The decision to transfer
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Section 5 Stabilisation before tran
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Level 3: Patients requiring advance
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Section 8 The ambulance The Europea
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Section 9 Documentation and handove
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References 1. Mackenzie PA, Smith E
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17
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Management of Anaesthesia for Jehov
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2
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SECTION 1 1. Introduction 1.1 The f
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2.5 It may be helpful to regard the
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SECTION 3 3. The legal position in
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SECTION 4 4. Clinical Management 4.
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4.2 Intra-operative Management 4.2.
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In Ireland the issue of the “matu
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6. Consequences of Bloodless Anaest
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6.4 Other considerations 6.4.1 Stre
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7. Conclusion 7.1 The Association o
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15. NHS Reference Costs 2003 and Na
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Appendix 2 Hospital Liaison Committ
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anaesthetic that he proposes to use
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Appendix 4 Simplified Procedure for
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Immediately Give an initial intrave
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AAGBI: Consent for anaesthesia 2017
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Anaesthesia 2017 Guidelines doi:10.
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Yentis et al. | AAGBI: Consent for
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Management of a Patient with Suspec
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The use of blood components and the
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Guidelines AAGBI guidelines: the us
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Klein et al. | AAGBI blood transfus
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Anaesthesia 2016 Klein et al. | AAG
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The Anaesthesia Team 3 Published by
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Contents 1. Recommendations 3 2. In
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2. Introduction It is now over 20 y
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The role of the clinical service ma
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5. The operating department Managem
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Assistance for the anaesthetist Tra
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Professional associations Continuin
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6. Recovery post-anaesthetic care u
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7. Postoperative pain management Ba
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References 1. The Association of An
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20
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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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Appendix 2a Frequently asked questi
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or another technique, to the point
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process has not been followed, he/s
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Appendix 2b Frequently asked questi
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8. What level of detail of anaesthe
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It is feasible that different peopl
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23. What should I do if a patient h
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contamination errors in arterial li
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Figure 1 Open and closed systems fo
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(a) (b) Figure 2 Appearance of sodi
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Pressurising devices All pressurisi
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• special connections between the
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Membership of the working party Dr
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Section 1-Summary 1. The availabili
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provide cover for off-site location
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Section 4-Detailed Recommendations
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assistant. As such there is little
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Rostering Who is responsible for th
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References 1. The Anaesthesia Team,
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The life changing POWER OF ULTRASOU
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3.0: Societal changes and financial
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4.0: Age, physiological changes and
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5.0: Workforce patterns and workfor
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The removal of an age-related retir
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These three publications incorporat
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6.4: The role of the public Appendi
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THE ROYAL COLLEGE OF ANAESTHETISTS
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ANNUAL CONGRESS BIRMINGHAM 14 -16 S
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MEMBERSHIP OF THE WORKING PARTY Dr
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SECTION I - SUMMARY AND RECOMMENDAT
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SECTION III - INTRODUCTION Patients
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purchase these services. They must
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SECTION VI - PREPARATION FOR THE TR
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A patient who remains hypotensive d
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A patient who has been made physiol
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4. Other equipment • suction •
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important to involve those who take
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REFERENCES 1. Association of Anaest
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APPENDIX II TRANSFER CHECKLIST FOR
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Membership of the working party Dr
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Introduction Recent health controve
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1.2 Communication needs In the opin
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2. Neonatal resuscitation in hospit
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3.2 Who is in charge? Children with
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Nursing care of the critically ill
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7. Summary The purpose of this docu
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MEMBERSHIP OF THE WORKING PARTY Dr
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SECTION 1. SUMMARY • The majority
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involved according to individual ne
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aftermath. A decision will need to
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It may be necessary to conduct a se
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SECTION 5. THE TRUST RESPONSE Each
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equired for the incident. This is a
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Fear You may become afraid of new t
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When to ask for help Sometimes even
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has a responsibility to ensure they
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Suspension It is not unusual for a
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The potential implications of a cri
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SECTION 9. SOURCES OF HELP Consult
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Sick Doctors Trust 0870 444 5163 ww
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15. Emmerik AAP, Kamphuis JH, Hulsb
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Membership of the working party Pro
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1. Recommendations • The use of I
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3. Getting organised and competenci
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Competencies Documents supporting c
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5. Technical aspects The surgical t
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6. Special circumstances The decisi
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Bowel contamination The use of ICS
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7. Financial considerations To keep
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8. Takemura M, Osugi H, Higashino M
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Appendix 1 Procedures and situation
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Appendix 2 Diagram of ICS set-up Dr
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AAGBI SAFETY GUIDELINE Checking Ana
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Guidelines Checking Anaesthetic Equ
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Hartle et al. | Checking anaestheti
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This checklist is an abbreviated ve
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Contents Introduction 1 Summary of
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1.0 Summary of recommendations 1.1
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3.0 Before treatment 3.1 Whenever p
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3.10 The consultant should tell the
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5.0 After treatment 5.1 Accounts 4
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6.0 Emergencies 6.1 Emergency treat
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Appendix 2 EXAMPLE OF AN INVOICE To
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