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Showing results for tags 'Anaesthesia'.
Found 146 results
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Content ArticleThe UK NHS has risen to the challenge posed by COVID-19 through Herculean efforts to expand capacity. This has included doubling or trebling intensive care (ICU) capacity within hospitals, augmenting this with Nightingale Hospitals, cancelling all non-emergency surgery and redeploying staff and equipment to focus on a single disease. At the same time, government and population efforts have – through social distancing then lockdown – successfully flattened the epidemic curve and so reduced demand. Together, these actions have enabled treatment of all those needing hospital care for COVID-19 and avoided the unfettered increase in mortality that would have accompanied an overwhelmed healthcare service. However, this has been achieved ‘by the skin of our teeth’ and until very recently, the threat of insufficient ICU beds ventilators, and the need for triage were all anticipated: a few hospitals were overcome by the surge of critically ill patents. Now, political and social thoughts and actions are turning to loosening lockdown and determining what ‘post-pandemic normality’ will look like. In this Editorial, William Harrop‑Griffiths and Tim Cook discuss the prospects and challenges of ‘planned surgery’ – both time-critical and wholly elective procedures.
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Content ArticleThe COVID‐19 pandemic has led to the manufacturing of novel devices to protect clinicians from the risk of transmission, including the aerosol box for use in intubation. The authors of this paper, published in Anaesthesia, evaluated the impact of two aerosol boxes (an early‐generation box and a latest‐generation box) on intubations in patients with severe COVID‐19 with an in‐situ simulation crossover study.
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Content ArticleThere has been an increase in the number of units providing anaesthesia for magnetic resonance imaging and the strength of magnetic resonance scanners, as well as the number of interventions and operations performed within the magnetic resonance environment. More devices and implants are now magnetic resonance imaging conditional, allowing scans to be undertaken in patients for whom this was previously not possible. There has also been a revision in terminology relating to magnetic resonance safety of devices. These guidelines, by the Association of Anaesthetists, have been put together by organisations who are involved in the pathways for patients needing magnetic resonance, reinforce the safety aspects of providing anaesthesia in the magnetic resonance environment and suggest that hospitals should develop and audit governance procedures to ensure that anaesthetists of all grades are competent to deliver anaesthesia in the magnetic resonance environment.
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Peri-operative care of people with dementia, 2019
Claire Cox posted an article in Dementia
Ageing populations have greater incidences of dementia. People with dementia present for emergency and, increasingly, elective surgery, but are poorly served by the lack of available guidance on their peri-operative management, particularly relating to pharmacological, medico-legal, environmental and attitudinal considerations. These guidelines seek to provide information for peri-operative care providers about dementia pathophysiology, specific difficulties anaesthetising patients with dementia, medication interactions, organisational and medico-legal factors, pre-, intra- and postoperative care considerations, training, sources of further information and care quality improvement tools. -
Content ArticleThe 5th National Audit Project (or NAP5) of the Royal College of Anaesthetists and Association of Anaesthetists was the largest ever study into accidental awareness during general anaesthesia (AAGA). Numerous publications emerged from the project and whereas a comprehensive list of 64 recommendations were made, the full report and associated publications were primarily academic outputs not accessible to all practitioners as a day-to-day ready reference, nor did they provide practical recommendations that individuals could use in their daily practice. The purpose of this publication is to distil and interpret the findings of the 5th National Audit Project into actions that individuals (and organisations) can follow to reduce the risk of accidental awareness.
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Content ArticleThe prevention of healthcare associated infections (HAIs) is an integral component of good medical practice; anaesthetists have a central role in ensuring every patient receives the best protection against HAIs. In this guideline, written by the Association of Anaesthetists, recommendations include that there should be a named lead consultant in each department of anaesthesia who is responsible for liaising with their trust’s infection prevention and control team and occupational health department to ensure best antimicrobial practice is maintained in all areas of anaesthetic practice.
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Content ArticleThis study, published by the International Institute of Gynaecology and Obstetrics, evaluates the safety and efficacy of flushing the cervical canal and the uterine cavity with local anaesthetic in order to reduce the pain felt by patients during office hysteroscopy.
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Airway Device Evaluation Project Team (ADEPT)
Claire Cox posted an article in Keeping patients safe
The aim of the Airway Device Evaluation Project Team (ADEPT) is to establish a process by which the airway-management community within the profession could lead a process of formal device/equipment evaluation. There is increasing number of airway management devices being introduced into clinical practice with little or no evidence of their clinical efficacy or safety. While there are several national and international regulations governing which products can come on to the market and be legitimately sold, there has hitherto been no formal professional guidance relating to how products should be selected (purchased). ADEPT has formulated such advice, emphasising evidence based principles and defined a minimum level of evidence needed to make a pragmatic decision about the purchase or selection of an airway device. ADEPT advises that this definition should form the basis of a professional standard, guiding those with responsibility for selecting airway devices. This paper, published by Anaesthesia journal, describes how widespread adoption of this professional standard can act as a driver to create an infrastructure in which the required evidence can be obtained. -
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Patient education and information: difficult airway
Claire Cox posted an article in Keeping patients safe
The Difficult Airway Society (DAS) is a UK based medical specialist society formed to enhance and promote safe airway management of patients by anaesthetists and other healthcare practitioners. DAS is actively involved in training healthcare professionals in the safe and competent practice of advanced airway management. DAS has produced guidelines for airway management of patient undergoing anaesthetic. These guidelines are highly valued and widely followed not only in the UK but also worldwide. With nearly 3000 members (most of whom are anaesthetists based in UK and worldwide ) DAS is also the largest specialist society in the UK. The links below lead you to patient information leaflets produced by DAS about how anaesthetist manage your airway (breathing passage) during an anaesthetic. -
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Airway alert card and difficult airway database
Claire Cox posted an article in Process improvement
The Difficult Airway Society (DAS) has produced a difficult airway card for patients to carry in their wallet. This is to alert the anaesthetist that this patient has a 'difficult airway' before they find out the hard way. This website also holds the database for patients with difficult airways. This is for clinicians to use to help assess risk in patients undergoing sedation or general anaesthetic. -
Content ArticleResilience in the context of anaesthesia and intensive care medicine is the ability to manage the breadth, depth, intensity and chronicity of the demands of the work. The concept of resilience is often misunderstood: it is a dynamic, contextual process that goes beyond the narrow conceptions of individual ‘toughness’ that it can be reduced to. Resilience is important for those working in anaesthesia and intensive care medicine, and indeed staff throughout healthcare, as it is inevitable that difficult cases and situations will be encountered during our working lives. In addition, the way in which we respond to these events is critical to our own welfare and competence at work.
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Brighton Anaesthesia FFP3 Donning & Doffing
Claire Cox posted an article in Good practice and useful resources
Brighton and Sussex University Hospitals Trusts Anaesthetic Department has produced this video demonstrating how to 'don' (put on) and 'doff' (take off) PPE pre- and post-intubation of a high risk/infected patient with COVID-19. -
Content ArticleThis article in the Anesthesia Patient Safety Foundation newsletter looks at the issues surrounding the contribution of anaesthetic gasses to healthcare pollution and emissions. The authors argue that the next patient safety movement should be sustainable healthcare. They highlight that anaesthetists have the opportunity to lead in the effort to reduce healthcare’s impact on population health, and demonstrate to the wider sector that sustainable healthcare is possible and important to the wellbeing of patients.
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Mandy Anderton is a Clinical Nurse specialising in learning disability and a hub Topic Leader. In this new blog, Mandy explains how they are using shared decision making and reasonable adjustments to implement a new care pathway, where patients with a learning disability needing to undergo a medical investigation can receive deep sedation within their own home. Working with patients, carers, relatives, anaesthetists and others, the aim is to improve access to important medical investigations with minimal distress, where other avenues have been exhausted. -
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The SPA experience: NHS Wales Award winner 2016
Claire Cox posted an article in Learning disabilities
Having surgery can be a daunting experience for most people. Staff at the Princess of Wales Hospital in Bridgend, Wales, have recognised this, especially in their patients with complex needs. The reasonable adjustments that they have put in place to ensure their patients receive a bespoke, calming, safe experience won them an NHS Wales Award in 2016 in the Citizens at the Centre of Service Redesign and Delivery category.- Posted
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Content ArticleThe Cappuccini Test is a simple six-question audit designed to pick up issues relating to supervision of anaesthetists in training and non-autonomous SAS grades (NASG) who do not fit the description in Guidelines for the Provision of Anaesthesia Services (GPAS) of 'SAS anaesthetists that local governance arrangements have agreed in advance are able to work in those circumstances without consultant supervision.' The test is named after Frances Cappuccini, who died giving birth to her son at Tunbridge Wells Hospital in 2012. The coroner’s inquest into her death noted that supervision arrangements for anaesthetists at the trust were ‘undefined and inadequate’. The test was developed for hospitals to assess the level of supervision given to their SAS and trainee anaesthetists, and to make improvements with the aim of improving the safety of patients.
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Safer Anaesthesia From Education (SAFE)
Patient Safety Learning posted an article in In surgery
Safer Anaesthesia From Education (SAFE) is a joint project developed in 2011 by the Association of Anaesthetists and the WFSA (World Federation of Societies of Anaesthesiologists). The training initiative aims to bring practitioners of obstetric and paediatric anaesthesia (who throughout the world may be physician anaesthesiologists but are largely non-physicians) to a level of practice whereby they can deliver vigilant, competent, and safe anaesthesia. The underlying principle is to equip anaesthetists with the essential knowledge and skills so they can deliver safe care to their patients, even in very low resource settings, and to train as many anaesthesia providers as possible in each country in order to create a sustainable training model which can be embedded in the national health system. -
Content ArticleThe safe management of a patient’s airway is one of the most challenging and complex tasks undertaken by a health professional - complications can result in devastating outcomes. Develop safe airway management strategies for your patients. This FREE course by University College London Hospital NHS Trust, will provide answers to your key questions and help you develop strategies to improve patient safety in your area of practice, discussing safe airway management in patient groups and multidisciplinary clinical settings. This course has been updated with the latest guidance on airway management in patients with COVID-19 and relevant personal protective equipment.
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Content ArticleThe Royal College of Anaesthetists set up PatientsVoices@RCoA to help the College improve the delivery of safe, more effective, patient-centred care to enhance patients’ experience of anaesthesia and perioperative care. This plan by PatientsVoices@RCoA aims to set out a clear direction for our future work which ensures patients’ voices are clearly heard across all relevant activities, as the College delivers its strategic aims over the next five years.
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation looked at the risks to patients when intravenous (IV) drugs are retained in cannulae and extension lines. Some drugs, such as those used in anaesthesia and pain management, can cause patients to stop breathing. After administration, these drugs should be flushed through cannulae and extension lines to make sure no residual quantities of the drugs are left. Despite the issuing of multiple safety alerts over the past ten years, residual drugs in cannulae and extension line events continue to happen. When these events involve drugs that cause the patient to stop breathing, there is a risk of hypoxic brain injury (where the brain is damaged after a period where it does not get enough oxygen) or death. The investigation was launched after concerns were reported to HSIB by a consultant anaesthetist at a district general hospital where a patient had stopped breathing several hours after undergoing an anaesthetic. It’s thought that a quantity of the drug Suxamethonium - a muscle relaxant - was retained in their cannula after the procedure. The cannula containing the drug was flushed on the ward by a nurse preparing to administer intravenous paracetamol around three hours after the patient had returned from his procedure. The event was witnessed by a doctor who immediately started manual ventilation. The patient began to breathe spontaneously a few minutes later and suffered no physical harm. However, they have been left with a significant psychological impact following their experience of being awake but unable to move or breathe.
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Content ArticleThe objective of this investigation was to understand the context of magnetic resonance imaging (MRI) scanning under general anaesthetic and how care may be reasonably adjusted for patients with autism or learning disabilities. The ‘reference event’ was Alice, a teenage girl who had autism. Sadly, Alice died following her MRI scan under general anaesthetic. The findings and conclusions of this investigation may be applicable to other non-invasive procedures carried out on patients who are under general anaesthetic.
