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Found 116 results
  1. Content Article
    In this article in the APSF newsletter, Jeffrey Cooper discusses the importance of the anaesthetist and surgeon relationship and why a healthy collaborative relationship is vital for patient safety. He suggests a number of practical relationship building principles. "I’m not promising you a rosy world if you work at this. But I think it’s worth your time for your patients’ safety to try as much as you can. Doing nothing will mean nothing will change. If your efforts succeed, you’ll have made a huge advance for patient safety, and you’re likely to find more joy and meaning in your professional daily life."
  2. Content Article
    There 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.
  3. Content Article
    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.
  4. Content Article
    The 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. 
  5. Content Article
    The responsibility of anaesthetists in prescribing and administering controlled drugs has extended not only to the recovery room and intensive therapy unit, but also to acute and chronic pain services both in hospital and home care. These guidelines written by the Association of Anaesthetists recommend best practice for the safe preparation, distribution and disposal of controlled drugs to meet current clinical demands in peri-operative care.
  6. Content Article
    Anaesthetists are thought to be at increased risk of suicide amongst the medical profession. The aims of the following guidelines written by the Association of Anaesthetists are: increase awareness of suicide and associated vulnerabilities, risk factors and precipitants; to emphasise safe ways to respond to individuals in distress, both for them and for colleagues working alongside them; and to support individuals, departments and organisations in coping with a suicide.
  7. Content Article
    The location of care for many brain-injured patients has changed since 2012, following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, the Association of Anaesthetists have included an expanded section on paediatric transfers.  This guideline has also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of the recommendations. These guidelines remain a mix of evidence-based and consensus-based statements.
  8. Content Article
    In this article, Prof Chris Frerk, Consultant Anaesthetist at Northampton General Hospital and trustee of the Clinical Human Factors Group explains what to do when things don’t go according to plan and we can learn from airway events.
  9. Content Article
    In this video, Prof Kevin Fong, Consultant Anaesthetist at UCL (University College London) is joined in a panel discussion by three other experts in Human Factors and Ergonomics (HFE): Dr Fiona Kelly, Consultant Anaesthetist and Intensivist at Royal United Hospitals Bath and lead of the Difficult Airway Society (DAS) group on HFE Prof Chris Frerk, Consultant Anaesthetist at Northampton General Hospital and CHFG (Clinical Human Factors Group)Trustee Mr Clinton John, Operating Department Practitioner and Head for Clinical Education at UCLH. They will discuss and share their top tips about HFE in the context of airway management. This forms part of a free course from Future Learn Airway Matters course to  help others explore key concepts underlying safe, multidisciplinary airway management.
  10. Content Article
    Following the traumatic death of an anaesthetic trainee who was returning home after a night shift, the Fatigue Group supported by the Association of Anaesthetists and RCoA have surveyed UK trainees about shift working and fatigue. With a 60% response rate, the survey highlights a wide variation in access to rest facilities, commuting distances and concerning effects of fatigue on trainees.
  11. Content Article
    The 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. How can anaesthetists improve safety, prevent complications, and be prepared to manage difficulties when they arise? How, in a crisis, can we ensure that human and technical resources are best utilised? This free course from Future Learn, endorsed by the Difficult Airway Society, will provide answers to these 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.
  12. Content Article
    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.
  13. Content Article
    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.
  14. Content Article
    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.
  15. Content Article
    Dr Joanna Poole is an Anaesthetic trainee and a Doctors Association UK (DAUK) member. After sharing a blog on Twitter about wanting to quit medicine which went viral, Joanna has been inundated with messages from fellow doctors who have found themselves in a similar situation. Now, Joanna has been invited to share her experiences with multiple Royal Colleges and Joanna is collating the responses she has received anonymously in the hope this will inspire a kinder NHS for our doctors. Joanna is a force for change and is a real example for what grassroots doctors can achieve when they speak up.
  16. Content Article
    The Safe Anaesthesia Liaison Group (SALG) Patient Safety Updates contain important learning from incidents reported to the National Reporting and Learning System (NRLS). The RCoA and the AAGBI would like to bring these Safety Updates to the attention of as many anaesthetists and their teams as possible.  The updates are published quarterly and contain data from an earlier three month period. To join the safety network, and receive patient safety updates direct to your inbox, please contact the SALG administrator at admin@salg.ac.uk .
  17. Content Article
    The 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.
  18. Content Article
    This article from Peden et al. reviews of some of the key topics and challenges in quality, safety, and the measurement and improvement of outcomes in anaesthesia. Topics covered include medication safety, changes in approaches to patient safety, payment reform, longer term measurement of outcomes, large-scale improvement programmes, the ageing population, and burnout. The article begins with a section on the success of the specialty of anaesthesia in improving the quality, safety, and outcomes for our patients, and ends with a look to future developments, including greater use of technology and patient engagement.
  19. Content Article
    Surgical fires are fires that occur in, on or around a patient undergoing a medical or surgical procedure. Surgical fires are rare but serious events. The ECRI Institute estimates that approximately 550 to 600 surgical fires occur each year in the USA. The American Association of Nurse Anesthetists (AANA) is a collaborating partner of the FDA Preventing Surgical Fires Initiative. This initiative was launched to increase awareness of factors that contribute to surgical fires, disseminate surgical fire prevention tools, and promote the adoption of risk reduction practices throughout the healthcare community. 
  20. Content Article
    The pursuit of patient safety involves reducing the gap between best practice and the care actually delivered to patients. Understanding how to reliably deliver best practice care using established anaesthetic techniques may, today, be more important than seeking new ones. Advances in anaesthesia safety involve analysing failures and devising strategies to address these. However, anaesthetists do not work in isolation, and their contribution to the function of the multidisciplinary teams in which they work has far-reaching consequences for patient care.
  21. Content Article
    Inadequate access to anaesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations. A lack of anaesthesia care providers has been identified as a major contributing factor to the shortfall of surgical and obstetrical care in rural and remote areas of these countries. In this report, Orser et al. summarises the challenges facing the provision of anaesthesia services in rural and remote regions
  22. Content Article
    New research by Dr Sabine Nabecker and colleagues, published in the European Journal of Anaesthesiology, suggests surgery patients overwhelmingly prefer pre-surgical safety checklists to be completed in front of them, contrary to what is thought by doctors.  Since WHO launched the Safe Surgery Saves Lives Program in 2008, surgery checklists have minimised errors and improve patient safety worldwide. The WHO-approved Safe Surgery checklist includes asking the patient to confirm their name, procedure and consent, and the medical team to check that the anaesthesia machine and medication has been checked. The list also checks if patients have known allergies and if antibiotics have been administered in the previous 60 minutes, as is standard with many surgeries. "Anaesthesia professionals are often reluctant to use checklists in front of patients because they fear causing patients' discomfort before anaesthesia and surgery," explains Dr Nabecker. "Yet our study shows that patients overwhelmingly prefer to see the checklist completed in front of them."
  23. News Article
    An NHS hospital has admitted it failed to properly anaesthetise a patient who was operated on while conscious – leaving her with post-traumatic stress disorder (PTSD) and recurring nightmares. The woman, who has chosen to remain anonymous, said she screamed out as the gynaecological surgery at Yeovil District Hospital began to operate, but could not be heard through her oxygen mask as the surgeon cut into her belly button. Medical negligence lawyers said she was given a spinal rather than general anaesthetic during the procedure at the hospital in Somerset last year. She remained conscious while a laparoscope – a long camera tube – was placed inside her, and her abdomen was filled with gas. Her law firm Irwin Mitchell said that an increase in blood pressure had alerted staff to her discomfort, but that the procedure was continued. The woman, who is in her 30s, said: “While nothing will change what has happened to me, I just hope that lessons can be learned so no one else faces similar problems in the future." A spokeswoman for Yeovil Hospital said the incident was the result of “a breakdown of communication” which “led to the use of a different anaesthetic to that normally required for such an operation”. Read full story Source: The Independent, 10 December 2019
  24. Content Article
    In Calgary, each of the three acute-care adult hospitals had different anesthetic medication carts with their own type and layout of anaesthetic medications. A number of anaesthesiologists moved among the different sites, increasing the potential for medication errors. The objective of this study from Schultz et al., published in the Canadian Journal of Anesthesia, was to identify the anesthetic medications to include and to determine how they should be grouped and positioned in a standardised anesthesia medication cart drawer. Implementation of the standardised medication drawer is expected to reduce the likelihood of medication errors. Future research should include testing the clinical implications of this standardization and applying the methodology to other areas.
  25. Content Article
    What happens if a surgeon accidentally drops an instrument on the floor, picks it up and reuses, without it going through a steriliser? Should this be allowed to happen? Well it did! 
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