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Emergency Crisis Management in Anaesthesia: Human Factors and Strategies 2019

Explore the principles of crisis management in anaesthesia, focusing on critical incidents and emergencies. Enhance your understanding of human factors and crisis resource management to prevent and manage complex situations effectively. Learn how to apply Crew Resource Management (CRM) principles and the SOS COVER ABCD approach in emergency situations. Discover key strategies to improve performance, reduce errors, and ensure patient safety in anaesthetic practice. Benefit from insights on risk assessment, simulation-based education, debriefing, and challenging authority in the operating room environment. Take home valuable messages on crisis management resources and incorporating CRM principles into practice for optimal outcomes.

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Emergency Crisis Management in Anaesthesia: Human Factors and Strategies 2019

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  1. An Introduction to Anaesthesia 2019 Emergencies Dr Dermot McGuckin SpR in Anaesthesia UCL Hospitals

  2. E is for Emergencies An introduction to crisis management Anaesthetic emergencies & critical incidents Human Factors & Crisis Resource Management Strategies for prevention & management

  3. AAGBI.org

  4. Simulation video

  5. Ann Intern Med 2005; 142(9):756-764.

  6. Crises & emergencies in Anaesthesia • Unexpected, rapidly-evolving events requiring immediate intervention to prevent disaster • Simple / Complex • Challenging & stressful situations • Interplay of patient, anaesthetic & surgical factors • May be attributable to characteristics of the human condition • Prevention better than cure

  7. “The important question isn't how to keep bad physicians from harming patients; it's how to keep good physicians from harming patients.” Atul Gawande Complications: A Surgeon’s Notes on an Imperfect Science

  8. “Miracle on the Hudson”

  9. Flight 1549 video

  10. Crew Resource Management • CRM training has its origins in the late 1970s following a string of serious aviation accidents • Incidents were more frequently related to pilots' non-technical & communication skills rather than technical flying abilities or aircraft malfunctions

  11. Crew Resource Management Chest 2009;136(3):910-17

  12. SOS COVER ABCD – A SWIFT CHECK • Stop • Oxygen • Shout for help • Circulation, Capnograph & Colour (saturation) • Ventilation & Vapourisation • Endotracheal tube & Eliminate machine • Review monitors & equipment • Airway • Breathing • Circulation • Drugs (consider all given & not given) • Be Aware - Allergy, Air • SWIFT CHECK of patient, surgeon, process, responses

  13. Error classification system from CRM principles Chest 2009;136(3):910-17

  14. Elaine Bromily video

  15. Fixation Error

  16. Fixation Error Anaesthesia 2010;65(1):61-69

  17. Das.uk.com

  18. Anaesthesia & Patient Safety • Risk assessment & stratification and pre-operative optimisation • Safety science • Simulation-based education & training • Development, implementation & promotion of checklists • Debriefing colleagues after they have experienced such challenging events • Challenging authority & speaking up in the OR environment • National audits, reporting & learning • Black-box recording in the OR • Impact of fatigue

  19. E is for Emergencies Take home messages: Crisis management resources on AAGBI.org Build CRM principles into your practice to improve performance & reduce error Get skilled at Human Factors: guidelines & protocols, courses, simulation & team training, checklists, incident reporting, alerts and M&M An introduction to crisis management • Special thanks to Dr Jane Lowery (Consultant Anaesthetist, RFH) and colleagues from Central London School of Anaesthesia

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