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Comprehensive Guide to Anaesthesia: History, Procedures, and Patient Safety

Dr. Andrew Badacsonyi, Consultant Anaesthetist, presents a detailed overview of anaesthesia for medical students, covering perioperative medicine, preoperative assessment, equipment, procedures, and safety protocols. Learn about pre-op, intra-op, and post-op care, practical procedures, and risk assessment techniques, including the ASA status classification. Explore the importance of vigilance, airway management, and patient safety in anaesthesia practice. Access valuable resources, lectures, tutorials, and assessment tools for a well-rounded understanding of this critical field.

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Comprehensive Guide to Anaesthesia: History, Procedures, and Patient Safety

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  1. Dr Andrew Badacsonyi Consultant Anaesthetist Welcome to Anaesthesia!

  2. History • Perioperative medicine • Preoperative assessment • Equipment • Procedures • Safety

  3. PERIOPERATIVE MEDICINE PRE-OP INTRA-OP POST-OP

  4. Anaesthesia for medical students • Pre-operative care • drugs, fluids, monitoring • care of the unconscious patient • post-operative care including analgesia, intravenous fluid management, and management of common complications • Practical procedures

  5. PRE-OP

  6. Aims of Pre-assessment • Screen for unknown conditions • Assess and optimise known medical problems • Assess risk • Anticipate complications Reduce risks of anaesthetic and surgery to a minimum

  7. Where? By whom? How urgent is the surgery? Anaesthetic clinical assessment – what questions?? History examination investigations consent plan Airway – assessment and plan

  8. Mallampati

  9. Who does it??

  10. Why is it important? Consider: You are clerking a patient evening before THR (on waiting list 6/12) • Pt has Fe def anaemia - Hb is 7.8 • Pt on diuretics - K is 2.7 • Pt on warfarin for AF – INR is 3.1 • Pt says they have worsening SOB on exertion for 3/12 – now housebound • ECG – heart rate is 135/min

  11. ASA status American Society of Anesthesiologists • Normal healthy patient • Mild to mod. systemic disease. No functional limitation • Severe systemic disease with limitation of normal function • Severe systemic disease that is a constant threat to life • Moribund patient unlikely to survive 24 hours with or without operation

  12. INTRA-OP

  13. “The most important monitor employed by the anaesthetist during anaesthesia is his/her own vigilence.”

  14. Not just observation.. • ... A very practical specialty!

  15. Anaesthesia = Airway!! (anywhere anytime, no if’s no but’s!)

  16. Anaesthesia for medical students • Theatre lists • Lectures • Tutorials • Website (google ‘ucl anaesthesia students’) • Articles + podcasts • student workbook • Assessment CBD

  17. Anatomy Physiology Pharmacology Physics Equations Intravenous (real time) medicine Risks (balance of) Clinical skills Patient safety Consent Capacity Communication

  18. Patient safety (Risk) • Wrong site surgery • Drug error • Surgical site infection • Procedural complication • Human factors (technical/non-technical) • Equipment • Organisational/system issues • Personal safety • sharps practice /body fluids/ radiation/back injury

  19. Anaesthesia • Local • Regional • Sedation • General • Pros v cons ??

  20. General Anaesthesia

  21. General Anaesthesia • Induction (inject vs inhale) • Maintenance (inject vs inhale) • Emergence • Recovery • Full stomach??  Rapid sequence

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