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E is for Emergencies. Dr Jane Lowery Anaesthetic Specialist Registrar & Walport Academic Clinical Fellow. Objectives. Define what constitutes an anaesthetic emergency Understand why emergencies occur Know how to prevent emergencies happening Know one approach to crisis management.
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E is for Emergencies Dr Jane Lowery Anaesthetic Specialist Registrar & Walport Academic Clinical Fellow
Objectives • Define what constitutes an anaesthetic emergency • Understand why emergencies occur • Know how to prevent emergencies happening • Know one approach to crisis management
Definition • An unexpected rapidly-evolving event requiring immediate intervention to prevent disaster • Can be simple or complex
Why do emergencies occur? • Patient factors • Anaesthetic factors • Surgical factors
How can we prevent emergencies occurring? • Optimise your environment, check equipment • Anticipate and plan • Take a leadership role & communicate effectively • Minimise distractions • Don’t rush • WHO surgical safety checklist
How do we approach the management of developing crisis? • Effective PRACTICAL and COMMUNICATION skills are the key! • Let people know - call for help! • Stay calm • Plan B or C possible? • Don’t Know?
AIMS StudyAnaesth Intensive Care 1993 Oct;21(5):520-8 • Australian Patient Safety Foundation • 90 hospitals • Anonymous & voluntary reporting • Unintended incidents which reduced patient safety • First 4000 reports indicated anaesthetists detected 7/8 critical events • SOS COVER ABCD A SWIFT CHECK
S- Stop • O- Oxygen • S- Shout for help • C- Colour, Circulation, Capnograph • O- Oxygen supply, Quantity • V- Ventilation • E- EET • R- Review equipment • ABC • D- Drugs • A- Anaphylaxis, Awareness, Air embolism • SWIFT CHECK- of patients, surgeons, surrounds
SOS ABCD A SWIFT CHECK • Cognitive aid • Allows us to systematically cycle through a basic series of thoughts and actions • Reduces prevalence and severity of incidents • Promotes patient safety awareness • Builds teamwork
Summary • Define what constitutes an anaesthetic emergency • Understand why emergencies occur • Patient, anaesthetic, surgical factors • Know how to prevent emergencies happening • Environment, distractions, communication, WHO checklist • Know one approach to crisis management • SOS COVER ABCD A SWIFT CHECK