Anaesthetic Emergencies for Consultants
On December 1st and 14th 2016 we ran our anaesthetic emergencies course at the Bill Mapleson Centre for the first time. This was a half-day course aimed at consultants, although SAS staff are also welcome. Anaesthetists are no strangers to emergencies in general, but some emergencies may only be experienced a few times in a career. Also, many guidelines such as management of massive haemorrhage have recently been updated to take account of new evidence or new technologies such as near-patient monitoring of coagulation. There is obviously pressure on anaesthetists to perform well in what may be very stressful situations. Under such circumstances, recollection of correct management may be difficult. Many departments have guidelines for the management of these emergencies, but they tend to be over-comprehensive and are not always to hand. There is some evidence that the use of cognitive aids can have a big impact on the management of anaesthetic emergencies, particularly when they are being used by the team. They take pressure off recollection of the correct actions by the team leader when under stress, and help the team to anticipate what needs to be done next. Having a systematic approach to emergency management also helps. We also need to be able to successfully manage a team, and for this, regular human factors training using simulation is invaluable. Review of the current literature, use of cognitive aids, encouraging a systematic approach and human factors training using simulation are all features of the course, and they are provided in a non-threatening, constructive way that encourages participation and engagement. Feedback from participants in the first courses was very encouraging, and we are re-running the courses in 2017. For our initial courses, we included malignant hyperthermia, air embolism, anaphylaxis, massive blood loss, arrhythmia management and head injuries in the list of emergencies covered. There were some requests to include management of local anaesthetic toxicity, so we intend to include it in the planned courses in 2017, perhaps at the expense of arrhythmia management which is also covered in our ALS update course. Check the Bill Mapleson Centre website for further details of all our 2017 courses.