MedWorm: Royal College of Anaesthetists

One year on from NAP3: dissemination and clinical changes after the Third National Audit Project of the Royal College of Anaesthetists

British Journal of Anaesthesia — Wed, 16 Nov 2011 05:00:00 +0100

Conclusions The results of the NAP3 report have been disseminated to the vast majority of UK anaesthetic departments and to the individual anaesthetists supervising the project in those hospitals. NAP3 has led to changes in practice by the majority of hospitals and by many of the anaesthetists surveyed. (Source: British Journal of Anaesthesia)

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Therapeutic hypothermia for out-of-hospital cardiac arrest: implementation in a district general hospital emergency department

Emergency Medicine Journal — Fri, 14 Oct 2011 04:00:00 +0100

Conclusions Among OHCA patients who met recognised inclusion criteria, therapeutic hypothermia was implemented successfully by the ED staff. The temperature should be measured continuously from the same site in both the ED and the ICU. This will provide consistent and continuous temperature monitoring between the ED and the ICU and will enable prompt intervention to prevent temperature increases. (Source: Emergency Medicine Journal)

Adult difficult airway equipment in the emergency department

Emergency Medicine Journal — Fri, 14 Oct 2011 04:00:00 +0100

The Fourth National Audit Project by the Royal College of Anaesthetists revealed a significant number of major airway events in the emergency department (ED), a third of which resulted in death or severe neurological damage.1 This was due to repeated inadequacies in care including the planning and provision of airway equipment. The Royal College of Anaesthetists recommends that difficult airway equipment immediately available in EDs should be similar to that in operating theatres. We audited the availability of difficult airway equipment in Croydon University Hospital (2011) and East Surrey Hospital (2009) and found discrepancies in the EDs compared with the operating theatres. For example, one ED had only one type and size of facemask and laryngeal mask airway, and standard cannulas for n...

Out-of-theatre tracheal intubation: prospective multicentre study of clinical practice and adverse events

British Journal of Anaesthesia — Thu, 13 Oct 2011 04:00:00 +0100

Conclusions Out-of-theatre intubation frequently occurs in the absence of essential safety equipment, despite the existing guidelines. The associated adverse event rate is high. (Source: British Journal of Anaesthesia)

Abstracts of the Free paper/Poster presentations of the Royal College of Anaesthetists Inaugural Annual Congress: Royal Geographical Society, London, UK, May 5-6, 2011

British Journal of Anaesthesia — Wed, 13 Jul 2011 23:00:00 +0100

(Source: British Journal of Anaesthesia)

Results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: Intensive Care and Emergency Departments

Medscape Today Headlines — Wed, 08 Jun 2011 11:04:44 +0100

At least one in four major airway events in a hospital are likely to occur in ICU or the ED. The outcome of these events is particularly adverse. British Journal of Anaesthesia (Source: Medscape Today Headlines)

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Results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia

Medscape Today Headlines — Wed, 25 May 2011 11:04:39 +0100

Airway management is fundamental to safe anaesthetic practice and is usually uncomplicated, but when problems do occur the consequences can be serious. British Journal of Anaesthesia (Source: Medscape Today Headlines)

Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia

British Journal of Anaesthesia — Thu, 14 Apr 2011 23:00:00 +0100

Conclusions Although these data suggest the incidence of death and brain damage from airway management during general anaesthesia is low, statistical analysis of the distribution of reports suggests as few as 25% of relevant incidents may have been reported. It therefore provides an indication of the lower limit for incidence of such complications. The review of airway management indicates that in a majority of cases, there is ‘room for improvement’. (Source: British Journal of Anaesthesia)

Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: intensive care and emergency departments

British Journal of Anaesthesia — Thu, 14 Apr 2011 23:00:00 +0100

Conclusions At least one in four major airway events in a hospital are likely to occur in ICU or the ED. The outcome of these events is particularly adverse. Analysis of the cases has identified repeated gaps in care that include: poor identification of at-risk patients, poor or incomplete planning, inadequate provision of skilled staff and equipment to manage these events successfully, delayed recognition of events, and failed rescue due to lack of or failure of interpretation of capnography. The project findings suggest avoidable deaths due to airway complications occur in ICU and the ED. (Source: British Journal of Anaesthesia)

Anesthesia Complications Twice As Likely in Obese

Modern Medicine — Wed, 13 Apr 2011 23:00:00 +0100

Airway management is a basic anesthetic responsibility and skill, and strategies need to be implemented to appropriately manage difficult airways, according to the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society, published online March 29 in the British Journal of Anaesthesia. (Source: Modern Medicine)

Proceedings of the Anaesthetic Research Society Meeting: The Royal College of Anaesthetists, London, UK, November 11-12, 2010

British Journal of Anaesthesia — Fri, 11 Feb 2011 00:00:00 +0100

(Source: British Journal of Anaesthesia)

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National census of airway management techniques used for anaesthesia in the UK: first phase of the Fourth National Audit Project at the Royal College of Anaesthetists

British Journal of Anaesthesia — Thu, 13 Jan 2011 00:00:00 +0100

Conclusions The second stage of NAP4 is designed to register and collect details of each major airway complication from the same hospitals over a 12 month period. The individual case reports will produce the numerator to calculate the incidence of airway complications associated with general anaesthesia in the UK. The results of the census presented here will provide the denominator. (Source: British Journal of Anaesthesia)

CUSUM analysis to assess competence: what failure rate is acceptable?

The Clinical Teacher — Wed, 17 Nov 2010 16:06:41 +0100

Discussion: Our study shows that CUSUM analysis can be successfully used for the continued assessment of competence in experienced trainees. It also shows that setting different failure rates can produce different results, leading to confusion and inconsistency when comparing CUSUM results. With the increasing use of CUSUM analysis, we believe that the organisations responsible for training, such as the Royal College of Anaesthetists, should provide guidance on what is an acceptable failure rate for different procedures, such as the administration of an epidural during labour, at different stages of training. (Source: The Clinical Teacher)

Nursing representative elected to Royal College of Anaesthetists

Nursing Times Breaking News — Sat, 30 Oct 2010 07:00:00 +0100

Critical care nurse practitioner Carole Boulanger of the Royal Devon and Exeter Foundation Trust has been elected to represent advanced critical care practitioners nationally in the Royal College of Anaesthetists. (Source: Nursing Times Breaking News)

Maternal critical care: what’s in a name?

International Journal of Obstetric Anesthesia — Mon, 13 Sep 2010 23:00:00 +0100

The Intensive Care National Audit and Research Centre (ICNARC), an organisation collecting and analysing data from adult general critical care units in the UK, recently published a detailed report on the admission of currently and recently pregnant women to participating units in 2007. The report was commissioned by the Joint Standing Committee (JSC) of the Royal College of Anaesthetists and Royal College of Obstetricians and Gynaecologists, together with the Obstetric Anaesthetists’ Association (OAA), as it has long been recognised that, although there are useful data from 50 years of maternal mortality reports resulting in recommendations that have improved maternity care, data are also needed on sick mothers who do not die. Whilst the ICNARC report provides useful information on women...

The principles of paediatric anaesthesia

Anaesthesia and intensive care medicine — Mon, 31 May 2010 23:00:00 +0100

This article provides an overview of paediatric anaesthetic practice in the UK. The safe provision of paediatric anaesthesia, as recommended by the Royal College of Anaesthetists, requires the delivery of a ‘comprehensive quality service dedicated to the care of patients and the education and professional development of staff.’ The article describes the provision of paediatric services in the UK, the conduct of practical paediatric anaesthesia and the principles behind fluid management and the treatment/prophylaxis of postoperative nausea and vomiting. (Source: Anaesthesia and intensive care medicine)

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Proceedings of the Anaesthetic Research Society Meeting: The Royal College of Anaesthetists, London, UK * December 3-4, 2009

British Journal of Anaesthesia — Fri, 12 Mar 2010 16:46:22 +0100

(Source: British Journal of Anaesthesia)

Conversion of regional to general anaesthesia at caesarean section: increasing the use of regional anaesthesia through continuous prospective audit

International Journal of Obstetric Anesthesia — Wed, 03 Mar 2010 00:00:00 +0100

Abstract: Background: Anaesthetic-related maternal deaths have largely been attributed to complications of general anaesthesia. In our unit a retrospective audit conducted between 1997 and 2002 showed a 9.4% conversion rate to general anaesthesia for caesarean sections amongst women with epidural catheters in-situ. The Royal College of Anaesthetists has stated that (Source: International Journal of Obstetric Anesthesia)

Complications of regional anaesthesia

Anaesthesia and intensive care medicine — Tue, 23 Feb 2010 13:41:16 +0100

Abstract: Complications of regional anaesthesia can be divided into those specific to central neuraxial blockade, those specific to peripheral nerve blockade, and those that pertain to both. Fortunately, severe complications – namely, spinal cord damage, vertebral cord haematoma and epidural abscess – are rare. Here, with reference to updated incidences available following the Third National Audit Project (NAP3) of the Royal College of Anaesthetists, an overview of these complications of regional anaesthesia is given. A thorough knowledge of anatomy and pharmacology, and a meticulous, unhurried technique are essential to prevent such complications. When considering the use of a regional anaesthetic technique, the risks and benefits for that patient should be assessed on a case-by-case ...

Training and the European Working Time Directive: a 7 year review of paediatric anaesthetic trainee caseload data

British Journal of Anaesthesia — Thu, 10 Sep 2009 23:00:00 +0100

Conclusions Since the implementation of the WTD, there has been a significant reduction in the number of cases performed by SpRs in paediatric anaesthesia and they are no longer achieving the RCoA recommended minimum numbers for advanced training. (Source: British Journal of Anaesthesia)

Training in pediatric anesthesia for registrars--UK National survey.

Paediatric Anaesthesia — Sat, 22 Aug 2009 04:44:41 +0100

CONCLUSIONS: It will be necessary to increase the duration of modular training with the implementation of EWTD. Modular training in pediatric anesthesia should be provided as a dedicated and protected module. Training opportunities in DGHs are limited. There is also a need for new guidelines, as current guidelines regarding pediatric anesthesia training will be outdated with the implementation of EWTD. PMID: 19691694 [PubMed - in process] (Source: Paediatric Anaesthesia)

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Rapid sequence induction anaesthesia: A guide for nurses in the emergency department

International Emergency Nursing — Tue, 30 Jun 2009 23:00:00 +0100

Abstract: Emergency rapid sequence induction (RSI) anaesthesia is the cornerstone of emergency airway management performed on patients in the emergency department (ED). The Royal College of Anaesthetists has stated that anaesthesia should not proceed without a skilled, dedicated assistant. It is essential that ED nurses are educated, skilled and competent to assist with RSI in the ED. (Source: International Emergency Nursing)

An evaluation of the performance in the UK Royal College of Anaesthetists primary examination by UK medical school and gender.

BioMed Central — Sun, 28 Jun 2009 23:00:00 +0100

Conclusions: Graduates from each of the medical schools in the UK do show differences in performance in the MCQ section of the primary FRCA, but significant curriculum change does not lead to deterioration in post graduate examination performance. Whilst females now outnumber males taking the MCQ, they are not performing as well as the males. (Source: BioMed Central)

The Royal College Of Anaesthetists Launches E-Learning Initiative

Health News from Medical News Today — Tue, 02 Jun 2009 12:00:00 +0100

The Royal College of Anaesthetists, the professional body representing anaesthesia in the UK, is introducing an interactive e-Learning resource to support training and professional development in anaesthesia. The programme will be launched by the President of the College, Dr Judith Hulf, at its annual College Tutors conference on 11 June, 2009. (Source: Health News from Medical News Today)

Introduction of “international syringe labelling” in the Republic of Ireland

Irish Journal of Medical Science — Wed, 13 May 2009 05:56:27 +0100

Discussion Future action should focus on practical, common sense interventions including techniques such as those that reduce reliance on memory, standardization, the use of protocols and checklists, and the elimination of look-alike products. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11845-009-0342-4Authors J. Shannon, BC Women’s Hospital Vancouver CanadaS. O’Riain, Mid-Western Regional Hospital Limerick Ireland Journal Irish Journal of Medical ScienceOnline ISSN 1863-4362Print ISSN 0021-1265 (Source: Irish Journal of Medical Science)

Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists

British Journal of Anaesthesia — Fri, 16 Jan 2009 05:00:00 +0100

Conclusions The data are reassuring and suggest that CNB has a low incidence of major complications, many of which resolve within 6 months. (Source: British Journal of Anaesthesia)

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RCOG Releases Standards In Maternity And Gynaecology, UK

Pregnancy News From Medical News Today — Wed, 02 Jul 2008 09:00:00 +0100

The Royal College of Obstetricians and Gynaecologists (RCOG) releases two important documents focusing on women's healthcare. The documents are: - Standards for Maternity Care. A report from a working party, jointly produced by the RCOG, and Royal College of Anaesthetists, Royal College of Midwives, and Royal College of Paediatrics and Child Health. (Source: Pregnancy News From Medical News Today)

The Faculty of Pain Medicine of the Royal College of Anaesthetists

British Journal of Anaesthesia — Fri, 13 Jun 2008 04:00:00 +0100

(Source: British Journal of Anaesthesia)

Royal College of Anaesthetists

RDFunding RSS feed — Sat, 24 May 2008 15:35:24 +0100

BJA/RCoA Project Grants Amount: £10K - £50K Closing Date : 25 July 2008 (Source: RDFunding RSS feed)

Survey of general paediatric surgery provision in England, Wales and Northern Ireland.

Annals of the Royal College of Surgeons of England — Tue, 01 Apr 2008 04:00:00 +0100

DISCUSSION: Almost 10 years ago, a change in the training of young surgeons took place. An increase in training posts in Tertiary centres was made available following advice from the British Association of Paediatric Surgeons (BAPS) but these posts were often not taken up. Many DGH surgeons became uncertain whether they should continue GPS training. A subtle change in the wording of the general guidance by the Royal College of Anaesthetists altered the emphasis on the age at which it was appropriate to anaesthetise children. Change in clinical practice, reducing need, and a drift towards tertiary centres has reduced DGH operations by 30% over a decade. Young surgeons are now seldom exposed to this surgery, and are not being trained in it. The large volume of these low-risk operations in we...

National Institute for Academic Anaesthesia launched

NHS Networks — Tue, 11 Mar 2008 12:56:20 +0100

The newly established National Institute for Academic Anaesthesia (NIAA) is a partnership of the four main national academic bodies in UK anaesthesia, namely The Association of Anaesthetists of Great Britain & Ireland (AAGBI), Royal College of Anaesthetists (RCoA) and the scientific journals Anaesthesia and British Journal of Anaesthesia. The aims of the new National Institute are to: improve patient care by promoting the translation of research findings into clinical practice facilitate high profile, influential research support training and continuing professional education in academic anaesthesia enhance the academic profile of anaesthesia within the healthcare profession, NHS, Universities and major research bodies. The first meeting of the NIAA took place on 19...

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Second UK Critical Care Concentrations Survey - request to participate

NeLM Headline News — Fri, 29 Feb 2008 00:00:00 +0100

A national project that is aiming to standardise drug infusion concentrations in critical care across the UK is conducting a second survey into the area. The project is multi-professional and has the backing of a wide range of NHS and Professional organisations. It is hoped that the majority of UK critical care units will take part, increasing the validity of the findings. More information can be found on the website of the Royal College of Anaesthetists. The survey closes on 28th March 2008. (Source: NeLM Headline News)

A national census of central neuraxial block in the UK: results of the snapshot phase of the Third National Audit Project of the Royal College of Anaesthetists*

Anaesthesia — Wed, 16 Jan 2008 10:26:22 +0100

Anaesthesia, Volume 63, Issue 2, Page 143-146, February 2008. SummaryThe first stage of the Royal College of Anaesthetists Third National Audit Project to assess the incidence of major complications of central neuraxial block in the UK was a 2-week national census of block use. A reporting system was established in ... (Source: Anaesthesia)

Safer childbirth : minimum standards for the organisation and delivery of care in labour

Tue, 30 Oct 2007 03:30:01 +0100

This document was published in October 2007 by the Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM), Royal College of Anaesthetists (RCoA) and the Royal College of Paediatrics and Child Health (RCPCH). It sets out the organisations' views regarding the essential minimum standards needed to support labouring women and to provide safe care for them and their babies. The report acknowledges the importance of midwives' autonomy in facilitating normal childbirth, in partnership with obstetricians, anaesthetists and paediatricians and stresses the need for effective team working. It aims to encourage a greater focus on woman-centred care and addresses the crisis in midwifery recruitment and retention. The report also recommends that the maternity network ...

New work programme to improve safety in anaesthetic services

NHS Networks — Thu, 25 Oct 2007 09:30:20 +0100

A key programme of work to improve safety in anaesthetic services has been announced by the National Patient Safety Agency at a conference opened by HRH the Princess Royal. The project will be outlined at 'Safety in Clinical Practice', a two day conference hosted jointly by the Royal College of Anaesthetists (RCoA) and the Association of Anaesthetists of Great Britain and Ireland where speakers will include NPSA Chief Executive Martin Fletcher. The Agency has embarked on four collaborative projects with differing Royal Colleges to improve patient safety in the relevant specialities. ‘Anaesthesia: Improvement through Partnership’ is a two year project led by the Royal College of Anaesthetists. The project will focus on: Developing a speciality based reporting system to...

NPSA announces programme of work to improve safety in anaesthetic services

NeLM Headline News — Fri, 19 Oct 2007 00:00:00 +0100

The National Patient Safety Agency has announced a programme of work to improve safety in anaesthetic services. The agency has embarked on four collaborative projects with differing Royal Colleges to improve patient safety in the relevant specialities. ‘Anaesthesia: Improvement through Partnership’ is a two year project led by the Royal College of Anaesthetists. The project will focus on: • Developing a speciality based reporting system to improve critical incident reporting by providing a single point of entry for data submission. • Patient safety incidents arising from errors during the administration of injectable drugs • The management of throat packs and in particular their retention following surgery. (Source: NeLM Headline News)

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Recommendations for safe organisation of care during labour and birth

NHS Networks — Mon, 15 Oct 2007 14:35:03 +0100

New recommendations on standards for the safe organisation of care during childbirth have been issued by the Royal Colleges of Anaesthetists (RCOA), Midwives (RCM), Obstetricians and Gynaecologists (RCOG), and Paediatrics and Child Health (RCPCH). The joint document, Safer Childbirth: Minimum Standards for the Organisation and Delivery of Care in Labour, provides clear and concise information about the roles and essential minimum staffing levels required to support and deliver safe care to women in labour and their babies. Underpinning the guideline is the need for good working relationships between a multi-disciplinary maternity team of midwives, obstetricians, anaesthetists, paediatricians, as well as support and managerial staff. Also of paramount importance is the expansion in number...

What is the best treatment for post-operative sore throat following tracheal intubation? Sore throat has been present for over one month since removal of tube.

NLH Question Answering Service — Thu, 20 Sep 2007 16:43:47 +0100

Unfortunately, we have been unable to locate any evidence on guidance on this topic. The nearest we came to was a 2006 Royal College of Anaesthetists patient information leaflet on post-operative sort throat [1]. (Source: NLH Question Answering Service)

Joint Royal Colleges Ambulance Liaison Committee Annual Conference

NHS Networks — Thu, 30 Aug 2007 15:11:08 +0100

The Joint Royal Colleges Ambulance Liaison Committee (JRCALC) holds its Annual Conference on Tuesday 27 November at the Royal College of Anaesthetists, Churchill House, Red Lion Square, London. Each year JRCALC holds a conference for those involved in out-of-hospital care with an ambulance clinical focus. The event provides an educationally-recognised opportunity for paramedics, doctors, nurses and all those involved in delivering care “at the sharp end” to get together and discuss challenges, research and controversial topics in the conducive surroundings of a leading London Royal Medical College. For the first time, JRCALC is working in conjunction with the 999 EMS Research Forum and the British Paramedic Association to bring added value to what is already a popular event. ...

Toolkit to support the introduction of non-medical Anaesthesia Practitioners

NHS Networks — Fri, 18 May 2007 09:21:15 +0100

A new toolkit designed to support the introduction of non-medical Anaesthesia Practitioners has been made available for download. It is the result of four years’ collaborative work between the Royal College of Anaesthetists and the National Practitioner Programme that has focused on exploring new ways of working, implementing the role and developing and refining the training programme. The toolkit should be used with the Anaesthesia Practitioner Curriculum Framework, which supports the commissioning process for the educational delivery of the national learning programme, and together they will provide essential support to employers in developing this new and important role through to its full potential to enhance our services to patients. Toolkit (PDF, 558K) Anaesthesia P...

Anaesthesia Postoperative care

studentBMJ: Contents RSS Feed — Sat, 31 Mar 2007 16:10:01 +0100

"All patients who have had an operation under either regional or general anaesthesia are in a potentially unstable cardiorespiratory state." Jonathan M Behar and colleagues explain this statement from the Royal College of Anaesthetists (Source: studentBMJ: Contents RSS Feed)

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Responses to the White Paper 'Trust, Assurance and Safety'

NHS Networks — Thu, 22 Feb 2007 11:34:12 +0100

Below are some of the responses to yesterday's White Paper, 'Trust, Assurance and Safety - The Regulation of Health Professionals'. Links to additional responses can be submitted to the Website Editor and will be added as they become available. British Medical Association Synopsis and analysis of the White Paper by the BMA's Health Policy, Economics and Research Unit Council for Healthcare Regulatory Excellence (Word, 48KB) General Medical Council Health Professions Council King's Fund NHS Employers Royal College of Anaesthetists Royal College of Obstetricians and Gynaecologists Royal College of Ophthalmologists Royal College of Paediatrics and Child Health (PDF, 22KB) Royal College of Physicians Royal College of Surgeons of Englan...

Joint Committee on Good Practice (Royal College of Anaesthetists)

Clinical Governance Sitewide RSS Feed — Fri, 11 Aug 2006 19:15:02 +0100

Webpages include a series of guidance documents for local use and adaptation. They are: - Appraisal Folder - (Source: Clinical Governance Sitewide RSS Feed)