Download – Anaesthetic novice decision support algorithm (Update 2011)

Rachel Rogers and Alastair Hellewell

Download – Algorithm of managment of bronchospasm under anaesthesia (Update 2011)

Alex Looseley

Download – Peripheral intravenous cannulae (Update 2011)

The insertion of intravenous catheters is one of the most frequently performed procedures by anaesthetists. It is one of the major concerns of patients and can also provoke a significant stress response. This article describes different types of cannula, troubleshoot common problems with cannula insertion and consider how and when to use local anaesthetic drugs in adults.

Eoin Harty

Download – Fibreoptic intubation (Update_2011)

Awake fibreoptic intubation is a useful technique where difficult intubation is anticipated on the basis of airway examination or previous anaesthesia. Intubating fibrescopes are not universally available, but are increasingly found in resource poor settings as donated equipment. The indications, contraindications, equipment and preparation required for awake fibreoptic intubation are discussed. Sedation is desirable although not essential and the drugs used to achieve this depend largely on availability. Adequate anaesthesia of the airway is essential for a safe successful procedure and we describe our preferred technique along with alternatives.

Sarah Barnett, Irene Bouras, Simon Clarke

Download – Facemask anaesthesia (Update 2011)

Effective and safe use of the anaesthetic facemask is a core skill of the anaesthetist. It is used less for maintenance of anaesthesia in well resourced countries, having been largely superseded by the laryngeal mask airway (LMA). In resource poor settings drug and equipment availability have limited use of the LMA and so the choice for airway management in general anaesthesia remains facemask or endotracheal tube. This article outlines the roles of facemasks in anaesthesia and provides advice on overcoming pitfalls in their everyday use.

Nicholas Boyd and Anna Negus

Download – Cerebral challenge 5 (Update_2011)

Case histories to demonstrate interpretation of ECGs, Chest Xrays and head CT scans.

Suzanne Coulter and Louise Finch

Download – Bronchospasm during anaesthesia (Update_2011)

Bronchospasm is a relatively common event during general anaesthesia. Management begins with switching to 100% oxygen and calling for help early. Stop all potential precipitants and deepen anaesthesia. Exclude mechanical obstruction or occlusion of the breathing circuit. Aim to prevent/correct hypoxaemia and reverse bronchoconstriction. Consider a wide range of differential diagnoses including anaphylaxis, aspiration or acute pulmonary oedema.

Alex Looseley

Download – Anaesthetic decision making (Update 2011)

As a new trainee in anaesthesia one of the most important skills to acquire is anaesthetic decision making, in particular choosing the most suitable anaesthetic for a particular patient. We propose an algorithm that allows the novice trainee to conceptualise the process in a simple, logical and sequential way. Using this algorithm, we discuss certain key principles which will help guide these decisions.

Alastair Hellewell and Rachel Rogers

Download – Acute pain management for opioid tolerant patients (Update 2011)

Diagnosis and management of acute pain in opioid tolerant patients is challenging and is often poorly managed in the hospital setting. The evidence base for this group of patients is limited and guidelines are largely based on evidence from case studies, case reports and expert consensus. This article is a review of the current recommendations relating to this group of patients and outlines the approach to management of acute pain in the opioid tolerant patient by anaesthetists in the hospital setting.

Simon Marshall and Mark Jackson

This edition of Update contains articles on facemask anaesthesia, anesthetic decision making, fibreoptic intubation and cannulation.