Chapter
Risk assessment in clinical practice
Risk assessment in emergencies
Carrying out risk assessments
3 ECG monitoring in the recovery area
The information that ECG gives us
The relevance of ECG information to the patient in theatre
Attaching the patient to the monitor
Setting the alarms on the monitor
Reasons a patient's heart may develop rhythm problems
Clinical assessment of the patient in recovery
Classifying ECG disturbance
How does the patient appear?
What is the ventricular rate?
Are the complexes regular or irregular?
Do P waves precede all QRS complexes?
Are there more P waves than QRS complexes?
Is the QRS broad or narrow?
Narrow complex rhythm disturbances
Broad complex rhythm disturbances
Conduction problems which might lead to rhythm changes
First degree AV dissociation
Second degree AV dissociation (Wenkebach phenomenon)
Second degree AV dissociation (Mobitz type II)
Third degree AV dissociation
4 The use of cricoid pressure during anaesthesia
Applying cricoid pressure
Training the technique of cricoid pressure
5 Anaesthetic breathing circuits
Gas flow during inspiration and expiration in the Mapleson D system
Gas flow during inspiration and expiration in the Mapleson E system
6 Deflating the endotracheal tube pilot cuff
Manufacturers' recommendations
Examples of 'snapping of pilot tubes'
The mechanics of the problem
7 How aware are you? Inadvertent awareness under anaesthesia
8 Aspects of perioperative neuroscience practice
Related anatomy and physiology
Management of head injury
Pathways leading to the need for resuscitation
Chronic obstructive pulmonary disease
Simple airway obstruction
Haemothorax (penetrating/blunt trauma)
Haemothorax (penetrating/blunt trauma)
Non-shockable cardio-respiratory arrest
Pulseless electrical activity
Broad complex tachycardia
Narrow complex tachycardia
Stable narrow complex tachycardia
Irregular narrow complex tachycardia
Notable anatomical and physiological differences
10 Intravenous induction versus inhalation induction for general anaesthesia in paediatrics
11 Managing difficult intubations
Area A: relative tongue/pharyngeal size
The revised Mallampati classification
Area B: the mandibular space
Area C: mobility of the atlanto-axial and TM joints
Alternative laryngoscope blades
Flexible fibreoptic bronchoscopic intubation (FBI)
Management of the unexpected failed intubation
Awake intubation technique
13 Understanding blood gases
Sampling arterial blood gases
The oxygen-haemoglobin dissociation curve
Clinical example of compensation
Disturbances of acid-base balance
The step-by-step guide to ABG analysis
Scenario 1 - Metabolic acidosis with respiratory compensation
Scenario 2 - Respiratory alkalosis (uncompensated)
14 Total intravenous anaesthesia
What's so new about TIVA?
Pharmacokinetics and pharmacodynamics
How are drug levels maintained at the correct level?
Awareness and depth of anaesthesia
Components of a TCI system
15 Anaesthesia and electro-convulsive therapy
The conditions that ECT is used to treat
Anaesthetic considerations for those undergoing a course of ECT
The care of a patient pre-, intra- and post-ECT
16 Mechanical ventilation of the patient
Indications for ventilation
Types and modes of ventilation
Controlled mechanical ventilation (CMV)
Synchronised mandatory ventilation (SIMV)
Bi-phasic positive airway pressure (BIPAP)
Assisted spontaneous breathing (ASB)
Positive end expiratory pressure (PEEP)
Non-invasive positive pressure ventilation (NIPPV)
Continuous positive airway pressure (CPAP)
Guidelines for weaning from a ventilator
Monitoring during transport
Risks of mechanical ventilation
Ventilator-associated pneumonia (VAP)
17 Perioperative myocardial infarction
Perioperative morbidity and mortality
Pathogenesis of acute coronary syndromes (ACS)
Clinical features of perioperative myocardial infarction (PMI)
Perioperative clinical evaluation and risk assessment
Electrocardiography (ECG)
18 Developing a portfolio
The portfolio as a professional requirement
Data and evidence collection
Using the portfolio when applying for a job
Using evidence to claim accreditation for prior learning and experience
Performance review and personal development
The portfolio as a form of assessment
19 Accountability in perioperative practice
Towards a consensus - recognising the importance of accountability
Accountability and responsibility
Primary and delegated legislation
Common law principles and judicial interpretation
Criminal and civil law principles
Criminal accountability in practice
Civil negligence and the anaesthetic practitioner
Testing for a breach in care
Statutory professional accountability
Dealing with an allegation
Conduct and competence and health committees
Appreciating employment law
The contract of employment
Accountability in summary
Core Topics in Operating Department Practice
：Anaesthesia and Critical Care
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