PS55 2012: Minimum safe facilities for anaesthesia

 

List:

·         Staff

·         Facilities

·         Systems

·         Equipment

·         Drugs

·         Special location

 

Staff:

Operating rooms

·      Anaesthesia assistant

·      ≥3 people for positioning the patient (anaesthetist for airway/head/neck)

Department

·      Anaesthetist(s) in charge of equipment purchasing and management

·      Anaesthesia technician: in charge of equipment maintenance

 

 

Facilities:

·         Operating room

·         Recovery area (see PS04)

·         Uninterruptable power source

·         Emergency lighting

·         Intercom to communicate emergency calls

·         Refrigeration for fluid, blood, biological products

·         Climate control 18-28°C

 

Systems for the following:

·         Replacement of drug stock

·         Decontamination of equipment

·         Checking of equipment

·         Routine servicing of equipment

·         Evacuation of theatre complex

 

Equipment:

Proper anaes machine

·      Selective gas delivery

·      Controlled and calibrated gas flow rate

·      Controlled and calibrated vapourisers

·      Circle circuit +/- T piece circuit

·      Mechanical ventilator

·      HME filters for sterility

·      Scavenging

·      Alarms for high/low pressure, hypoxia

·      (TIVA infusion pumps)

Extra airway stuff

·      Range of sizes where appropriate

·      Manual bag & mask resuscitator

·      Suction + Yankeur + catheters for anaesthesia use only

·      Face masks / OPA / NPA / LMA

·      ETT / stylets / bougies /connectors

·      Two laryngoscopes / blades

·      Cuff inflating syringe

·      Tapes and scissors

·      Sterile lubricant jelly

·      Magill's forceps and throat packs

·      Adhesive tapes

IV stuff

·      Range of sizes where appropriate

·      Cannulae / bungs / dressings / alcohol wipes / tourniquets

·      IV giving sets including pump sets

·      Crystalloid

Monitoring (see PS18)

·      Stethoscope

·      BP cuff

Protective stuff

·      Temperature control: blankets, forced air warmer/cooler

·      Positioning: arm boards etc

·      Transfer: slideboard, slidesheet

·      Pressure care: head rings, gel or foam pads

Other emergency stuff

·      Defibrillator / cardioverter

·      Chest drain kits

·      Difficult airway equipment (if intubation common)

·      ABP and CVP measurement kits (if sick patients or major surgery

PPE

·      Gowns

·      Gloves

·      Masks

·      Goggles

Waste disposal

·      Ordinary

·      Biological fluid

·      Sharps

 

Drugs for the following conditions:

Cardioresp

·      Adrenal dysfunction

·      Anaphylaxis

·      Bronchospasm

·      Cardiac arrest

·      Cardiac arrhythmias

·      Hypotension

·      Hypertension

·      Respiratory depression

Drug

·      Local anaesthetic systemic toxicity

·      Malignant hyperthermia

o  24-36 x 20mg ampoules

o  Depends upon size and location of hospital

Other

·      Hypoglycaemia

·      Hyperglycaemia

·      Uterine atony

·      Raised ICP

 

Special locations:

Labour ward

·      Midwife present during and available after epidural insertion

·      If Entonox then O2 ≥30%

·      Neonatal resus equipment

o  Dedicated O2 and suction

o  Bag+mask / guedel / ETT / laryngoscope

o  IV cannula kit / IV fluid / drugs

o  Temp control e.g. radiator

ECT

·      Spont and mech breathing system

·      Oxygen source

·      Emergency backup for each of the above

·      O2 failure warning device

·      Backup breathing system

Dental

·      Chair must turn into a bed

Medical imaging

·      Consider the impact of there being minimal space

 

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