NAP and Guidelines

Question 1

What was NAP 7 - what are the key points

Answer 1

Looked into perioperative cardiac arrest

Incidence 1:3000

75% survived arrest, 44% survived until discharge

Most common causes:
1. Haemorrhage 17%
2. Bradyarrythmia - highest survival
3. Cardiac ischaemia

80% non-shockable

More common amongst:
1. Older, frail patients
2. Higher ASA
3. Urgent/emergency surgery
4. Cardiac/vascular/angio suite/vascular

Question 2

What was NAP 6 - what are the key points

Answer 2

Anaphylaxis occured in 1:10,000 anaesthetics

Culprits:
Abx 47% (teic over-represented)
NMBDs 33% (sux most common)
Chlorhexidine
Patent blue
Others e.g. gelatins

Features
Hypotension 46% cases
Bronchospasp, high pressures
Tachycardia
Low sats
Bradycardia
Reduced or absent capno trace
Cardiac arrest in 1%