PS and other health documents Flashcards
PS03 - What is the purpose for the guidelines for the ANZCA PS03 management of major regional analgesia?
to facilitate management of major regional blocks including major regional blocks including;
epidural, subarachnoid, plexus and nerve blocks
to reduce the likelihood of adverse outcomes and complications which may be associated with such nerve blocks including;
cardiovascular collapse, seizures, hypotension, allergic reactions, ventilatory impairment, impaired consciousness, infection and nerve damage
PS03 - what are some principles of the PS03 management of major regional analgesia?
Requires a medical practioner
systems and protocols to eliminate complications
informed consent
appropriate assistance
environment consistent with PS55
infection control
coagulation status
IV access prior to regional anaesthesia
monitoring BP, RR, consciousness ECG available, if sedating use O2 source EtCO2 and SpO2
Block time out; name, site and reconfirm this prior to needle insertion
procedure list to remain available
can delegate to another practioner
record and document technique, drug, dose
protocols and procedure to continue post op
PS03 - what are some equipment required for the PS03 management of a major regional analgesia?
Ultrasound
nerve simulator
Liquid emulsion - (Intralipid)
PS08 - what is the purpose of the ANZCA document PS08 statement of assistant for anaesthetist?
to recognize the importance of and to promote the development of quality assistants to the anaesthetist and to guide training of assistants
Scope - applies whenever there is a GA, regional or local / sedation is administered by an anaesthetist
PS08 - what are some principals of the PS08 statement of assistant for anaesthetist
present of a trained assistant to the anaesthetist during the preparation, induction, maintenance and conclusion of anaesthesia
service which ensures equipment is available, clean, maintained and serviced
staff properly trained assistance must be wholly and exclusively responsible to that anaesthetist
informed consent
informed on risks of sedation of decreased airway patency and decreased RR
patient assessment
staffing
facilities and equipment; ambu bag, ability to call for help, adequate lighting, ability to tild head down, sharps bin, stethoscope, suction, tourniquet/IV equipment, monitoring, emergency airway equipment, emergency drugs
what are the guidelines on sedation on analgesia?
to optimise patient care in the management of procedural sedation
to identify the competencies that sedationists should possess
Minimal sedation; a drug induced state during which patients respond purposefully to verbal commands or light tactile stimulation
moderate sedation; a druge induced state of depressed consciousness during which patients retain the ability to respond purposefully to verbal commands and tactile stimulation
deep sedation; a druge induced sate of depression consciousness during which patients are not easily roused and may respond only to noxious stimulation
PS18 - What is the purpose of PS18 monitoring during anaesthesia?
The purpose of this guideline is to guide practioners on monitoring standards that should be applied to clinical management in order
monitoring defined as observing and checking progress and quality over a period of time
what are the 5 must haves of monitoring?
SpO2
EtCO2
oxygen analyser
agent analyser
ventilator alarms
monitoring available; ECG, NIBP, NMT, EEG, temp, invasive monitoring,
Circulation where arterial pulse is checked every 10 minutes
Ventilation is continuously monitored
Oxygenation observe the colour of the patient with adequate lighting
PS54 - what are 10 minimum safety requirements for an anaesthetic machine?
Pin index
Reserve oxygen supply
Non-interchangeable gas hose connectors both inlet and outlet
Gas supply line and cylinder pressures displayed on front of machine
Oxygen failure alarm - generates automatically, cuts off gas supply except air or oxygen cant be cancelled until supply restored above preset pressure
Oxygen must enter gas manifold last and be the first knob from the left on the rotameter
One gas flow knob per gas
Mechanical knob is tactically different from other gas knobs
No less than 25% oxygen can be delivered in the presence of N2O
a vaporiser interlock system must prevent more than one from being used at a time
Vapour can only be increased by turning dial anti-clockwise
Fresh gas outlet must have an outer diameter of 22mm and inner 15mm
High pressure relief valve must be present
Gas scavenging connection must be a different diameter than other breathing systems - 30mm
Monitor alarm functions must activate automatically
High priority high airway pressure alarm
High priority low airway pressure alarm - less than 10cmH20 for more than 1 second
Emergency oxygen flush cannot be unintentionally activated
On/Off switch should not be unintentionally activated or deactivated
Backup power supply should be present and permit at least 30 minutes of operation
PS55 minimum facilities for anaesthesia in OT or other location
The minimum requirements to be provided by healthcare facilites when designing upgrading and equipping and staffing clinical areas where anesthesia is delivered
Anaesthesia delivery system capable of delivering measure oxygen flow
Calibrated vaporisers for inhalation agents
Infusion devices capable of giving an intravenous anaesthetic
Range of suitable breathing system
Separate means of inflating the lungs
Oxygen source independent of the anaesthetic machine
Exclusive suction
PS55 what are 10 things that must be present in every location for anaesthesia?
Appropriate PPE
Stethoscope
Monitoring
Range of face mask sizes
OPA and NPA
LMA / SAD device
ET tube and connection
Two laryngoscope blades
Range of tube introducers
Syringe
Magills
Tapes
Scissors
Tourniquet
IV cannualation equipment
IV infusion equipment
Sharps bin
Equipment for savanging
PS55 what must be available in every location for anaesthesia?
Managing difficult intubation
Automatic ventilation
Rapid infuser
Arterial line and central line
Cool the patient
Regional block
Safe positioning
Additionally;
Appropriate lighting
Ability to communicate
Refrigeration facilities
Mean maintaining room temperature
Patient trolley and slide equipment with a minimum of 3 people
Health and disability patient rights - What are the 10 patient rights?
Right to be treated with respect
Right to fair treatment and freedom from discrimination
Right to dignity and independence
Right to service of an appropriate standard
Right to be listened to and understood
Right to receive information benefit and risks of treatment
Right to make informed choice
Right to support
Right to teaching and research
Right to complain
