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Emergency & Crisis Checklists for Rural Hospital

NB: Click here for the 2013 UPDATED version for use with Avery 20 tab index sheet and standard A4 2 ring binder. The same 2013 updated information optimsed for iPad or iPhone (or indeed other tablet) can be downloaded here :

2013 Update PDF – iPad version

Responsibility for checking procedures and drug doses remains with the user. I use this in my ED and OT as an aide memoire

See also the ANAESTHESIA CRISIS MANUAL 

Airway Planning – Plans A, B, C & D

Before every anaesthetic (particularly RSI in OT or ED), I run through my plans for failed airway with staff – not so much because we are expecting difficulty, but because this sets up a shared mental model if a crisis rapidly unfolds. The plan is summarised on wall charts and utilises specific equipment which we have locally. Ain’t no option for AFOI or ‘call the senior anaesthetist’ in a rural hospital!

RSI Kit Dump

A useful visual aid and integrated checklist for performing RSI, especially useful with junior or non-anaesthetic staff in a crisis to reduce cognitive overload. You can download this, take to print shop and get them to print out full size and laminate for use in your location.

Major Haemorrhage in Rural Hospital

Managing bleeding in a rural environment can be a challenge – many smaller hospitals only have two units of packed cells. This list from Broome Docs is a start – but you may need to adapt for local conditions. Remember to consider adjuncts like tranexamic acid, haemostatic dressings and damage control surgery. Some remote sites in Oz will still use a living donor, walking blood-bank!

RSI CHECKLIST

 

PODCASTS

There is also an excellent series of podcasts relevant to airway management :

Emergency Airway Management Pt 1 with Minh le Cong, Amit Maini & Andy Buck at ETMcourse.com

ATUL GAWANDE on CHECKLISTS in MEDICINE

LINKS

Frequently used and most visited

http://anaestricks.tumblr.com (Dr. Gavin Doolan @anaestricks has a wealth of helpful tips/tricks and helpful practice)

http://gasclass.wordpress.com (Twitter class and case discussion)

http://hqmeded-ecg.blogspot.com.au (Practice makes perfect, ECG interpretation is an essential GP anaesthetist skill)

http://broomedocs.com (Leading generalist blog with a rural critical care flavor)

http://prehospitalmed.com (Minh posts widely on airway management and PHARM hosts an amazing array of airway videos)

http://www.nysora.com (Principal regional anaesthesia site with a wealth of information and instruction, making it possible to learn regional techniques)

http://totw.anaesthesiologists.org (Exceptional reviews of anaesthetic topics)

http://www.joondalup.org/wp-content/files/Pain-Manual.pdf (Joondalup Anaesthetic Pain manual, JCCA training in WA)

http://www.rph.wa.gov.au/anaesth/downloads/Common_Bolus_Doses.pdf

http://www.rph.wa.gov.au/anaesth/downloads/Drug_Infusions_for_Intensive_Care.pdf

Journals

These articles provide excellent reviews, pitched at the busy anaesthetist to keep them relevant with an ever changing clinical environment.

http://www.aaic.net.au (Australian critical care journal, incredibly helpful and current opinion in anaesthesia)

http://www.anaesthesiajournal.co.uk (Basic science and clinical anaesthesia articles)

http://ceaccp.oxfordjournals.org (Critical care review articles, easy to read)

Critical care blogs

Both of these need no introduction, they are must-read blogs for all GP anaesthetists

http://emcrit.org

http://lifeinthefastlane.com

Anaesthesia blogs

These sites are on my blog roll and provide an array of anaesthestic perspectives from around the world.

http://oxccjc.wordpress.com

http://joburganaesthesia.co.za

http://www.anaesthesiacases.com.au/

http://www.developinganaesthesia.org/

http://gasexchange.com

iPhone Apps

Free

Awake Fibreoptic Intubation

https://itunes.apple.com/au/app/awake-fibreoptic-intubation/id521631047?mt=8

Difficult Airway Society Guidelines

https://itunes.apple.com/gb/app/idas/id401649695?mt=8

One Minute Ultrasound

https://itunes.apple.com/us/app/one-minute-ultrasound/id512301845?mt=8

Paid

iGasLog

https://itunes.apple.com/au/app/igaslog/id294882478?mt=8

Oxford Handbook of Anaesthesia, Third Edition

https://itunes.apple.com/au/app/oxford-handbook-anaesthesia/id459744011?mt=8

For more FOAMed links, see the anaesthesia blog roll from lifeinthefastlane.com and the Useful Links tab on ruraldoctors.net


3 Comments

  1. […] algorithms (needless to say, The Vortex got a plus) as well as enabling team-buy in via use of checklists EVEN IN A CRISIS. There are even rumours of involving a psychologist on future […]

  2. […] and a smaller ‘checklist action card’ is available for download and adaptation from the anaesthesia resources section of the ruraldoctors.net site, along with an ED/Theatre Crisis Checklists pdf for […]

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About

Http://about.me/timleeuwenburg

Http://about.me/timleeuwenburg

I am a Rural Doctor on Kangaroo Island, South Australia with interests in EM, Anaes & Trauma. Currently working with MedSTAR Retrieval, SA. Avid user & creator of #FOAMed; EMST & ATLS Director, Instruct on ETMcourse.com. My sites include KIdocs.org & RuralDoctors.Net, affiliated with smaccUs in Chicago 2015 Opinions expressed on these sites must not be used to make decisions about individual health related matters or clinical care as medical details vary from one case to another. Reader is responsible for checking information inc drug doses etc.

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