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In rural and remote Australia, anaesthesia services are mostly provided either by fly-in, fly-out specialist anaesthetists or by rural doctors who have undergone advanced training in anaesthesia, to a standard determined by the Joint Consultative Committee on Anaesthesia.

Whilst the purpose of such training is to ensure the GP-Anaesthetist can deliver safe services for selected, low complexity cases in an elective setting, the reality is that these doctors may also be called upon to provide expert assistance to colleagues in an emergency with a difficult airway. They need to be both appropriately trained, to have appropriate equipment and to continue ongoing professional development.

The FOAMed revolution has been enthusiastically taken up by Emergency & Critical Care Physicians (with the inaugural SMACC2013 conference in Sydney being a success). Clearly there are topics relevant to the rural doctor from this explosion of debate – particularly in regard to airway planning, equipment and management. New paradigms and debates are active – the role of cricoid pressure, the argument for rocuronium over suxamethonium for RSI, ketamine use, delayed-sequence intubation and apnoeic diffusion oxygenation.

There is a lot here that would be useful for GP-anaesthetists and may not be taught by FANZCAs on annual upskilling – the elective and emergency airway are different beasts, plus rural doctors have to practice in resource-limited settings where options like awake fibreoptic intubation are only a dream.

This section contains information on JCCA training in anaesthesia, on anaesthesia resources and relevant FOAMed.

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I am a Rural Doctor on Kangaroo Island, South Australia with interests in EM, Anaes & Trauma. I am an Ass/Prof in Aeromedical Retrieval with Charles Darwin University and hold senior specialist (retrieval) positions in NT and QLD Avid user & creator of #FOAMed; EMST & ATLS Director, Instruct & Direct on; faculty for Critically Ill Airway course and smaccAIRWAY workshops. 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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