Emergency Evacuation - Guidelines for Crises in Anaesthesia Anaesthetised or sedated patient requires unplanned transfer because of environmental hazard (e.g. flood, fire, smoke, structural collapse, noxious gas). ❶ Consider if patient can be safely moved: if not see Box A. ❷ Stop any operative procedure as soon as safe. Pack and cover wounds. ❸ Transfer patient to bed or trolley. Transfer on operating table in extremis. ❹ Evacuate non-essential staff. Consider calling for help but be aware their own safety may preclude their attendance. ❺ Airway: Consider tracheal intubation to improve airway security if time allows. ❻ Breathing/ventilation options: • Minimise oxygen usage: lowest flows possible. • Self-inflating bag +/- supplemental oxygen. • Mechanical ventilator or C-circuit require higher flows. ❼ Circulation: • Ensure adequacy and security of i.v access. • Take adequate supplies of fluid ± infusion sets. • Take vasopressor(s) and/or resuscitation drug box. ❽ Maintenance of anaesthesia: • Intermittent bolus propofol simplest and quickest. • Infusion if time allows – remember mains cable for pump if available. • Consider taking stocks and pump to make infusion later. • Take blankets and/or warming devices if possible. ❾ If time allows, assemble adequate supply of drugs (Box B). ❿ Take existing monitoring and mains cabling. ⓫ Agree and communicate staff and patient muster points (Box C). By Association of Anaesthetists @ https://twitter.com/AAGBI Quick Reference Handbook - Guidelines for crises in anaesthesia #Patient #Evacuation #Anesthesiology #Anesthesia #Intraoperative #Checklist #Management
