Case

A Patient was admitted for emergency cardiac catheterisation  in a state of cardiogenic shock with ongoing chest pain and pulmonary oedema . The anaesthetic team were called urgently. An anaesthetist, who was unfamiliar with the equipment, arrived without an ODP, but could not activate capnography. In the absence of this and an ODP the anaesthetist managed the airway with an i-gel rather than intubate. The patient subsequently went into cardiac arrest from which they could not be resuscitated.

Commentary

It’s vital that all anaesthetists are familiar with the available anaesthetic and emergency equipment in all clinical areas where they may be called to work. This is particularly important where staff work across multiple areas/hospitals such as temporary/locum staff. This requirement is clearly described in the Guidelines for the Provision of Anaesthetic Services Chapter 1: The Good Department Section 3.1.¹

The Association’s Guideline on Checking anaesthetic equipment explains the anaesthetists’ responsibilities in relation to this in the following way: ‘The anaesthetist has a primary responsibility to understand the function of the anaesthetic equipment and check it before use.²

References

1. Royal College of Anaesthetists. Guidelines for the Provision of Anaesthetic Services. Chapter 1: The Good Department (2024)

2. Association of Anaesthetists. Checking Anaesthetic Equipment (2012)