Keep Calm in an Anaesthetic Crisis

Week 1 - Principles of Anaesthetising Critical Patients

• Anaesthetic risk in the compromised patient
• The importance of patient history and physical examination
• Diagnostic tests
• Patient stabilisation
• Anaesthetic protocol, monitoring and recovery

Learning outcomes:

• Gain an understanding as to why critical patients are at an increased anaesthesia and sedation risk
• Understand that improving patient safety requires a holistic, overall management process, not simply using “the best drug protocol”.  This will include consideration of:
  • What pre-anaesthetic tests may be required and the benefit they offer
  • What pre-anaesthetic stabilisation may be required
• Have an introduction into the type of patient monitoring which is required during the peri-anaesthetic period
• Understand general principles for appropriate anaesthetic drug protocols for the critical patient

Week 2 - General Approach to Adverse Events and Introduction to Anaesthetic Complications

• Near misses and adverse events
• Minimising adverse events by preparation
• Checklists and non-technical skills
• Common anaesthetic complications

Learning outcomes:

• Name the three steps necessary for approaching adverse events and discuss why they are important, including methods in which near misses and adverse events can be minimised in practice.
• Understand the role of human factors in patient safety and the value of checklist use in anaesthetic practice.
• Have an overview of what anaesthetist non-technical skills (ANTS) are and be able to begin using them in clinical practice.
• Know the most common anaesthetic complications encountered in small animal practice.

Week 3 - Cardiovascular Complications

• Alterations in heart rate:
  • Bradyarrhythmias
  • Tachyarrhythmias
• Alterations in blood pressure:
  • Hypotension
  • Hypertension

Learning outcomes:

• Recognise abnormal physiological parameters with regards to the cardiovascular system for individual patients undergoing anaesthesia.
• Gain an understanding of the most common underlying causes for alterations in heart rate (bradyarrhythmias and tachyarrhythmias) during general anaesthesia.
• List some main treatments for the most common arrhythmias which present under general anaesthesia.
• Gain an understanding of the most common underlying causes for alterations in blood pressure (hypotension and hypertension) during general anaesthesia.
• List some main treatments for the most common blood pressure alterations which present under general anaesthesia.
• Begin to apply this knowledge to individual cases within the clinic with use of the available equipment

Week 4 - Respiratory Complications

• Alterations in ventilation:
  • Hypoventilation
  • Hyperventilation (including tachypnoea)
  • Apnoea or respiratory arrest
• Hypoxaemia
• Respiratory obstruction:
  • Upper respiratory tract
  • Lower respiratory tract
• Restrictive pulmonary disease
• Aspiration (and regurgitation)

Learning outcomes:

• Recognise what are abnormal physiological parameters with regards to the respiratory system for individual patients undergoing anaesthesia.
• Gain an understanding of the most common underlying causes for alterations in ventilation, including hypo- and hyperventilation, apnoea and respiratory arrest.
• List the main treatments for the most common changes in ventilation under anaesthesia.
• Understand the difference between hypoxaemia and hypoxia, listing the potential causes for these and therefore be able to suggest methods to manage these conditions.
• Recognise the clinical signs of respiratory obstruction and restrictive pulmonary disease and describe what steps could be taken to alleviate the underlying problem
• Have the knowledge to state why aspiration is a risk under anaesthesia and how to manage a case of gastro-oesophageal reflux in order to minimise patient risk
• Begin to apply this knowledge to individual cases within the clinic with use of the available equipment

Week 5 - 'Other' Complications

• Central nervous system:
  • Emergence delirium
  • Post anaesthetic blindness and deafness
• Thermoregulation:
  • Hypothermia
  • Hyperthermia
• Anaphylactic and anaphylactoid reactions
• Embolism

Learning outcomes:

• Outline why cats are at particular risk for post anaesthetic blindness and deafness and describe methods which can minimise this risk.
• List available methods for patient warming, with recognition of the need to counteract patient hypothermia and the potential risks associated with warming device use.
• List risk factors associated with peri-operative hyperthermia and discuss steps which can be implemented to manage the hyperthermic patient.
• Have the ability to recognise if an anaphylactic or anaphylactoid reaction is occurring and be able to suggest steps to manage the situation.
• Understand that embolisms are a rare, but potential complication during anaesthesia and be able to list the clinical signs associated with their occurrence.

Week 6 - Cardiopulmonary Resuscitation

• Detecting cardiopulmonary arrest
• Basic life support:
  • Chest compressions
  • Tracheal intubation
  • Ventilation
• Advanced life support"
  • Drug therapy
  • Oxygen supplementation
  • Intravenous fluid therapy
  • Correction of electrolyte and metabolic disturbances
  • Defibrillation
• Monitoring during CPR
• Post cardiac arrest care

Learning outcomes:

• Explain the purpose of cardiopulmonary resuscitation and describe its two main components.
• Recognise when cardiopulmonary resuscitation should be instigated
• Understand the importance of regular CPR training within the practice team.
• Describe and demonstrate the method for effective chest compressions, tracheal intubation and ventilation during cardiopulmonary resuscitation.
• Have the knowledge to list what steps can be taken to provide advanced life support during cardiopulmonary resuscitation.
• Know what monitoring tools are recommended for cardiopulmonary resuscitation and be able to interpret the main waveforms that will be seen during a resuscitation event.

The course will be fully tutored by Rebecca Robinson and will consist of 15 hours of CPD given in various formats, including tutorials, tasks, case scenarios, forum discussions and quizzes.

For some further information about our Online Tutored CPD courses - please open the guide below:

ONLINE TUTORED CPD COURSES - PDF GUIDE