AAGBI recommendations for standards of monitoring during anaesthesia and recovery 2015 - a further example of ‘aggregation of marginal gains’

Implications of the 2015 AAGBI recommendations for standards of monitoring during anaesthesia and recovery

“…The first edition was published in 1988 and was generally perceived to have had a profound, positive effect on clinical practice at that time. Each of the subsequent four updates and revisions can be considered as ‘marginal gains’ based on more contemporary evidence and advances in technology.…”

Electronic anaesthesia records - a reply

“…The latest obstetric airway management guidelines by the Obstetric Anaesthetists' Association (OAA) and the Difficult Airway Society (DAS) discuss the importance of pre-oxygenation as it increases oxygen reserve in the lungs during apnoea [1]. The guideline recommends that an end-tidal oxygen fraction (FetO 2 ) of ≥ 90% is achieved before induction of anaesthesia, states that nasal oxygenation could be considered as part of a pre-oxygenation method, and suggests that the anaesthetist should consider attaching nasal cannulae with 5 l.min À1 oxygen flow before starting pre-oxygenation, to maintain bulk flow of oxygen during intubation attempts, or attach nasal oxygenation after pre-oxygenation during the apnoeic period.…”

“…White and MathiszigLee for their comments on the AAGBI Recommendations for Standards of Monitoring (SoM) during anaesthesia and recovery [1,2]. I agree with them that anaesthetic departments in the UK and Ireland should aim to move to electronic anaesthetic record systems (EARS) in the medium to long term.…”

Potential for conduction of microshock via intravenous fluids – manufacturer's reply

“…Chuan et al address a challenging set of important questions about assessing procedural skills for regional anaesthesia [1]. The definition and assessment of clinical competence and procedural skill is extremely difficult.…”