Emergency Manuals in Context: One Component of Resilient Performance

Implementing emergency manuals to respond to perioperative crises

“…An EM implementation plan should be based on the organizational culture and team attributes 1 . Implementation will need to address a variety of factors, such as where the EM should be located (e.g., quick access) and possible team member roles (e.g., dedicated reader to read the steps from the EM out loud) 1,2,7 . Agarwala indicated that having specific assigned roles will ultimately depend on how many people are available in the OR at the time of the crisis.…”

“…Safe patient care is dependent on having effective systems in place to achieve the best possible outcomes. This is especially important during uncommon clinical emergencies, such as a malignant hyperthermia (MH) crisis or cardiac arrest, during which a quick response will help improve outcomes for patients 1‐5 . One tool that is gaining popularity in the perioperative setting to support teams during crises is the emergency manual (EM), which is a set of cognitive aids or checklists to help guide decisions and decrease dependence on memory 1,3‐6 …”

Anesthesia care in the interventional neuroradiology suite: an update

“…even minimal delay having potentially fatal consequences [3]. With abundant data about the best periinterventional care for stroke patients but a paucity of evidence for elective procedures [4 Elective diagnostic and therapeutic procedures performed in the INR suite include but are not limited to interventions to treat arteriovenous malformations (AVMs) or dural arteriovenous fistulas, intracranial aneurysms, carotid artery stenosis (CAS), refractory cerebral vasospasms from SAH, venous angiomas, retinoblastoma, and Vein of Galen malformations.…”

Anaesthesia for minimally invasive cardiac procedures in the catheterization lab

“…With their prospective study including some 1400 patients in various centres, the authors concluded that the 3M approach is feasible and well tolerated for a centre of any size [30 && ]. Additional measures -such as ultrasound guidance [31] for vascular access, fascia iliaca blocks for transfemoral TAVR [32] or cervical plexus blocks for transcarotid TAVR [33] -have been shown to be feasible and well tolerated.…”

“…Patient and procedure-related complications can result extremely quickly in deleterious outcomes if they are not managed with the utmost care. Catheter-based cardiac procedures in the catheterization lab require involvement of highly trained staff and well established teams [6,31,52]. Such training includes familiarity with technical aspects of the procedures and devices and extensive experience in cardiac anaesthesiology in case of a need for surgical conversion and haemodynamic management.…”