Read the press.....

Guidelines and national publications for two years previously are much beloved of this exam. Common places to look include:

The Association of Anaesthetists (2007-8)

-LA toxicity +/- Intralipid use
-Malignant Hyperthermia treatment
-Perioperative Management of the Morbidly Obese Patient - THIS IS FAIR GAME FOR THIS YEAR!!
-Standards of monitoring during anaesthesia & recovery
-Blood Transfusion & the Anaesthetist (recent publication: I will summarise very soon)

NICE (2007-8)

-Venous Thromboembolism: April 2007
-Acutely Ill patients in hospital: July 2007
-Head Injury: September 2007
-Intrapartum Care: September 2007
-Ultrasound Guidance in locating the Epidural Space: January 2008
-Prophylaxis against Infective Endocarditis: March 2008
-Perioperative hypothermia: April 2008
-Technical solutions for VAP in adults: August 2008

NPSA

Reducing the risk of hyponatraemia when administering intravenous infusions to children

-Since 2000, there have been four child deaths following neurological injury from hospital-acquired hyponatraemia reported in the UK.

Recommendations
-Remove 0.18% NaCl with glucose 4% from stocks & general use in areas treating children.
-Produce local clinical guidelines for the fluid management of paediatric patients.
-Provide adequate supervision and training for all staff involced in the prescribing, monitoring, and administering of IV fluids for children.
-Review & improve design of existing drug prescription/fluid balance charts.
-Promote reporting of hospital-acquired hyponatraemia incidents

Resuscitation: intravascular volume depletion should be managed with 0.9% NaCl boluses
Deficit: estimate fluid deficit & replace as 0.9% NaCl with 5% dextrose or 0.9% NaCl over a minimum of 24hrs
Maintenance: do not use 0.18% NaCl with glucose 4%

The majority of children may be managed with 0.45% NaCl with 5% glucose (or 2.5% glucose)

CEMACH (report summarised in previous blog posting)