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PREPARATION FOR GENERAL ANAESTHESIA
Make sure that an experienced and trained assistant is available
to help you with induction. Never induce anaesthesia when alone
with the patient.
Before starting, check that you have the correct patient scheduled
for the correct operation on the correct side. The responsibility
for this check belongs to both the anaesthetist and surgeon.
The surgeon should mark the operation site with an indelible
marker before the patient comes to the operating room.
Check that the patient has been properly prepared for the operation
and has had no food or drink for the appropriate period of
time. It is normal to withhold solid food for six hours preoperatively,
but a milk feed can be given to babies up to three hours preoperatively.
Clear fluids are regarded as safe up to two hours preoperatively
if gastric function is normal.
Measure the patient’s pulse and blood pressure, and try
to make him or her as relaxed and comfortable as possible.
Induction of anaesthesia is a
critical moment. Before inducing anaesthesia – check.
Before you start, check the patient’s progress through
the hospital up to this moment. Then check that your actions
will be the right ones. It is also vital to check your equipment
before you give an anaesthetic. The patient’s
life may depend on it.
Make
sure that:
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All
the apparatus you intend to use, or might need, is
available and working |
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If
you are using compressed gases, there is enough gas and
a reserve oxygen cylinder |
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The
anaesthetic vaporizers are connected |
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The
breathing system that delivers gas to the patient is
securely and correctly assembled |
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Breathing
circuits are clean |
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Resuscitation
apparatus is present and working |
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Laryngoscope,
tracheal tubes and suction apparatus are ready and have been
decontaminated |
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Needles
and syringes are sterile: never use the same syringe
or needle for more than one patient |
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Drugs
you intend to use are drawn up into labelled syringes |
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Any
other drugs you might need are in the room. |
Always begin your anaesthetic with the patient lying on a table
or trolley that can be rapidly tilted into a head-down
position in case of sudden hypotension or vomiting.
Before inducing anaesthesia,
always ensure adequate inserting an indwelling needle
or cannula in a large vein, unless this is impossible.
The choice of technique for induction of anaesthesia
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Intravenous
injection of a barbiturate, ketamine |
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Intramuscular
injection of ketamine |
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Inhalational
induction (“gas induction”). |
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