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Hear from one of the compendium editors, Dr Maria Chereshneva, why you should use the new Raising the Standards: RCoA Quality Improvement Compendium, what's new, and how it can revolutionise your practice.
Dr Omar Khan attends the Hajj pilgrimage in Saudi Arabia. Due to the combined effects of extreme heat and huge crowds, he considers the responsibility of medical professionals to help when they're just bystanders.
Approximately two million people attend the Hajj pilgrimage in Saudi Arabia every year. The journey is obligatory for those who have the physical and financial means, once in a lifetime. The pilgrimage lasts five days and is based in and around the city of Makkah.
The climate is one of a hot desert with day temperatures regularly exceeding 45ºC (113ºF) during the summer. This is made all the tougher with average relative humidity reaching 33%. Pilgrims travel from around the world. They include all ages and backgrounds, and individuals with complex medical conditions.
I was lucky enough to be given the opportunity to attend this year. My journey began like any other pilgrim’s, initially solely focusing on the religious events ahead. The first few days went as planned, with challenging walks, but nothing more than I had physically and mentally prepared for. Things however changed as the days went on and as the weather deteriorated. I cannot emphasise enough the combined effects of extreme heat and huge crowds. Despite an umbrella to keep one out of direct sunlight and copious amounts of water consumption, heat exhaustion is relatively common. I was also soon to learn that heat stroke was becoming dangerously frequent during my time there. As anaesthetists, our challenge is often to keep patients undergoing major surgery warm. As I entered my hotel lobby, my job was to do the opposite and help cool my fellow pilgrims down!
Find out more about our two-year national project in collaboration with THIS Institute to improve the time it takes for patients to have emergency bowel surgery.
The Royal College of Anaesthetists has undertaken a two-year national project in collaboration with The Healthcare Improvement Studies (THIS) Institute to use new approaches to improve the time it takes for patients to have emergency bowel surgery.
The time taken for patients to get to the emergency operating theatre remains a stubborn problem, despite many years of research and national guidance emphasising the importance of prompt surgery to reduce morbidity and mortality.
The diagnostic and treatment pathways are complex – involving clinicians from emergency medicine, anaesthesia, surgery, critical care, radiology, and often other specialties. Patients also require resources like CT scanners and operating theatres that are often in short supply. Thinking about the multiple steps each patient must traverse, it is no surprise that they often don’t get speedy access to the operating theatre.
Agreed local clinical guidelines should be in use that have been produced by an appropriately constituted multiprofessional team, comprising anaesthetists, specialist nurses, surgeons, critical care clinicians, pharmacists, specialty consultants or aut...
Agreed local clinical guidelines should be in use that have been produced by an appropriately constituted multiprofessional team, comprising anaesthetists, specialist nurses, surgeons, critical care clinicians, pharmacists, specialty consultants or autonomously practising anaesthetist and managers. These guidelines should cover at least the following:
- assessment and management of pain and pruritus, including the recording of pain and itch scores13...
Chapter 6: Guidelines for the Provision of Anaesthesia Services for Day Surgery 2021
Each DSU should have a clinical director or specialty lead. This will often, but not always, be an anaesthetist with some management experience. The role of the clinical director is to champion the cause of day surgery and ensure that best practice is followed. This role may involve the development of local policies, guidelines and clinical governance and should be...