Professional Documents

Question 1

FPM Statement regarding the use of opioid analgesiacs in non cancer pain

Answer 1

Lack of definitive evidence for opioids in non cancer pain
FPM recognises that opioids are widely and often inappropriately prescribed for CNCP
Opioid responsive
Other treatments failed, not tolerated, or inappropriate

Principles
Careful assessment - biopsychosocial model
First line - develop pain self management skills
Second Line - drug treatment - functional goals
-multimodal plan towards self managment
- time limited basis

Opioid Treatment

• demonstrate benefit
• active surveillance for harm
• periodic attempts at dose minimisation

5As
Analgesia
Acitivity
Adverse Effects
Affect 
Aberrant Behaviour

Question 2

GUIDELINES FOR MAJOR REGIONAL ANAESTHESIA

Answer 2

KNOWLEDGE/ExPERtise
Issues physiological / drugs / catheter

STOP BEFORE YOU BLOCK
Consent
Need Assistant
Infection control
Coagulation status
IV access
Monitoring - NIBP, ECG, Sp02, O2 (sedation) +30 mins
Record
Post block monitoring
Safety with infusion devices
Procedures to monitor block and complications

Question 3

PACU

Answer 3

Anaesthetist transfers to PACU
Patient dignity and privacy respected - safety first
PACU should be near OT
Formal Handover
PACU staff trained and ratio >1:1 for airway/unstable
Airway - ETT - anaesthetist - SGA - recovery
Monitoring Spo2 NIBP
Anaesthetist must be physically present or delegate
emergency system for asistance

ANAESTHETIST RESPONSIBILITY
Accompany patient - transfer and handover
handover incl PMH,allergies, anaesthesia, drugs, fluids, airway mgmt, pain , sig events, any concerns
Provide written and verbal instructions to staff
specify O2 therapy
remain in the vicinty until patient is assessed as stable.
be available for consultation during recovery - may need to review and alter discharge criteria.

Question 4

AnZCA fasting

Answer 4

ADULT fOOD 6 Fluid 2
Children
<6mo Formula 4hr, Breast 3 hr, CF 1hr
>6 Breast/Formula/Solid @ 6hr CF 1 hr

Question 5

PACU

Answer 5

Transport patient to PACU and stay with until H/O
Respect patient dignity / safety number 1
PACU close to OR if possible
Formal Handover
Experienced Staff
Ratio >1:1 until airway and stable obs
All patients with ETT need PS18 monitoring - extubation by anaesthetist of delegated medical practitioner
SAD = spont ventialtiont unless direct care by anaesthetist.
By availiable to deal with crises/issues must be physically unless delegated.
PACU monitoring
Discharge criteria agreed
An effective call system should be installed
O2 order