Emergency Evacuation  - Guidelines for Crises in Anaesthesia

Anaesthetised or sedated patient requires unplanned transfer because of environmental hazard (e.g. flood, fire, smoke, structural collapse, noxious gas).



❶ Consider if patient can be safely moved: if not see Box A.

❷ Stop any operative procedure as soon as safe. Pack and cover wounds.

❸ Transfer patient to bed or trolley. Transfer on operating table in extremis.

❹ Evacuate non-essential staff. Consider calling for help but be aware their own safety may preclude their attendance.

❺ Airway: Consider tracheal intubation to improve airway security if time allows.

❻ Breathing/ventilation options:

  • Minimise oxygen usage: lowest flows possible.

  • Self-inflating bag +/- supplemental oxygen.

  • Mechanical ventilator or C-circuit require higher flows.

❼ Circulation:

  • Ensure adequacy and security of i.v access.

  • Take adequate supplies of fluid ± infusion sets.

  • Take vasopressor(s) and/or resuscitation drug box.

❽ Maintenance of anaesthesia:

  • Intermittent bolus propofol simplest and quickest.

  • Infusion if time allows – remember mains cable for pump if available.

  • Consider taking stocks and pump to make infusion later.

  • Take blankets and/or warming devices if possible.

❾ If time allows, assemble adequate supply of drugs (Box B).

❿ Take existing monitoring and mains cabling.

⓫ Agree and communicate staff and patient muster points (Box C).



By Association of Anaesthetists @ https://twitter.com/AAGBI

Quick Reference Handbook - Guidelines for crises in anaesthesia 



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