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Simulators in Anaesthesia

The advancements in computer technology since ALS was first introduced have provided us with a third generation of human simulator manikins. These lifelike, computer-model–driven manikins have pulses, heart sounds, breath sounds, and pupillary reflexes. They can develop bronchospasm with audible wheezing, hypotension, laryngospasm, laryngeal oedema, pneumothorax, and many other anaesthesia complications. Commercial airline pilots have didactic knowledge of how to manage their own life-threatening airliner emergencies, but they go one step beyond the classroom by requiring flight simulation emergency training in which they actually “fly” under the intense stress that the flight simulator emergencies provide. The availability of anaesthesia simulators has become more widespread in training programs, and their value in education increasingly recognised. Indeed manikins are now used in the Primary FRCA OSCE to assess resuscitation skills. Click the link below to learn more about simulation.

Simulators in Anaesthesia

New guidelines for CPR with a compression to ventilation ratio of 30:2

The new recommendations for 2005 are described as a 'consensus on science' and they reflect the growing recognition that different countries and regions have varied resources and needs.

The Resuscitation Council (UK) now recommends:

 For adults

CPR with a chest compression to ventilation ratio of 30:2

no initial ventilations before starting compressions

when professional help is delayed for more than 4-5 minutes, one option is to give compressions for up to three minutes before attempting defibrillation

compressions for two minutes after defibrillation

if coordinated rhythm is not restored by defibrillation, second and further shocks should be given only after additional cycles of chest compressions

 For children

Solo lay rescuers should give CPR with a compression to ventilation ratio of 30:2

two rescuers (usually healthcare professionals) should use a ratio of 15:2

 For neonates

Will almost certainly be anoxic, so still need a ratio of 3:1

 For Peri-Arrest Arrhythmias

Previous Resuscitation Council (UK) guidelines have included three separate tachycardia algorithms: broad-complex tachycardia, narrow-complex tachycardia, and atrial fibrillation.  In the peri-arrest setting many treatment principals are common to all tachycardias.  For this reason, they have been combined into a single tachycardia algorithm.

Tachycardia Algorithm (with pulse)

Resuscitation courses

 NLS-Newborn Life Support

 PALS-Paediatric Advanced Life Support

 APLS-Advanced Paediatric Life Support

(you are required to register your name on the Advanced Life Support Group's waiting list for APLS).

 ALS-Advanced Life Support

 ATLS-Advanced Trauma Life Support

Relevant Links:

Click here for educational information regarding Cardiorespiratory Arrest in children

Resuscitation Council (UK) Guidelines 2005

Adult Basic Life Support Guidelines
Adult Advanced Life Support Guidelines
Paediatric Basic Life Support Guidelines
Paediatric Advanced Life Support Guidelines
Newborn Life Support Guidelines

Worldwide Resuscitation courses

Advanced Paediatric Life Support (APLS)

Australia Sandy Willis
Belgium Els Duval
Croatia Ivan Vidmar
Falklands Roger Diggle
Greece Kostas Katsanoulas
Netherlands Laura De Kleijn
New Zealand Margaret Findlay
Norway Thomas Rajka
Portugal Luis Almeida-Santos
Slovenia Ivan Vidmar
South Africa  Di Girdwood
Trinidad Ian Sammy
UAE Dr Omar Qais Muhammed 
Major Incident Medical Management (MIMMS)

Australia Denys Cato
Japan (Tokyo)  Naoko Takei (Tokyo)
Japan (Osaka) Yukiko Hirose (Osaka)
Netherlands Laura De Kleijn
Sweden Anne-Marie Engström
Trinidad Ian Sammy 
Managing Obstetric Emergencies and Trauma (MOET)

Egypt Gamal Abbas
Netherlands Laura De Kleijn
Russia Anton Mikhailov 
1 Day Paediatric Life Support (PLS)
Australia Sandy Willis
South Africa  Di Girdwood 

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