Quick Reference Handbook
The AAGBI is pleased to announce its forthcoming Quick Reference Handbook (QRH); a collection of guidelines for occasional and unexpected crises in anaesthesia.
Many anaesthetists are already familiar with the concept of the QRH and already have their own version in place, either locally created or downloaded from an existing online resource.
The QRH Working Party has been working hard to produce a high quality set of guidelines and the prototype QRH is now in its testing phase. We have used the template layout developed by US safety pioneers Ariadne Labs to create a set of reference guidelines specifically relevant to UK practise.
The AAGBI QRH has guidelines in three distinct sections (prototype contents list, liable to change):
- “Unknowns” - guidelines for crises manifesting as signs or symptoms, where diagnosis and treatment are commonly simultaneous:
Cardiac arrest; Hypoxia /desaturation/cyanosis ; Increased airway pressure; Hypotension; Hypertension; Bradycardia; Tachycardia; Cardiac ischaemia; Perioperative hyperthermia
- “Knowns” - guidelines for crises where a known or suspected diagnosis or event requires treatment:
Anaphylaxis; Massive blood loss; Can't intubate, can’t oxygenate (CICO); Bronchospasm; Circulatory embolus; Laryngospasm and stridor; Patient fire (airway and non-airway); Malignant hyperthermia crisis; Cardiac tamponade; Local anaesthetic toxicity; High/total spinal; Neuroprotection following cardiac arrest; Sepsis; Primary and secondary trauma surveys
- “Other” - guidelines for crises external to, but posing risk to the patient:
Mains oxygen failure; Environmental fire; Mains electricity failure; Emergency evacuation
There is also an overarching “Key basic plan” – a guideline for situations where the nature of the problem is completely unclear.
The QRH will be distributed, by free download, in two formats:
- An uneditable version for immediate implementation;
- An editable version for local departments to customise.
We aim to release the QRH in 2017 and will update members as that time nears.