Category Archives: Safety

AnSafe Meeting 2nd August 2019

Next Meeting 2019
  • Date: Friday 2nd August
  • Time: 6.00pm
  • Topic: Ansafe meeting
  • Presenter: Alison Herdman
  • Venue: SAS Rooms, 82-86 Minnie St, Southport.
Meeting will be finished by 8pm
 
Refreshments tonight courtesy of APS
 
A note on AnSafe Meetings : Both Pindara Private Hospital and the Gold Coast Private Hospital consider 50% attendance at these meetings essential to continued accreditation of anaesthetists.
If you are unable to attend please email alisonherdman (at) icloud.com  so your apologies can be documented. 
On attending you will be able to claim 2 credits per hour ANZCA CPD points .

AnSafe Meeting Friday February 1st 2018

(Posted on behalf of Alison Herdman)

The first AnSafe Meeting of the year will be on Friday February 1st at the SAS Rooms at 82 Minnie St Southport starting at 6pm.

Please remember that AnSafe is classified as an Anaesthetic  craft group/M&M Meeting by both Pindara and the GCPH. As part of the accreditation process VM0s are expected to attend 50% of these meetings or at least one per year. CME points can be claimed for your attendance. Please check on the Gcape website after the meeting for details.

Best wishes

Alison Herdman

AnSafe M&M Friday September 14th

(Posted on behalf of Alison Herdman)

There will be an extra AnSafe M&M Meeting on Friday September 14th to discuss Endoscopic Aspirations, SGLT 2 inhibitors with a talk from a Brisbane Endocrinologist and anything else we have time for bearing in mind its strictly 6pm- 8pm on a Friday night.

This will be held at the SAS Rooms in Minnie St and will start as mentioned above at 6pm.

All welcome, Refreshments served.

Thanks to Adrian Skidmore for instigating this.

AnSafe Meeting Friday 6th July

(Posted on behalf of Alison Herdman)

Dear All, 

The second  AnSafe Meeting 2018 is to be held at 6pm on Friday July 6th  at the SAS Rooms in Minnie St, Southport. 

This meeting is hosted by SAS and sponsored by APS.

Please email James Derrick or myself for Pindara issues for the Agenda, Stuart Green or Adrian Skidmore for GCPH issues, and Nick Hogan for any Paediatric issues in either hospital.

AnSafe has its own WebAirs reporting and we go through all incidents reported (anonymously) at the meetings. You can sign up with AnSafe webAirs by going to the Gcape website and following the prompts. Please share your near misses for our communal benefit.

Please remember that AnSafe is classified as an Anaesthetic  craft group/M&M Meeting by both Pindara and the GCPH. As part of the accreditation process VM0s are expected to attend 50% of these meetings or at least one per year. CME points can be claimed for your attendance. Please check on the Gcape website after the meeting for details.

Best wishes

Alison Herdman

Detection of Euglycaemic Ketoacidosis preoperatively

(Posted on behalf of Alison Herdman)

Pindara Admissions now finger prick test every preoperative patient on dapagliflozin (Forxiga), empagliflozin (Jardiance) or a combination with metformin (Xigduo, Jardiamet) with a ketone reagent strip.

They write the result on the Preop Check List.

If it is > 0.6mmol/l you will be notified by phone.

The Australian Diabetic Society (ADS) recommends that strong consideration to postponing non urgent surgery be given if SGLT2 inhibitors have not been stopped preoperatively and either the blood ketones are > 0.6 mol/l or the HbA1c is >9% .

Download ADS Alert and Recommendations here… ADS Alert and Recommendations

AnSafe meeting Thursday 15th March 2018

(Posted on behalf of Alison Herdman)

Dear All,

There will be three AnSafe Meetings instead of two in 2018. This is because:

1) All the other craft groups meet at least 3-4 times per year

2) We have so much to talk about we need three meetings a year to get through it all.

The first meeting is to be held at 6pm on Thursday March 15th at the SAS Rooms in Minnie St, Southport. 

Please email James Derrick or myself for Pindara issues for the Agenda, Stuart Green or Adrian Skidmore for GCPH issues, and Nick Hogan for any Paediatric issues in either hospital.

AnSafe has its own WebAirs reporting and we go through all incidents reported (anonymously) at the meetings. You can sign up with AnSafe webAirs by going to the Gcape website and following the prompts. Please share your near misses for our communal benefit.

Please remember that AnSafe is classified as an Anaesthetic craft group/M&M Meeting by both Pindara and the GCPH. As part of the accreditation process VM0s are expected to attend 50% of these meetings. CME points can be claimed for your attendance. Please check on the Gcape website after the meeting for details.

Best wishes

Alison Herdman

Poorly labelled drug ampoules: The wall of shame.

I am putting this post up to upload pictures of ampoules which are difficult to read, or which are easily confused with other drugs.

 Here is a new candidate which has just appeared at Pindara. I saw the LIN and thought I wonder why Lincomycin is in the drug drawer. The font size of the manufacturer’s name is nearly 3x that of the drug.

 

 

 

 

I found this ampoule of lignocaine in a box of normal saline. I put this up first because I found they have appeared in Pindara OT.

 

Here is a contender for worst ever label. The writing was so small, we had to photograph it and blow it up to see what the drug was.

 

 

 

 

 

We had a similar problem with granisetron a few years ago, but the manufacturer improved the label when they were notified.

 

 

 

 

 

 

A couple from Aspen pharmaceuticals. Almost impossible to read, even in the best lighting.

 

 

 

 

 

Some more from Pfizer.

Lignocaine, midazolam and heparinised saline all very similarly labelled. Pfizer’s reply was that this label was designed to improve safety as can be seen by the Pfizer label being rotated and the black highlighting on the lignocaine dose.

They also reminded me that secondary means of product identification do not absolve the anaesthetist from the legal responsibility to check the ampoule.


 

 The lignocaine 10% is markedly different from lignocaine 1%!

SPANZA Advisory on Tramadol

Recommendations Following FDA Warnings about Tramadol Use in Children
  1. Tramadol can have a useful role as part of a multimodal analgesic regimen for managing acute pain in children.
  2. Tramadol dose should be limited for acute pain after tonsillectomy (e.g., maximum dose 1 mg/kg 6-8 h, max 400 mg/day). We suggest starting with a lower dose of 2 mg/kg daily in divided doses (e.g., 0.5 mg/kg 6-8 h). Tramadol overdose is a greater danger than CYP variants.
  3. Children with obstructive sleep apnoea who have undergone tonsillectomy should continue to be monitored in hospital overnight to assess both response and sensitivity to opioids before discharge. While evidence is lacking, it may be prudent to observe any child given opioids during a period of sleep before discharge.
  4. The use of any opioid in children after day-stay surgery should be done so with caution.

The full document can be downloaded here.