Anaesthesia & Critical Care Pathways

RSI checklist — drugs, equipment, positioning, and failed intubation drill

Bundle-based approach to sedation, analgesia, and delirium in ICU — ABCDEF bundle

Rational vasopressor selection and dose escalation in septic/distributive shock

Tracheostomy insertion, tube changes, and emergency management in ICU

DAS 2015 unanticipated difficult intubation — Plans A→B→C→D, optimise on each attempt, declare 'CICO' early.

Recognise (cardiovascular > cutaneous), 100% O₂, adrenaline IV titrated, fluid bolus, identify trigger, NAP6 reporting.

Recognise rising ETCO₂ + hyperthermia + masseter spasm during anaesthesia; STOP triggers, dantrolene, supportive care.

Recognise CNS + cardiac toxicity, immediate lipid emulsion (Intralipid), modified ALS.

Sympathetic blockade → hypotension; phenylephrine first-line in obstetric, ephedrine if bradycardic; IV fluids + positioning.

Apfel score, multimodal prophylaxis, rescue antiemetics from different drug class.

1-hour bundle (SSC 2021): lactate, cultures, antibiotics, fluid, vasopressor; reassess perfusion + lactate trend.

AOMRC 2008 — preconditions, exclusion of confounders, 6 cranial nerve tests + apnoea test, 2 sets, 2 doctors.

Activate MHP, balanced 1:1:1 ratio, TXA, identify + treat source, monitor.

PADIS bundle, CAM-ICU screening, non-pharmacological + pharmacological (avoid benzodiazepines).

NICE CG32 — recognition of high-risk patients, slow reintroduction, monitor + replace electrolytes (P, K, Mg), thiamine.

Modern fasting (clear fluids 2h, solids 6h), carbohydrate drinks, ERAS principles for elective surgery.