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From small beginnings 50 years ago and in addition to serving its current membership of over 1000, the APA is now the primary source of information and guidance on pediatric anesthesia to the royal colleges and other regulatory authorities in the United Kingdom and Ireland. A group of anesthetists who specialized in the care of children created a committee devoted to pediatric anesthesia within the American Academy of Pediatrics (AAP) in 1965; it soon became the AAP Section of Anesthesiology which was the first organized grouping in the world devoted to the subspecialty.[1] In summer 1972, by which time there was still no forum for meetings of pediatric anesthetists working in Britain and Ireland, Drs. In 1997, the first female APA president, Dr Susan Jones (Birmingham) was elected; she was followed in 2011 by Dr Kathy Wilkinson (Norwich). [Extracted from the article]

Safe vascular access is integral to anaesthetic and critical care practice, but procedures are a frequent source of patient adverse events. Ensuring safe and effective approaches to vascular catheter insertion should be a priority for all practitioners. New technology such as ultrasound and other imaging has increased the number of tools available. This guidance was created using review of current practice and literature, as well as expert opinion. The result is a consensus document which provides practical advice on the safe insertion and removal of vascular access devices. [ABSTRACT FROM AUTHOR]

This guideline updates and replaces the 4th edition of the AAGBI Standards of Monitoring published in 2007. The aim of this document is to provide guidance on the minimum standards for physiological monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the United Kingdom and Ireland. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included. There is also guidance on monitoring patients undergoing sedation and also during transfer of anaesthetised or sedated patients. There are new sections discussing the role of monitoring depth of anaesthesia, neuromuscular blockade and cardiac output. The indications for end-tidal carbon dioxide monitoring have been updated. [ABSTRACT FROM AUTHOR]

Aims Anaphylaxis during anaesthesia is a rare and potentially fatal event. Adequate reporting and investigation of anaphylaxis associated with anaesthesia results in improved patient safety and outcomes. Guidelines from the Association of Anaesthetists of Great Britain and Ireland ( AAGBI) designed to improve this process were first issued in 1990 and updated in 1995, 2003 and 2008. In a setting where no formal guideline was previously in place, we compared the reporting and investigation of anaphylaxis in a large hospital before and after the introduction of the 2008 guideline. Methods A retrospective outcome audit was conducted to compare data from 12 patients referred from April 2006 to May 2008 prior to release of the 2008 AAGBI guidance, with 53 patients referred from 2008 until April 2011. Data were collected using the AAGBI Anaphylaxis Referral Form. Results There was an increase in the number of referrals for suspected anaphylaxis following implementation of the AAGBI guidance. The clinical features observed in patients were consistent with previous studies. There was improved documentation of referral to local and national databases. Most cases resulted in cancellation of surgery, and there were no patient deaths. A substantial increase in the number of patients with amoxicillin allergy was noted in the second time period, which was linked to a change in the local perioperative antibiotic policy. Conclusions Implementation of the AAGBI guidelines locally in a large hospital in 2008 resulted in an improved awareness of the importance of reporting and investigation of suspected anaphylaxis under anaesthesia. This tool was implemented coincidentally with the change in hospital antibiotic prophylaxis and enabled the cases detected to be accurately recorded and investigated. This led to a change in the hospital antibiotic policy for surgical prophylaxis. Implementation of structured guidance from a national anaesthesia organisation enhances recognition of the clinical features of anaphylaxis, increases number and completeness of referrals and more thorough immunological investigation, leading to improved patient safety during anaesthesia. [ABSTRACT FROM AUTHOR]

The number of anaesthetists who are involved in magnetic resonance (MR) units is increasing. Magnetic resonance systems are becoming more powerful and interventional procedures are now possible. This paper updates information relating to safety terminology, occupational exposure, reactions to gadolinium-based contrast agents and the risk of nephrogenic systemic fibrosis. Magnetic resonance examinations of patients with pacemakers are still generally contra-indicated but have been carried out in specialist centres under strictly controlled conditions. As availability of MR increases, so the education of anaesthetists, who are occasionally required to provide a service, must be considered. Anaesthesia in MR units was first described in the 1980s. Guidelines on the provision of anaesthetic services in MR units were published by the Association of Anaesthetists of Great Britain and Ireland (AAGBI) in 2002 [1]. Since then, the number of hospitals with MR units, and hence the number of patients requiring anaesthesia for MR, has increased. While the issues relating to setting up anaesthetic services in MR have not changed, there have been a number of developments that warrant this update: 1 Safety terminology and guidelines have changed. 2 MR systems utilise higher magnetic-field strengths and more open designs are available. 3 Interventional and intra-operative MR are now routine in some centres. 4 Mobile MR scanners are increasingly used to reduce waiting lists. 5 Although still generally contra-indicated, some patients with pacemakers have been scanned under strictly controlled conditions in specialist centres. 6 'MR safe' medical implants are now being produced. 7 New equipment is now available for use in MR. 8 Out-of-hours availability of MR investigations has increased. 9 Reports of allergic reactions to MR contrast media have increased. 10 Gadolinium based contrast agents (Gd-CAs) are associated with a varying degree of risk of nephrogenic systemic fibrosis in patients with impaired renal function. [ABSTRACT FROM AUTHOR]

Objectives: To discover whether any consensus exists among the Association of Paediatric Anaesthetists of Great Britain and Ireland (APA) members regarding the use and acceptability (or otherwise) of physical restraint. Background: Despite growing recognition of children’s right to be consulted regarding their healthcare, the issue of how to proceed when faced with a child unwilling to undergo induction of general anesthesia remains relatively unaddressed. Methods: APA members were surveyed regarding their use or avoidance of physical restraint and alternate techniques to facilitate induction; factors affecting choice of technique; and extent of preoperative discussion. The anonymous online survey used both structured and free text responses. Results: Of 596 surveys, 310 were returned, a 52% response rate. Use of physical restraint and extent of restraint employed declines with increasing child age. Distraction techniques are frequently employed for children under 6 years, with the use of sedative premedication increasing as child age increases. Urgency of procedure, developmental delay, and preoperative discussion all have an effect. Comments demonstrated a wide range of views and lack of consensus on what constitutes physical restraint, and what degree of restraint, if any, is acceptable. Conclusion: Our results are similar to the US Society of Pediatric Anesthesia members, suggesting this remains an issue internationally. Consideration of practices in other specialties gives some guidance. Our survey shows a range of views as to what physical restraint is or involves, and what constitutes acceptable practice regarding the use or avoidance of physical restraint. We were unable to demonstrate consensus. [ABSTRACT FROM AUTHOR]

Infusion of lipid emulsion has been demonstrated to facilitate return of spontaneous circulation in animal models and human cases of local anaesthetic induced cardiac arrest. Guidelines for lipid application exist; however, experimental evidence of efficacy at recommended dosing is lacking. In 20 sedated, mechanically ventilated, and invasively monitored New Zealand White rabbits, asystole was induced via bolus bupivacaine injection. Animals were randomised to receive either 20% Intralipid administered according to Association of Anaesthetists of Great Britain and Ireland guidelines, or identical volumes of 0.9% saline solution, in addition to standard Advanced Cardiac Life Support resuscitative measures. Seven lipid treated rabbits developed return of spontaneous circulation vs four saline treated animals (p = 0.370). A trend toward sooner return of spontaneous circulation in the lipid treated group was observed (2.4 (0.53) vs 3.8 (1.7) min; p = 0.082). Five animals in the lipid treated group survived to protocol termination vs nil animals from the saline treated group (p = 0.033). The current Association of Anaesthestists of Great Britain and Ireland lipid infusion protocol provides a useful beginning for lipid emulsion administration. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Association of Anaesthetists of Great Britain and Ireland. ri-operative management of the surgical patient with diabetes 2015" in a 2015 issue.

The article provides information on the results of a survey conducted on the use of throat packs in neuroanaesthesia by the Neuroanaesthesia Society of Great Britain and Ireland. According to the survey, 49 percent of the anesthetists reported inserting a throat pack during neurosurgery, 30 percent for tracheal tube stabilization, 27 percent for the prevention of spillage of secretions and 18 percent for the minimization of airway soiling during trans-sphenoidal surgery.

The article presents information about the Group of Anaesthetists in Training (GAT) Committee. The committee was formed in the year 1967. It aims to represent the interests of trainee anaesthetists across Great Britain and Ireland. It meets four times a year and holds an Annual Scientific Meeting which is open to all its members.

The article offers information related to seminars organized by the Association of Anaesthetists of Great Britain & Ireland (AAGBI). It presents the schedules of several AAGBI seminars for December 2008 to January 2009 including seminars on resuscitation, ultrasound in anesthesia and critical care setting. Details on how to organize an AAGBI seminar are also provided.

The article provides information on the Linkman Scheme of Association of Anaesthetists of Great Britain & Ireland (AAGBI). It notes that AAGBI is one of the largest specialist medical organizations in Great Britain and Ireland and has over 10,000 members in its 77th year. It mentions that the Linkman Scheme has provided a two way link between AAGBI's members and council since 1974. It informs that AAGBI has about 258 linkmen who represent 500 hospitals in the two countries.

The article highlights the Scottish Standing Committee of the Association of Anaesthetists of Great Britain and Ireland (AAGBI). The author throws the question on whether there is a need for the Scottish Standing Committee. According to the author, there is a need for an instrument for anesthesia if anesthetists aspire to remain as a specialty and a service across legislatures.

The article announces the establishment of the Standards Group, an offspring of the Safety Committee of the Association of Anaesthetists of Great Britain & Ireland (AAGBI) in 1994. Standards Group is designed to work various techniques for the improvement of patient safety through standardization agreement of anaesthetic equipment in Great Britain and at the European International level. The standardization applies in anaesthetic equipment such ventilators, tracheal tube and catheters.

Lists members of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) who died between October 2002 and September 2003. C. Beeton; T.A. Brown; T.T. Currie; M. Fanning; J. Freeman; B.E. Grant-Lewis; L. Henderson; E. Holden; G. Katsaros; P.J. Keep.