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Guidelines are presented that summarise the legal position regarding the audio/visual recording of doctors and others in hospitals. In general, there are few, if any, legal grounds for refusing a request by patients to record procedures and/or discussions with clinicians, although some staff may feel uncomfortable being recorded. Trusts and others are advised to draw up local policies and ensure staff and patients are adequately informed., (© 2020 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.)

We examined the prevalence of novel acronyms in the titles of anaesthetic and related studies and the response of anaesthetists to them. We separately analysed trainee-led research projects in the UK supported by the Research and Audit Federation of Trainees (RAFT), and a 10-year cohort of papers identified using the PubMed literature search tool. We also conducted a survey of 20 anaesthetists within our institution regarding the utility and impact of titles containing acronyms, and their recall of the associated topics. Finally, we developed a scoring system for acronym accuracy and complexity, the ORigin of AcroNym letterinG Used Term AppropriateNess (ORANGUTAN) score, and measured the progression of acronym usage over the 10-year period studied. Our results show that while acronyms themselves are sometimes considered memorable, they do not aid recall of topics and are, in general, not considered helpful. There has been an increase in the prevalence of acronymic titles over 10 years, and in the complexity of acronyms used, suggesting that there is currently a selective pressure favouring the use of acronyms even if they are of limited benefit. [ABSTRACT FROM AUTHOR]

We analysed data from the electronic rota system CLWRota, covering 2,689,962 anaesthetic sessions between 01/01/2014 and 31/12/2015, in 91 UK Trusts, in order to investigate trainees' supervision. There were 8209 trainee attachments analysed, during which 618,695 sessions were undertaken by trainees. The number of supervised sessions per week that trainees worked varied considerably (median (IQR [range]) 2.6 (1.6-3.6 [0-10]) for all grades combined), with senior trainees more likely than junior trainees to be supervised for fewer than the three sessions per week mandated by the Royal College of Anaesthetists. The number of supervised sessions was unrelated to Trusts' size, suggesting that trainees in smaller hospitals receive the same level of supervision as in larger teaching hospitals. Analysis of a dataset of this size should be a good reflection of the delivery of anaesthesia training in the UK. [ABSTRACT FROM AUTHOR]

Previous guidelines on consent for anaesthesia were issued by the Association of Anaesthetists of Great Britain and Ireland in 1999 and revised in 2006. The following guidelines have been produced in response to the changing ethical and legal background against which anaesthetists, and also intensivists and pain specialists, currently work, while retaining the key principles of respect for patients' autonomy and the need to provide adequate information. The main points of difference between the relevant legal frameworks in England and Wales and Scotland, Northern Ireland and the Republic of Ireland are also highlighted. [ABSTRACT FROM AUTHOR]

The authors discuss the impact of the reports on anesthesia by the 5th National Audit Project (NAP5) and by the Mothers and Babies: Reducing Risk Through Audit and Confidential Enquiries Across the UK (MBRRACE-UK) on obstetric general anesthesia. Topics discussed include cases of awareness in obstetric anesthesia, recommendations of the reports for anaesthetists, and a forecast for general anaesthesia.

We have evaluated the TEG® thromboelastograph and the ROTEM® thromboelastometer, two point-of-care devices that measure blood coagulation. During a one-week period, seven consultant anaesthetists, one consultant haematologist, one associate specialist anaesthetist and two senior trainee anaesthetists were trained by the manufacturers and set up, calibrated and used both systems, after which their views were obtained and specific technical/support information was sought from the manufacturers using a questionnaire. Although the devices shared common features, they differed in complexity and aspects of ease of use, and in their purchase and running costs. [ABSTRACT FROM AUTHOR]

We contacted the duty obstetric anaesthetist in 219 of the 220 consultant-led maternity units in the UK (99.5%) and asked about departmental and individual practice regarding temperature management during Caesarean section. Warming during elective Caesarean section was routine in 35 units (16%). Intravenous fluid warmers were available in 213 units (97%), forced air warmers were available in 211 (96%) and warming mattresses were available in 42 (19%). Only 18 (8%) departments had specific guidelines for temperature management during Caesarean section. Personal intra-operative practice was variable, although all of those contacted would initiate some form of active temperature management after a mean (SD) volume of blood loss of 1282 (404) ml, length of surgery of 78 (24) min, or core body temperature (if measured) of median (IQR [range]), 36 (35.5–36 [34–37.2]) °C. [ABSTRACT FROM AUTHOR]

The handover of patient information between shifts enables continuity of care and increases patient safety. We surveyed UK practice during handovers in obstetric anaesthesia. A questionnaire was sent to 239 lead consultant obstetric anaesthetists to record routine practice in their unit and individual opinion about handover procedures. Responses were received from 168 anaesthetists, a 70% response rate. Handover policies were available in 10% of units. Most (76%) responding units had an allocated time for handover. In most units (76%), the duration of handover was reported as being < 15 min but the actual duration and depth of any discussion involved were not specified. Handovers were rarely documented in writing (7%). Consultant anaesthetists were most likely to be present at the morning handover and few handovers were multidisciplinary. Four percent of units reported critical incidents following inadequate handovers in the past 12 months. We identify features in handover procedures that could be improved. [ABSTRACT FROM AUTHOR]

Summary We investigated the attitudes of 96 patients and 163 anaesthetists to the need for obtaining informed consent before specialist airway techniques. Participants were asked to score six questions using a numerical scale, as to whether they thought consent was necessary before specific procedures, particularly in relation to fibreoptic intubtion used for teaching or maintaining skills. Significant differences in opinion were found between patients and anaesthetists despite a wide range of views. Overall, patients felt that specific consent was required for non-routine techniques, whilst anaesthetic respondents felt this was unnecessary, even if teaching. We conclude that guidance in obtaining consent is needed to support anaesthetists wishing to practice or teach fibreoptic intubation. [ABSTRACT FROM AUTHOR]

Summary The current recommendation of one consultant session per 500 deliveries with full sessional cover␣for units over 3000 deliveries is arbitrary and is not based on workload. The Audit Commission has questioned the wide variability of anaesthetic staffing on labour wards. The aim of this study was to investigate whether there is a relationship between current workload and obstetric anaesthetic staffing in five maternity units. In 1998, a 2-week diary of workload in the participating obstetric units was assessed in terms of staffing and clinical and nonclinical activities. The busiest time was 08:00 to 12:30. The working patterns between consultants and trainees varied considerably. Time spent on nonclinical activity by consultants averaged 51%. Any calculation of consultant sessions will need to take into account nonclinical activities. Other factors requiring consideration are the number of high-risk cases, as well as the number and experience of trainees. [ABSTRACT FROM AUTHOR]

The author comments on the policy of face mask ventilation (FMV) before the administration of neuromuscular blocking drugs (NMBs) to trainee anaesthetists in Great Britain. The argues that theoretical advantage of FMV has not yet fulfilled in the practice and could wake up the patient. The author believes that anaesthetists might underdose the patients or they might be fearful in administering adequate doses at induction.

An introduction is presented in which the editor discusses a national survey of anaesthetists to estimate an annual incidence of accidental awareness during general anaesthesia in Great Britain.

The author reflects on the collective effort in monitoring and reducing the maternal deaths, as well as improving the safety of childbirth in Great Britain. He says that one of the major achievements of anaesthetists is the reduction of maternal deaths due to anaesthesia. Furthermore, he notes that the ongoing review and reporting of maternal deaths in Great Britain should be continued to support the efforts in improving maternal safety.