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07 / Anaesthesia · Crisis drills

Crisis drills

13 algorithms in 5 groups, hidden one step at a time. Decide your move, then reveal the algorithm’s: reading one is not the same as being able to run one.

Airway
Breathing
Circulation
Drugs and reactions
Neuraxial

Anaphylaxis under anaesthesia

Minutes after induction, an antibiotic, or a colloid

Recognise it

  • Cardiovascular collapse is the commonest first sign under anaesthesia, not rash.
  • Rising airway pressures and bronchospasm that will not settle.
  • Flushing or urticaria, often hidden under drapes.
  • A tryptase rise, sampled at the time, at one hour and at 24 hours.

The usual mistake

Reaching for hydrocortisone and chlorphenamine first. They are second line and they treat nothing in the minutes that matter.

On the cart

AdrenalineHydrocortisoneSalbutamol

Do it in order

0/6

  1. 1Hidden until you have committed

  2. 2Hidden until you have committed

  3. 3Hidden until you have committed

  4. 4Hidden until you have committed

  5. 5Hidden until you have committed

  6. 6Hidden until you have committed

Decide your first move before you reveal it. Rehearsing the order is the whole point: in a real crisis the failure is jumping to step four.