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1.   INTRODUCTION

During an anaesthetic, the major responsibility of the anaesthetist is to provide care for the patient. This requires the continuous presence of an anaesthetist. In certain circumstances, it is necessary for the anaesthetist to hand over that responsibility to an anaesthetic colleague. Such handovers will not compromise patient safety provided that appropriate procedures are followed. In prolonged anaesthetics, handover may be advantageous to the patient by preventing undue fatigue of the primary anaesthetist.

TEMPORARY RELIEF OF THE ANAESTHETIST

This is necessary when the primary anaesthetist must leave the patient but will return to resume management of the patient.

PERMANENT HANDOVER OF RESPONSIBILITY FOR CARE

This is necessary when the primary anaesthetist must leave the patient under the care of another anaesthetist for the remainder of the anaesthetic.

2.   PROTOCOL FOR TRANSFER OF RESPONSIBILITY

The primary anaesthetist must be satisfied as to the competence of the relieving anaesthetist to assume management of the case AND must only hand over responsibility at a time when the clinical status of the patient is stable and no potential adverse events are likely to occur.

The relieving anaesthetist must be willing to accept responsibility for the case and must have had all facts relevant to the safe management of the patient adequately explained.

The following matters must be considered by both the primary and the relieving anaesthetists:

2.1   The patient's health status must be reviewed having regard to past history and the present condition.

2.2   A description of the anaesthetic including drugs, intravascular lines, airway security, fluid management, untoward events and any foreseeable problems plus the plans for further intraoperative and postoperative management.

2.3   The current state of the surgical procedure and its implications for the management of anaesthesia.

2.4   Observations of the patient according to College Professional Document PS18 Recommendations on Monitoring During Anaesthesia as shown by the anaesthetic record.

2.5   A check to ensure correct functioning of the anaesthesia delivery system, monitoring devices in use and any other equipment which is interfaced with the patient.

2.6   Notification of the handover to the operating surgeon and to the consultant anaesthetist (in the case of a trainee).

2.7   In the case of a temporary relief, the relieving anaesthetist should not change the anaesthetic management substantially without conferring with the primary anaesthetist except in an emergency AND the primary anaesthetist must be available to return at short notice.

COLLEGE PROFESSIONAL DOCUMENTS

College Professional Documents are progressively being coded as follows:

TE Training and Educational

EX Examinations

PS Professional Standards

T Technical

POLICY – defined as ‘a course of action adopted and pursued by the College’. These are matters coming within the authority and control of the College.

RECOMMENDATIONS – defined as ‘advisable courses of action’.

GUIDELINES – defined as ‘a document offering advice’. These may be clinical (in which case they will eventually be evidence-based), or non-clinical.

STATEMENTS – defined as ‘a communication setting out information’.

This document is intended to apply wherever anaesthesia is administered.

This document has been prepared having regard to general circumstances, and it is the responsibility of the practitioner to have express regard to the particular circumstances of each case, and the application of this document in each case.

Professional documents are reviewed from time to time, and it is the responsibility of the practitioner to ensure that the practitioner has obtained the current version. Professional documents have been prepared having regard to the information available at the time of their preparation, and the practitioner should therefore have regard to any information, research or material which may have been published or become available subsequently.

Whilst the College endeavours to ensure that professional documents are as current as possible at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently.

Promulgated: 1985

Reviewed: 1991, 1994, 1999

Date of Current Document: Oct 2004

© This document is copyright and cannot be reproduced in whole or in part without prior permission.

College Website: http://www.anzca.edu.au/