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In recent years, the College Council has grown the number of co-opted members of Council to include representation from anaesthetists in training, FRCA examinations, defence anaesthesia and regional advisors anaesthesia. 

Since September 2022, the College Council has welcomed new representatives to support all clinical, professional, and health policy matters. Following on from the four new Council members featured in April’s Bulletin, you can read more about our new members below. 

The following new appointments were approved, and with sadness we record the deaths of some of our fellows. 

Author: Dr Stuart Connal, Fellow in Perioperative Medicine, North Central London Deanery

Perioperative Journal Watch is written by TRIPOM (trainees with an interest in perioperative medicine – tripom.org) and is a brief distillation of recent important papers and articles on perioperative medicine from across the spectrum of medical publications.

Chat Generative Pre-trained Transformer (ChatGPT) is the latest iteration freely available on the internet. Trained using transformer architecture, it generates human-like text by sifting through terabytes of data and billions of written works from internet sources¹ – many from familiar authors – to create human-like answers to prompts or questions.

As an experiment, I prompted ChatGPT to write this article, and it produced a not-terrible piece of work – although Reader, you will be reassured to know that this publication is man-made.

For your enjoyment, here is an example of a prompt related to anaesthesia:

In recent years, ‘mental health awareness’ and ‘wellbeing’ have been hot topics in almost all facets of life. It goes without saying that I was pleased to see this ethos entering into the mainstream. However, a recent incident while on call left me questioning whether this ethos had translated into my workplace.

In the early hours of an August morning, a cardiac arrest call came through on my bleep. I arrived to find chest compressions being performed on an 11-week-old baby. I was immediately filled with dread, anxiety, and confusion. As with many district general hospitals with limited paediatric service, the vast majority of sick children are diverted elsewhere, so I was not expecting to see a child. I remember feeling totally out of my depth. It had been a while since I’d dealt with paediatric patients, and I’d certainly never participated in a real paediatric arrest. 

Once the immediate shock subsided, I assumed the default position and took over the airway. It was at that point that I could see and feel the baby up close. I’d seen this colour in a child before, and knew this wasn’t going to end well. As I held that baby’s face, ventilating him, I became conscious of my racing thoughts: ‘Am I doing this right?’… ‘I think I’m going to cry’… ‘No one else is crying, get a grip’… ’Thank goodness the registrar is here’… ’This baby is not going to make it’…

‘You always own the option of having no opinion. Things you can't control are not asking to be judged by you. Leave them alone.’

Marcus Aurelius (121–180 CE)

For the record: I am a full-time NHS consultant in pain medicine and anaesthesia, and the sole provider of ‘interventional pain procedures’ to my local hospice, where I have a weekly session to see inpatients, outpatients and discuss complex pain problems in the end, and not-so-end, of life scenarios. I am also a former dean of the Faculty of Pain Medicine.

Discussions have started within the RCoA on whether the College, and its faculties, should take a stand on the issue of ‘assisted dying’.

They should not. Not pro, anti, or neutral (this last stance is multifaceted and arguably not ‘neutral’ at all).

Authors:

• Dr Samantha Black, RCoA Patient Information Lead
• Dr Lucy Connolly, Clinical Trust Fellow, Medway NHS Foundation Trust
• Elena Fabbrani, RCoA Patient and Public Involvement Manager

Over the past months, the patient information team has been busy creating new resources and collaborating with a wide range of partners to create innovative content to help you meet the challenges of preoperative assessment.

Helping you ‘make every contact count’

A child presenting for surgery provides an excellent occasion for health promotion, with the results of the PErioperAtive CHildhood obesitY (PEACHY) study showing that 24% of children presenting for surgery are overweight or obese. It has never been more important to address the physical health of children at every opportunity, ‘making every contact count’, especially in light of the surgical backlog and our ever-growing waiting lists that we are all too aware of.

At Newham University Hospital there were extensive refurbishments taking place in order to make the theatre complex compliant with current fire-safety regulations. As well as this, there have been a number of fires in intensive care units in the UK over the past decade requiring full-scale staff and patient evacuation.

We realised that we were unsure ourselves of how we would manage such a situation, and so we looked up whether there were fire-safety guidelines specifically for anaesthetists. We came across the recent Association of Anaesthetists fire-safety and emergency evacuation guidelines, published in May 2021. One of the key recommendations was that all healthcare workers should have ‘practical walk-through and/or simulated evacuation training’ at least every two years.

Authors:

• Dr Linda Nel, Consultant Anaesthetist, Perioperative Allergy Service, Southampton University Hospitals NHS Foundation Trust
  Email Dr Nel
• Dr Tomaz Garcez, Consultant Immunologist, Manchester University NHS Foundation Trust
• Dr Louise Savic, Consultant Anaesthetist, Leeds Teaching Hospitals NHS Trust
• Dr Lucy Gurr, Anaesthetic Registrar, Leeds Teaching Hospitals NHS Trust

The Perioperative Allergy Network (PAN) was set up under the joint auspices of the British Society of Allergy and Clinical Immunology (BSACI), the British Society for Immunology Clinical Immunology Professional Network (CIPN), and the Association of Anaesthetists. It represents a formal collaboration between UK anaesthetists, allergists and immunologists with an interest in perioperative hypersensitivity and is supported by the Royal Colleges of Anaesthetists, Pathologists and Physicians. It is affiliated with the International Suspected Perioperative Allergic Reactions Group (ISPAR).

Why now, and what need is being met?

The need for a diverse workforce

It is understood that in healthcare having a diverse workforce that reflects the population they care for can have better outcomes for patients, improve staff retention, and can positively improve staff morale.

Traditionally, medicine has been a career dominated by those from socioeconomically advantaged backgrounds.¹ Despite this, there have been progressive changes in this stereotype in recent times – for the last 25 years more than 50% of medical students have been female, and in 2017 59% of those accepted into medical school were women.² In contrast to this, there is currently a disproportionately low number of doctors who come from lower socioeconomic backgrounds. Data from 2015 shows that only 14% of new medical students were from lower socioeconomic groups, yet these groups represent 56% of the population.^3,4 The RCoA has pledged to develop equality, diversity, and inclusion within the specialty of anaesthesia.