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Dr Viola Mendonca and Dr Emma Smith look at the effectiveness of medical students in recognising cardiac arrest, initiating chest compressions, and delivering defibrillation.

The annual incidence of in-hospital cardiac arrest is 1 to 1.5 per 1,000 hospital admissions, and return of spontaneous circulation is achieved in 53% of those who are treated by a hospital’s resuscitation team.

The hospital resuscitation team must, at a minimum, be able to perform basic airway interventions, including the use of a supraglottic airway in adults, intravenous cannulation, intraosseous access, defibrillation, and drug administration. They also should be able to provide immediate post-resuscitation care. In some hospitals, the cardiac-arrest team may not include an anaesthetist, but advanced airway skills such as tracheal intubation should be accessible when needed.

The Difficult Airway Society (DAS) recommends awake tracheal intubation as a primary airway management technique in people with difficult airways. It can be achieved either by fibreoptic bronchoscopy or videolaryngoscopy. However, in our experience, despite the guidance, anaesthetists are sometimes reluctant to perform either.

While it’s useful to be able to perform both techniques depending on what’s needed for the patient, videolaryngoscopy requires fewer technical skills and can be applied with a comparable success rate and safety profile to fibreoptic intubation. Furthermore, the more commonly the procedure is undertaken, the more that anaesthetists and the wider anaesthesia and theatre teams come to regard it as a straightforward, almost ‘everyday’ event. This creates a virtuous circle where it then becomes even easier to consider and perform.

With this in mind, we suggest that anaesthetists should be introduced to awake video intubation early in their career. Seeing that airway management can take place without general anaesthesia opens up a range of possibilities and gives them further confidence for managing the various patients that could present with anticipated and unanticipated difficult airways.

As this issue’s theme is training, we’ve picked out six for anaesthetists in training, supervisors, or anyone involved in training. We hope you find them interesting and helpful.

If you’d like us to feature resources from your subspecialty here, or have any other suggestions or feedback, please email us at education-resources@rcoa.ac.uk.

He famously declared that he wouldn’t want to belong to a club that would have him as a member. We’ve been thinking about how we can attract people who might not usually think that ‘our club’ is for them.

The challenges we face in reaching a wide range of patients are common to the ones many of you experience when engaging with patients locally. Perhaps you were trying to audit or redesign services, or prepare or revise patient information. Some of the responses to these challenges are also common.

PatientsVoices@RCoA is a group of volunteers who help the College improve the delivery of safe, more effective, patient-centred care to enhance patients’ experience of anaesthesia and perioperative care. It’s vital for us to understand and represent the views of diverse communities, as we live in one of the most multicultural countries in the world.

During 2024, almost 7.4 million unique actions were completed within it, while the LLP support team closed 17,000 emails, ensuring that customer service remains our top priority. The LLP serves more than 25,000 users, with many of these being anaesthetists in training.

The LLP team has been busy delivering a range of webinars and workshops as part of our commitment to helping and supporting doctors on their individual and collective training paths. One important webinar was a pre-ARCP preparation workshop held in January 2025, with trainers and trainees contributing useful guidance, information and top-tips to navigate the process. This supplemented previous introductory guidance covering reviewing the curriculum and creating ESSRs, HALOs and SLEs.

Across the UK, great perioperative care is being delivered by a range of professionals from different clinical backgrounds. 

Many of these professionals receive some formal training in perioperative care during their careers, but many do not. Many anaesthetists recognise that optimal perioperative care is crucial in reducing the number of people waiting for surgery, improving outcomes when they do have surgery, and optimising long-term health.

To do this, we need a skilled multiprofessional workforce with consistent training and education. NHS England therefore contracted the Centre for Perioperative Care (CPOC) to develop a multiprofessional medical curriculum in perioperative care. CPOC – a cross-specialty collaboration which works with patients and partner organisations to promote and develop perioperative care – is ideally placed to harness the expertise of professionals and patients, reflecting both users and providers of perioperative care.

The rigorous demands of anaesthetic training in the UK are well known, with long hours, high-stress situations, and the constant need for precision and vigilance. Adding to this the stress of COVID, change in the curriculum, and a wedding to plan led me to look for ways to refresh and rejuvenate myself.

Looking through the Health Education England (HEE) Gold Guide, you can find the information about an Out-of-Programme Career Break (OOPC). OOPCs allow trainees an opportunity to step away from training to give them time to pursue other interests, including interests not connected with medicine. This is different from the other out-of-programme options which are more related to clinical training (OOPT), clinical experience (OPPE) or research (OOPR). This led me down a path I will never regret.