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More than one in five of the non-trainee anaesthetic workforce are SAS doctors, yet the grade is still sometimes misunderstood.

The College is keen for SAS doctors to get the recognition and support they deserve. As SAS Wellbeing lead, I started an initiative last year to spotlight the achievements of our SAS members by asking them to share their stories with us for publication on the College website and social media. Our aim was to enhance people’s understanding of the huge range of skills, experience and responsibilities of SAS doctors, to boost pride in being an SAS doctor, and to improve wellbeing.

We're delighted to announce that since September 2022 we have welcomed new elected and co-opted Council members.

The main purpose of Council is to provide clinical leadership to the specialty, set standards for education, learning and examinations, and ensure adherence to evidence-based practice.

It is the role of Council members to make sure that the College represents the needs of members and the profession. Find out more about new Council members in this article.

In addition to the newly elected and co-opted anaesthetists in training on College Council there are a number of other individuals who, through their roles within the College, work directly on behalf of anaesthetists in training.

Since its launch in August 2018, the Lifelong Learning Platform (LLP) has undergone an unprecedented amount of change. As well as adding the new Anaesthetic and ACCS 2021 curricula in August 2021, it also supports CPD Learners for Revalidation and FICM users, and automatically updates member details via our Customer Relationship Management system.

The platform continues to receive extremely high levels of use, supporting the career lifecycle of more than 24,000 fellows and members in the UK. Currently more than 21,000 of these have used the LLP for assessments and documenting their training in general. In a typical month there will be more than 400,000 LLP user interactions, including 100,000 Logbook entries and the addition of 45,000 Workplace Based Assessments or Supervised Learning Events.

The National Emergency Laparotomy Audit (NELA) has been a real success story – engaging with clinical teams and feeding back high-quality comparative process and outcomes data to improve care.^1,2,3 As NELA enters its second decade, it is important to look at persisting challenges as well as successes, and consider where improvement efforts should now be concentrated. This article highlights three areas of emphasis from Year 10 (2023) of the audit.

Infection and sepsis management

Successive NELA reports have highlighted failings in this area – with many patients recorded as having sepsis at admission and/or at time of the decision to operate (DTO), but seemingly poor timeliness of care in terms of both antibiotic administration and definitive source control. Closer examination reveals potentially missed opportunities to streamline decision-making ‘upstream’ of the DTO. Year 8 data³ shows that the median time from arrival in hospital to arrival in theatre for those with sepsis at time of arrival was 15.6 hours. Fewer than a quarter of those with sepsis on arrival at hospital received antibiotics within an hour. This finding might be partially explained by an over-interpretation of the term ‘sepsis’.

Anaesthetists are familiar with the ‘Schimmlebusch Mask’. This article evolves from Arusha, Tanganyika and a small boy’s memory of a white mask descending over his face circa 1963, having fallen while climbing the household log heap and splitting his eyebrow open, requiring sutures by the local doctor.

Open-ether-mask anaesthesia was a common and safe technique utilised in many countries at the time. Tadeusz Szreter’s recollections of performing ether anaesthesia for children in the late 1950s in Poland is an illuminating read. He describes how two facemasks had to be prepared for each procedure, and how when one became covered in frost, it was replaced by the other. Each mask had to be covered with several layers of gauze neatly trimmed to prevent cheek frostbite. With regard to the safety of ether, Perndt in 2010 and Chang et al in 2015 wrote papers advocating a rethink of this abandoned agent.^1,2,3

Numerous articles have been written about Curt Theodor Schimmelbusch (1860–1895) and his eponymous mask; this article is not attempting to review them all, the intention is to stimulate colleagues to explore for themselves.

Delivering training is a complex process. One of the disconnects that crops up between the FICM and intensivists in training is fuelled by the constraints of how the curriculum is delivered. While there are aspects of training that we can adjust, we are very much constrained by the GMC, which is our statutory body for training.

Read the latest letters submitted by members in April's Digital Bulletin.