Statements on COVID-19
COVID-19, Anaesthetists and Intensivists and the law
The Association of Anaesthetists and the Intensive Care Society wrote to regulators and public prosecution services, chief coroners and equivalents in the UK and Ireland highlighting the frontline roles that anaesthetists and intensivists are taking in the COVID-19 crisis and to raise concerns about the risk of civil, regulatory and criminal prosecution that may follow in the aftermath of the pandemic. Matters of particular concern include: clinicians working outside their usual scope of practice, ethical and difficult decision making and the ability to speak up when we consider resources, guidance or support to be inadequate. In our letter we stated that we would ‘offer our expert opinion in support of any member subject to inappropriate or unreasonable investigation in relation to the clinical care they provided during the COVID-19 pandemic’.
Risk reduction framework: COVID-19
Risk factors for incidence and severity of COVID-19 have been identified and include hypertension, cardiovascular disease, diabetes, chronic kidney disease, obesity, age >70, pregnancy and more recently a disproportionately high death rate has been highlighted in the black Asian minority ethnic community (BAME).
Vitamin D supplementation and BAME healthcare workers
The Association is aware of disproportionate rates of COVID-19 infection in Black, Asian and Minority Ethnic (BAME) healthcare workers compared to the white population and also with sex, age, comorbidities and a high BMI. The relationship between Vitamin D and respiratory infections risk has long been known. We bring the information together here for all members to consider how it might impact on their own wellbeing.
Returning to ‘new normal’ working
As the UK and Ireland move beyond the current peak (or ‘surge’) in the Covid-19 pandemic, national (state) health systems are looking to resume non-emergency and some elective surgery. Clinicians will rightly have concerns about what this means for their patients and for themselves. The ICM and anaesthesia Covid-19 collaborative in the UK has published a document describing when anaesthetic departments can start to move towards planned surgery, based on an assessment of their readiness.
To ensure we do not inadvertently contribute to a second surge, the Association of Anaesthetists has produced a list of those areas we believe need further consideration. We acknowledge that not all these questions can be answered now; some will require national policies to be developed while others will require local solutions, so that our patients, colleagues and their families are not placed at risk.
Statement on ST3 recruitment
On March 30, the four national education leads published a letter outlining the contingency plans for specialty recruitment during the COVID-19 pandemic. The Association of Anaesthetists Trainee Committee understand the difficult situation and appreciate the reasons behind their decision to cancel ST3 recruitment interviews. However, we have concerns about using unvalidated portfolio self- assessment scores alone to allocate ST3 posts for August 2020 and about the adverse effects this may have on our trainee members.
Statement on liquid medical oxygen supply and use
On 1 April 2020 the MHRA released a Central Alerting System (CAS) notice about the risk of a sudden pressure drop in oxygen supply pipes if demand through multiple wall outlets exceeds the maximum capacity of the Vacuum Insulated Evaporator (VIE). The alert was triggered following reports of oxygen supply failures due to the increased use of oxygen during the COVID-19 crisis (e.g. use of ventilators, CPAP, NIV, face mask).
Statement on the safe use of oxygen cylinders
The Association of Anaesthetists has learned of a patient death following an explosion and fire involving an oxygen cylinder. It is important to remember that oxygen delivery from a cylinder is a very safe process and adverse events are very rare.
Update on educational activities
Educational activities lie at the core of The Association of Anaesthetists' activities. COVID-19 has resulted in the cancellation or postponement of our scheduled educational events (seminars, webinars and core topics) as well as the July Trainee Conference in Newcastle and the September Annual Congress in Harrogate.
Summary of ethical & legal advice or statements relating to personal liability
The Association of Anaesthetists and the Intensive Care Society (ICS) are aware that many of our members have concerns about their personal liability to civil, regulatory or criminal actions as a result of their work during the Covid-19 pandemic.
Supplies of soda lime during the COVID-19 pandemic
The MHRA issued a medical device alert about the off-label use of anaesthetic machines during the COVID-19 pandemic. The alert draws attention to the use of soda lime for carbon dioxide absorption.
Vital Signs in Anaesthesia
'Vital Signs in Anaesthesia; a guide for anaesthetists seeking help and advice in the COVID crisis' was
prepared by the Association of Anaesthetists in association with the Royal Medical Benevolent Fund
Association COVID-19 task group update 20 March
Anaesthetists working closely with intensive care doctors to tackle COVID-19
Updating of core skills can reduce pressures on critical care resources and enhances patient care for those who need it most.