GuidelinesandStandards

ClinicalGuidelines
PerioperativeAnaphylaxisManagementGuidelines
ThesecondversionofthePerioperativeAnaphylaxisManagementGuidelineshasbeenreleasedasaco
badgeddocumentbetweentheAustralianandNewZealandAnaestheticAllergyGroup
(http://www.anzaag.com/)(ANZAAG)andANZCA(throughtheAnaestheticAllergySubcommitteeofthe
SafetyandQualityCommitte).

Therevisededitionoftheguidelineshasbeenmodifiedtoaddressobservationsmadeduringsimulation,
feedbackfromanaesthetistsaftermanagementofepisodesofintraoperativeanaphylaxisandfromthemany
anaphylaxisworkshopsthathavebeenconductedsincetheinitialguidelineswereintroducedthroughout
Australasia.

Thefollowingdocumentsaredesignedtobeusedasacrisismanagementpackageintheeventofanacute
perioperativeanaphylaxis:

PerioperativeAnaphylaxisManagementGuidelin
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/GuidelinesAnaphylaxis_2016.pdf) (/getattachment/Resources/Endorsedguidelines/
Anaphylaxis_2016.pdf)
PerioperativeAnaphylaxisManagementGuidelin
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/BP_Anaphylaxis_2016.pdf)
Paper(/documents/bpanaphylaxis2016.pdf
PerioperativeAnaphylaxisManagementGuidelin
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/Adult_Immediate_Management_Card_2016.pdf) ImmediateManagementCard
(/getattachment/Resources/Endorsed
guidelines/1_Adult_Immediate_Management_Ca
PerioperativeAnaphylaxisManagementGuidelin
ImmediateManagementCard
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/Paediatric_Immediate_Management_Card_2016.pdf) (/getattachment/Resources/Endorsed
guidelines/2_Paediatric_Immediate_Managemen
PerioperativeAnaphylaxisManagementGuidelin
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/Adult_Refractory_Management_Card_2016.pdf) RefractoryManagementCard
(/getattachment/Resources/Endorsed
guidelines/3_Adult_Refractory_Management_Ca
PerioperativeAnaphylaxisManagementGuidelin
RefractoryManagementCard
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/Paediatric_Refractory_Management_Card_2016.pdf) (/getattachment/Resources/Endorsed
guidelines/4_Paediatric_Refractory_Managemen
PerioperativeAnaphylaxisManagementGuidelin
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/Differential_Diagnosis_Card_2016.pdf) DiagnosisCard(/getattachment/Resources/Endo
guidelines/5_Differential_Diagnosis_Card_2016.p
PerioperativeAnaphylaxisManagementGuidelin
(http://www.anzaag.com/Docs/PDF/Management%20Guidelines/Post_Crisis_Management_Card_2016.pdf) ManagementCard(/getattachment/Resources/E
guidelines/6_Post_Crisis_Management_Card_20

Fordetailsonpatientreferralsseehere(http://www.anzaag.com).

EndorsedGuidelines
ANZCAhasendorsedaselectionofguidelinesdevelopedbyotherorganisations.ProfessionaldocumentA02
PolicyonEndorsementofExternallyDevelopedGuidelines(/Resources/Professionaldocuments)articulates
ANZCA'sapproachinthisregard.PleasenotetherelevantwebsitesarenotmaintainedbyANZCA.

Disclaimer
Thestatementsandguidelinesexpressedasendorsedonthiswebsitehavebeenendorsedasgeneral
documents,havingappropriateregardtothegeneralcircumstancestowhichtheyapplyatthetimeoftheir
endorsement.Formoreinformation,pleaseclickhere(/Documents/ANZCADisclaimer20140604.pdf).

OsteoarthritisoftheKneeClinicalCareStandard
TheAustralianCommissiononSafetyandQualityinHealthCarelaunchedtheOsteoarthritisoftheKnee
ClinicalCareStandardandaccompanyingsupportmaterialsinMay2017.

DownloadtheOsteoarthritisoftheKneeClinicalCareStandard(PDF4MB)(/documents/osteoarthritisofthe
kneeclinicalcarestandard.pdf)
FormoreinformationontheClinicalCareStandard,pleaseclickhere
(https://www.safetyandquality.gov.au/ourwork/clinicalcarestandards/osteoarthritisclinicalcarestandard/).

AustralianOpenDisclosureFramework
TheAustralianCommissiononSafetyandQualityinHealthCarehasdesignedanopendisclosureframework
(http://www.safetyandquality.gov.au/ourwork/opendisclosure/theopendisclosureframework/)toenable
healthserviceorganisationsandclinicianstocommunicateopenlywithpatientswhenhealthcaredoesnotgo
toplan.

ABestPracticeGuideforContinuousPracticeImprovement(NewZealand)
TheCouncilofMedicalCollegesofNewZealand(CMC)haslaunchedABestPracticeGuideforContinuous
PracticeImprovementfordoctors.CMCmembercolleges(includingANZCA)developedtheguidein
collaborationwiththeMedicalCouncilofNewZealand,theMinistryofHealthanddistricthealthboardChief
MedicalOfficers.

Theguidebringstogetheragreedprinciplesandprocessesthatcanbeusedwhensettingupanddeveloping
programstoenabledoctorstodemonstratetheircompetenceandperformance.ThedraftCMCBestPractice
GuidereceivedprovisionalendorsementfromANZCACouncilinNovember2015andendorsementwas
confirmedwhenthefinalversionwasreleasedinFebruary2016.Seehere(http://www.cmc.org.nz/news
publications/publications)formoreinformationandacopyoftheguide.

CentralLineInsertionandMaintenanceGuideline
InApril2012theAustralianandNewZealandIntensiveCareSociety(ANZICS)publishedtheCentralLine
InsertionandMaintenanceGuideline
(http://www.anzics.com.au/Downloads/ANZICS%20Central%20Line%20Insertion%20&%20Maintenance%20Guideline%20April%202012.pdf).
TheguidelineisaproductoftheANZICSCentralLineAssociatedBloodStreamInfectionPreventionProject
anationalqualityimprovementprojectledbyANZICSwithsupportfromtheAustralianCommissiononSafety
andQualityinHealthCare.

ClinicalIndicators
TheAustralianCouncilonHealthcareStandards(ACHS)facilitatestheClinicalIndicatorProgramwhichallows
healthcareorganisationstobenchmarkatapeerandnationallevel.The2015AnaesthesiaandPerioperative
Care,ClinicalIndicatorUserManaualv6canbeaccessedthroughtheACHSwebsite
(http://www.achs.org.au/programsservices/clinicalindicatorprogram/).Thispublicationshould,withfeedback
andreflection,enableorganisations,departmentsandclinicianstoimproveclinicalperformanceinorderto
ensuregoodoutcomesforpatients.

Pleasenote:ifyourhospital/healthserviceisamemberoftheclinicalindicatorprogramyoushouldhave
directaccesstothismanual,otherwiseyouwillneedtocontacttheACHStoobtainacopy.

GuidelinesforSurgicalPatientswithPostoperativeNauseaandVomiting
Theseguidelines(/Documents/2014consensusguidelinesforthemanagementofpo.pdf)werecompiledby
amultidisciplinaryinternationalpanelofindividualswithinterestandexpertiseinpostoperativenauseaand
vomiting(PONV)undertheauspicesoftheSocietyforAmbulatoryAnesthesia.Thepanelmemberscritically
andsystematicallyevaluatedthecurrentmedicalliteratureonPONVtoprovideanevidencebasedreference
toolforthemanagementofadultsandchildrenwhoareundergoingsurgeryandareatincreasedriskfor
PONV.

MalignantHyperthermiaCrisisManagement
MalignantHyperthermiaAustraliaandNewZealand,agroupofanaesthetistsandscientistswithaspecial
interestinmalignanthyperthermia,havedevelopedaresourcekit(http://www.anaesthesia.mh.org.au/mh
resourcekit/w1/i1002692/).Thecomprehensivekitincludesguidelinesonresuscitation,linesand
investigations,dantrolenereconstitution,cooling,logisticsandothertopics.
ManagementofSevereLocalAnaestheticToxicity
TheAssociationofAnaesthetistsofGreatBritainandIreland(http://www.aagbi.org/)hasreleasedasafety
guideline(http://www.aagbi.org/sites/default/files/la_toxicity_2010_0.pdf)regardingthemanagementofsevere
localanaesthetictoxicity.TheguidelinewasproducedbyaworkingpartythatcomprisedGrantCave,Will
HarropGriffiths(chair),MartynHarvey,TimMeek,JohnPicard,TimShortandGuyWeinberg.Accompanying
notes(http://www.aagbi.org/sites/default/files/la_toxicity_notes_2010_0.pdf)arealsoavailable.

NationalStandardforUserappliedLabellingofInjectableMedicines,FluidsandLines
InAugust2010theAustralianCommissiononSafetyandQualityinHealthCare
(http://www.safetyandquality.gov.au/)publishedNationalRecommendationsforUserappliedLabellingof
InjectableMedicines,FluidsandLines.Thesecondedition,publishedinFebruary2012andANZCAendorsed
thisdocument.ThecommissionreplacedtheLabellingRecommendationswiththeNationalStandardfor
UserappliedLabellingofInjectableMedicines,FluidsandLinesin2015.TheStandardand
associatedresourcesisavailablehere(http://www.safetyandquality.gov.au/ourwork/medicationsafety/safer
naminglabellingandpackagingofmedicines/userappliedlabelling/).

TheLabellingStandardappliestoALLclinicalareasinAustralianhealthserviceswhereinjectablemedicines
andfluidsareadministered.ImplementationoftheLabellingStandardisamandatoryrequirementformeeting
theNationalSafetyandQualityHealthService(NSQHS)Standardsinparticular,NSQHSStandard4:
MedicationSafety.ReplacementoftheRecommendationswiththeStandardisimmediatehoweverhealth
servicesmaytransitiontoimplementingitinduecourse.

TheNewZealandGuidelinesforHelpingPeopletoStopSmoking
TheNewZealandGuidelinesforHelpingPeopletoStopSmoking(http://www.health.govt.nz/publication/new
zealandguidelineshelpingpeoplestopsmoking)providehealthcareworkerswithadvicetheycanusewhen
dealingwithpeoplewhosmoke.Theguidelines,publishedbytheNewZealandMinistryofHealth,arebased
onarecentreviewoftheeffectivenessandaffordabilityofstopsmokinginterventions.Arangeofsupporting
resourcesarealsoavailable.ANZCAendorsement:July2014.

OSSIEGuidetoClinicalHandoverImprovement
TheOSSIEGuidetoClinicalHandoverImprovement(http://www.safetyandquality.gov.au/ourwork/clinical
communications/clinicalhandover/ossieguide/),developedbytheAustralianCommissiononSafetyand
QualityinHealthCare(http://www.safetyandquality.gov.au/),assistswiththeimplementationofastandardised
processforhandoverthatsuitslocalcontext.ItiscomplementedbytheImplementationToolkitforClinical
HandoverImprovement(http://www.safetyandquality.gov.au/ourwork/clinicalcommunications/clinical
handover/implementationtoolkitforclinicalhandoverimprovementandresourceportal/),a"howtoguide"for
managersandcliniciansreviewinglocalclinicalhandoverprocesses.

PatientBloodManagementGuidelines
TheNationalBloodAuthority(http://www.nba.gov.au/)isdevelopingaseriesofsixevidencebasedpatient
bloodmanagementguidelines.Todate,ANZCAhasendorsedfivemodules,asfollows:

Module1CriticalBleeding/MassiveTransfusion(http://www.blood.gov.au/pbmmodule1)

Module2Perioperative(http://www.blood.gov.au/pbmmodule2)

Module3Medical(http://www.blood.gov.au/pbmmodule3)

Module4CriticalCare(http://www.blood.gov.au/pbmmodule4)

Module5ObstetricsandMaternity(http://www.blood.gov.au/pbmmodule5)

Module6NeonatalandPaediatrics(http://www.blood.gov.au/pbmmodule6)

AssociateProfessorLarryMcNicolisamemberoftheExpertWorkingGroupandchairedthe
Clinical/ConsumerReferenceGroupformodules1and2.

StandardsforResuscitation:ClinicalPracticeandEducationAResourceforHealthcare
Thispublication(http://resus.org.au/standardsforresuscitationclinicalpracticeandeducationrelease/),
developedcollaborativelybytheAustralianResuscitationCouncil(http://www.resus.org.au)andtheNew
ZealandResuscitationCouncil(http://www.nzrc.org.nz),providesguidelinesforclinicalpracticeandeducation
forhealthcareprovidersresponsibleforresuscitationserviceswithinhealthcareinstitutions.Timelyand
effectiverecognitionandtreatmentofthosewhoseconditionisdeterioratingisimportantforpositivepatient
outcomes.ANZCAendorsement:March2014.

WorldHealthOrganizationSurgicalSafetyChecklist(Australia&NewZealandEdition)
InAugust2009,ANZCAwelcomedtheintroductionofthesurgicalsafetychecklist(/Documents/WHOSurgical
SafetyChecklist.pdf),animportantclinicaltoolforAustralianandNewZealandhospitals.ProfessorAlanMerry
wastheprincipalinvestigatorforAuckland,oneoftheeightpilotsitesintheWorldHealthOrganization
(/Documents/WHOSurgicalSafetyChecklist.pdf)globalstudy.ANZCAalsoassistedinrefiningthechecklist,
whichemphasisesteamworkandcommunication,foruseinAustraliaandNewZealand.Thechecklistisnot
intendedtobecomprehensiveadditionsandmodificationsareencouragedtofitlocalpracticeand
responsibilities.

SupportedStandards

DeliriumClinicalCareStandard
TheAustralianCommissiononSafetyandQualityinHealthCarehasdevelopedtheDeliriumClinicalCare
Standard(http://www.safetyandquality.gov.au/ourwork/clinicalcarestandards/deliriumclinicalcarestandard/)
toprovideanationalapproachtoimprovingtheprevention,diagnosisandmanagementofdelirium.Thisnew
ClinicalCareStandardwillhelpidentifyolderpatientsatrisksopreventivemeasurescanbeputinplaceand
helpimprovetheearlydiagnosisandtreatmentofdeliriumtominimiseharm.

Inaddition,clinicianandconsumerfactsheets,indicatorspecifications:DeliriumClinicalCareStandardand
datacollectiontoolshavebeendevelopedtosupportlocalmonitoringofthestandardtoassistclinicians,
consumersandhealthservicestoimprovesafetyandqualityofcare.

(http://www.anzca.edu.au/aboutanzca/historyandheritage/25yearsof
anzcaleadership)