ALERT/READY

C

  • 循環:If there is an impending arrest allocate the “circulation” task (1) and ask for the cardiac arrest trolley to be fetched)。1)
  • 顏色:If the oximeter is suspect, resite or replace it and/or do an arterial blood gas. Consider inserting an arterial line.

O

  • 氧:在100%氧氣情況下,可考慮是否提供鎮痛或麻醉深度。
  • 氧氣分析:卻整個呼吸道管路,都有提供到100%氧氣。

V

  • 呼吸器:Allocate the “airway and breathing” task (1). Ventilate the lungs with a

self-inflating bag. See breathing below. Exclude obstruction. (3)

  • 汽化器:如果有影響到心肺功能,需關吸入性麻醉藥物。並考慮使用別種止痛和麻醉方式。

E

  • 氣管插管或喉罩氣道:Allocate the “equipment” task (1). If

suspicious, prepare to remove and change the tube or LMA.

  • 排除:Prepare & check the correct function of an alternate breathing system and

separate oxygen source.

R

  • 回顧監測器:Recheck, correlate and record all readouts and trends. Call for

additional monitors as necessary. Don’t forget body temperature in infants

  • 審視儀器設備:Remove or replace suspect equipment. Bring in additional

emergency equipment as appropriate

A

  • 氣道:Adjust head and neck, attempt gentle chin lift. Prepare for pharyngoscopy; if

suspicious, go to the airway obstruction sub-algorithm

B

  • 呼吸:Expose the chest and abdomen. Repeat SCAN and CHECK whilst comparing

L & R sides. Consider causes

C

  • 循環:Check IV access. Secure additional access (venous & arterial) as necessary.

Prepare to transfuse.

D

  • 藥物:Allocate the “drugs” task (1). Check all drugs & infusions & the entire IV

apparatus. Draw up, check & label drugs that may be needed.

AAAA

  • Decide whether Awareness, Air (or other) embolism, Air in pleura (pneumothorax),

Allergy and Anaphylaxis are possible causes of the problem, and act accordingly (see sub-algorithms).

SWIFT CHECK

Make another assessment of the general situation, of the patient, of the activities of the surgeon and other personnel, and of the possible effects of the operation and/or any drugs or infusions.

1)
Initially the anaesthesiologist - to look after A, B, overall coordination and cycling through COVER and the appropriate sub-algorithm(s). When skilled assistance is available the anaesthesiologist may delegate A, B, and concentrate on coordinating activities and checking algorithms.