In the storm of data and opinion generated by a pandemic it can be difficult to find timely anaesthesia specific information about a changing practice environment, and at the same time stay on top of everything else.
The ASA set out on a mission under the guidance of Dr Suzi Nou in 2020 to make life easier for members by coalescing resources of interest into one location, so that anaesthetists can avoid reinventing the wheel and having to learn for themselves that which our colleagues have already determined.
There are terrific resources already available via the ASA website and we now aim to refresh, adapt and augment the information responding to the results of the survey.
Anaesthetists, as perioperative physicians who often trouble shoot logistics problems throughout healthcare, who interact with every part of the system, and who have critical care and risk management expertise are ideally placed to coordinate solutions to resource allocation and clinical problems, drawing on our usual network of contacts.
In order of the priority assigned by over 800 respondents to the survey, the portal contains the current topics of most interest to members, and the resources that may help from within our current library, government and educational authorities, as well as new sources. Our website, where the further information is held will be updated constantly and expanded as required.
It is likely that we will be affected for some time yet, given the potential for a long tail of BA.2 Omicron, and another variant after that. The equally incessant pressure on the profession in an industrial and workplace sense is foremost also in our minds. We are aware that some will try to take advantage of a crisis and achieve goals that are in conflict with maintaining the central role and effectiveness of medical anaesthesia providers.
If you are aware of a resource we should add or any issue with an existing linked resource, please contact us
The ASA remains dedicated to supporting, representing and educating anaesthetists. It is what we do. Join us and become a member
The sudden emergence of variable public-in-private arrangements has caused great disruption and concern for anaesthetists.
The ASA has been involved in discussion with state AMA’s, private hospital groups and government in an attempt to ensure fair and just conditions for anaesthetists involved.
Some states may be using this as a way to reduce waitlists as well as for covid care and we need to ensure it does not usher in an era of convenience for others at the expense of providers.
The ASA has assisted members in NSW, Victoria and SA in applying for ACCC protection in order to undertake discussions with hospitals and government collectively in a lawful manner.
ASA - Contract Guidelines
NSW Indemnity for Public in Private
Victorian Hospital Agreement
Many enquiries have been received in relation to how to deal with practice liability in relation to staff around
ANZCA general resources
ANZCA: Living guidance: Surgical patient safety in relation to COVID-19 infection and vaccination
COVID-19 advice for health professionals
COVID-19: Infection prevention and control risk management
Confessions of a COVID Community Doc - Videos by Dr Suzi Nou
Sick leave COVID-19 Workforce Advice for NSW Health
Members are interested in the experience of others in obtaining and continuing training for ICU competencies and use of new therapies.
Adult ICU and paediatric ICU
NSW Health: Managing the expanded role of anaesthetists in response to COVID-19
ICU for Non-Intensivists
An area of political controversy, there is far more nuance required than lockdown vs freedom, and the interaction between public health and anaesthesia should respect the expertise of each, and the unique contribution that each brings.
Anaesthetists have a real world insight into what healthcare systems are capable of, which can differ from the expectations of the public and the assertions of politicians and commentators.
Burnet Insitute Public Health Resources
Doherty Institute : Public Health Resouces
Healthcare workers have not traditionally been as effective as those in other unionised workplaces in enforcing safety standards for themselves, as opposed to patients.
There are federal and state laws however that mandate safe workplaces for all who are there, including healthcare facilities.
The ASA can guide members to legal advice on their own workplace situation.
Occupational physicians and hygienists have contributed much understanding to the poorly controlled risks that many healthcare workers face.
In advocating for better working conditions we need to build on expertise that is applied already in other industries.
ASA Guide : Workplace Safety
Health Care Worker COVID-19 Exposure Risk Assessment Matrix
Mandatory Vaccination for Healthcare Workers: Frequently asked question
OzSAGE advice : Workplace safety
Last updated: 21 March 2022
All anaesthetists will now be familiar with the issues of airborne spread and PPE.
This section aims to have the latest consolidated information for comparison between jurisdictions and settings so members can be aware of best practice and share information about sourcing and using PPE as required.
COVID-19 infection prevention and control guidelines (added on 21 March 2022)
Australian Guidelines for the Prevention and Control of Infection in Healthcare
ASA Fit-Testing Poster
COVID-19 Personal Protective Equipment Decision Matrix
COVID-19 Infection Prevention and Control Manual
Putting On and Removing Personal Protective Equipment
Personal protective equipment in the operating theatre and procedural areas
More info PPE: ACT NSW VIC TAS WA QLD SA NT
While many operating theatres are among the better healthcare areas for air turnover and HEPA filtration, anaesthetists and our colleagues work in many other environments where the air purity is not as predictable.
HEPA filtration - which one for which space, and air exchange, CO2 monitoring and remedies are covered in these resources.
Dr Suzi Nou : Podcast on Airborne Transmission - Nick Wilson & Euan Tovey
Example Businesses Implementing Clean Air (also has advice on purifier purchase in Australia)
OzSAGE advice : Safe Indoor Air
The central role of rapid antigen tests was not anticipated last year when PCR remained the only test for most. The need to frequently test both patients and staff means an understanding of which of the tests that are available are useful for omicron, and under what conditions, is essential.
Better understanding of the sensitivity and specificity of the tests in different populations, and uniformity around implementation for routine admissions are areas that the ASA is pursuing.
Recommendations for COVID-19 Surveillance Testing in NSW Healthcare Facilities
TGA - RAT
The public health settings for isolation now are a balance between trying to reduce transmission while enabling, where possible, earlier return to work.
In healthcare, the risk of transmission to patients is ever present and potentially catastrophic so a reduction into the zone of the average incubation period for Omicron requires vigilance.
Managing Aged care and Disability Worker Exposures (latest 2021)
Managing Healthcare Worker Exposures
Managing Health Care Worker Exposures – high COVID-19 community transmission
NSW guidance on healthcare worker exposure
Risk Matrix for Health Care Worker Exposures
Surgery and Anaesthesia for Patients after COVID – Public Patients in Private Practice
Timing of Elective Surgery under GA for Patients after COVID
One of the better risk controls is the administrative layer where reducing exposure and cross-contamination can be achieved through thoughtful processes. Here we collate the experience of different workplaces so that best practices can be replicated and improved upon.
ASA Pandemic Plan
ASA Practical Planning
This has had an ICU focus, but of course relates to every area of healthcare from general practice to aged care and emergency departments as well.
ASA President, Dr Andrew Miller is sitting on the AMC working group that is developing a paper on Triage in Disaster Management.
NSW Evidence re ICU Triage
SARS-Cov-2 affects multiple systems and remains of concern in the perioperative period even if the clinical course was mild.
The ASA has been advocating for a standard approach between representative organisations to the issue of surgery for recent covid positive patients. The ANZCA/RACS document is welcome and will likely need some modification based on experience over the next few months.
The treatment of COVID-19 disease itself is of interest to members and the ASA commends the National Covid Evidence Taskforce for the guidance around treatment of the acute and chronic disease.
ANZCA - Surgical Patient Safety
ASA Airway Management - Covid
ASA Airway Management - Paediatrics - Covid
Caring for Adults and Children with COVID-19 in the Community
Caring for your Child with COVID-19 at Home
COVID-19 Clinical Advice Update (COPS)
COVID-19 Infection Prevention and Control Manual
COVID-19 Keep Patients Safe IPAC Manual
Delaying Surgery for Patients Recovering from COVID-19
Guidance on Management of Surgery NSW
Healthcare Services Contact Management (VIC)
Managing at Home with COVID-19
National COVID 19 Clinical Evidence Taskforce
Surgery and anaesthesia experts issue update on timing of elective surgery following emergence of omicron variant of SARS-CoV-2
The ASA along with all representative medical bodies has faced challenges with face-to-face opportunities for continuing professional development.
Many innovations, in addition to standard hybrid meetings, now make achieving CPD goals easier.
Anaesthesia as a specialty has been at the vanguard of welfare initiatives. We have an ongoing commitment to making the best resources available.
Planning for Quarantine
Wellness on the fly Series
Fortunately the airborne spread question is no longer contested seriously, but the provision of adequate protections for workers is not universal yet.
There may be a significant number of perioperative nursing staff, particularly in the private sector who have still not been able to access fit testing and/or supply of the appropriate P2/N95 respirator. Where anaesthetists identify that fit testing and P2/N95 supply is not being made available to either themselves or their workplace colleagues they can talk to their relevant states Worksafe organisations or contact the ASA.
The ANMF is also working in this area.
Find more resources on the Media Releases page
With many thanks to the ASA COVID-19 Working Group :
Dan Holmes FANZCA, Suzi Nou FANZCA, Brian Spain FANZCA, Matt O’Sullivan FRACP FRCPA, Joey Byrne FANZCA, Verna Aykanat FANZCA, Peter Harrigan FANZCA FCICM, Yasmin Endlich FANZCA, Thar-Nyan Lwin FANZCA, Alpha Tung FANZCA, Lan-Hoa Le FANZCA, Ben Piper FANZCA, Nadia Vargas FANZCA, Julie Lee FANZCA, Victoria Eley FANZCA, Stefan Sabato FANZCA, Max Moser FCICM, Michelle Horne FANZCA, Isaac Cheung FANZCA, Niketh Kuruvilla MBBS Hons, Divya Sharma FANZCA, Yasmine Ali Abdelhamid FCICM
In Collaboration with :
Sunshine Coast Hospital and Health Service, ANZICS COVID-19 Working Group, ANZCA/ASA/NZSA Airway SIG, SPANZA, NZSA, SCGH Anaesthesia Wellbeing Team