The European Society of Anaesthesiology without borders

Transcription

Volume
43
Autumn 10
CONTENT
EDITOR: IAIN MOPPETT
2-9
The European Society of
Anaesthesiology without borders
1
Creation of a task force on severe
bleeding management
3
In Memoriam:
Albert Van Steenberge
4
The financial status of the ESA:
A short report to members
5
European Journal of
Anaesthesiology: An Update
6
Airway Hands-on Workshop:
Meet the experts
7
Intensive Care Medicine:
Are we losing ground?
8
10
Join the ESA Clinical Trials
Network!11
Scientific Subcommittee 1:
Evidence-base Practice and
Quality Improvement
12
Improving relationships between
National Anaesthesia Societies
and the ESA: The case of the
Italian Society
12
HVAP member vacancy
13
Refresher Course Deputy
Editor Vacancy
13
EDA Subcommmittee
Part I Vacancy
14
EDA Subcommmittee
Part II Vacancy
14
15 - 22
OLA Subcommittee Vacancy
15
The WFSA and the World Congress
of Anaesthesiologists
15
ESA Trainee Exchange Programme
at the Academic Medical Centre
(AMC)18
Scientific Subcommittees vacancies 20
Future Meetings
Coming together is a beginning, staying together
is progress, and working together is success.“
Henry Ford (1863-1947), American industrialist. Founder of Ford Motor Company
10 - 14
The Netherlands
The European Society of Anaesthesiology
without borders: Toward a brighter future!
23
Copyright 2010
The
European
Society
of
Anaesthesiology a.i.s.b.l. (ESA) No part of this Newsletter may be reproduced without prior permission. The views expressed in this Newsletter
are not necessarily those of the ESA. Where
identified, the opinions are those of the author.
Otherwise the views expressed are those of the
Editor(s). The ESA cannot be responsible for the
statements or views of the contributors.
Printed on recycled paper to save the environment
Dear Members,
The mission of the European Society of Anaesthesiology (ESA) is to aim for the highest standards
of practice and safety in Anaesthesiology, through
education, research and professional development
throughout Europe. The ESA is founded on a well
organised and efficient structure, its leaders, but
more importantly on its members. In general,
three benefits emerge as primary attributes of
Society Membership: (1) information exchange
through publications and meetings, (2) collective
representation of shared interests, and (3) professional networks and professional recognition.
The ESA must become the “natural” representation of European Anaesthesiologists and provide
facilities for that. The ESA is doing a great effort
to further improve its Educational, Training and
Research activities. But more importantly the
ESA is opening its activities and coming closer
to its members in, and outside Europe. This brief
report will present the developments as well as
new projects that were successfully completed in
recent months. In particular, the following issues
will be discussed: 1) the Scientific Committee;
2) the expansion of Education, Teaching and
Training; 3) the involvement of Non Physician
Registered Healthcare Professionals (NPRHPs);
4) Medical Student Membership; 5) the Clinical
Trials Network; 6) collaboration with other
scientific European and non-European societies;
7) our connection with the European Union; 8) the
opening of the ESA to non-European countries.
Of course, these important achievements could
not have been obtained without the help of many
colleagues and ESA members working in different
positions within the Society as well as the terrific
job made by the ESA Secretariat. Without them and
their individual contribution nothing could have
been done, emphasising the role of team work to
brighten the future of Anaesthesiology.
The Scientific Programme
The ESA must improve continuously the standard of
the scientific sessions as well as the participation
of its members. In recent months, the ESA has made
significant progress in improving transparency for
recruitment of chairmen and members of the different
subcommittees of the SC. Among new rules which
are coming into effect, each ESA member is strongly
encouraged to participate actively in the activities
of a specific subcommittee. Upon application or
renewal of his/her membership, each member will be
required to choose one scientific subcommittee of
particular interest. Hopefully, “related“ members will
support their subcommittee in fulfilling its tasks. In
addition, all ESA members may submit proposals for
sessions to the subcommittee chairpersons, by using
specific form available on the website. ESA members
related to a specific scientific subcommittee might
also attend the meeting of their subcommittee as
guests at Euroanaesthesia Annual Meeting. Their
external support will promote greater interest in ESA
activities, and undoubtedly open the ESA Scientific
Committee up to new ideas and proposals.
Education, teaching and training
Education, teaching and training have always been
a crucial part of ESA activities. We need a better
defined strategic coordinated plan for different
educational, teaching and training activities in ESA,
clearly indicating what the policies for development
are. Educational, teaching and training initiatives
can always be improved. More focused programmes
should be implemented towards Central-Eastern
European Countries. The new Education and Training
Platform chaired by Prof. Robert Sneyd has recently
been constituted and will help greatly to allow better
integration and homogenisation of the different
activities of the ESA. Many other educational activities have been developed and/or are under development such as the e-Learning programme and European
Virtual Anaesthesia. The ESA has always been involved
in the educational, teaching and training activities
in Central-Eastern European countries. Within ESA,
we have the expertise of people who have visited
and cooperated with almost every Central-Eastern
European country. The time has come to try to bridge
the gap between the two parts of Europe.
The standard of the scientific content of the
sessions organised by the ESA Scientific Committee
(SC), chaired by Prof. Benedikt Pannen, is very high
and much appreciated by ESA members coming to
Euroanaesthesia every year.
Page 1
The European Society of Anaesthesiology without borders:
Toward a brighter future!
The ESA may play a crucial role in this
respect, mainly by developing strategic
plans to help Central-Eastern Europe with
guidelines and advice regarding Anaesthesiology. The proposal is that at least two main
subjects should be considered: Guidelines and
Regulations. Differences exist among CentralEastern European countries and thus specific
strategic plans would need to be adapted
accordingly.
Guidelines
Guidelines are always important as they
do define what may be considered to be
the standard of care for different areas of
competence. ESA recently established the
ESA Guidelines Committee chaired by Prof.
Andrew Smith. The benefits to the ESA of
the Guidelines Committee activities include:
a) making available a European guideline
to be used by individual ESA members and
adopted, with any desired modifications, by
National Societies of Anaesthesiology for
their own use, if they so wish; b) harmonisation of clinical management of anaesthesiology, perioperative medicine and related
clinical areas throughout Europe; c) improvement of standards of care throughout Europe
both in Western and Central-Eastern European
countries. Most of the Directors of Anaesthesia in Central-Eastern Europe are currently
dealing with difficult obstacles produced
by the fact that no international organisation has established specific rules directing
them on how they can achieve internationally recognised standards. Sometimes,
they only need “official” documents stressing
the importance of specific topics. Most local
leaders would know how to use these kinds
of documents for improving the situation
in their own country, region, and hospitals.
Today, with the inclusion of most CentralEastern European countries into the European
Union, this objective must be a very significant priority. The European Union in the
future may not accept major differences in
medical activities among different member
states.
Regulations
Most, but not all, of the Central-Eastern
European countries do not have recovery
areas for immediate postoperative care, no
acute pain services, no epidural service in
labour, and no rules for strict sterility
in intensive care units.
Anaesthesia departments in that part of
Europe have not always been developed in a
similar way to what we are familiar with in
Western Europe. Even in Western countries
there are major differences.
Page 2
Both approaches are intended to solve the
problem of patient safety in the operating
room and outside of it, and to significantly
upgrade Anaesthesiology in Central-Eastern
European Countries. This support, if well
organised and integrated into specific
strategic plans in the ESA, would not require
huge amounts of money. What we do need is the
goodwill groups of experts, regular meetings,
producing sensible and realistic documents,
and creating the necessary material to be
offered to Central-Eastern European countries
colleagues. Some support from industry in
this project would be welcomed. However,
the ESA must look carefully at the differences
between countries. Some Central European
countries have differing demands or needs,
and are asking for different guidelines, and
a high quality of methodological research
support.
The Non Physician Registered
Healthcare Professionals
(NPRHPs)
Non Physician Registered Healthcare Professionals play an important role in assisting
anaesthesiologists in their daily clinical
practice. From 1 September 2010, the ESA
gives the opportunity to become an ESA
Member at reduced fee to individuals who are
NPRHPs, including nurses, bio-technicians,
therapists, laboratory technicians and audiologists. This is of relevance, since our job is a
“team work” and each entity involved should
be able to exchange its experiences, discuss
together proposing new ideas, and strategies
on how to improve the daily clinical activities
and overall clinical management of patients.
Although associations for anaesthetic and
intensive care nurses exist at national and
international level, no major recognition,
formal or informal, is given at the European
level or in most of the congresses related to
our specialty. Furthermore, the organisation
of nurses working in Anaesthesia, Perioperative Medicine, Intensive Care Medicine and
Pain differs throughout European countries.
The ESA should promote activities at the
European level: a) to define the role of nurses
working in Anaesthesiology field in different
countries, discussing general policies;
b) to organise specific sessions within
Euroanaesthesia; c) to create an ESA NPRHP
Committee. The main objective of this
committee will be to facilitate the integration of NPRHPs within all other ESA committees and to develop active participation at all
levels of the Society.
Medical Student Membership
The ESA is looking to care for the junior
members who are the future of the Society.
For this reason, from 1 September 2010 individuals attending medical school are allowed to
become ESA members at reduced fee. Younger
colleagues are essential to allow future
exchange in the leadership of the Society,
to contribute in the development of new
educational, training and research activities,
and produce new ideas and suggestions. On
the other hand, medical students should be
encouraged to better familiarise themselves
with Anaesthesiology and clearly understand
which are the main areas of interest.
The Clinical Trials Network
The ESA Research Committee chaired by Prof.
Andreas Hoeft recently launched the ESA
Clinical Trials Network (ESA CTN) to provide
an infrastructure to improve the care of
patients in the fields of anaesthesia, pain,
intensive care and emergency medicine
through transnational European collaborative investigations. Critical care networks in
different parts of the world have shown that
some of the most relevant clinical questions
can only be answered if several centres
join efforts. In Europe, many groups have
undertaken successful clinical investigations in the field of intensive care medicine
in past years but, unfortunately, long-term
collaborative relationships have not been
achieved. In view of these facts, the ESA,
as a society with more than 4400 members
working in 95 countries, decided to establish
the ESA CTN, which aims at facilitating,
integrating and supporting clinical Anaesthesiology research conducted by ESA members.
All ESA members will be allowed to participate in the network activities. Four studies
have been selected by the ESA Research
Committee: 1) The European Surgical Outcomes
Study (EuSOS), in collaboration with the
European Society of Intensive Care Medicine.
The EuSOS Study is an international seven
day study of standards of care and clinical
outcomes after non-cardiac surgery; 2) The
Incidence and risk factors of chronic post
surgical pain (PAIN-OUT): A European followup Study; 3) The Occurrence of Bleeding and
Thrombosis during Antiplatelet therapy In
Non-cardiac surgery Study (OBTAIN); 4) The
Prospective Evaluation of a RIsk Score for
postoperative pulmonary COmPlications in
Europe (PERISCOPE): A 7-day data collection,
prospective, observational Study.
The European Society of Anaesthesiology without borders:
Toward a brighter future!
Collaboration with other
European and non European
scientific societies
Several activities in the ESA have been
developed in conjunction with other European
and non-European scientific societies. Most
of these activities are related to the organisation of joint sessions at Euroanaesthesia
meetings. Furthermore, the ESA created an
ESA Specialist Societies membership as an
umbrella for Societies involved in any area
of anaesthesia, intensive care, emergency
medicine or pain treatment. We are
promoting joint meetings with the Presidents
of Specialty Scientific Societies for discussion of common strategic plans in the field of
education, teaching, and training, as well as
future joined research plans.
The European Union
The ESA is a well-recognised scientific society
at the European level in the medical world.
However, the visibility of Anaesthesiology
through Europe among the general population
and in European Union offices is, in contrast,
relatively low. This represents not only a
professional, scientific and social problem
but may also influence possible economic
funding of educational, research and other
activities related to the ESA.
To improve the visibility of Anaesthesiology
throughout Europe, the ESA Board is actively
investigating the possibility of creating
a specific task force. The aim would be to
develop contacts with politicians (including
respective national Health Care Ministers),
TV/Radio, Journals, and Charitable institutes
to promote ESA activities.
ESA National representatives and National
Societies could be keyplayers, having the
double benefit of both European and local
National contacts. Through the website,
the ESA could promote the implementation of specific educational areas to
explain what are the activities involved
in the Anaesthesiology to the public, as
well as development of relationships with
the representatives of patients. An ESA
European Union Affairs Committee will be
created with the following assignments:
a) to help with applications for project
funding at national and international institutions, including European Union grants for
educational projects and scientific studies;
b) to organise forums for discussion of
research projects in the field of Anaesthesiology in European Countries, fostering communication within the research community;
c) to stimulate public and political awareness
on the importance of anaesthesia, pain,
intensive care and emergency medicine in
Europe; d) to involve the ESA proactively and
directly in shaping European Union policies
at the highest societal and political levels.
The ESA should be able to initiate public
events and influence decision-making on
issues related to Anaesthesiology in the
European Union, with particular attention to
education, science and research policies.
The non-European countries
More and more participants at Euroanaesthesia are coming from non-European countries.
The investment in these countries is essential
for the development of the ESA, and the
largest scientific societies in Europe have
followed this strategy with positive results.
We need the implementation of a specific task
force for ESA non-European countries affairs
aiming to increase visibility in non-European
countries.
This needs to develop investment and strategies to promote contacts with local associations related to Anaesthesiology, mainly in
North Africa and Middle East. Future targets
could be South America, India and China.
The implementation of the “ESA for the
Third World” project including educational,
teaching, training and support activities
with sponsorships from various industries,
charities and other associations would be of
great importance for future political strategy
of the ESA.
We have the experience and the resources
within our Society. In fact, we have the educational courses organised by the Committee
for European Education in Anaesthesiology
(CEEA), chaired by Prof. Philippe Scherpereel
and Prof. Carmen Gomar, in several European
and non-European Countries. Moreover, there
is an increasing interest from non-European
countries for the European Diploma in Anaesthesiology and Intensive Care chaired by Prof.
Zeev Goldik and the Hospital Visiting and
Training Accreditation Programme, chaired by
Prof. Lennart Christiansson. Of course these
projects should be strategically planned in
joint efforts with the World Federation of
Societies of Anaesthesiologists (WFSA).
I am sure members will have many thoughts
on these developments. Please share your
ideas with your Council members. I look
forward to seeing as many of you as possible
in Amsterdam next year. II
Paolo Pelosi
President of the ESA
Creation of a task force on severe bleeding management
Sibylle Kozek-Langenecker, Chairperson of the Scientific Subcommittee 6: Transfusion and Haemostasis
The guideline shall cover the following areas:
The Guidelines Committee has established a
task force on severe bleeding management
with the goal to produce scientifically
robust, evidence-based recommendations for
clinical practice on this topic. The task force
is chaired by Prof. Sibylle Kozek. Members
of the task force are: Dr. César Aldecoa
Alvares Santullano, Dr. Arash Afshari, Prof.
Edoardo De Robertis, Dr. Klaus Görlinger,
Prof. Patrick Wouters.
1) Definition of severe bleeding
2) Pre-operative coagulation evaluation
(bleeding history, routine coagulation
tests, platelet function tests,
primary haemostasis capacity)
3) Perioperative coagulation testing
Sibylle Kozek Langenecker, Chairperson of the Scientific
Subcommittee 6: Transfusion and Haemostasis
Page 3
Creation of a task force on severe bleeding management
Sibylle Kozek-Langenecker, Chairperson of the Subcommittee 6
4) Perioperative factors affecting
haemostasis (temperature, pH, Cai,
haematocrit, and fluid management)
5) Indications (triggers), contraindications,
dose and route of administration of
interventions and cost implications:
• Stable blood products - factor
concentrates: fibrinogen, prothrombin
complex, factor XIII, factor IX, factor
VIII/von Willebrand factor, (activated)
protein C
• Recombinant
factor
concentrates:
recombinant activated factor VII,
factor XIII, recombinant factor XIII,
recombinant factor VIII
• Labile blood products - red blood
cells, platelet concentrates, human
plasma: SD-plasma, quarantine plasma,
lyophilised plasma
• Antifibrinolytic drugs: tranexamic acid
• Others: DDAVP, vitamin K
6) Bleeding management in specific clinical
fields:
•
•
•
•
•
•
Orthopaedic surgery and neurosurgery
Visceral and transplant surgery
Cardiovascular surgery
Gynaecology and obstetrics
Paediatric surgery
Intensive care medicine
7) Perioperative bleeding management in
patients on anticoagulant or anti-platelet
therapy
8) Perioperative bleeding management
in patients with comorbidities with
haemostatic derangements
9) Perioperative bleeding management in
patients with congenital bleeding disorders
10) Role of anaesthesiologists:
Experts in perioperative bleeding
management; education and training II
In Memoriam: Albert Van Steenberge
31.07.1925 – 23.09.2010
On behalf of the entire former and current
Boards of the European Society of Regional
Anesthesia and Pain Therapy, and all its
members.
• André van Zundert, former Secretary-General and President ESRA
• Narinder Rawal, former Secretary-General
ESRA
• Marc van de Velde, President ESRA
• José de Andrés, Secretary-General ESRA
• Harald Rettig, Treasurer ESRA
The world of Regional Anesthesia has lost
one of its founding ambassadors, someone
who dedicated most of his life to the
promotion of regional anesthesia and pain
management. Prof. Albert Van Steenberge
died peacefully and surrounded by his
family at his home on September 23, 2010.
Page 4
Albert studied medicine at the University of Leuven, Belgium (a classmate of
Dr. Paul Janssen). Soon after his graduation in 1951, he started his internship at
the University Hospital St. Raphaël (Leuven,
Belgium), gained experience in thoracic and
vascular surgery (Karolinska and Sabbatsberg hospitals, Stockholm, Sweden) and did
his residency in the Notre-Dame Hospital in
Montréal (Canada) and at the University of
Leiden (The Netherlands).
All became friends of Albert. Later on he sent
several of his residents to them in order to
raise standards in his own country. He never
stopped sharing experiences and continued
developing relationships with overseas
colleagues.
For almost 35 years (1966-1990) Albert
worked at the St. Anne Clinic in Brussels
and kept on developing new techniques such
as the low dose epidural and the combined
spinal-epidural.
After specialising in anesthesiology & reanimation (1955), Dr. Van Steenberge established
the first reanimation centre in Belgium, in the
St. Martinus Clinic, Kortrijk. Soon its success
lead to the organisation of anesthesiology
departments in seven other Belgian hospitals.
Founder member of European
Societies
At the forefront
In 1956 and as a groundbreaker Albert introduced and developed loco-regional anesthesia and epidural analgesia in childbirth.
In 1962 Albert co-founded the Belgian
Society of Anesthesia and Reanimation.
He was co-founder and first national president
of the Belgian Union of Medical Doctors
(1963-1965) and worked actively to establish
a private hospital based on US models.
In 1965 he undertook a journey to the USA
and Canada to establish contact with famous
chiefs of departments of anesthesia, such as
Professors Ph. Bromage (Montréal), Fr. Moya
(Miami), J. Bunker (Palo-Alto) J. Gravenstein (Gainsville Florida), J. Bonica (Seattle
Washington), S. Schneider (San Francisco, CA)
and N. Greene (Yale New Haven).
As a member of the Board of the Obstetric
Anaesthetists Association (OAA), he organised
its first congress on the continent in 1978. A
year later, during a US organised meeting in
Heidelberg (Germany), Prof. Bonica advised
him to set up a similar society to the American
Society of Regional Anesthesia (ASRA). Albert
did so by creating the European Society of
Regional Anesthesia – ESRA (Royal Decree on
January 31, 1980). He was the first SecretaryGeneral (1980-1989) and its president from
1993 to 1997.
With the vision of making ESRA a truly
European organisation, he broadened its
scope by initiating contacts and scientific
meetings with Eastern Europe from the early
‘90s onwards: with Professors E. MayznerZawadska (Warsaw, Poland), F. Constandache
and C. Berteanu (Bucharest, Romania),
I. Kanus (Minsk, Belarus), J. Nojkov (Skopje,
Macedonia), J. Samarütel (Tartu, Estonia) and
Paver-Erzen (Ljubljana, Slovenia).
In Memoriam: Albert Van Steenberge
31.07.1925 – 23.09.2010
Meanwhile in 1991 he co-founded the
European Society of Anaesthesiology (ESA)
with his colleagues and friends Pierre Viars
(Paris, France) and Bruce Scott (Edinburgh,
UK).
Due recognition
Albert Van Steenberge received several
awards, including the Distinguished Service
Award (ASRA) and the Carl Koller Gold Medal
Award (ESRA). The Honorary Albert Van Steenberge annual lecture was initiated in 2004 by
the Belgian Association for Regional Anesthesia (BARA). He was awarded professorship in
anesthesiology by the University of Leuven,
Belgium. Albert Van Steenberge was a true
chairman, clinical researcher and a fantastic
tutor. He trained numerous anesthesiologists
(250) and his scientific output is enviable.
His first book ‘Epidural anesthesia’ was
published already in 1969.
Albert was very much loved and a charming
person. Together with his life-long friend
Bruce Scott, Albert was always open for a
joke.
His wife Françoise was always there to assist
Albert in every of his endeavours. She was the
perfect hostess for many colleagues who were
invited to stay at their house in Overijse.
Albert Van Steenberge devoted his entire
career to the practice, teaching and the
promotion of regional anesthesia, made a
remarkable contribution to the profession
by improving and teaching new techniques.
The work of pioneers like Albert contributed hugely to the increasing popularity of
regional anesthesia in Europe.
A loss to many
With the passing away of Albert, ESRA has
lost its first three presidents, Bruce Scott
(1925-1998) and Hans Nolte (1929-1998).
The world of regional anesthesia grieves
the loss of one of its founders. Albert is
survived by his beloved wife Françoise, their
children Pierre, Martine and André and their
grandchildren. Albert will be remembered
as a wonderful friend, a true gentleman, a
talented regional anesthesiologist, a great
organiser and a visionary.
His memory will live on through his accomplishments and the friends and people whose
lives he touched. II
Condolences:
www.veiller.be/rouwbeklag/rouwbeklag.php?id=199
Welcome!
We are glad to welcome Jean-François Pilier as a permanent staff of the ESA Secretariat after his 6 month
try-out period. Jean-François is Belgian from the city of Brussels. He is 45 years old, has a degree in Tourism
Management and will be reinforcing the ESA membership and administration Department staff. II
The financial status of the ESA: A short report to members
Maurizio Solca, ESA Treasurer
The ESA is a very active Society, successfully running a great variety of scientific and
educational initiatives:
• the Annual Scientific Congress, Euroanaesthesia,
• as, of this year, the Autumn
Meeting,
• the European Diploma (endorsed by the
European Board of Anaesthesiology,
Section of the UEMS-European Union of
Medical Specialists), with the related
activity of multiple sites examination,
• the Continuing Medical Education
program, through the CEEA (Committee
for European Education in Anaesthesiology),
• the Trainee Exchange Programme,
• the Hospital Visiting and Training Accreditation Programme,
• the administration of various Prizes and
Research Grants,
• editing the European Journal of
Anaesthesiology,
• publishing the ESA Newsletter (that you
are reading right now),
• and maintaining the ESA Website.
Since 2009 the ESA has started two additional
strategic initiatives: setting up ESA Guidelines, through a specific Committee and
various Task forces, and the ESA Clinical Trial
Network, a framework aimed to support large
scale multinational multicentre clinical trials
in the field of anaesthesia, perioperative and
intensive care medicine, and pain treatment.
Behind these efforts are a number of Committees, and an administrative structure which
ensures the day to day life of the Society and
allows all the above mentioned activities to
run smoothly.
All of this costs a considerable amount
of money, and it is vital for the Society to
maintain a good financial health.
Where does the money come
from?
Where does the money come from and where
does it go? This is a legitimate question by
any ESA member who through their annual
dues contributes to such a financial health.
Every year the Treasurer presents the
accounts (which are audited by a licensed
independent company) to the Council and
then to the General Assembly for approval by
the members. For the year 2009 the operational balance was positive in the face of a
small budgeted loss, thanks to the exceptional return from the Milan Euroanaesthesia
Congress, which was characterised by a much
greater attendance than expected. Revenue
from the annual congress is the major income
for the ESA, and we rely on an ever improving
quality of the scientific content to maintain
high participation.
Page 5
The financial status of the ESA: A short report to members
Maurizio Solca, ESA Treasurer
In order to improve the efficiency of the organisation of the Congress, since its insourcing
in 2008, last year the ESA has established a
“commercial entity with a social goal”, (the
same as the aims of ESA) called ESAACS (ESA
Administration and Conference Services).
The real world
The budget for 2010 is much less optimistic,
due to the persistently low economic outlook
worldwide, and the continuing reduction of
industrial support brought about by more
stringent legal requirements. The ESA is
required to hold significant financial reserves.
These are vital for its survival in case of any
eventualities preventing a successful annual
meeting.
These reserves were badly hurt (on the paper
only, as we were not forced to realise them),
in the wake of the worldwide financial crisis
of 2008-2009. In spite of this, the financial
reserves of the Society markedly recovered
during the second part of 2009 and beginning
of 2010, allowing ESA to continue with confidence its investments in research, education
and members services. II
European Journal of Anaesthesiology: An Update
Martin R Tramèr, Editor-in-Chief of the EJA
The “new“ EJA is not even
one year old, and we can
already give you a summary
of what has changed since
the beginning of this
year. We are constantly
working on both structure
and presentation of the
Journal. On the front page, readers will
now find either the “Editor’s choice” or the
“Topic of the month”. Within the Journal,
article types are more clearly labelled.
We are regularly publishing Editorials
and Comments. These are usually commissioned. Editorials discuss issues that are
not directly related to published material.
Comments accompany original articles,
critically assess their results and put their
conclusions into a wider context.
A new Editorial Board
We have restructured the Editorial Board.
Some of the “old” editors are still with us
and are doing a great job. Some have stepped
back during the year. These are Martin Leuwer
(Liverpool-UK), Carla Nau (Erlangen-GER),
and George Shorten (Cork-IRL). I would like to
take the opportunity to thank Martin, Carla
and George for all they have done for the
Journal. New editors have joined us during
the year. These are: Rolf Rossaint (AachenGER), Bernd Böttiger (Cologne-GER), Patricia
Lavand’homme (Brussels-BEL), Thomas FuchsBuder (Nancy-FR), and most recently Francis
Veyckemans (Brussels-BEL). We have also, and
in agreement with the ESA Board of Directors,
appointed Mike Nathanson (Nottingham-UK),
the current editor of ESA Refresher Courses,
as an ex-officio member of the EJA Editors
Board. Mike will be handling all incoming
review articles including invited refresher
courses. As of November, Nadia Elia (GenevaSwitzerland) will become our Methods &
Statistics Editor.
Page 6
We put much weight on improving the quality
of data reporting and it will be one of Nadia’s
main responsibilities to initiate and follow-up
these changes. Last but not least, Alan
Aitkenhead (Nottingham-UK) has joined the
Editorial Board; he will be our second English
language editor. His and Gordon Lyon’s work
is highly appreciated as they ensure an appropriate English style throughout the Journal.
A new initiative is called “Anaesthesia for
Orphan diseases”. As we are regularly getting
case reports on the anaesthetic management
of patients, often children with rare diseases,
we thought that the implementation of a new
section dealing with the anaesthetic management of patients with so-called orphan
diseases would be useful. Francis Veyckmans
will be dealing with these reports.
Ethical standards
We have introduced a variety of standard
operating procedures for authors. Our ethical
requirement, for instance, is that authors
of articles dealing with original human
or animal data must include a separate
subheader entitled “Ethics” in the Methods
section. That paragraph must contain
information on name and address of the
responsible Ethics Committee, the protocol
number that was attributed by this Ethics
Committee, the name of the Chairperson (or
the person who approved the protocol) of the
Ethics Committee, and the date of approval.
Submitted manuscripts that do not fulfil
these requirements are not considered for
peer review and are sent back to the authors.
Similarly, we are asking authors to add a
separate "Acknowledgement" section at the
end of their manuscripts. That section should
contain statements about assistance with the
study, financial support and sponsorship, and
conflict of interest.
If there was support from a pharmaceutical
company or a manufacturer, we insist that it
is clearly stated what the role of the company
was, as for instance, editing the protocol,
financial support, drug supply, data analysis,
or writing the paper.
New EJA Symposium
Finally, the EJA has initiated the EJA
Symposium to be held at the annual Euroanaesthesia congress. Each year we intend
to choose a specific subject that is related
to scientific publication and we will invite
one or several keynote speakers. For the
2011 congress in Amsterdam, the topic of
the EJA Symposium will be “Quality of data
reporting”, and we have the great pleasure to
announce Drummond Rennie, Deputy Editor
of JAMA, as our distinguished guest speaker.
His lecture will be entitled “The Prescriptive
Editor. Quality of Reporting, CONSORT et al.”.
All ESA members, readers, peer reviewers and
authors, are invited to attend this lecture
that will be held on Sunday, 12 June 2011.
Thanks
I would like to express my gratitude towards
all those who are helping us, directly and
indirectly, to bring our Journal forward. A
large number of peer reviewers have been
doing a great job so far; they are helping us
to keep our return times short and to provide
authors with high-quality feedbacks. All ESA
members are invited to participate in this
project. Remember: we need good original
articles, scholarly reviews, thoughtful
editorials, and critical comments! II
Airway Hands-on Workshop: Meet the experts
Amsterdam, the Netherlands
Euroanaesthesia
2011
The European Anaesthesiology Congress
June 11-14
Airway management is a cornerstone of patient safety. The role of the
error prevention has been repeatedly emphasised in documents from
leading healthcare bodies:
• World Health Organization (WHO): “Guidelines for Safety Surgery”
• ESA, in cooperation with the EBA (European Board of
Anaesthesiology-UEMS): “Helsinki Declaration on Patient Safety in
Anaesthesiology”
• World Federation of Societies of Anaesthesiologists (WFSA)
• European Patients’ Federation (EPF)
All of these bodies as well as various national guidelines describe
the good clinical practice of recognising and effectively preparing for
life-threatening loss of airway or respiratory function. Unfortunately,
despite these numerous guidelines and many innovative techniques to improve airway management, airway related adverse
events continue to represent one of the most frequent cause of anaesthesia-related morbidity and mortality in perioperative
care, critical care and emergency medicine.
Euroanaesthesia Hands-on workshop
The Euroanaesthesia Airway hands-on workshop organised by the ESA Scientific Subcommittee 19: Airway Management, has been
designed to provide participants with the state-of-the-art in this field and to experience on a multitude of proven and promising
airway techniques and devices. The delegates will have the chance to meet 36 of the main experts from ESA (European Society
of Anaesthesiology), EAMS (European Airway Management Society) and SAM (the American Society for Airway Management) with
a common passion for education and continuing professional development for safe airway management.
Course objectives
The workshop will offer the participants:
• a small group, hands-on training in advanced airway management techniques outlined in the
airway guidelines, using a variety of safe techniques and promising new devices;
• an opportunity to share ideas and experiences with a panel of international experts in airway management;
• simulated airway scenarios to practice skills and strategies used in managing a difficult airway.
Target audience
The airway course is intended for all grades of anaesthetists wishing to learn, refresh and update skills in managing patients with
a difficult airway and to learn about the newest developments in the field of airway management.
Scientific Task Force: Pierre A. Diemunsch (Strasbourg, France, ESA Scientific Subcommittee 19 Chair), Ankie Hamaekers
(Maastricht, the Netherlands), Vicente Martinez (Valencia, Spain), Flavia Petrini (Chieti-Pescara, Italy, EAMS President), Arnd
Timmermann (Berlin, Germany, Coordinator of the Airway Hands-on Workshop).
Airway Hands-on Workshop – Meet the experts will be organised twice during the Euroanaesthesia 2011
(Amsterdam, the Netherlands) on:
• Sunday, 12 June 2011, 14.00-17.30 – Workshop 1
• Monday, 13 June 2011, 9.00-12.30 – Workshop 2
Registration is limited to 72 delegates per session. Online registration will be available as
of 3 November 2010. Please visit www.euroanaesthesia.org for more information. II
Page 7
Intensive Care Medicine: Are we losing ground?
Jannicke Mellin-Olsen, president of the european board of anaesthesiology (eba)
With contributions from all members of the
panel:
• Prof. Hugo Van Aken, Germany, Chairman
of the UEMS Multidisciplinary Joint
Commitment of Intensive Care Medicine
and Chairman of the NASC Committee
• Prof. Paolo Pelosi, Italy, President of the
ESA
• Prof. Philippe Scherpereel, France,
Chairman WFSA Scientific Committee
• Prof. Gabriel Gurman, Israel, Founder and
Faculty Chairman, ISIA
• Prof. Dragan Vučković, Serbia, the
Congress President
Anaesthesiologists pioneered the field of
intensive care medicine (ICM) - to name just
a few:
• Prof. John Severinghaus for his contribution to the interpretation of gas-exchange
and acid base during anaesthesia and
blood gas analysis;
• Prof. Bjørn Ibsen, the founding father
of intensive care and hero of the 1952
Copenhagen polio epidemic;
• Prof. John Lundy, a pioneer in transfusion medicine, balanced anaesthesia and
for the use of ventilators, oxygen tents
and more;
• Prof. Peter Safar who is the father of
cardiopulmonary
resuscitation
and
recognised as the founder of critical care
medicine in the USA.
The goal will be to discharge the patient
as soon as he or she is deemed sufficiently
stable, with appropriate discharge instructions. All these components combined, and
not independently, are definitely important
to make Anaesthesiology one of the most
fascinating, ongoing developing and innovative areas in medicine in recent decades.
ICM as a separate speciality?
Will Intensive Care Medicine (ICM) leave
Anaesthesiology and become a separate
speciality? The experience from Spain, the
only European Union (EU) country where it
is recognised as such, is that it does not
appear to be as good a solution as intended
(in addition, ICM is a separate speciality in
Switzerland).
At the same time Prof. Hugo Van Aken,
Chair of the UEMS Multidisciplinary Joint
Committee of Intensive Care Medicine of the
UEMS, negotiated with Prof. Bion on an alternative approach: The particular competence
of intensive care medicine. This approach was
unanimously agreed by the nine UEMS sections
(anaesthesiology, cardiac surgery, cardiology,
internal medicine, neurology, neurosurgery,
paediatrics, pneumonology and surgery). The
reasons are obvious: A reduced involvement
of the primary specialties in intensive care
medicine and enormous problems with physicians who will leave intensive care medicine
after a couple of years due to the enormous
physical and mental stress (burnout). In April
2010 the proposal to incorporate intensive
care medicine into the medical directive
But we our glorious past does not entitle us
to be the ICM leaders in the future. We need
to continuously prove that we are worthy.
Anaesthesiology includes several areas of
expertise, including:
• Anaesthesia in the operating theatre and
in other locations;
• Post anaesthetic Care Units (PACU);
• Intensive care medicine - surgical,
medical and specialised;
• Critical emergency medicine inside and
outside the hospital;
• Pain treatment - acute, chronic and
palliative care.
This means that Anaesthesiology is not only
dedicated to perioperative medicine but
also to the provision of acute care. Acute
care identifies the necessary treatment of a
disease for a short period of time in which
a patient is generally treated for a brief,
but severe episode of illness. In the future,
the increasing need for acute care combined
with financial restrictions, will stimulate
re-structuring of hospitals to develop acute
care facilities.
Page 8
From left to right: Paolo Pelosi, President of the ESA,
Dragan Vucovic, Gabriel Gurman, Founder of ISIA, Jannicke
Mellin-Olsen, President of the EBA, Philippe Scherpereel,
Chair of the ESA CEEA and Chair of the WFSA Scientific
Committee, and Hugo Van Aken, Chairperson of the NASC
2005/36/EC was discussed again with the
Internal Market and Services Directorate
General of the EU.
The major strength of the current approach
in most countries is the multidisciplinary
approach. The entry point could be anaesthesiology, cardiology, neurosurgery, paediatrics, etc. ICM could also be a sub-speciality,
particularly of Anaesthesiology. In several
countries, there is more than one model.
This meeting was initiated by Prof. Van Aken,
in his capacity as president of the Multidisciplinary Joint Committee on Intensive
Care Medicine of the UEMS, to request the
inclusion of the concept of particular competence within the Directive on the recognition of professional qualifications (2005/36/
EC). In most European countries, intensive
care medicine can be obtained as a “particular competence” with a common training
programme for specialists with Board certification in a variety of base disciplines.
In 2007, Prof. Julian Bion, the European
Society of Intensive Care Medicine (ESICM)
president, proposed the introduction of ICM
as a separate speciality at the European level.
The requirement for a separate speciality is
that the discipline must be recognised in at
least 2/5th of the Member States and supported
by a weighted ‘qualified’ majority (determined
by the population of each country and other
factors) by the committee on Qualifications of
the European Commission.
Symposium in Belgrade: “Who
are supposed to be intensivists”
The recent Serbian congress which included
the first Balkan Symposium of Anaesthesiologists and Intensivists, in Belgrade
in October 2010, put the question on the
agenda by arranging WFSA (World Federation
of Societies of Anaesthesiologists) session on
“Who are supposed to be intensivists?”
The panel consisted of:
• Prof. Dragan Vučković, Serbia, the
Congress President
• Prof. Philippe Scherpereel, France,
Chairman of the WFSA Scientific
Committee
• Prof. Hugo Van Aken, Germany, Chairman
of the UEMS Multidisciplinary Joint
Commitment of Intensive Care Medicine
and Chairman of the NASC Committee
• Prof. Paolo Pelosi, Italy, President ESA
• Prof. Gabriel Gurman, Israel, Founder and
Faculty Chairman, ISIA
• Dr. Jannicke Mellin-Olsen, President
of the EBA and Chairman of the WFSA
Education Committee
ICM as separate speciality –
pros and cons
The arguments that have been launched in
favour of a separate ICM speciality are:
• It would acknowledge quality training
and practice in ICM
• Self-regulation and responsibility for
professional standards may translate into
even better (more reliable) patient care
• It would make ICM a more attractive
career option for committed trainees
• The profile of ICM in universities would
be raised:
»» It would be easier to attract the
next generation of intensivists;
»» It would contribute to teaching in
acute care;
»» There would be better access to
research funding.
• Consistent with European Commission’s
intentions:
»» Focus training on competencies;
»» Harmonise standards;
»» Free movement of professionals.
But there are other arguments against:
• It would lead to reduced involvement of
primary specialities in ICM, and thus,
impair patient care. One of the strengths
of current ICM is its multidisciplinary
nature.
• It could potentially create professional
barriers within the patient journey.
• Workforce issues:
»» here is no doubt that ICM is hard on
mental level – the intensivists are
with the sickest of the sick all the
time, with relatives in mental shock,
and the risk of burn-out is high. If ICM
becomes a primary speciality, then
there will be no escape to other fields
within one’s speciality. Furthermore,
there is no guarantee that ICM will
become a popular career choice. From
where are we going to recruit all these
new specialists?
»» For Anaesthesiology, we must also
think about the attractiveness of
our speciality. Currently, there is a
worldwide shortage of anaesthesiologists. ICM gives us an opportunity to
take continuous care of the patients
over a longer period of time, and it
gives us more challenges and may be
more rewarding than being gasmen
and women only.
»» If we are to stay in the operating
theatre all the time, for the rest
of our lives, many of us would get
bored. Then it certainly will affect
the recruitment to and sustainability
of our speciality. A trend for those
countries where Anaesthesiology is a
popular speciality is notably that all
four pillars are a part of our training.
• Anaesthesiology is applied physiology.
It contains pain and sedation, fluid and
electrolyte and blood product treatments; we administer antibiotics and
cardio active medications. We are used
to emergencies and acute situations, we
are skilful in invasive procedures, used to
taking quick decisions and multispecialty
teamwork is our order of the day. Prof.
Gurman provocatively argued that anaesthesia is ICM + nitrous oxide!
What gives the best patient
care?
The panel did agree that intensive care
patients, whatever their level of risk, are best
treated where more high-risk patients are
treated. It has been demonstrated that the
“optimal” number of individual ICU beds in
a department is 8 – 12. There should be full
time, on site specialists in the ICU . Special
expert consultations, like microbiologists and
infectious disease specialists, are useful. We
know that standardised, optimised procedures and protocols can be defined and better
fulfilled by a closed team.
Complications of invasive monitoring can be
reduced by a dedicated ICU team. Uniform
admission and discharge policies should be
installed.
ICM as a particular professional
qualification
The panel was uniform in the conclusion that
we must work hard to ensure that intensive
care medicine remains an integral part of our
speciality. This does not mean that ICM is
exclusively for anaesthesiologists.
The panel would rather recommend that ICM
is incorporated in the Directive 2005/36/EV
of the European Parliament and of the Council
on the recognition of professional qualifications as a particular medical competence/
qualification in Europe.
The definition of a particular medical qualification is: “An area of expertise in addition
to a primary specialty, where extra expertise
outside the domain of the specific speciality
is required to provide high quality patient
care by multidisciplinary input from doctors
from various specialities with extra, relevant
expertise.”
This means that one could enter the field
from many various specialties, and acquire
a specified list of competencies. These have
been described by the CoBaTrICE programme
(www.cobatrice.org)
The CoBaTrice reckons that those competencies can be achieved during two years. Of
those five years that the European Board has
recommended for speciality training, one
year is supposed to take place in intensive
care medicine. This means that for us, one
additional year will be required.
Positioning for the future –
the Scandinavian approach
We need to define our own future. The
Scandinavian Society tried to do just that
when they organised a web based survey for
their members –to explore what the members
wanted and to make everyone accountable for
the strategy for the future. Based on this, a
strategic position paper for the future was
developed. For ICM, it was stated: “Further
training in intensive care medicine of
specialists in Anaesthesiology will increase
the quality of treatment and patient outcomes
and ensure that anaesthesiologists remain in
the lead of this medical field in Scandinavia.
Page 9
A set of minimum requirements for other
specialities to enter advanced educational
programmes in intensive care needs to be
defined as multidisciplinary intensive care
develops further as a PMC. The SSAI suggests
that 24 months of training in perioperative
anaesthesia care required for other UEMSrecognised medical specialists to be eligible
to enter an educational programme leading to
a PMC in intensive care medicine.”
This undertaking makes it easier for the
Scandinavian Society to define their position.
Similar efforts can easily be done in other
societies in Europe. The EBA will then use
this input in its political activities in the
EU, both as a single entity and through our
co-operation and leadership
(Prof. Van Aken) in the Multidisciplinary Joint
Committee of Intensive Care Medicine within
the UEMS.
At this time, we support the proposal that:
• We do not support ICM as a separate
speciality.
• The UEMS recommends the incorporation
of Intensive Care Medicine in Directive
2005/36/EC of the European Parliament &
Council on the recognition of professional qualifications, as a particular medical
competence/qualification.
• The content of training be defined and
managed through the CoBaTrICE collaboration and monitored via the EBICM
(European Board of Intensive Care
Medicine)
• The current EDA (European Diploma of
Anaesthesiology and Intensive Care
Medicine) examination is an examination
also for ICM, and this should be marketed
and recognised.
• Anaesthesiologists should be at the lead,
not because we have the expertise on
how to intubate and insert catheters,
etc., but because we, if we follow the
recommendations, will prove ourselves to
be the most competent. II
I
Iapichino G et al. Volume of activity and occupancy rate in intensive care
units. Association with mortality Intensive Care Med 2004; 30:290–297
II
Burchardi H, Moerer O. Twenty-four hour presence of physicians in the ICU.
Crit Care 2001; 5:131-137.
III
Gajic O, Afessa B. Physician staffing models and patient safety in the ICU.
Chest 2009;135:1038–1044
IV
Kim MM et al. The effect of multidisciplinary care teams on intensive care
unit mortality Arch Intern Med 2010;170:369-376
V
Aneman A, Mellin-Olsen J, Søreide E. The future role of the Scandinavian anaesthesiologist: a web-based survey. Acta Anaesthesiol Scand. 2010; 54:1071-1076.
VI
Søreide E et al. Shaping the future of Scandinavian anaesthesiology: a
position paper by the SSAI. Acta Anaesthesiol Scand. 2010; 54:1062-1070.
The Netherlands
Marjolein Swinkels, the Netherlands society of Anaesthesiology
In preparation for Euroanaesthesia 2011 we
are very proud to have the opportunity to
tell ESA members about the great country
where next year’s congress is organised,
the Netherlands.
The Netherlands is famous worldwide for
its water management, its water engineering and architecture, its trade spirit and
traditional products and symbols such as
windmills, tulips, wooden shoes, cheese and
the bicycle. The capital Amsterdam enjoys
an international reputation, but Rotterdam
(as an international port) and The Hague (an
international legal centre) are well known.
The Netherlands is considered as a modern
Western country, industrially and technologically well developed, with a strong
economy, good social security and a stable
political establishment. For some decades the
Netherlands has also had an international
reputation for its liberal policy in the fields
of narcotics, prostitution, euthanasia and
same-sex marriage.
Water
For ages the history of the Netherlands has
been linked strongly to water. The geographically favourable position in relation to the
sea and its waterways has been made the
Netherlands a nation of shipping and trade.
Of all port areas, Rotterdam has the largest
port in Europe and one of the largest in
the world. The hinterland of these ports is
supported by an extended system of rivers,
canals and waterways.
P a g e 10
For this reason shipping and navigation play
an important role in the Dutch economy. The
rivers Rhine, Meuse and Scheldt which flow
in from the neighbouring countries end up
in the North Sea and make the Netherlands a
node for the European inland shipping.
The largest part of the Netherlands lies below
sea level. The never ending fight against
overflowing rivers and the sea has lead, after
the dyke opening and flood in 1953, to the
construction of The Delta Works: miles of
coast protection, which was just completed
in August 2010 with the raised sea dyke at
the Frisian city Harlingen.
A Royal heritage
Besides trade, the Netherlands has been
anchored in Europe by the royal family which
has German and English blood flowing through
their veins. The man who was most important
in the evolution of the current Kingdom of
the Netherlands, our national father Willem
of Orange (Willem the Silent, 1533-1584), was
born in the German city Nassau, served under
the Spanish king and owes his name to the
French heritage Orange. These days the name
of the royal house is visible to the whole
world in the colour of the Dutch soccer team.
A progressive country
The Netherlands is densely populated with
16,5 million people in just over 41,000
square kilometres. It’s a country which has
developed rapidly and where traditions have
been surpassed by the market economy. The
farmer on wooden shoes has been replaced
very rapidly by the office manager and Willem
of Orange as national symbol has abandoned
the field for Johan Cruyff. II
Join The
ESA Clinical Trials
Network!
ANAESTHESIA
INTENSIVE CARE
Did you know that the most important and challenging clinical questions are more
likely to be solved if several centres join forces?
The ESA Clinical Trials Network (CTN) has been established to facilitate, integrate and support clinical
anaesthesiology research on an international level. The ESA CTN is open to all European CLINICIANS.
Observational multicentre studies have been selected BY THE ESA RESEARCH COMMITTEE.
YOU AND YOUR DEPARTMENT may wish to join one of these studies as a centre!
By creating international European collaborative investigations, the network provides the
infrastructure for Europe-wide multicentre studies in the fields of:
•Anaesthesia,
•Pain,
•Intensive Care, and
•Emergency Medicine.
The ESA CTN is a Clinical Research Network created and maintained by the European Society of
Anaesthesiology.
To join us and for more information, please visit
www.euroanaesthesia.org or contact us directly at
research@euroanaesthesia.org
PAIN
The ESA can seem at times to be a complicated structure with committees, subcommittees, task forces, chairs, presidents and the all
encompassing secretariat. In an attempt to untangle some of this, the Newsletter has asked various officers of the ESA to write something
about their particular niche. If readers have a particular section which they would like to know more about,
please do get in touch (newsletter@euroanaesthesia.org).
Scientific Subcommittee 1:
Evidence-based Practice and Quality Improvement
Peter Kranke, Chairperson of Subcommittee 1
Once rather a niche business, evidencebased medicine (EBM) as an approach to
clinical decision-making requiring the
integration of the best available research
evidence with individual clinical expertise
and patient values, has gained widespread
acceptance and support within the healthcare community. Subcommittee 1 (SSC 1)
focusing on Evidence-based medicine and
Quality Improvement within the Scientific
Committee aims to represent and foster the
core topics in conjunction with the Evidencebased Medicine and Quality Improvement
and related topics. Methodological issues as
well as cross section topics with core issues
from other subcommittees are covered in
the format of refresher course lectures, pro
and con sessions as well as symposia on the
annual congress (Euroanaesthesia) as well as
the Autumn Meeting.
Chaired by Peter Kranke (Germany) the group
is currently composed of five other members
from Denmark (Arash Afsari), Hungary (Akos
Csomos), Germany (Alex Heller), Spain
(Susanna Parente) and Portugal (Pablo RamaMaceiras). II
In view of the guideline initiative of the
ESA, SSC 1 aims to provide methodological
expertise as well as content expertise in
existing and upcoming guideline projects.
For instance, members of SSC 1 participate
in the guideline on perioperative fasting and
the recently established group that intends to
establish a guideline on acute bleeding.
Improving Relationships between National Anaesthesia
Societies and the ESA: The Case of the Italian Society
Flavia Petrini, Member of the ESA Council and Member of SIAARTI,
Maurizio Solca, ESA Treasurer and Chair of the ESA Media Committee and Member of SIAARTI
ESA National is the representation of
National Anaesthesia Societies within the
new ESA resulting from the amalgamation process; its governing body is the
NASC (National Anaesthesia Societies
Committee), whose President sits ex-officio
in the ESA Board.
This structure was created to foster relationships between the National Societies and
the ESA. However, these relationships have
been solid and intense in many, but not in all
instances: in particular Council members, who
are elected by and represent individual ESA
members of the respective countries, may too
often have not been duly recognised by the
respective National Societies, and were not
able to effectively interact with them.
The Italian situation
This has been, until recently, and for a variety
of reasons, the case in Italy. In the past few
months though, things have changed, and
closer links have been tied: following the
drive of the SIAARTI President, Prof. Peduto,
and the ESA President, Prof. Pelosi (also
Italian, and SIAARTI member), a joint task
force has been set up, composed of prominent
P a g e 12
SIAARTI Board members (including its
President), the Chairman of the College of
Professors of Anaesthesia and Intensive Care,
Italian ESA (and SIAARTI) members holding
office within the ESA (the President, the
Treasurer, the Council member, and a few
Scientific Subcommittees Chairs), and Italian
representatives in the EBA (the Section on
Anaesthesiology of the European Union of
Medical Specialists). This task force, which
met for the first time in October 2010, already
proposed and evaluated a number of initiatives aimed to foster the awareness of the
ESA among Italian anaesthesiologists, to
increase the number of Italian ESA members,
and to support Italian anaesthesiologists in
developing European perspectives (the
European Diploma in Anaesthesiology and
Intensive Care, and the Hospital Visiting and
Training Accreditation Programme).
New website information
A section dedicated to ESA news and information has already been made available on
the SIAARTI website, and rules to maintain
it have been set during the recent task force
meeting.
The programme for the joint SIAARTI-ESA
main session at the SIAARTI Congress in
Turin in 2011 was also finalised during this
meeting.
A proposal to the ESA
Finally a proposal was put forward to ESA,
which will be brought to the relevant
audience: Why not establishing a new
category of “national membership” to the ESA
(with privileges to be defined) by virtue of
the membership to the own National Society,
to be paid through the dues already paid
by National Anaesthesia Societies to ESA
for membership in ESA National (eventually
renegotiated)?
We propose such a model of cooperation and
integration of initiatives as an example to
improve National Anaesthesia Societies and
ESA relationships. II
HVAP member vacancy
The HVAP wishes to increase its pool of visitors
The Hospital Visiting and Training Accreditation Programme (HVAP) is offered to academic departments of anaesthesia applying
for teaching accreditation in accordance with European training guidelines. The main goals of these visits are to ensure that
these institutions meet the prerequisites of training in anaesthesia, serve as reference centres of excellence and thereby contribute to harmonisation of anaesthesia training throughout Europe.
The quality of training in an institution is assessed by a team of two reviewers/visitors, one representing the ESA and the other
one the UEMS. Visitors act on a voluntary basis but their accommodation and transportation expenses are reimbursed. Active
visitors will be invited to register for the Annual Euroanaesthesia Congress free of charge and also to take part in a visitors’
meeting during this event.
Interested in becoming a visitor?
Send your CV with mention of your experience in accreditation (if any) and your language skills to hvap@euroanaesthesia.org.
Applications must be received no later than 15 November 2010. II
The ESA is seeking to recruit a Refresher Course
Deputy Editor
The post requires close liaison with Requirements
the Refresher Course Editor, Mike
The RC deputy editor:
Nathanson, throughout the year, but
• Is an active member of the ESA
the main work load is from beginning
• Writes and speaks at native English
of December until end of April, when
speaker level
all Refresher Course texts have been
• Has access to reliable email and
submitted for publication in the
internet connections
Euroanaesthesia Congress CD-Rom.
• Has PC / Mac word processing competence
Role
• Has an understanding of all subject
areas (includes anaesthesia, ICU,
The Refresher Course (RC) deputy editor
pain management and emergency
fulfils the following functions:
medicine)
• Liaises with RC editor and edits the
• Has experience in reviewing and
lectures submitted
sub-editing manuscripts
• Liaises
with
authors
about
formatting errors / deficiencies
• Liaises with authors where meaning Term of office
is not clear
The RC Deputy Editor term of office is
• Maintains a watchful eye for
3 years in the first instance, which can
plagiarism
be renewed if necessary for up to three
• Attends the Scientific Committee
further years. Travel expenses to attend
meetings
meetings of the Scientific Committee
• Advises on RC format and content
are provided according to standard ESA
• Has a commitment to the tasks
policy.
allotted
How to apply
If you wish to apply, please send
your Curriculum Vitae, which should
detail how you meet the criteria, by
e-mail to Mirka.Cikkelova@euroanaesthesia.org.
If you would like to discuss any
aspect of this post, please contact Dr.
Mike Nathanson through his e-mail
RC_Editor@euroanaesthesia.org.
Applications must be received no later
than 22 November 2010 (23:59 CET).
Appointment will be made by the ESA
Board following recommendation by the
Nominations Committee. It is possible
that interviews will be held at the ESA
Secretariat to select the successful
candidate. II
2011
Euroanaesthesia
June 11-14
P a g e 13
The ESA Examinations Committee is seeking to recruit a
French representative for its Subcommittee Part I
The candidate must have the following
profile:
• Strong interest in Education and
involved in training of residents in
Anaesthesia and Intensive Care
• Familiar with the European Diploma
in Anaesthesiology and Intensive
Care or with the national French
Board examination
• Good understanding of written and
oral English with French as a mother
tongue, and a good standard of
written French
• Active (not retired)
• ESA member or ready to become one.
The French representative of the Examinations Subcommittee Part I will have
full voting rights in this Subcommittee
and his/her duties will be the following:
• attendance at the annual October
meetings (which can clash with the
ASA meetings; a second meeting can
also be organised during the Euroanaesthesia congress if necessary)
• yearly translation of the 120
Multiple-Choice Questions for the
EDA Part I examination from English
into French
• translation of other EDA documents
(regulations,
policies,
promotional material etc.) from English
into French and update of these
documents when required
• yearly review of 10-20 MultipleChoice Questions for the EDA Part I
examination (once per year)
• report on the ESA Part I examination in France at the Subcommittee meetings if requested by the
Subcommittee Chair
• assistance with the organisation of
the EDA examinations in France if
required.
The French representative in the Examinations Subcommittee Part I will be
elected for a term of 3 years, with
possible successive re-elections of 1 year
up to a maximum term of 8 years.
Interested?
Please send us: (1) a curriculum vitae
(2) an application letter explaining
your motivations and highlighting
clearly your interest in Education
(3) a picture and (4) a recommendation
letter. A list of publications can be
added. The letter should be addressed
to the ESA Nominations Committee.
Please send your application by
30 November 2010 to the following
address: exam@euroanaesthesia.org
(please do not send e-mails larger than
3MB). II
Any questions? Please contact
exam@euroanaesthesia.org
The ESA Examinations Committee is seeking to recruit a
German representative for its Subcommittee Part II
The candidate must have the following
profile:
• EDA Examiner and ESA member
active in a teaching academic or non
academic hospital (not retired)
• German as a mother tongue
oral English, with a good standard of
written English.
The German representative of the Examinations Subcommittee Part II will have
full voting rights in this Subcommittee
and his/her duties will be the following:
ASA meetings;
a second meeting can also be
organised during the Euroanaesthesia congress if necessary)
P a g e 14
• yearly review of open Guided
Questions for the EDA Part II examination (once per year)
• contribution to the question
database of the EDA Part II examination
• translation of EDA documents if
required (letters to candidates etc.)
from English into German and update
of these documents
• assistance with the organisation of
the EDA examinations in Germany if
required.
Interested?
(2) an application letter explaining your
motivations and highlighting clearly
your interest in Education (3) a picture
and (4) a recommendation letter. A list of
publications can be added. The letter has
to be addressed to the ESA Nominations
Committee. Please send your application
by 30 November 2010 to the following
3MB). II
The German representative in the ExamiAny questions? Please contact
nations Subcommittee Part II will be
elected for a term of 3 years, with
The ESA Examinations Committee is seeking to recruit
four members for its new Online Assessment
Subcommittee
The Examinations Committee and the ESA
oral English, with a good standard of
Board are proud to announce the creation
written English expression
of a new Examinations Subcommittee,
• Active (not retired)
the Online Assessment (OLA) Subcommit• ESA member or ready to become one
tee. The purpose of this Subcommittee
is to offer an online assessment using • Experience in management of examinations is an asset
questions in a format similar to the one
• Familiar with website designing is a
used for the EDA Part I examination.
plus.
In this context, the ESA is looking for
4 members to form the new OLA Subcommittee, which will be chaired by the The members of the OLA SubcommitChairman of the Examinations Subcom- tee will have full voting rights in this
Subcommittee and their duties will be
mittee Part I.
the following:
The candidates must have the following
profile:
ASA meetings; a second meeting can
also be organised during the Euroinvolved in training of residents in
anaesthesia congress if necessary)
Anaesthesia and Intensive Care
• creation of a database of Multiple• Enthusiastic and ready to start up a
Choice Questions in English language
new challenge at European level
• yearly review and creation of new
• Familiar with the European Diploma
Multiple-Choice Questions for the
in Anaesthesiology and Intensive
Online Assessment (once per year).
Care or with your national Board
examination
The members of the OLA Subcommittee
will be elected for a term of 3 years, with
Interested?
(2) an application letter explaining
your motivations and highlighting
clearly your interest in Education
(3) a picture and (4) a recommendation
letter. A list of publications can be
added. The letter should be addressed
to the ESA Nominations Committee.
Please send your application by
30 November 2010 to the following
3MB). II
Any questions? Please contact
The WFSA and the World Congress of Anaesthesiologists
David Wilkinson, Secretary of the WFSA and Alfredo Cattaneo, President of WCA 2012
The World Federation of Societies of
Anaesthesiologists
(WFSA) was founded
in 1955 in The
Netherlands. When
it was initiated,
there were 28 founding Member National
Societies and today this has extended to
over 120.
The World Congresses of
Anaesthesiologists
There have been a series of World Congresses
of Anaesthesiologists (WCA) held in the
name of WFSA since then. In recent years,
other groups have held ‘alternative’ World
Congresses, often focusing on specific
sub-specialties, but there is only one WFSA
sponsored WCA. This happens every four
years in a different area of the world.
Each WCA is organized by a national member
society which imparts its own local flavour
to the proceedings but there are a specific
set of targets that need to be achieved by
each Congress. Many people have discussed
what defines a ‘good Congress’. Such debate
is outside the scope of this article and
there can be no doubt that the perception
of a Congress depends very much on one’s
own circumstances. There are four main
components of a WCA; firstly the delegates
who spend their money to attend; secondly
the trade exhibitors who invest large sums
of money to support the meeting; thirdly the
WFSA which has a series of constitutional
obligations to meet and fourthly the local
Conference Organizing Committee (COC). All of
this activity is facilitated by the Professional
Congress Organizer (PCO).
Why do people come to the
WCA?
We believe there are many different types of
delegates but the majority attend the WCA to
learn new aspects of their professional
activity; this may be in terms of activities that
take place in their own geographical region
which are often highlighted by presentations
from the WFSA Regional Sections. Others
will be looking for new initiatives which may
appear in programmes facilitated by specialist
groups, like obstetrics or paediatrics, while
others will be searching for answers relating
to their professional development and
organizational requirements. Many young
(and old!) delegates will be presenting
their own research or a distillation of their
experience either at oral sessions but more
commonly at poster sessions. Others will be
looking to attend the plethora of workshops
which are presented at the WCA.
P a g e 15
The WFSA and the World Congress of Anaesthesiologists
David Wilkinson, Secretary of the WFSA and Alfredo Cattaneo, President of WCA 2012
One of the most important aspects of any WCA
is the ability of delegates to meet others from
different backgrounds and environments. The
exchange of ideas and experiences that takes
place within scientific sessions, but also over
breakfasts, lunches and evening social
gatherings, often leads to lasting friendships
and facilitation of professional improvements
in less affluent areas of the world. The
trade exhibition is a vital aspect of any
WCA. It permits the industrial companies
operating in our sector to demonstrate
their latest innovations and allows them to
access anaesthesiologists from all over the
world. They provide a huge funding boost
to the meeting and their attendance, with
the associated financial support, should
never be taken for granted. Most delegates
recognise the benefits of attending the trade
exhibition to familiarise themselves with the
latest innovations and, increasingly, they
are also attending the growing number of
‘scientific presentations’ that occur within
the exhibition
Administration
The WFSA has to undertake a series of
administrative duties within the time frame
of the WCA. All of the activities of the WFSA
are governed by the General Assemblies
(GAs) to which every member society, which
has paid its annual membership fees, sends
representatives in proportion to their number
of announced member anaesthesiologists.
These representatives accept the reports of
the myriad of permanent and sub-specialty
committees of WFSA and determine the
future activity of the organization, often
at the instigation of the elected Executive
Committee and Officers. In addition, the GA
confirms the appointments of all members of
all committees and, for the first time in Buenos
Aires, will actively elect those standing for
the Executive Committee and Officer posts.
All WFSA committees have the opportunity to
meet at the WCA and plan their activity for
the next 4 years.
Local flavour
The Conference Organizing Committee,
besides wishing to run a memorable meeting,
wants to provide for the delegates that attend
a flavour of their country and culture. 2012
Congress President Alfredo Cattaneo writes:
P a g e 16
“By going to the 15th WCA you will really have
the world of anaesthesia at your fingertips.
Our Scientific Program for the 15th WCA will
try to globalise the level of knowledge and
practice of anaesthesia through:
• Reporting progress and knowledge in
anaesthesia
• Promoting the best anaesthetic practice
• Improving your skill in workshops
• Promoting safe practice in anaesthesia
• Encouraging organisation of
anaesthesiologists.
The Scientific Program will cover the latest
scientific knowledge in different areas of
Anaesthesiology, Perioperative Medicine,
Intensive Care, Emergency Medicine and Pain
Management. Topics will include research,
organisation, economy and education.
The preliminary program will be available
shortly. It will be comprehensive and diverse,
representing the needs of our colleagues
from all around the world. You will surely
be able to find the best level of lectures, not
just at the cutting edge of the science of
anaesthesiology, but also the ‘ABC’ of the safe
practice of our specialty, for those delegates
looking for this information. We hope to
have only electronic poster sessions to save
delegates having to transport bulky posters.
Workshops will have a special priority in
this WCA, with simulations and the latest
technology designed to improve our access
to new skills. Our aim is to improve the skill
and knowledge level of all of our colleagues
coming to Buenos Aires. Be sure that there
will be a lot of science, but there will be also a
lot of fun! We are developing a wide variety of
social and cultural programmes – there will be
tango lessons, parties, and the ever present
possibility of tasting our famous cuisine
including fantastic barbeques which will be
surely enjoyed by you all. I am confident
you will feel very comfortable living with
our Argentinean culture and it will provide
you with a unique opportunity to make new
friends in the world of the anaesthesia.
Buenos Aires is Argentina’s capital city, with
easy access from almost anywhere in the
world. It’s breadth of attractions make it an
excellent city for hosting the World Congress.
These attractions include shows, theatres,
sports, museums, art shows, antiquarians,
shopping, and of course, as I mentioned
before, our gastronomy. Before, and/or after
the WCA you can also enjoy the many
interesting tourist possibilities that
Argentina can bring you such as:
• Iguazú Falls, one of the wonders of nature
• Perito Moreno Glacier, a fantastic place
to visit
• Patagonia, a very different landscape
• Mendoza’s wineries and wines
• Mar del Plata, very nice beaches
• Córdoba, beautiful and peaceful hills
• Litoral, with the fantastic Paraná River
There are so many places you will surely feel
that this WCA is a unique opportunity to mix
science and leisure. It will be an unforgettable
experience.
It will be a great pleasure for us to meet you
in Buenos Aires!”
I am sure you will all agree he ‘paints’ a
very attractive picture. The website www.
wca2102.com is the ‘definitive source’ for all
information relating to the congress and your
attendance. The website will have full details
of the scientific program, posters, social
programmes, exhibitors, sponsors and much
more. The information on the website is being
constantly updated and if you want to be sure
you don’t miss any important deadlines (such
as poster submission dates, closing of early
registration) then make sure you register your
interest on the website. A few final comments:
The WCA needs to be a financial as well as
a scientific success so that the WFSA can
continue to run its extensive programme of
educational, publication and safety activity
all around the world. The membership dues
of the member societies do not fund this
activity which comes almost entirely from the
surpluses generated by the WCA. This in part
determines the registration fees charged for
the delegates. We hope you will attend the
WCA in Buenos Aires. It will be a scientific,
social and cultural triumph and, if you are not
there, then for years in the future you will
hear from those who were that phrase “Ah but
you should have been there in 2012 in Buenos
Aires; that was a truly great meeting.” Oh and
start taking your Tango lessons soon!
25-30 March 2012 is the date for the next
World Congress of Anaesthesiologists in
Buenos Aires, Argentina; start planning
NOW! II
Setting a high European standard for
Anaesthesiology and Intensive Care
Have you ever considered a unique
opportunity to raise your training to a
European level ?
The European Society of Anaesthesiology organises
a two-part examination, the European Diploma
in
Anaesthesiology
and
Intensive
Care
(EDA)
that is endorsed by the European Board of
Anaesthesiology. Thanks to the assessment of the
candidates by an independent board of European
Examiners, the EDA helps anaesthesiologists wishing
to apply for high quality posts or wishing to practice in
any European country. For more information please
visit www.euroanaesthesia.org or contact us directly at
exam@euroanaesthesia.org.
European Society of Anaesthesiology
24, rue des Comédiens
BE-1000 Brussels
Phone: +32 (0)2 743 32 99
Fax: +32 (0)2 743 32 98
www.euroanaesthesia.org
The advert for the ESA Trainee Exchange Programme at the
Academic Medical Centre (AMC), University of Amsterdam, in
Tatjana Goranović, Zagreb, Croatia
Centre. Approximately a
fifth of these interventions
are performed on children,
and about 800 procedures
for heart surgery.
There is a well equipped
pre-operative outpatient
clinic and a 24-hours
recovery and high-care
unit. There is also a
specialist outpatient clinic
for chronic pain patients.
The Academic Medical Centre (AMC), University of
I come from Zagreb, the capital of Croatia,
where I was born, educated and trained
in anaesthesiology. Last year I applied
to the ESA Trainee Exchange Programme,
and was fortunate to be selected as one of
six candidates that ESA Trainee Echange
Programme Committee decided to support for
a three-month stay in one of the European
host centres in 2010.
I applied for the programme with the
expectation to extend my capabilities in
general anaesthetic practice. I hoped that
this programme would help me in obtaining
additional specialised skills and knowledge in
anaesthesia, that I could not obtain during
my national training. This would help me
to further improve specialisation in my own
Department and Academic unit in Zagreb. In
addition, I looked forward to meeting new
colleagues who were interested in future
research cooperation. Finally, I expected to
learn about a different health care system.
In addition to direct
patient
care,
the
Department also takes
important part in academic
roles: research, training in
anaesthesiology and education of students of
the University of Amsterdam. The Department
for Experimental and Clinical Experimental
Anaesthesiology is chaired by Prof. Markus
W. Hollmann, who is one of the founders of
the Laboratory of Experimental Intensive
Care and Anaesthesiology (L.E.I.C.A.) of the
Academic Medical Centre (AMC), University of
Amsterdam. L.E.I.C.A is the first laboratory in
the Netherlands and almost unique in Europe
consisting of a common research platform to
address basic science questions in Intensive
Care and Anaesthesiology. The main focus of
research concentrates on cardio–protection,
mechanical ventilation and pharmacology of
local anaesthetics.
Prepration
The ESA Exchange Programme starts with the
initial visit to a host centre with the aim that
both, the trainee and the host centre, meet
P a g e 18
The process of BIG-registration took me
three months, and included sending a list of
documents to support my obtained medical
qualification in Croatia. I need here to
emphasise, that Dr. Preckel performed a great
effort during those three months in helping
me to understand all the Dutch written forms
and requirements, and to obtain final positive
declaration, which allowed me to work during
my training as a resident under supervision.
Big job, a lot of paper work, but finished
just in time to start the training in May as
planned! Simultaneously, I needed to find my
accommodation, and get permission from my
home Department to be absent during these
three months.
The programme schedule
Upon arrival to the AMC, Dr. Preckel and I
made the schedule of my stay to hopefully
achieve my expectations; the plan consisted
of both clinical and academic parts.
It was decided that I attend the Department
from 7.30 am till 17 pm. At 8 am, all the
anaesthesiologists were in the operation
theatres ready to start the induction, except
on Wednesdays, when it started later because
of Department lecture meetings.
Cardiac anaesthesia
The Academic Medical Centre
(AMC)
I chose the Academic Medical Centre (AMC)
in Amsterdam, in the Netherlands, to be my
host centre, where my supervisor during my
training was Dr. Benedikt Preckel.
The AMC is one of the eight university medical
centres in the Netherlands and probably the
most well-known hospital in the Netherlands,
too. The Department of Anaesthesiology
chaired by Prof. Wolfgang Schlack,
holds a pivotal position in the hospital.
Anaesthesiologists there perform 13000
clinical interventions annually in 19
operating theatres. In addition there are
6000 interventions performed in the Day Care
January, 2010. During the initial visit I
was introduced to the basic organisational
scheme of the Department of Anaesthesiology
in the AMC, as well as several colleagues. We
agreed that my English would be good enough
to work in AMC during my planned visit. We
agreed also upon the planned time of threemonth stay, but I was obliged to register with
BIG-register; that is necessary for anybody
working with patients in the Netherlands.
Museums of Anaesthesiology at the AMC
and exchange their expectations. Therefore,
immediately after I was informed by the ESA
secretariat, I communicated by e-mail with
my future supervisor, Dr. Benedikt Preckel,
and we arranged an initial week visit in
The first four weeks I spent exclusively with
cardiac anaesthesia. I learned to prepare
cardiac patients for surgery, the techniques
of cardiac anaesthesia and the regular
monitoring used in AMC. The list of cardiac
surgical procedures included various single or
combined operations: CABG, on and off pump,
valve replacement or repair, Bentall surgery,
correction of congenital defects. I was taught
tips and tricks in basic arterial line insertion
and central vein catheterisation. I learned
how to use ultrasound for or during central
vein catheterisation.
In addition, I was introduced to the basics
of transoesphageal ultrasound examination
(TOE) during cardiac surgery, and held the
transoesphageal ultrasound probe for the very
ESA Trainee Exchange Programme at the Academic Medical
Centre (AMC), University of Amsterdam, in Amsterdam,
the Netherlands
Moreover, I was instructed in TOE by an
anaesthesiologist with great experience in
the intraoperative use of transoesphageal
ultrasound, Dr. Edouard de Beaumont, who
shared with me the secrets of making the
most of an examination. I was also present
for several complex cases, when additional
cardiological expertise was requested for
intraoperative ultrasound examination.
Beside learning how to use newer extended
monitoring techniques such as near-infrared
cerebral oximetry, I was present during
performance of clinical research on
monitoring and cardioprotective techniques
in cardiac patients undergoing CABG. This
was a great opportunity to find out and
learn how to prepare, organise, and perform
clinical research in cardiac anaesthesia
during complex surgical operations, without
interfering with the surgery and regular
anaesthetic procedures. In addition, in
Operation theatre at the AMC
direct communications with researchers, I
extended my knowledge with much updated
information on cardioprotection techniques
in high-risk cardiac patients.
During my whole stay in AMC, I visited the
AMC catheterisation laboratory several times
also, where I was able to see anaesthetic
technique for diagnostic and interventional
heart catheterisation in children. I was
involved in some cases where transfemoral or
transapical approach was used for aortic valve
replacement in patients in whom classical
surgery on open heart would be too risky.
Neuroanaesthesia
During my round in neurosurgical anaesthesia,
I was able to see anaesthetic techniques for
different neurosurgical procedures: resection
of brain and pituitary tumours, aneurysms,
and cranioplastic surgery. In addition, I was
able to see the procedure of insertion of
brain neurostimulators which was new for me.
I had the opportunity to discuss the various
techniques for neuroprotection and the
control of brain swelling.
General anaesthesia
The rest of my stay, I spent performing
anaesthesia for a great variety of surgical and
diagnostic procedures including urological,
ophalmogical and paediatric procedures.
I learned how to use total intravenous
anaesthesia technique (TIVA) by TCI or
infusion pump. I also saw how endoscopic
procedures on the
Department
of
Gastroenterology
were
safely
performed
by
anaesthesia nurses
according to a local
sedation protocol.
I spent some time
working
in
Day
Centre. I learned
about organisation
of Day Centre and
the
specificity
of
anaesthetic
techniques for the
day case surgery.
During
the
last
part of my visit, I
was introduced to
Acute Pain Service
and Chronic Pain Clinic. There I found out
about organisation of acute pain service
run by nurses. In addition, I learned about
postoperative acute pain management
protocols in AMC, and observed some chronic
pain interventional procedures.
The benefits of the programme
Getting familiar with Dutch health care
system was a precious and unique experience
for me. Being on the spot in the operating
theatres gave me opportunity to compare
directly the style of anaesthetic techniques
and organisation, which I had learned in
Croatia, to the practices in the AMC. In
addition, I had an opportunity to see how
to work according to standardised protocols.
It was amazing to find out that every single
surgical procedure was proceeded with
SURgical PAtient Safety System (SURPASS©)
checklist in accordance to AMC’s rules.
I learned new techniques and improved
my technical skills particularly airway
management, and vessels catheterisation
techniques, and was introduced to TOE.
Academic endeavours
Besides improving my clinical work, I spent
an equal part of the visit doing research
work in a form of reviewing selected topics:
perioperative management of patients
with implanted coronary artery stents and
perioperative management of patients on
clopidogrel. I enjoyed this part very much,
because I felt an obvious improvement each
day. Dr. Preckel taught me a new strategy
to be more efficient in choosing a topic
for research and focusing on it in given
timeframes. Under his tactical supervision, I
did a literature research for a review article
in a very constructive way. I learned how
to manage references in a time sparing way
and wrote a final review article, which will
hopefully be published. I brought home this
article submission as my favourite souvenir of
a time spent in the Netherlands.
The benefits back home
The way of working in the AMC impressed me
and stimulated me on thinking what new ideas
I might introduce to my Clinical Department
and Academic Unit. I definitively feel
that, after this experience, I have enough
knowledge and self confidence to initiate
certain changes starting from next week.
Very soon, I will present the organisational
structure of acute pain service (APS) in the
AMC to the colleagues in my Department and
initiate discussion about acute postoperative
service in our hospital. I will introduce and
propose to colleagues propofol infusions as
an alternative to using volatile anaesthetics
in all sites working without proper scavenge
systems with the aim of reducing air pollution.
I will do a cost benefit analysis for such a
scheme for our Department. I will also
discuss with Radiology Department about the
possibility of making
P a g e 19
ESA Trainee Exchange Programme at the Academic Medical
Centre (AMC), University of Amsterdam, in Amsterdam,
the Netherlands
first time in my own hands some minor
infrastructure changes in the wall of MRI
unit to allow the use of infusion pump
situated outside the MRI unit. In addition,
since I learned a lot about perioperative
management of patients with implanted
coronary artery stents, I will discuss with
the Chair of the Academic Unit to involve the
Department in the ESA Clinical Trial Network
project OBTAIN. As an intermediate goal that
may be finished in the following six months, I
will initiate and organise the groups to write
local hospital protocols according to the
Helsinki Declaration. Hopefully in next year
I will work on introducing APS working with
nurses at least during day shifts five days a
week in my hospital, and on a new hospital
Day Centre project.
Final notes
I would like to thank all the people who
supported me during this period.
This
includes a long list, but I need to mention
first my mother, father, and sister Vesna. I
thank my very best supervisor Dr. Preckel, and
all the colleagues and the staff at AMC for all
their useful advice and patience, especially
Dr. Eberl, Dr. Fräßdorf, Dr. Stevens,
Dr. Jansen, Dr. Allison, Dr. Brink, Dr. de
Beaumont , Prof. de Hert, Dr. Wegener,
Dr. Evers, Prof. Hollmann, and APS nurses
Karolijn Hendrickx and Saskia van Beek. Also
I would like to thank all my colleagues in
my home hospital Sveti Duh in Zagreb, who
needed to take over my duties and shifts
during my absence.
Thanks to my boss, Prof. Katarina Šakić, and
my colleagues, Dr. Morena Milić, Ass. Prof.
Branka Maldini, Dr. Branka Mazul Sunko and
Dr. Marko Jukić, who were in touch with me
regularly during my three-month stay in the
Netherlands. II
Jessica T. Wegener (left), Markus F. Stevens (middle back),
Benedikt Preckel (right), and Tatjana Goranović (middle
front)
The ESA Scientific Committee (SC) is seeking to recruit
new chairpersons and members for its Subcommittees.
All vacancies will commence on 1 January 2011. Deadline to apply is 22 November 2010 (23:59 CET).
Subcommittee Chairperson’s vacancies:
Subcommittee 7: Neurosciences
Subcommittee 10: Paediatric Anaesthesia and Intensive Care
Subcommittee 11: Obstetric Anaesthesia
Subcommittee Member’s vacancies
Subcommittee 5: Respiration - 2 vacancies
Subcommittee 17: Patient Safety - 1 vacancy
How to apply
The application form (available on the ESA website) with CV (maximum 2 sides of A4) has to be sent to the ESA Secretariat by
e-mail to Brigitte.Leva@euroanaesthesia.org no later than Monday, 22 November 2010 (23:59 CET).
More information
Further details regarding the role, term of office and application conditions are available on the ESA website
www.euroanaesthesia.org under section ‘About the ESA – Vacancies’. II
P a g e 20
European Patient Safety Course (EPSC)
Learn about how errors evolve in medicine, what the root-causes are and how
patient safety can be improved on a systematic level!
Threat & Error
Adverse Events
Patient Harm
Incident Reporting
Human Factors
Crisis Resource Management (CRM)
Simulation Team Training
Patient Safety
Health Care as a High Reliability Organisation (HRO)
Safety Culture
Incident Analysis
Resilience
Systems Safety
The Helsinki Declaration on Patient Safety in Anaesthesiology1 was a
landmark publication and consensus in Europe. The EPSC covers all topics
of the Declaration and gives examples of the state-of-the-art in patient
safety.
In connection with Euroanaesthesia 2011, an extracurricular course
will be offered by the ESA and its Subcommittee 17: Patient Safety
in collaboration with the international faculty.
The course is intended for all physicians and nurses in
anaesthesiology and intensive care medicine as an overview and
perhaps as a primer to start working systematically on patient
safety and to start achieving the goals of the Helsinki Declaration
on Patient Safety in Anaesthesiology1. The course also gives you
the unique opportunity to exchange and network with colleagues
from all over Europe.
We look forward to welcoming you at our course!
The one-day post graduate European Patient Safety Course provides you
with a very intensive insight into the general topics of patient safety as
endorsed by the ESA and EBA (UEMS) in the Helsinki Declaration on Patient
Safety in Anaesthesiology1.International experts will give you an overview
of why things go wrong, what works in practice to reduce errors and
enhances the safety culture to make patient care safer.
Initiated by: Marcus Rall (EPSC Course Director)
Planned by: ESA Subcommittee 17 Patient Safety - Sven Staender (Chairman),
Marcus Rall, François Clergue, Doris Østergaard, Tanja Manser, Ravi
Mahajan, Filippo Bressan, Maurice Lamy, Sven Eric Gisvold, Lazlo Vimlati,
Andrew Smith and Peter Dieckmann.
1. Mellin-Olsen, Jannicke; Staender, Sven; Whitaker, David K; Smith, Andrew F. European Journal of Anaesthesiology. 27(7):592-597, July 2010.
The EPSC takes place just before the Euroanaesthesia 2011 Congress at the Amsterdam RAI Convention
Centre. The course is 8 hours, split in two parts:
Friday, 10 June 2011 from 14:00 to 18:00 (Part 1)
Saturday, 11 June 2011 from 8:00 to 12:00 (Part 2)
More information and pre-registration: www.euroanaesthesia.org
Organises Refresher Courses in Anaesthesiology
Continued medical education to improve your
professional practice
Because continuing medical education in anaesthesiology is a
lifelong learning process, the CEEA will help you to maintain and
improve your knowledge by organising a cycle of six courses
covering all aspects of the speciality.
The CEEA courses are a unique opportunity to discuss, and share
your experiences. We believe that the most successful approach to
learning is to identify key topics, build relationships with colleagues
and qualified speakers and to create a forum for learning and
reflection.
The CEEA courses are held throughout the year in more than a hundred independent centres across the world. The duration of the course
is three days and is limited to 50 participants. Complete the courses
at your own rhythm, in the language of your choice, and in the order
you prefer.
Future Anaesthesia Meetings
November, 1 - 5
June, 11 – 14
CSA Fall Hawaiian Seminar
Contact: www.csahq.org
Kona, Hawaii, USA
Euroanaesthesia 2011
Contact: secretariat@euroanaesthesia.org;
Amsterdam, The Netherlands
November, 5 – 6
June, 15 – 17
ESA Autumn Meeting
Contact: secretariat@euroanaesthesia.org;
Budapest, Hungary
2011
November, 5 – 7
31st Congress of the Scandinavian Society of
Anaesthesiology and Intensive Care (SSAI)
Bergen, Norway
2010
23rd Annual Meeting - International
Symposium on Critical Care Medicine
Catania, Italy
September, 13 - 15
22nd International Congress of the Israel
Society of Anesthesiologists (ICISA)
Contact: team7@congress.co.il;
www.icisa.co.il
Tel Aviv, Israel
November, 17 - 20
7th International Conference on Pain Control
and Regional Anaesthesia (IPCRA)
Contact: info@ipcra.com;
www.ipcra.com
Marrakech, Morocco
November, 2 – 5
New Zeeland Anaesthesia ASM 2011
Contact: www.nzasm2011.org.nz
Auckland, New Zealand
March, 5 - 8
5th Annual Iowa International Anesthesia Symposium
Contact: lorri-barnes@uiowa.edu
Cabo San Lucas, Mexico
March, 25 - 30
3rd World Congress of Total Intravenous
Anaesthesia & Target Controlled
Infusion (TIVA-TCI 2011)
Contact: www2.kenes.com/tiva-tci2011
Singapore
P a g e 23
2012
March, 31 – April, 1
15th World Congress of
Anaesthesiologists 2012 (WCA 2012)
Contact: www.wca2012.com
Buenos Aires, Argentina
June, 9 – 12
Euroanaesthesia 2012
Contact: secretariat@euroanaesthesia.org
Paris, France
Euroanaesthesia
2011
Symposia
Refresher Courses
Workshops
Industrial Symposia & Exhibition
Abstract Presentations
CME Accreditation
EACCME - UEMS
Deadline abstracts:
December 15th 2010
Online submission:
June 11-14
ESA Secretariat
Phone +32 (0)2 743 32 90
Fax +32 (0)2 743 32 98
E-mail: registration@euroanaesthesia.org

The European Society of Anaesthesiology without borders

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