FANZCA Safety and Compliance 2 — Questions and Answers
Question 1: Under ANZCA professional standards, which of the following best describes the minimum monitoring requirement during general anaesthesia?
- Pulse oximetry alone is sufficient for short procedures
- Continuous ECG, pulse oximetry, capnography, and non-invasive blood pressure are mandatory (Correct answer)
- Capnography is optional if end-tidal CO2 is visually estimated
- Blood pressure measurement every 10 minutes is acceptable
Correct answer: Continuous ECG, pulse oximetry, capnography, and non-invasive blood pressure are mandatory
ANZCA PS18 mandates continuous ECG, pulse oximetry, capnography, and regular non-invasive blood pressure monitoring as minimum standards during general anaesthesia.
Question 2: A patient is scheduled for elective surgery but refuses a blood transfusion for religious reasons. The most appropriate action is to:
- Cancel the surgery as it is unsafe to proceed
- Document refusal, explore alternatives, and proceed only if surgically safe without transfusion (Correct answer)
- Obtain a court order to override the refusal
- Administer blood intraoperatively without telling the patient
Correct answer: Document refusal, explore alternatives, and proceed only if surgically safe without transfusion
A competent adult's informed refusal of treatment must be respected; the team should document this, explore cell salvage and other alternatives, and only proceed if safe.
Question 3: Which ANZCA professional document specifically addresses the pre-anaesthesia consultation?
- PS04
- PS07 (Correct answer)
- PS15
- PS28
Correct answer: PS07
ANZCA PS07 outlines the requirements for pre-anaesthesia consultation, including history, examination, investigations, and informed consent.
Question 4: When checking an anaesthetic machine before use, the correct sequence for a high-pressure circuit leak test is to:
- Pressurise with oxygen to 30 cmH2O and observe for pressure drop over 10 seconds
- Close the APL valve, occlude the Y-piece, fill the breathing circuit to 30 cmH2O, and observe pressure stability (Correct answer)
- Turn all flowmeters to maximum and check for audible leaks
- Connect a capnograph and observe for CO2 accumulation
Correct answer: Close the APL valve, occlude the Y-piece, fill the breathing circuit to 30 cmH2O, and observe pressure stability
The standard circuit leak test involves closing the APL valve, occluding the patient port, inflating to 30 cmH2O, and confirming pressure is maintained.
Question 5: An anaesthetist discovers a critical defect in anaesthetic equipment mid-case. Which action is most appropriate?
- Continue the case and report the defect postoperatively
- Immediately switch to backup equipment, ensure patient safety, then report per hospital incident protocol (Correct answer)
- Tag the equipment out of service but continue using it if no backup is available
- Inform the surgeon and allow them to decide whether to continue
Correct answer: Immediately switch to backup equipment, ensure patient safety, then report per hospital incident protocol
Patient safety takes priority; switching to backup equipment and reporting via the incident management system is the required response.
Question 6: Regarding the management of latex allergy in the operating theatre, which statement is correct?
- Latex allergy only causes contact dermatitis and is not an anaesthetic risk
- Latex-allergic patients should be scheduled first on the list in a latex-safe environment (Correct answer)
- Latex-free gloves alone are sufficient to protect a latex-allergic patient
- Adrenaline is not needed in the theatre for latex allergy management
Correct answer: Latex-allergic patients should be scheduled first on the list in a latex-safe environment
Latex-allergic patients require a completely latex-safe theatre environment and are best managed as the first case to minimise aerosolised latex particles.
Question 7: Which of the following is a key principle of the ANZCA Safe Anaesthesia Liaison Group (SALG) reporting framework?
- Reports are used for medico-legal disciplinary action
- Anonymous reporting promotes a just culture and improves system-level safety (Correct answer)
- Only adverse events resulting in patient death must be reported
- Reporting is voluntary and has no structured review process
Correct answer: Anonymous reporting promotes a just culture and improves system-level safety
SALG promotes anonymous, non-punitive incident reporting to identify system-level hazards and drive quality improvement in anaesthesia safety.
FANZCA Safety and Compliance 2
Under ANZCA professional standards, which of the following best describes the minimum monitoring requirement during general anaesthesia?