Intro -- AAGBI Core Topics in Anaesthesia 2015 -- Contents -- List of Contributors -- Foreword -- 1 Abnormalities of Coagulation and Obstetric Anaesthesia -- What are the risks? -- General anaesthesia for parturients with abnormal coagulation -- What are the causes of coagulation abnormalities in obstetric patients? -- Congenital coagulopathies -- Von Willebrands disease -- Haemophilia -- Acquired coagulopathies -- Disseminated intravascular coagulation -- Pre-eclampsia and HELLP syndrome -- Liver disease -- Platelet abnormalities -- Which tests for which patients? -- Full blood count -- Activated partial thromboplastin time ratio and international normalised ratio -- Thromboelastography -- Guidance for the use of regional anaesthetic techniques in patients given anticoagulant drugs -- Risk assessment for the use of regional techniques in women with coagulation abnormalities -- Guidance for regional techniques in women with low platelets -- Risk of regional techniques in women on LMWHs and aspirin -- Is the seniority of the anaesthetist an issue? -- Which technique should be used? -- When should epidural catheters be removed? -- What follow-up is required? -- References -- 2 Acute Coronary Syndromes and Anaesthesia -- Definition of acute coronary syndromes -- Pathogenesis of acute coronary syndromes -- Non-atherosclerotic causes of ACS -- Atherosclerosis, plaque disruption and ACS -- Who is going to suffer an ACS? -- Classification of myocardial infarction: are cardiologists and anaesthetists seeing different types? -- Treatment of acute coronary syndromes in peri-operative and critically ill patients -- STEMI -- NSTEMI -- Unstable angina -- Prediction and prevention of ACS in peri-operative patients -- Beta-blockers -- Statins -- Conclusion -- References -- 3 Acute Pain Management of Opioid-Tolerant Patients -- Definitions. Assessment and monitoring -- Aims of acute pain management in opioid-dependent patients -- Management of patients on high-dose sublingual buprenorphine -- References -- Further reading -- 4 Echocardiography and Anaesthesia -- Before surgery -- During surgery -- After surgery and in critical care -- Persistent unexplained hypotension -- Persistent unexplained hypoxaemia -- Future trends -- Further reading -- 5 Medico-Legal Aspects of Regional Anaesthesia -- The pre-operative visit and consent -- Preparation for the performance of regional anaesthesia -- Performance of a regional block -- Postoperative care -- How to reduce the likelihood of being sued -- References -- Further reading -- 6 Peri-Operative Use of Beta-Blockers: Yes or No? -- Pathophysiology of peri-operative myocardial damage -- Mechanisms of the myocardial protective effects of beta-blockers -- Risk assessment for peri-operative cardiovascular mortality and morbidity -- Use of peri-operative beta-blockers in non-cardiac surgery: evidence of efficacy and safety -- Limitations of the studies -- Current guidelines -- Where do we go from here? -- Conclusions -- References -- 7 Transfusion Requirements and the Older Person -- Anaemia in the elderly -- Prevalence -- Pathophysiology -- Anaemia and outcomes in the elderly -- Community -- The peri-operative period -- Evidence for transfusion thresholds in the elderly -- Complementary approaches to haemoglobin management -- References -- 8 Organ Donation and the Anaesthetist -- Organ donation policy -- Types of organ and tissue donation -- The UK organ donation potential -- The UK organ donation report card -- Scientific, ethical and legal issues in deceased donation -- The diagnosis of death -- A summary of the current published best practice, ethical, legal and professional guidance -- Human Tissue Acts (2004 and 2006). Academy of Medical Royal Colleges Code of Practice for the Diagnosis and Confirmation of Death (2008) -- Legal guidance from all four UK jurisdictions on DCD (2009-2011) -- Joint professional statement from the Intensive Care Society and the British Transplantation Society (2010) -- General Medical Council Guidance: 'Treatment and care towards the end of life' (2010) -- Joint professional statement from the College of Emergency Medicine and the British Transplantation Society (2011) -- Independent UK Donation Ethics Committee (2011) -- NICE Guidance (2011) -- College of Emergency Medicine Best Practice Guidance for End of Life Care (2012) -- Organ donation practice for the theatre anaesthetist -- Identifying and referring potential donors -- Donation after brainstem death -- Donation after circulatory death -- Living kidney donation (living donor renal transplant nephrectomy) -- Anaesthetic management -- Acknowledgements -- References -- Recommended reading -- 9 Postoperative Cognitive Dysfunction: Fact or Fiction? -- Cognition and postoperative cognitive disorders -- Delirium -- Postoperative cognitive dysfunction -- The International Study of Postoperative Cognitive Dysfunction Group -- The case against POCD -- Is POCD fact or fiction? -- What can be done about POCD? -- The future -- References -- Further reading -- 10 Pre-Operative Anaemia: Should We Worry? -- Definitions of anaemia -- Prevalence -- Clinical implications of anaemia -- Pre-operative anaemia and postoperative outcome -- Risk factors for peri-operative blood transfusion -- Risk factors for postoperative mortality and morbidity -- Pre-operative anaemia is an independent risk factor -- Aetiology of anaemia -- How should we manage the pre-operative patient with a low Hb? -- Patient assessment -- Investigations -- Iron status -- Iron stores -- Iron supply -- Other tests. Treatment of iron deficiency -- Oral iron -- Intravenous iron -- Dose of intravenous iron -- Safety and efficacy of intravenous iron -- Erythropoietin -- Treatment of coexisting pathologies -- Renal disease -- Vitamin B12 and folate deficiency -- Other aetiologies -- Quality assurance -- Conclusions -- Declaration of interests -- References -- EULA.