Anaphylaxis: Expect the Unexpected

This article decisively evaluates an Anaesthetic Nurse Specialist’s (ANS) response to a critical incident. The role of the Anaesthetic Nurse Specialist (ANS) is to provide high-quality anaesthetic assistance to safeguard the health, safety, and welfare of patients. Critical incident reporting, in the health care system comprises of accurate measurements and analytical scrutiny of incidents; it is a quality control measure that identifies matters to improve, develop and expand good practice. A critical incident analysis framework is chosen, to allow a clear logical assessment of the difficulties encountered in this patient scenario. Aspects are scrutinized to improve and develop future practice. Chlorhexidine (CHL) is not a drug but an antiseptic solution, it is, however a ‘hidden’ allergen, anaphylaxis can result, although this is rare. CHL is found for example as a coating on medical devices, central line catheters and urinary catheters. Early detection of any suspected anaphylactic reaction during anaesthetic procedures requires prompt management, identification of the offending agent and prevention of exposure in the future. Clearly, this is the responsibility of the Anaesthetic Nurse Specialist and the theatre team as was demonstrated in this patient situation.