221 Patient Safety 17AP3-1 Review of anaphyla xis associated with anaesthesia in Nor thern Ireland from 1999-2010 Joseph J., Megaw K.E.S., Shields M.O., Edgar J.D.M. Belfast Health and Social Care Trust, Department of Anaesthesiology and Intensive Care, Belfast, United Kingdom Background: In Nor thern Ireland cases of suspected anaphyla xis associated with anaesthesia are referred to the Regional Immunology ser vice. The aim of this audit was to examine the method of the follow-up testing available within Northern Ireland and the patterns of anaphylaxis within Northern Ireland be- t ween 1999 and 2010. Methods: Anaesthetists involved in the acute management of suspected anaphyla xis were requested to complete a standard referral form including chronological sequence of events. Three samples of clotted blood were requested, the first within one hour of the onset of the reaction and 2 nd and 3 rd samples at 6 and 24 hours. Mast cell tryptase (MCT) was measured using Pharmacia UniCAP ® Tryptase fluroenzy- meimmunoasssay (Pharmacia Diagnostics). A level greater than 14.0 mcg/l was taken to be elevated. Specific IgE was reported as grade 0 to 6 depend- ing on the level identified in the assay. Patients were referred for skin prick testing (STP) based on the history of their reaction, grade of reaction and the mast cell tryptase levels and were carried out in accordance with the European Academy of Allergy and Immunology guidelines (Allergy 1989). Results and Discussion: 254 adverse reactions were reported from January 1999 to December 2010. Demographics as shown in Table1. Female/Male 61/32 65.5% (Females) Age (years) 52.4 (mean) 18.47 (SD) MCT within 1st Hour (mcg/l) 57.8 (mean) 106.92(SD) [Demographics, Table 1.] Among the referred, 93 (36.6%) patients had MCT > 14 mcg/l on the first sample. Also 10 patients with MCT < 14 mcg/l, had positive SPT to the agent they were exposed. Results of 54 patients who had positive SPT were available for analysis. Ma- jority of the rest of the patients had negative SPT, how ever advice included avoiding the most likely agent. Neuromuscular blocking agents (NMBAs) accounted for 37 (68.5%) of the allergic reactions, followed by antibiotics, 7 (12.9%), colloids, 5 (9.24%), chlorhexidine, 3 (5.5%) and the miscellaneous group (3.96%) included latex and contrast media. Conclusions: Mast cell tryptase levels remains the initial investigation in cases of suspected anaphyla xis, how ever we found 18.5%of patients with positive SPT had no rise in MCT levels. Majorit y of the anaphyla xis associated with anaesthesia are due to muscle rela xants. Of the NMBAs Rocuronium was identified as the causative agents in 59.4% cases. Reference: Anaphyla xis during anaesthesia. Plaud B, Donati F, Debaene B. Br J Anaesth 2002; 88:604-5 17AP3-2 Sevoflurane and propofol safety for electroconvulsive therapy Rodriguez Gimillo P., Soliveres J., Balaguer J., Estruch M., Solaz C. Hospital Universitario Doctor Peset, Depar tment of Anaesthesiology, Valencia, Spain Background and Goal of Study: The primary objective of electroconvulsive therapy (ECT) is the length of the seizure, and it seems not to be altered by sevoflurane or propofol sedation, so it could to be reasonable to choose the safer one. The objective of this randomized single blinded study is to compare safety of 8% sevoflurane or 2 mg kg-1 propofol for electroconvulsive therapy. Materials and Methods: This prospective, randomised, single-blind, cross- over study was conducted to compare the ef fects of propofol and sevoflu- orane. Analysis of 68 treatments in 8 patients was conducted. The incidence of apnea (manual ventilation needed) pre and postoperatively, nausea and vomiting and shivering were measured. There was a washout period of two to three days in between procedures. The induction time, qualit y of induction, haemodynamic changes, seizure du- ration, recovery time and need of ventilation were measured and analyzed. Results and Discussion: Eight ASA II women with major depression not re- sponding to other therapy were included. 10 ECT were administered to two patients and 8 to six patients. Results are shown in Table1. All patients suf- fered postoperative apnea. * p < 0,05 Group Apnea (%)* Shivering (%) Nausea- Vomiting (%) Eyelash (sec)* Discharge (min) Seizure duration (sec) Propofol 94,1 20,6 14,7 85,6 17,1 26,4 Sevoflurane 14,7 11,8 8,8 212,5 18,5 26,5 [Table1] Conclusion(s): Both sevoflurane and propofol are suitable for ECT, with similar safety, although sevoflurane seems bet ter to maintain spontaneous breathing. References: 1. Loughnan T, McKenzie G, Leong S. Anaesth Intensive Care. 2004 Apr;32:236-40. 2. Toprak HI, Gedik E, Begec Z. J ECT. 2005 Jun;21:108-10. 3. Rasmussen KG, Spackman TN, Hooten WM. J ECT. 2005 Dec;21:239-42. 17AP3-3 Evaluation of sedation practices for gastrointestinal endoscopy by Greek gastroenterologists and their knowledge in basic resuscitation and airway management Korre M., Arnaoutoglou E., Papathanakos G., Papadopoulos G. Universit y of Ioannina, Depar tment of Anaesthesiology and Intensive Care, Ioannina, Greece Background and Goal of Study: Gastroenterologists of ten provide analge- sia and sedation during endoscopy procedures. The aim of our study was to record and evaluate within the two-day seminar on First Aid and Sedation, which was organized by our depar tment at the Annual Conference of the Pro- fessional Union of Greek Gastroenterologists, their practice in analgesia and sedation and the incidence of events related to the airway. Material and Methods: The study involved 105 doctors and 65 nurses. All par ticipants were asked to complete a questionnaire on the t ype of analgesia and sedation they use, the complications they obser ved and more. Statistics: Mean values (mean), standard deviations (SD), medians, Pearson’s x 2 test, Fisher’s exact test, Student’s t-test, Mann-Whitney, parametric control analysis of variance (ANOVA), non-parametric Kruskal-Wallis test. Results and Discussion: The average age of respondents was 36,1±9,3 years. 67.6% of them use during gastrointestinal procedures analgesia/se- dation (Midazolam 27% of them, Propofol 1%, Midazolam and Propofol 3%, Midazolam and Fentanyl 6%, Midazolam, Propofol and Fentanyl 5%). 54.6% of them had never been trained in the management of the airway and 28.8% in resuscitation. 9.2% of the participants witnessed cardiac arrest of the pa- tient during endoscopy procedure. Other events reported were apnea (10%), SpO 2 desaturation (12%), bradycardia and hypotension (34%), allergic reac- tion (2.1%), seizures (2.1%) and tachycardia (6.4%). Conclusion: The high rate of events during gastrointestinal endoscopic ex- aminations under analgesia-sedation and the low level of education in air- way management and resuscitation, indicates the necessit y of education and certification of those who apply analgesia-sedation for gastrointestinal endo- scopic procedures. 17AP3-4 Evaluation of gastroenterology and endoscopy medical and nursing staf f who provide sedation, in basic resuscitation and airway management Korre M., Arnaoutoglou E., Papathanakos G., Papadopoulos G. Universit y of Ioannina, Depar tment of Anaesthesiology and Intensive Care, Ioannina, Greece Background and Goal of Study: Gastroenterologists of ten provide analge- sia and sedation during endoscopy procedures. The aim of our study was to record and evaluate within the two-day seminar on First Aid and Sedation, which was organized by our depar tment at the Annual Conference of the Pro- fessional Union of Greek Gastroenterologists, the knowledge and skills in re- suscitation and airway management of Gastroenterology doctors and nurses who provide analgesia and sedation. Material and Methods: Participants were gastroenterology and endoscopy medical and nursing staf f. They were asked to complete a questionnaire about their knowledge in basic resuscitation and the use of automated ex ter- nal defibrillator. The ability of par ticipants to handle the airway and to resusci- tate as provided by the algorithm of the European Resuscitation Council, was evaluated on adults resuscitation mannequins. Statistics: Pearson’s x 2 test, Fisher’s exact test, Student’s t-test, Mann-Whitney, parametric control analysis of variance (ANOVA), non-parametric Kruskal-Wallis test. Results: The questionnaire was completed by 170 people, 105 doctors and 65 nurses (mean age 36 years). Despite the fact that many of them had not been trained previously in basic resuscitation and airway management tech-