I chat with Dr David Borshoff about the latest edition of the Anaesthetic Crisis Manual. This edition includes a new 'Prevention' section, collaboration with Médecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC) and comes out in 2 versions: International and North American.
As an ASA member, you are eligible for a FREE(!) or discounted Manual. Contact asa@asa.org.au for more details.
Not a member? Find out about more benefits of being a member here:
https://asa.org.au/types-of-membership
Key Takeaways
Cognitive aids like the Anesthetic Crisis Manual reduce cognitive load and anxiety during crises by providing systematic reassurance rather than replacing clinical judgment.
Simplicity in crisis management protocols requires substantial effort— Dr Borshoff spent nine months updating the fourth edition with fellowship-level study commitment to distill information to essential directives.
Team communication and psychological safety are critical; the anaesthetic technician's willingness to speak up during Dr Borshoff's front-of-neck access directly contributed to patient survival.
Passion projects and creative outlets in medicine maintain professional engagement and curiosity, preventing burnout while advancing patient safety and departmental culture.
Accessibility matters: offering manuals free to trainees and discounted to members embeds cognitive aid culture into the profession from early career stages.
Quotable Moments
"None of us are infallible 100% of the time."
"When you're cognitively loaded, you want to be making as few decisions as possible so that you can stick to the big stuff."
"The crisis manual is there to support the clinical acumen and the decision making of the doctor. It's not the other way around."
"If you've got something that you're passionate about, then you're prepared to do the work and you don't realise how many hours are ticking away while you're doing it."
"Why don't you just do it properly, doc?" — The anaesthetic technician's intervention that broke Borshoff's fixation error during emergency front-of-neck access.
