We will contact the local coordinator on a monthly basis. However, questions 4-14 may be best answered by the anaesthetising team; they can complete these and submit the form. The link-person can then complete the followup with a second form later. Please ensure the start of surgery and centre numbers match; these two questions require an answer before the form can be submitted. Thanks in advance for your efforts!


Tom Gilbey and Gudrun Kunst, King's College Hospital, London
On behalf of the ACTACC committee.

Question Title

* 1. Which centre NUMBER was this patient anaesthetised in? (centres will be anonymised).

Question Title

* 2. Patient age (years)

Question Title

* 3. Patient sex

Question Title

* 4. Was this the first cardiac surgical centre to which they were referred?

Question Title

* 5. What was the reason for refusal at the first surgical centre (tick all that apply)?

Question Title

* 6. Time of symptom onset

Date
Time

Question Title

* 7. Time of attendance to first hospital accident and emergency department

Date
Time

Question Title

* 8. What was the patient's GCS upon first presentation to A+E? (From 3-15)

Question Title

* 9. What was the patient's blood pressure upon first presentation to A+E? (systolic/diastolic in mmHg NB. note change from MAP for ease of reporting)

Question Title

* 10. Time of arrival at cardiac surgical centre

Date
Time

Question Title

* 11. Transfer team upon arrival at cardiac surgical centre (Please tick all that apply)

Question Title

* 12. If accompanied by a doctor, what was the level of the most senior transferring doctor?

Question Title

* 13. Which of the following pharmacological treatments were ongoing upon arrival at your centre? (Please tick all that apply)

Question Title

* 14. What forms of monitoring, support and vascular access were in place upon arrival at your centre? (Please tick all that apply)

Question Title

* 15. What was the patient's GCS upon arrival in theatre? (From 3-15)

Question Title

* 16. What was the patient's blood pressure upon arrival in theatre? (systolic/diastolic in mmHg NB. note change from MAP for ease of reporting)

Question Title

* 17. Investigations for diagnosis at first hospital

Question Title

* 18. Start of surgery (knife to skin)

Date
Time

Question Title

* 19. Surgical procedure (Please tick all that apply)

Question Title

* 20. Intraoperative technique (Please tick all that apply)

Question Title

* 21. Lowest intraoperative temperature (°C)

Question Title

* 22. Intraoperative cross-clamp time (minutes; please enter 0 for a deliberate no-cross-clamp surgical technique)

Question Title

* 23. Please list blood products given in theatre (PRC, FFP and Cryo in units; platelets in pools; PCC in units, fibrinogen in mg;  use question 31  for non-numeric input)

Question Title

* 24. Were there any significant delays (>1hr) during the patient's journey between onset of symptoms and admission to theatres?

Question Title

* 25. Was there a significant clinical deterioration between presentation to accident and emergency in the first hospital and arrival in the operating theatre?

Question Title

* 26. Did the patient die in hospital?

Question Title

* 27. Was there a second surgical intervention in the same admission?

Question Title

* 28. Length of ICU stay in days (ICU is any unit capable of delivering Level 3 care)

Question Title

* 29. Length of hospital stay in days (if repatriated ICU-ICU or ward-ward, discharged to a rehabilitation facility or otherwise lost to follow-up, please describe in Q31).

Question Title

* 30. Is there a history of known or suspected SARS-CoV-2 infection (defined as any of: persistent cough, fever, loss of smell or taste, positive PCR result) occurring on or after January 1st 2020?

Question Title

* 31. Anything else to record? Local hospital number, special clinical circumstances, correction to previous submission, caveats to data etc.

T