Metabolic crises in anaesthesia

The ability to effectively manage an anaesthetic emergency by using a combination of knowledge, skills and experience is vital in gaining confidence from the patient, work colleagues and the public. Whilst it is fortunate that these emergencies occur infrequently the result of this is that it becomes very easy to become deskilled in their management. Until anaesthetic simulators form a regular part of training and possibly revalidation, the onus is on the individual to keep their skills and knowledge up to date. This review of the emergency management of metabolic crises will hopefully act as a reminder to help in the diagnosis and emergency management of these rare but life-threatening events.