The Case Log the ANZCA Assessor Will Actually Read

ANZCA logbook requirements for Fellowship candidacy specify minimum case numbers by specialty, by technique, and by ASA status. Knowing you've done "a lot of obstetric epidurals" and "quite a few cardiac cases" isn't the answer to "how many ASA IV cases have you anaesthetised unsupervised?" The answer requires a searchable database, not a paper folder that's been sitting in the registrar's locker since first term.

This template is that database, built specifically for Queensland training hospitals.

Hospital Location as the Rotation Tracker

The hospital location field covers fourteen Queensland sites: The Prince Charles Hospital (TPCH), Nambour General (NGH), Ipswich General (IGH), Royal Brisbane and Women's (RBWH), Caloundra, Princess Alexandra (PAH), Gold Coast, Redcliffe, Caboolture (BBH), Rockhampton, Toowoomba, Queen Elizabeth II (QE2), and Townsville. An anaesthetic trainee rotating across a two-year Queensland program will accumulate cases at five to eight of these hospitals. Filtering by hospital at the end of each rotation produces the rotation-specific case summary that the supervisor sign-off requires.

Supervision level runs five options: Direct (consultant physically present and actively involved), Indirect Local (consultant in the department), Indirect Distant (consultant off-site but contactable), Teaching Others (trainee is supervising a junior), Unsupervised. The progressive shift from Direct toward Indirect Distant and Unsupervised entries over the training program is the documented evidence of developing independent competence. An assessor reviewing a trainee who has three hundred cases logged but ninety percent Direct supervision is reviewing a different training trajectory than one with thirty percent Direct and fifty percent Indirect Local.

Airway: Forty-Two Options Covering Everything From ETT to McGrath

The Airway field is the most technically detailed aspect of this logbook. ETT sizes (6.0 through 8.5), LMA Classic sizes (3, 4, 5), iGel sizes (3, 4, 5), ProSeal sizes (4, 5), Supreme sizes (3, 4, 5), Guardian sizes (3, 4, 5), Laryngoflex sizes (7, 8, 9), double-lumen tube (DLT 39), MLT (microlaryngoscopy tube), Oral Rae, Nasal Rae, Reinforced ETT. Adjuncts: Bougie, Aintree catheter. Laryngoscope blades: Macintosh, McCoy, McGill, Miller, Long blade. Video laryngoscopes: Airtraq, McGrath, CMAC. Cormack-Lehane grading: Grade 1 through Grade 4.

The grade of laryngoscopic view is documented alongside the device used. A Grade 3 view managed with a McGrath video laryngoscope and a bougie is a different clinical event from a Grade 3 view that required an awake fibre optic intubation. Both are documented; the technique used to manage the difficult airway is captured in Procedures (which includes Awake Fibre Optic Intubation, Fibre Optic Intubation, C-MAC, Airtraq, McGrath) alongside the primary Airway device record.

Technique and PMHx: The Two Fields That Explain the Case

Technique records the drug cocktail: forty-seven agent options including induction agents (Propofol, Thiopentone, Ketamine, Midazolam), volatile agents (Sevoflurane, Desflurane, Isoflurane), opioids (Fentanyl, Alfentanil, Remifentanil, Remifentanil TCI, Morphine, Hydromorphone), muscle relaxants (Rocuronium, Suxamethonium, Atracurium, Vecuronium, Cisatracurium, Mivacurium), reversal (Sugammadex), TIVA, vasopressors (Phenylephrine, Metaraminol infusion, Noradrenaline, Adrenaline, Vasopressin), antiemetics (Ondansetron, Granisetron, Cyclizine, Dexamethasone), and Dantrolene. The presence of Dantrolene as a logged option is the malignant hyperthermia flag — when it appears in Technique, it correlates with Adverse Events = Malignant Hyperthermia.

PMHx covers forty-two comorbidities from IHD, AF, and CABG through OSA, COAD, CCF, permanent pacemaker, ICDefib, Aortic Stenosis, Mitral Stenosis, Takotsubo, Suxamethonium Apnoea, Retrognathia, and Limited Neck Movement. The airway risk comorbidities — Retrognathia, Limited Neck Movement, OSA, RA (rheumatoid arthritis, which can cause atlantoaxial instability) — are the ones that should correlate with the harder airway grades and the more advanced device selections in the Airway field. When they do, the trainee's technique choices are appropriate. When they don't, the logbook is showing a pattern the educational supervisor needs to address.

Adverse Events: The Documentation That Matters Most

Eighteen adverse events including Anaphylaxis, Aspiration, Awareness, Malignant Hyperthermia, Suxamethonium Apnoea, Failed Nasal Intubation, Failed Oral Intubation, Failed Regional, Local Anaesthetic Toxicity, Spinal Worn Off During Case, Opioid Overdose requiring Naloxone, Inadequate Relaxant Reversal, and Intra-Arterial Injection. These entries are the critical incident documentation layer of the logbook.

A trainee who logs Adverse Events = Awareness twice in two hundred cases has a pattern that's above population baseline. A trainee who logs Failed Oral Intubation with Airway = Grade 4 view, Procedures = Awake Fibre Optic, and Supervision = Direct has a documented difficult airway scenario handled with appropriate escalation and supervision. Both patterns matter to the ANZCA assessor, and neither is visible without a structured, searchable log.