What Didn't Get Counted
The standard logbook question is "how many spinals have you done?" The harder question is "of the spinals you logged, how many did you actually perform versus supervise?" The number on paper and the number where your hands were in the field are not always the same. This version of the ANZCA logbook addresses that problem with four boolean fields that most logbooks skip entirely.
Four Checkboxes That Change What the Log Means
Did I do airway? Did I do access? Did I do procedure? Did I do regional?
Each is a yes/no against the case record. When the Regional Anaesthetic field says "Spinal" and the "did I do regional?" checkbox is ticked, that's a personally performed spinal. When the checkbox is unticked but Supervision = Direct, the case was observed with the consultant's hands doing the block. Two hundred logged spinals look very different depending on what fraction have that checkbox ticked.
ANZCA Fellowship requirements specify minimum numbers of personally performed procedures, not just observed cases. The distinction matters during the formative assessment process. These four booleans are the mechanism that makes personally-performed case counts filterable without requiring a separate column or a narrative note in every record.
Skill Booleans Across 26 Surgical Specialties
The Specialty field runs 26 options: Thoracic, Breast, Colorectal, Upper GI, Vascular, Urology, Orthopaedics (the default at Mackay Base Hospital, reflecting its surgical volume), Gynaecology, Cardiac, Dental, Maxillofacial, General, Neonatal, Neurosurgery, Ophthalmology, Paediatrics, Plastics, Radiology, Resuscitation, Trauma, Hepatobiliary, Obstetrics, ENT, Psychiatry, Birth Suite Epidural, Burns.
The trainee at Mackay doing predominantly orthopaedic and general surgical lists will build a very different specialty distribution than one rotating through TPCH with heavy cardiac and thoracic exposure. Neither is wrong — ANZCA's requirements specify minimum case numbers in specific specialties, and the logbook's job is to make gaps visible before the formative assessment, not during it.
Position: The Data Layer Most Logs Skip
Ten patient positions: Supine, Lateral, Lithotomy, Trendelenberg, Reverse Trendelenberg, Prone, Beach Chair, Head Up, Traction Table. Position drives the anaesthetic challenge in ways that the Specialty field alone doesn't capture. Prone Orthopaedic is a different airway and ventilation management problem than Supine Orthopaedic. Beach Chair position for shoulder surgery carries a specific cerebral perfusion risk profile. Traction table cases for hip operations require careful padding and positioning documentation.
When Position = Prone correlates with Airway = ETT and Procedures = Nasal Intubation or Armoured ETT in the filter, you're looking at the trainee's thoracic and spinal surgery airway management experience specifically.
PONV and the Outcome Tail
Adverse Events includes Post Op Vomit, Post Op Nausea No Vomit, Post Dural Puncture Headache, and Extended Time in Recovery — four outcome fields that capture what happens after the case ends. Most adverse event logs stop at intraoperative events. PONV is the most common anaesthetic complication, affecting up to 30% of unpremedicated patients, and it's entirely preventable in high-risk patients if risk factors are identified and prophylactic antiemetics are given.
Tracking PONV cases against the Technique field shows whether Ondansetron, Dexamethasone, and Granisetron are being used in the cases where they should be. A trainee with a PONV rate significantly above expected baseline for their case mix has a prescribing pattern that needs review. The data is only visible if the outcomes are logged.
Come from ICU and Go to ICU are the two boolean flags that bracket the case's critical care context. A patient arriving from ICU is already physiologically compromised at the time of anaesthetic induction. A patient going to ICU post-operatively represents a planned or unplanned high-dependency outcome. The proportion of cases with Go to ICU = true is a case complexity marker that the skill booleans and ASA field contextualize.
Prescription PCA documents that a patient-controlled analgesia prescription was written as part of the anaesthetic plan — the post-operative pain management decision that happens in the operating theatre and follows the patient to the ward.