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NAP6 Report

Anaesthesia, Surgery and Life-Threatening Allergic Reactions

Report and findings of the Royal College of Anaesthetists' 6th National Audit Project


NAP6: Perioperative Anaphylaxis is the largest ever prospective study of anaphylaxis related to anaesthesia and surgery.

The full NAP6 Report is available in full as a single PDF, or as individual chapters below.

Some key findings of NAP6 are summarised on the NAP6 Infographic.
 NAP6 Infographic.pdf (718 KB)


Full Report

 NAP6-REPORT-2018 FINAL.pdf (11.75 MB)



Individual Chapters

1. Introduction
 NAP6 Chapter 1 - Introduction.pdf (248 KB)

2. Key findings and recommendations
 NAP6 Chapter 2 - Key findings and recommendations.pdf (133 KB)

3. A patient's experience of perioperative anaphylaxis
 NAP6 Chapter 3 - A patient’s experience of perioperative anaphylaxis.pdf (26 KB)

4. The lay perspective
 NAP6 Chapter 4 - The lay perspective.pdf (90 KB)

5. Methods
 NAP6 Chapter 5 - Methods.pdf (159 KB)

6. Summary of main findings
 NAP6 Chapter 6 - Summary of main findings.pdf (467 KB)

7. The Baseline Survey - perspectives and experiences of perioperative anaphylaxis before NAP6
 NAP6 Chapter 7 - The Baseline Survey - perspectives and experiences of perioperative anaphylaxis before NAP6.pdf (191 KB)

8. The Activity Survey - anaesthetic practice
 NAP6 Chapter 8 - The Activity Survey - anaesthetic practice.pdf (335 KB)

9. The Allergen Survey - perioperative drug exposure
 NAP6 Chapter 9 - The Allergen Survey - perioperative drug exposure.pdf (486 KB)

10. Clinical features
 NAP6 Chapter 10 - Clinical features.pdf (152 KB)

11. Immediate management and departmental organisation
 NAP6 Chapter 11 - Immediate management and departmental organisation.pdf (3.79 MB)

12. Deaths, cardiac arrests, profound hypotension and outcomes
 NAP6 Chapter 12 - Deaths, cardiac arrests, profound hypotension and outcomes.pdf (332 KB)

13. Allergy Clinic Baseline Survey - provision of specialist allergy clinic services
 NAP6 Chapter 13 - Allergy clinic baseline survey - provision of specialist allergy clinic services.pdf (509 KB)

14. Investigation
 NAP6 Chapter 14 - Investigation.pdf (1.14 MB)

15. Antibiotics
 NAP6 Chapter 15 - Antibiotics.pdf (289 KB)

16. Neuromuscular blocking agents and reversal agents
 NAP6 Chapter 16 - Neuromuscular blocking agents and reversal agents.pdf (84 KB)

17. Chlorhexidine
 NAP6 Chapter 17 - Chlorhexidine.pdf (94 KB)

18. Patent Blue dye
 NAP6 Chapter 18 - Patent Blue dye.pdf (197 KB)

19. Colloids and infrequent trigger agents
 NAP6 Chapter 19 - Colloids and infrequent trigger agents.pdf (63 KB)

20. Obstetric anaesthesia
 NAP6 Chapter 20 - Obstetric anaesthesia.pdf (214 KB)

21. Paediatric anaesthesia
 NAP6 Chapter 21 - Paediatric anaesthesia.pdf (206 KB)

22. Critical care
 NAP6 Chapter 22 - Critical care.pdf (60 KB)

23. The independent sector
 NAP6 Chapter 23 - The independent sector.pdf (85 KB)

24. Reporting and learning
 NAP6 Chapter 24 - Reporting and learning.pdf (117 KB)