NAP7 Activity Survey

The Activity Survey will provide a detailed snapshot assessment of anaesthetic activity and will collect rigorous data on intraoperative events that may be pertinent to understanding perioperative cardiac arrest.

Activity Survey FAQs

For grade of surgery, how should an angiogram, PCI or TAVI or other interventional cathlab procedures be graded?
We feel probably a TAVI is similar in complexity to an EVAR which is major complex.

For PCI the best comparison is say angiography of iliac vessels +/- stent is 'major' according to SORT so it may be best to put major but we can see it could be intermediate, particularly if just diagnostic...

Having said that we appreciate that there is considerable subjectivity and not all anaesthetists are familiar with this grading so have left if relatively undefined. If you feel not easy to say a grade N/A is appropriate also.

In my hospital anaesthetists insert PICC lines in theatre area: anaesthesia room, OR or recovery. Should the activity survey be completed for these?
Yes please include if these are done in theatre by anaesthetists.

We are seeing a 502 error at the end of the survey and the details are not uploading.
Refreshing the page should do the trick, otherwise please try a different browser and/or check with local IT whether they block survey monkey.

Is there any way the co-ordinator can check which survey entries have been done/not done?
Due to the anonymous reporting to the online survey there is no way to check which cases have been submitted and which haven't. You will need to liaise with your colleagues to find out which cases have been submitted. We have created a tracking sheet that you can adapt to help in tracking your cases:  Activity Survey Tracking Sheet (325 KB)

One of our survey dates is a CME/clinical governance day and there will be limited activity in theatres. Should we change our survey dates to days of full activity?
We understand that there will be some sites where this is the case. Please keep your survey dates as they are as this represents a normal variation.

Should we include Hickman line insertions which are performed by some anaesthetists in my hospital. The patients are awake during the procedure.
Yes please include as it is a 'procedure under the care of an anaesthetist' if you can.

We've missed the start date but would still like to take part in the Activity Survey. Can we still take part?
Please contact where we can discuss options for running the activity survey in your hospital.

I am not sure how question 45 (neurological complications) should be answered in patients who at the end of the procedure remain anaesthetised and transferred to intensive care unit. The presence of stroke in these patients will not be apparent until they are waken up, potentially after a significant length of time.
You are correct - you may not know if a patient has had a stroke and this may only become apparent later. Only tick if you think it is very likely to have occurred during anaesthesia. Some complications are obvious, e.g a high block, but others may not be. It may be that some such as stroke do not work well as options for the GA patients but we felt this was important enough to include as an option.

We are really interested in complications that have occurred, or highly likely to have occurred, during anaesthesia. It may be that some are highly linked with progression to cardiac arrest, whilst others as less so.

Are Remifentanil PCAs for labour to be included in the activity survey?
Yes if possible please do... enter under case specialty 'obstetrics:labour analgesia'. We will be able to pick them out as you will select intravenous analgesia rather than epidural as an anaesthetic technique during the survey (Q22 in the paper version).

The form isn't working well for epidural analgesia.
It asks for:
- grade of surgery Q16
- ecg, bp pulse etc Q40

I suspect you are entering a labour epidural under case type 'obstetrics: labour analgesia'? If so please select 'minor' for grade of surgery and 'yes' for monitoring.

We will add N/A options to these shortly. We will be able filter the labour epidurals within the survey and set them all to procedure type and monitoring to recovery as N/A.

Are vascular access procedures (peripheral cannulae/ midlines / central lines) and lumbar punctures to be included in the activity survey.
These would only be included if the patient was coming to theatre or recovery to have the procedure done. A CVC or LP in theatre would count as a procedure. I.v. access on the wards, particularly peripheral cannulas don't need to be included.

All cases under the care of an anaesthetist during the period are to be included. This includes cases under general anaesthesia, regional anaesthesia/analgesia, sedation, local anaesthesia, or
monitored anaesthesia care.

Each centre has been assigned 4 days during November to perform the survey, with the first group starting on Monday 8th. Individual dates by Trust are on the below spreadsheet.

Data collection begins at 00:00:00 on your first survey date and ends at 23:59:59 on your last survey date.

 Activity Survey Dates (52 KB)

Speak to your NAP7 Local Coordinator to get involved!

It should be easy to identify elective cases, but do not forget to think about other areas, e.g.:

  • Emergency and trauma theatres,
  • Labour ward- include interventions for labour analgesia on labour ward as separate cases,
  • Procedures that occur away from your main site- e.g. day surgery unit, ECT,
  • Pain procedures that occur in operating theatres or pain clinics,
  • Diagnostic and interventional radiology,
  • Emergency anaesthesia or sedation in the emergency department if administered by an
  • Out of hours work,
  • Regional anaesthesia,
  • Any return to theatre should be entered as a separate case.

Note the following are not to be entered:

  • Sedation or anaesthesia solely for critical care, or procedures on critical care,
  • Newborn resuscitation,
  • Inter- or intra-hospital transfers.

The survey will be completed electronically via the below Survey Monkey links:

NHS Sites click here
Independent Sites click here

The survey is best completed just after a case is complete. No question requires information that is not instantly available, and it takes about 4-5 minutes. The survey can be completed on any desktop, tablet, or phone with internet access. At the end of the survey, there is an option to restart to enter further cases.

The help sheet can be found here:
 Activity Survey Help Sheet (412 KB)

The paper form can be found below. The NAP7 Activity Survey has inbuilt branching logic, making it complex to complete on paper. Most survey responses will see about 30 fields (comparable to previous NAPs), and this can be completed most easily and quickly online. All responses should be easily identifiable without needing to reference patient notes.

This paper version of the survey should only be used in the event of severe IT issues or internet access during the survey period. We encourage people to use the survey link where possible. If internet access in theatre is limited, the survey can be completed in the recovery area, an office or coffee room.
 NAP7 Activity Survey Paper Form (396 KB)

An adaptable tracking sheet can be found below to enable Local Coordinators to track that all cases have been reported:
 Activity Survey Tracking Sheet (325 KB)

Further information