Emergency Manual

Are you seeking to help clinicians deliver the best possible care during medical emergencies?

Despite best intentions, well-trained clinicians often miss known key steps during critical events.

This FREE perioperative Emergency Manual contains 25 critical events as well as Crisis Resource Management key points. It has been iteratively tested with simulation over many years.

Download the Manual

Click here for PDF in
other languages.

* Given requests for easier mobile access on multiple devices using PDF bookmarks: As of July 2015 the downloadable pdf can still be printed but also has bookmarked hyperlinks to jump directly to specific events on computers and mobile-devices. We cannot supply specific IT support and warn users that the red home buttons we added to go from each event back to table of contents may not work on some mobile devices or on some readers, though the hyperlinks work more reliably. If any added features of this cost-free download do not work, please try a different device or pdf reader or consult your institution's IT for help.

For Download problems only, please contact our Tech Support:


  1. In simulation studies, integrating emergency manuals results in better management during operating room critical events. NOTE: Familiarization and training in why and how to use EMs appears to be key for success.
  2. Pilots and nuclear power plant operators use similar cognitive aids for emergencies and rare events, with training on why & how to use them.
  3. During a critical event, relevant detailed literature is rarely accessible.
  4. Memory worsens with stress & distractions interrupt planned actions.
  5. Expertise requires significant repetitive practice, so none of us are experts in every emergency.


Richard P. Dutton, MD, MBA

"Anesthesiologists have developed many tools to rescue patients from life-threatening situations, from the laryngoscope to the pulse oximeter to crisis management in the simulator. The latest of these is the Emergency Manual, a cognitive aid for any medical provider confronted with a crashing patient. This tool will save lives."

Richard P. Dutton, MD, MBA
Executive Director, Anesthesia Quality Institute

Bryan Bohman, MD

"This manual is an excellent addition to every anesthesia cart and OR nursing station. It is helpful pre-, during, and post-crises. A great deal of expert medical wisdom, academic research and practical, simulation-tested protocols are condensed into this compact, accessible manual."

Bryan Bohman, MD
Associate Chief Medical Officer

Alex Macario, MD

"Our trauma patient had refractory hypotension before Stanford implemented emergency manuals in our ORs… There were plenty of people available, so someone could have taken the ‘reader’ role. Tunnel vision is a real issue under stress when caring for unstable patients or in code situations and emergency manuals can help."

Alex Macario, MD
Anesthesia Residency Program Director

“During a recent MH crisis, I assigned a ‘reader’ to read aloud from the accessible emergency manual. As event leader it was extremely helpful. The clear directions helped guide a calm, unified, team response. I knew that no evidence-based part of the treatment algorithm would be missed, giving our patient the best chance for full recovery."

Anita Honkanen, MD, MS
Chief, Pediatric Anesthesia Division

Brice Gaudilliere, MD

"I noted climbing EtCO2, despite increased minute ventilation. Having used the emergency manual to review ‘what if’ cases, I thought to reach for it and found the correct page within seconds of considering the diagnosis of malignant hyperthermia. It helped our team to manage this unexpected event efficiently and accurately."

Brice Gaudilliere, MD
CA-3 Anesthesia Resident

Lauren Friedman, MD

"Having the emergency manual as a staple resource in the OR and at home is extremely helpful… I look to the manual to guide me, either during an event or after one to make sure that I have covered everything."

Lauren Friedman, MD
CA-1 Anesthesia Resident


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