Download the Manual

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.

Mobile Download

If you download emergency manual to an iDevice with iBooks, it will give you option to ‘Save to iBooks’ so you can view pdf anywhere. Similarly, Android and other mobile device users can save as PDF on that device.

Permissions Customization

Creative Commons License

We are aware that cost as well as clinically usable design are big challenges for all institutions, which is why we chose to share the pdf at no cost under a  creative commons license.

The following modifications for local customization are approved by SACAGBesides these exceptions, all other pages and content should stay as is, unless explicit permission is granted.

Front Cover, Top Horizontal Text Box, Entitled Emergency Numbers

  • Institutions are encouraged to insert your own local emergency phone numbers here
  • At top right of same text box, you may add if you wish “Adopted by _______” (Institution Name)
  • If you’re outside the United States, you may change “To report adverse events…” from AQI to list relevant link.

Back Cover, Phone List

Institutions are encouraged to insert a full page of useful clinical phone numbers here. To get started here is a: telephone numbers template.

Hemorrhage Event (#14)

  • Top blue box Item #1 “Follow local protocol to order Massive Transfusion Guideline” may be replaced to include an appropriate phone number, terminology, and where to find local guidelines. If desired, it can refer to local guidelines at bottom of 2nd Hemorrhage page.
  • The blank space at bottom of 2nd Hemorrhage page may be used to add further local details if desired. Note that if local guidelines change frequently and are updated in an easily accessible different location, it may be better to include only a phone number and where to find further details on local guidelines.

We welcome any suggestions for generic changes for the next version, based on further medical content or clarity of design. However, we will sometimes grant permission for further local modifications beyond the above 3 permissions. See process below.

Recognizing the many pros of extensive local customization, there are also significant cons and potential for introducing errors or less clinically-usable design. This format has been iteratively tested in simulated critical events over many years, with clinicians from many institutions, as well as being successfully implemented clinically already at multiple institutions. Further requested specific local changes to latest version should be compiled on an Excel or Word table, with columns for: event name, event section, exact current wording (or ordering, etc), requested new wording, and another column with strong reasoning for the change. Send to, and these will be considered, as able, at SACAG group meetings quarterly.

Appropriate Citation

Stanford Anesthesia Cognitive Aid Program*. Emergency Manual: Cognitive aids for perioperative critical events. See for latest version. Creative Commons BY-NC-ND. 2016 (Version 3) (
*Core contributors in random order: Howard SK, Chu LF, Goldhaber-Fiebert SN, Gaba DM, Harrison TK.


The material in this manual is not intended to be a substitute for sound medical knowledge and training. Clinicians using this manual should use their clinical judgment and decision making for patient management. Since treatment for the medical conditions described in this manual can have variable presentations, departure from the information presented here is encouraged when appropriate

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