Discover and read the best of Twitter Threads about #anaesthesia

Most recents (9)

I don’t normally geek out about #anaesthesia but given the ongoing Remifentanil shortage in 🇬🇧 I thought I’d post my alfentanil TIVA recipe.
IMHO it’s elegant, precise and allows for absolutely minimal anaesthetic poly pharmacy.
(Very boring for non anaesthetists…..)
Remifentanil is useful but I have never liked it in cases where one is reliant on subsequent IV analgesia.
The transition from a carefully titrated anaesthetic to smashing in 10mg morphine, or the like, towards the end has always irked me. You don’t really know where you are!
Most people use small aliquots of Alfentanil for short sedation cases but when given in larger amounts by infusion it can be used entirely differently.
Below is a graph of CSHT’s which are relevant in this context.
Read 18 tweets
#JanuAIRWAY Day 31 (the last day!) – Difficult Airway Conditions. There are loads – what follows isn’t a definitive list – but it’s pretty long all the same! Let’s dive in…
#DifficultAirway #FOAMed
#JanuAIRWAY 1/7 ImageImageImageImage
Unfortunately this #OnePager has to occupy this tweet by itself #FOAMed
#JanuAIRWAY 3/7 Image
Read 7 tweets
Utterly shocked by the performance of Anaesthesia Consultant Steve James & his assertion that staff don’t need vaccination following recovery from COVID
He is wrong on the facts - vaccines have proven beneficial boosting “natural immunity”
Anti-vac are eating it up
Read 45 tweets
Do we need maintenance fluids at all? What is your preferred maintenance fluid solution?
#IFAD2021 #FOAMed #FOAMcc

REPOSITORY (access 100+ lectures):…

@avkwong - @Manu_Malbrain - @azJanPalfijn - @FOAMecmo - @Wilkinsonjonny - @strachanjamie - @iceman_ex
When do you use (hypotonic) albumin 4% solutions?

#IFAD2021 #FOAMed #FOAMcc
REPOSITORY (access 100+ lectures):…
@avkwong - @Manu_Malbrain - @azJanPalfijn - @FOAMecmo - @Wilkinsonjonny - @strachanjamie - @iceman_ex - @icmteaching - @Gas_Craic
Read 30 tweets
Some recent chatter about single-moment-in-time high-stakes examinations. Let’s call them #SMITHSEx for short.

Here’s why I think #SMITHSEx is dirty and should be consigned to the rubbish bin, as far as postgraduate / specialty medical training is concerned.

A thread 🧵
Been ruminating on this for a while, and a recent #ICRE2021 thread on #SMITHSEx got my attention. @ICREConf
A few things happened soon after. A good friend didn’t pass their #SMITHSEx, by a small margin. Meant that they couldn’t take up permanent consultant / attending post that was already offered to them, in the dept they had trained in for the past 5-7 years.
Read 13 tweets
This thread is all about Monitoring Neuromuscular Blockers (NMBs) for anaesthetic novices

I think this is often underplayed in clinical practice and we can be lazy

I’ll start with this summary infographic and elaborate as we go along.

#anaesthesia #novice
NMBs are not benign drugs. Their use (or lingering effect) is associated with:
- Risk of awareness (NAP5)
- Laryngeal weakness
- Aspiration
- Patient distress
- Adverse airway events
- Reduced hypoxic drive

…all of which we want to avoid and shouldn't leave for the PACU

The duration of action quoted for NMBs is the duration until recovery to 25% of original twitch height (roughly just after the 4th twitch is visible as far as I can tell)

Not time to full function
Not time to elimination
Not time to extubation…

Read 11 tweets
Every speciality who is on (or wants to be) the ‘Mucor’ team- how many are willing to admit a patient with Mucor under their care and manage (even after surgical debridement). How many were admitting before and will admit after the pandemic? (1/n)#Mucormycosis #COVID19India
Some hypothetical consultations in the emergency before and after the pandemic:

#ENT : We will operate and transfer back

#Ophthalmology : Call us during the Surgey, we will coordinate with ENT in the OT, if needed

#Neurology : Continue Amphotericin (2/n)
#Endocrinology : Send us a consultation after admission under primary, we will control sugars

#Neurosurgery :No active neurosurgical intervention required

#Nephrology :We will do renal modification of Amphotericin

#Medicine/ #Infectiousdisease Admit under any of the above
Read 4 tweets
Starting as a novice anaesthetic trainee. A thread of #FreshPrince Gifs

1. “Hey everyone, I am the new “baby anaesthetic trainee!” (I actually said this!)
2. When you realise that actually, you don’t know anything about any of the drugs, doses, procedures... and basically, you are a med student again!
3. When you have to cannulate all your patients with the consultant standing over you and your success rate is not so hot!
Read 15 tweets
MYTH BUSTER: #anaesthesia & #anaesthetists are hard words to say (I’m one & have trouble!) & people are sometimes confused about what we do (even other doctors!) and that’s fair enough, but we are way more than just people who “put you to sleep” for your surgery #covid19aus 1/
It’s better to think of us as #anesthesiologists (with an american accent!) like they say in the US. We are medical specialists. We have a medical degrees & a specialist qualification, are highly trained having done continuous training until we are often at least 30 years old 2/
We assess all aspects of you before giving you an anaesthetic - Such as your health conditions, your medication, your worries/concerns about what about to happen to you, your pain requirements, & make decisions about the safest anaesthetic to give you for your surgery 3/
Read 12 tweets

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