Discover and read the best of Twitter Threads about #oaa23asm

Most recents (20)

Just off great @dasairway @OAAinfo #OBAnes airway masterclass webinar with @silv24 chairing, @ProfEllenO @noolslucas @Chakladar_A and @DesireOnwochei giving expert opinions - lots of notes taken, tweets to follow twitter.com/i/web/status/1… Image
Right, let’s get to it. The #OBAnes airway - shifting the paradigm; a @dasairway & @OAAinfo masterclass. Two Profs in the corner… this should be interesting. @noolslucas kicks off the webinar. Image
What is a difficult airway? @ASALifeline definition: a clinical situation, conventionally trained anesthesiologist, difficult face mask ventilation/ intubation/ both.

Complications - hypoxemia: @MariePierreBon2 et al @BJAJournals 2020, @DavidGray37 @rosshofmeyr and co, SAJAA… twitter.com/i/web/status/1… ImageImageImageImage
Read 38 tweets
@rr_metabolicmed presents the Bruce Scott Lecture 2023 at #OAA23ASM: Obesity & diabetes in pregnancy - legacy for the child. #OBAnes Image
Study of 1.3 million pregnant women reveals global obesity crisis: 75% pregnant women fail to achieve healthy weight gain during pregnancy, leading to preventable adverse health consequences for both the women and their babies. Obesity has strong evidence for increased risk of… twitter.com/i/web/status/1… ImageImageImage
Maternal obesity and offspring cardiovascular disease: maternal obesity increases offspring cardiovascular death (Hazard ratio [all cause mortality] = 1.35). At current UK maternal obesity rates, this equates to extra 650 deaths before age 50 each year. The Hazard ratio for type… twitter.com/i/web/status/1… ImageImageImage
Read 14 tweets
@TasPirani presents of Liver disease in pregnancy. A lot to cover! #OBAnes #OAA23ASM ImageImage
Physiological changes in pregnancy. Normal LFT/ laboratory changes. #OBAnes #OAA23ASM ImageImage
Causes of liver derangement in pregnancy: flare of pre-existing liver disease (known or unknown). Incidence of pregnancy in people with chronic liver disease at King’s College Hospital. Historically, cirrhotic patients have been infertile d/t anovulation. Population based data… twitter.com/i/web/status/1… ImageImageImageImage
Read 18 tweets
@ICULone presents on Severe Maternal Morbidity (SMM) and its consequences at #OAA23ASM. #OBAnes Image
Definition of acute SMM: severe, life threatening event during pregnancy & within 6 weeks of delivery. @NPEU_UKOSS provides UK wide high quality obstetric surveillance. Deaths, while uncommon, investigated in depth.

Study Aims: operationalise definition of SMM; report incidence… twitter.com/i/web/status/1… ImageImageImage
SMM at a population level. Study population derivation. #OBAnes #OAA23ASM ImageImage
Read 11 tweets
Prof Donald Peebles on Embedding Maternal Medicine Networks at #OAA23ASM. Knowing who to call is half the solution to any problem? (Touched on by @elsmere_g during #OBAnes session at #Anaesthesia2023) Image
Direct maternal mortality rate per 100,000 maternities had been decreasing over the last 2 decades, but should a remarkable upswing since 2018, not all accounted for by #COVID19. @mbrrace outlined a case for change: most parts of UK have MDT, but make up variable most without… twitter.com/i/web/status/1… ImageImage
The Maternal Medicine Network (MMN) mandate: ensure timely access to specialist advice and care at all stages of pregnancy. Development of Maternal Medicine specialist centres as regional hub & spoke model = urgent national priority (@DOckendenLtd report)

MMN Ambition and… twitter.com/i/web/status/1… ImageImage
Read 5 tweets
Dr Katy Sheehan and @ArcBroom present the pick of the posters at #OAA23ASM. 4 criteria for selection of #OBAnes abstracts. ImageImage
A positive start, with the power of positive communication on patient satisfaction, morale & culture, and #patientsafety #OBAnes #OAA23ASM ImageImageImageImage
Barriers to care. Ethnicity, Language and Socioeconomic deprivation. @mbrrace, @TheLancet, and most recently @Anaes_Journal (@LateralTilt @noolslucas @SQuashie @Marianfknight) set the stage. #OBAnes #OAA23ASM ImageImageImageImage
Read 18 tweets
@NoelleHealy (another 🇮🇪 representative - @ISOA_Ireland well represented!) presents on #OBAnes as a team sport - how do we perform better? at #OAA23ASM. Quite an inspiring quote, then setting the stage with @Fionafionakel et al #humanfactors guidelines in @Anaes_Journaltwitter.com/i/web/status/1… ImageImageImage
Why is teamwork important in OB/ #OBAnes? @mbrrace suggests some lessons to be learned. Prompt action is arguably reliant on good communication, within & between teams. Involving consultant/ specialist care early has been a theme for over a decade. #OAA23ASM ImageImageImage
@DOckendenLtd’ final report highlighted “conflicting agendas and poor teamwork” contribute to adverse maternal & neonatal outcomes? So how do we create good teams?

The @JulieAndrews approach may have the hills alive, but for #OBAnes we may need to start at the very beginning,… twitter.com/i/web/status/1… ImageImage
Read 10 tweets
@emirakur presents an update on @NAPs_RCoA NAP7 Perioperative cardiac arrest & #OBAnes at #OAA23ASM. ImageImage
The history of @NAPs_RCoA projects and key findings for #OBAnes over the years (failed intubation NAP4 1:390, recent US data 1:808 - gotten better or different methodology?) #OAA23ASM ImageImage
Cardiac arrest in pregnancy. CAPS study @BJOGTweets (I see @Marianfknight?) looked at incidence, management & outcomes in UK. #OBAnes have a significant slice of the pie. @SOAPHQ serious complication repository project (incl. @RichSmileyMD @bscottsegal) provide US data: cardiac… twitter.com/i/web/status/1… ImageImageImageImage
Read 11 tweets
@Rose_Kearsley (@RotundaHospital - my fellowship alma mater) speaks on #OBAnes in the 4th trimester at #OAA23ASM. ImageImage
At the outset, @Rose_Kearsley addresses the definition of trimester (3 months, not only “a third of”). It’s not a novel concept - in lay, academic and anesthesia literature - which makes sense when one thinks of how many pregnancy-associated disease extend beyond delivery (not… twitter.com/i/web/status/1… ImageImageImageImage
#OBAnes workload. 33.3% time on procedures. NB average workload does NOT reflect ebbs & flows, more so surges of activity. @NAPs_RCoA NAP7 data: majority of labour analgesia 1800-0800; #OBAnes accounts for majority of single speciality #AnyAnes work 1800-0800; increasing obesity… twitter.com/i/web/status/1… ImageImageImageImage
Read 10 tweets
@LimGrapes continues her tour de force at #OAA23ASM with Decision Making and Neuraxial Anesthesia. New evidence around thrombocytopenia and how those guidelines affect decision making in #OBAnes ImageImage
To start: a Case. Possible evolving HELLP. Trends are important. Discuss anesthesia options.
#OBAnes #OAA23ASM ImageImageImageImage
Defining the problem: preeclampsia itself results in qualitative platelet dysfunction (even before HELLP). Preeclampsia has circulating microthrombi. Platelets are pre-activated, proaggregatory and prothrombotic BUT don’t respond to exposed collagen —> perioperative bleeding… twitter.com/i/web/status/1… ImageImageImageImage
Read 15 tweets
@AliciaTDennis starts day 2 of #OAA23ASM with an update on the management of preeclampsia. #OBAnes ImageImage
The problem of preeclampsia and maternal morbidity & mortality is not new (1933 - 33.3% with eclampsia DIED) Nor is it a UK/ US problem. #OBAnes #OAA23ASM ImageImage
Cardiac disease and preeclampsia feature as leading causes of maternal mortality in @mbrrace reports. Complications of preeclampsia are multiple. Preeclampsia and heart disease are included in key messaging. It’s a @WHO problem: international comparisons. #OBAnes #OAA23ASM ImageImageImageImage
Read 13 tweets
ERAC at #OAA23ASM, expertly managed by #OBAnes @LimGrapes from @OBAnesUPMC Image
@LimGrapes lays out the objectives of her talk and highlights the model for improvement applicable to #AnyAnes. Great quote! #OBAnes #OAA23ASM ImageImage
What is ERAC? Well, let’s start at the very beginning (seems like a good place to start): enhanced recovery is about quicker recovery and improving outcomes. Most of all it is an APPROACH! #OBAnes #OAA23ASM ImageImageImage
Read 14 tweets
@DevroeSarah presents on Anaesthesia in Pregnancy and Neurodevelopment at #OAA23ASM. Quite an outline! #OBAnes ImageImage
@DevroeSarah begins with epidemiology - 0.4-1% pregnant women will have non-OB surgery during their pregnancy. Fetus = innocent bystander. Complicated question. What is the pathobiology of normal brain development? Is there a link between anaesthesia and impaired brain… twitter.com/i/web/status/1… ImageImageImageImage
Mechanisms? Drug-induced vs multifactorial. Preclinical evidence of consistent association. Clinical evidence inconclusive. Preclinical findings certainly headline grabbing, which prompted a systematic review and meta-analysis from Bleeser et al (incl. @DevroeSarah @rex_steffentwitter.com/i/web/status/1… ImageImageImageImage
Read 10 tweets
@RopeyP: it’s good to talk - multispeciality decision-making for the pregnant patient having urgent non-OB surgery. SLIDO. Disclosures - #OBAnes is quite welcoming though. #OAA23ASM ImageImageImage
Some more background for case-based discussion. Aims of anaesthesia when there’s more than 1 patient. Planning for surgery isn’t “big syringe, little syringe”. What are the patient’s priorities? Do ours align? #OBAnes #OAA23ASM ImageImageImageImage
Multiple disciplines feeding into patient experience and decision making. She has indications for surgery - don’t delay. Management options (BRAN) - laparoscopic subtotal colectomy. #OBAnes #OAA23ASM ImageImageImage
Read 7 tweets
@rjharrison79 opens #OAA23ASM with an update on Labour Analgesia for 2023. Sir James Young Simpson remembered. ImageImage
It reads like an #Ostheimer - @rjharrison79 may be a contender to fill @PervezSultanMD’s shoes? Love the QR codes! #OBAnes at #OAA23ASM has gone state of the art! ImageImage
Analgesia efficacy: to puncture or not to puncture, that may be the question. (Puncture and give something or not?) #DPE studies on surgical onset times required, worrying signal regarding PDPH?#OBAnes #OAA23ASM ImageImageImage
Read 14 tweets
Dr Neel Desai provides an Update on Anesthesia for Cesarean Delivery at #OAA23ASM #OBAnes Image
Starting with the mainstays: choice of local anaesthetic and intrathecal morphine. Prilocaine 2% has compared favourably with bupivacaine 0.5%. However, there are caveats: if prilocaine is to be considered for routine #OBAnes it is recommended a CSE be used. ITM does NOT prevent… twitter.com/i/web/status/1… ImageImageImage
The very topical: inadequate neuraxial anaesthesia for cesarean section. See lectures from @hnixon147 and @PervezSultanMD from recent @SOAPHQ annual meeting elsewhere on my timeline - this is a widespread concern. @Jamesocarroll has initiated a large multicentre trial through the… twitter.com/i/web/status/1… ImageImageImage
Read 11 tweets
Bill Kirkup presents on the independent investigation into East Kent Maternity Services at #Anaesthesia2023 #OBAnes ImageImage
Battled with how to put “In their own words…” together. 4 slides at a time doesn’t cut it. It was a very emotive experience. So I hope this works (Twitter Blue perk)
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
In their own words: FAMILIES.

Midwives, not nurses. They cut me open (@HofkampMichael @emilysharpe @ruthi_landau). He’s singing, then he died. We don’t talk about cesareans. Physician: I’m the doctor. Midwife: we won’t be doing that.

And that last one… apropos of @SQuashie’s… twitter.com/i/web/status/1…
Read 10 tweets
@DOckendenLtd presents at #Anaesthesia2023 on the Ockenden Report - a year on, have we made progress? #OBAnes ImageImage
What were the key messages of the Ockenden Report from @DOckendenLtd? Final report March 2022 (distributed amongst #OBAnes at @IWKHealth @DalAnesthesia - learnings valuable even across the pond): failures of quality of care & governance; failure of external bodies to monitor;… twitter.com/i/web/status/1… ImageImageImageImage
What did the media say? Overall coverage fair, balanced and commended by families.
And Nottingham? Maternity review is underway… themes continue.
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM) ImageImage
Read 12 tweets
@SQuashie presents on ethnic disparities in #OBAnes outcomes at #Anaesthesia2023… lots in lead up to #OAA23ASM ImageImageImage
A break down of the objectives of the talk. Census data demonstrates increases in all minorities, nationally and locally. Definitions: What is a health disparity? >10% health difference closely linked to disparity. Inequality, equality, equity and justice are linked.… twitter.com/i/web/status/1… ImageImageImageImage
Race vs ethnicity - an important difference. Maternal inequalities have been subject of several reports, resulting in Maternal Disparities Taskforce and Equity & Equality guidance. Reducing inequalities focus on CORE20PLUS5: the most deprived 20% with 5 key clinical areas… twitter.com/i/web/status/1… ImageImageImage
Read 15 tweets
@elsmere_g presents on Maternal Medicine at #Anaesthesia2023. Pregnancy is stressful - it will unmask disease. Pick up the phone. Why are we worried? #OBAnes #OAA23ASM ImageImageImageImage
When looking at @mbrrace reports the UK has shown some improvements in maternal mortality, however, there has been an uptick since 2018. While this is partly accounted for by a changing maternal population (older, more obese, more comorbidities, etc), start inequalities related… twitter.com/i/web/status/1… ImageImageImage
Majority are indirect deaths. #OBAnes contributes only a small amount (not to be ignored though). Everyone has a role to play in improving maternity care and reducing mortality & morbidity. Remember majority of deaths occur AFTER delivery - recent pregnancy history shouldn’t be… twitter.com/i/web/status/1… ImageImageImage
Read 11 tweets

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