Discover and read the best of Twitter Threads about #perioperative

Most recents (3)

A #periopmedicine #tweetorial/#medthread

It’s that time of year again!
Sunday football?
ERAS applications?
Girl Scout cookies?
Well, yes…but for the purposes our discussion, it’s “COLD & FLU SEASON”

What do you do if a patient scheduled for surgery has a URI?

1/N
what is the theoretical concern?
That presenting for surgery, and the anesthetic management including intubation required to facilitate it, will lead to #perioperative complications if the patient has (or has recently had) an upper respiratory tract infection.

2/N
these concerns include the risk of periop pulmonary complications:
🔘respiratory failure
🔘airway hyperreactivity (during induction or emergence) ➡️laryngo/bronchospasm
🔘deeper infection like pneumonia

does this “biologic plausibility” translate into real-world events?

3/N
Read 23 tweets
As voted upon, a #Tweeotorial #Medthread:
#perioperative medicine meets #backtobedside
.
.
.
so let’s talk about functional capacity and METS!

1/x
METS?
“metabolic equivalent of task”

Huh?

Have you ever seen that report out on exercise equipment? Usually a number < 10?
It’s a measure of physical activity via oxygen consumption

Again, huh? #backtobedside??
Stay with me…
2/x
en.wikipedia.org/wiki/Metabolic…
Recall that the 2007 and 2014 ACC/AHA perioperative guidelines both include a step in their algorithms that no additional ischemic testing is recommended for patients who can achieve > 4 METS

So...how about those METS???
3/x
Read 27 tweets
#Periopmedicine #Medthread!
Based on requests (esp @JenniferBrokaw), a long over-due #tweetorial with my advice & pearls for providing patient-centered care for the surgical patient with #ParkinsonsDisease
1/x
@JenniferBrokaw Caveats
1⃣I’m not an anesthesiologist & don’t care for pts w PD #intraoperatively
2⃣I practice outpatient #PREoperative medicine, so I am not providing inpatient postop care
3⃣There are several high yield publications/resources, & much of this is pulled from my own experience
2/x
@JenniferBrokaw Caveats out of the way, let’s chat about why understanding #periop #ParkinsonsDisease management is so foundational.
Remember how Osler said to know syphilis is to know all of internal medicine?
Yeah…PD meets #periopmedicine is potentially THAT informative.
3/x
Read 28 tweets

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