Simon Ash Profile picture
Passionate about #OBAnes and #patientsafety (#OBcritcare special interest). Father of 2 future Jedi. Views my own. he/his #heforshe 🇿🇦🇮🇪🇨🇦

Nov 8, 2022, 7 tweets

@AraniPillai presents first part of GA for cesarean section session (virtually) - hybrid presenter meeting here at #OAA3dc2022. @LondonSneh @oldandbaffled @R_S_Chaggar @Chakladar_A and other @NorthwickNEO may even tune in after their successful workshop?

Can’t discuss #OBAnes without mentioning work by @maretha_smit @dyk_dominique @rosshofmeyr (handles for others, please tag?) and their excellent article. @BruceBiccard - is SAJAA on twitter? Article here:
journals.co.za/doi/pdf/10.363…
#OAA3dc2022

@AraniPillai reviews the @dasairway master algorithm for #OBAnes GA & failed intubation. PERoxygenation with HFNO considered. Gentle bagging encouraged. Apnoeic oxygenation buys time. PERoxygentation may be ideal? #OAA3dc2022

HFNO in pregnant women has been studied, BUT does NOT meet @OAAinfo/ @dasairway preoxygenation standards, less effective than FMO2. May increase PaO2 though.

HOWEVER, does benefit of apnoeic oxygenation outweigh loss of preoxygenation? HFNO out performs LFNO (sorta) #OAA3dc2022

Optiflow “switch” offers possibilities but needs evaluation. The DL-VL debate continues. First attempt should be your best, that may be VL. But remember glottic impersonation - VL alone doesn’t prevent oesophageal intubation (may -> false security) DL has pro’s too #OAA3dc2022

In @AraniPillai’s practice:
1. HFNO - accepting mods & no ETO2 > 90 (achievable or not) & NOT for emergency #OBAnes GA.
2. VL - standardized type across hospital, available everywhere. Accessible = in reach.
Rotation = VL changes = problem
@UniversalAirway guidelines
#OAA3dc2022

@threadreaderapp unroll please

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