@Rose_Kearsley (@RotundaHospital - my fellowship alma mater) speaks on #OBAnes in the 4th trimester at #OAA23ASM.
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…
#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…
The patient experience is central to our practice in #OBAnes.
@SusannaStanford’s @Anaes_Journal editorials and Dr Felicity Plaat et al guidelines on prevention & management of intra-operative pain during cesarean section has been very topical in #OBAnes community as well as the… twitter.com/i/web/status/1…
A reminder of @DOckendenLtd’s final report (see 🧵 from #Anaesthesia23 #OBAnes session elsewhere on time line, as well as Bill Kirkup’s). 15 IEA’s including postnatal follow up (4th trimester!) #OAA23ASM
Why does anaesthesia follow up in the 4th trimester?: clinical, psychological and when things go awry. Clinical: follow-up of PDPH. At 3 months, 1 in 10 patients were receiving medication for either HA or LBP. At 18months: 58.4% of ADP group had persistent HA. #OBAnes #OAA23ASM
Clinical: maternal health - preeclampsia up to 3x increased risk of MACE; GDM 50% chance DM2 in 5-10 years.
Psychological: parturients - difficult/ traumatic birth for varied reasons; feel weren’t listened to/ treated with respect; some need time to mourn.
Same experience but… twitter.com/i/web/status/1…
Is just right… lukewarm? (Better not be porridge). Hot debrief whilst inpatient.
Postnatal Post-Anaesthesia Clinic (POPAC) held monthly at @RotundaHospital. Clinical follow up: PDPH, EBP, other. Referrals from Birth reflection service.
Before POPAC, looks like what exists in… twitter.com/i/web/status/1…
The future of POPAC begins with PDSA cycle of audit and compare. Review themes arising from birth reflections. Patient perspectives to improve patient experiences and outcomes of #OBAnes. Closing with an appropriate Maya Angelou. #OAA23ASM
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