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

May 21, 2023, 11 tweets

@emirakur presents an update on @NAPs_RCoA NAP7 Perioperative cardiac arrest & #OBAnes at #OAA23ASM.

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

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…

The ever topical Remifentanil PCA - always a source of debate. (See excellent @damien_hug261 lecture 🧵 from #OAA3dc2022 for a balanced update). Recognizing the risk and ameliorating by design (1:1 nursing, monitoring, etc) may address the same? But it’s not ONLY remifentanil in… twitter.com/i/web/status/1…

#NAP7 inclusion criteria, inclusion period and structure. 3 parts: baseline survey, case reporting and activity survey. #OBAnes #OAA23ASM

Baseline survey (1): 72% response rate (NHS hospitals). Three quarters of anaesthesia departments have #OBAnes. ~33% OB units are remote location (cf. main OR/ theatre). 1 in 2 units offer remifentanyl PCA. 71% of all UK anaesthetists represented. #OAA23ASM

A continuum. @IARS_Journals #patientsafety article on impacts of Perioperative catastrophes found: > 70% experienced guilt/ anxiety/ reliving. 1 in 5 never recovered. Ability to work compromised - 70% first 4 hrs, 50% first 24h. ~45% anaesthetists involved in management of 1 or… twitter.com/i/web/status/1…

Psychological impact on anaesthetists. ~5% anaesthetists affected - impacting patient care delivery after recent cardiac arrest. #OBAnes only a small proportion thankfully. #OAA23ASM

Activity survey: been covered at #OAA23ASM on several occasions, so a brief recap - #OBAnes accounts for 13 % of ALL anaesthetic workload, but SEVENTY percent of anaesthesia workload 00h00 to 07h00. Other finding covered before - median BMI of OB patients increasing (3,7kg/m2)… twitter.com/i/web/status/1…

Case registry: #OBAnes ~3% of perioperative cardiac arrests, more are overweight/ obese. Top 3 causes: hemorrhage, high neuraxial block & bradyarrythmias. ~1 in 10 associated with epidural for analgesia. ~80% women survived. Arrests & anaesthesia care - disconcerting large piece… twitter.com/i/web/status/1…

NAP7 #OBAnes summary. @emirakur acknowledges local coordinators, collaboration of all UK anaesthetists. #OAA23ASM

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