Simon Ash Profile picture
Nov 8 6 tweets 7 min read
@peteodor speaks on drugs & technique in GA cesarean (will tweet objectively, discuss later). What #OBAnes risks do we need to discuss - not just induction. DDI may not be the “be all and end all”? #OAA3dc2022 ImageImageImageImage
Lower GA rates possible - #COVID19 taught us that. HOWEVER, no data on IV adjuvants (how many GAWA’s were administered - oops already questions) The modified RSI in #OBAnes. Thiopentone is dead (taken less time outside UK) #OAA3dc2022 ImageImage
@peteodor raises the use of opioids during induction - we probably don’t really have the answer (@rosshofmeyr probably didn’t collect this sort of data in #OBAnes airway registry). Propofol not faster, but wins deeper for longer race (no place for thiopentone). #OAA3dc2022 ImageImageImage
Still a place for sux. Sugammadex mandatory for rocuronium. Maintenance - TCI understudied, which model would you use & what setting: elective/ emergent?(@Eltonchris). TIVA/TCI work better with drugs in syringe - I have spoken (@RobJimFleming) #OAA3dc2022 ImageImageImage
Final thoughts from @peteodor. Not sure I completely agree with rocuronium for everyone even with sugammadex (titrate additional opioid analgesia to RR, works better if done with intention rather than postop rush). Done properly sevo okay, TIVA may have value? #OAA3dc2022 Image
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More from @OBsleepmerchant

Nov 11
@euklaas from @asznl presents on PDPH: new perspectives at #OAA3dc2022. (As promised by teaser) August Bier = father of PDPH, a surgeon started it not #OBAnes 😉 ImageImageImageImage
Current perspective on PDPH. ICHD-3 definition, tied to CSF pressure & volume as is pathophysiology. #OAA3dc2022 ImageImageImage
New anatomical perspectives challenge the classic CSF hypothesis. Choroid plexus not main site of production, CSF doesn’t circulate unidirectionally.

Bulat-Kiarica-Orešković hypothesis: osmotic & hydrostatic forces are main determinants of CSF movement, pulsates

#OAA3dc2022 ImageImageImage
Read 14 tweets
Nov 10
Everyone needs to be on #Medtwitter @StephenLap! Watching @obstetriciasati talk about Obstetric hemorrhage I notice a trend observed at #OAA3dc2022 continuing: manual external aortic occlusion (a REBOA without surgeons or balloon catheter) Image
Dr Ove Karlsson and EXAC group have an article in press:

sciencedirect.com/science/articl…

#OAA3dc2022
Find out more at:

exac.no/about

#OAA3dc2022 ImageImage
Read 4 tweets
Nov 10
@Airwayman1 presents on #HumanFactors in #OBAnes. MedTRiM: medical trauma & resilience management - reminding us of the Declaration of Geneva #OAA3dc2022 ImageImageImageImage
The Boabab lesson (Zambia) applicable to #OBAnes #OAA3dc2022 Image
The plan for the talk. Your patient - straight after new bag sats drop…
NOT Swiss cheese (@girardDev), Emmental(?) model #OAA3dc2022 ImageImageImageImage
Read 14 tweets
Nov 10
@ArviPalanisamy presents his philosophy on the Future of #OBAnes Research in this final session of #OAA3DC2022: practical, aspirational, inspirational (skipping the queue to catch a train, @noolslucas & @OAAinfo) very accommodating in view of train/tube strikes affecting London) ImageImageImageImage
#OBAnes research has plateaued, advancing in increments. A change in thinking is required. Several low hanging fruit, #MindTheGap between #OBAnes research and practice - implementation science something for future? #OAA3dc2022 ImageImageImageImage
One subject ripe for implementation science study is awareness. DREAMY study factors associated are known, awareness common (perhaps we’re losing a skill?) & linked to PTSD. #BridgeTheGap #OAA3DC2022 ImageImageImageImage
Read 9 tweets
Nov 10
@girardDev presents on managing the obese parturient at #OAA3dc2022. He sets the bar high for the future of presentations at #SOAPAM2023, #OAA23, #ASM23SYD: a QR code that links to all his references as well as a pdf of his slide deck - perfect for #OBAnes #SoMe & #FOAMed. ImageImageImageImage
The value of PERI-oxygenation in obesity is not to be ignored. All patients will go blue, perioxygenated ones take 52 seconds longer (how long it feels depends on the sats?). We all remember the troop pillow, but do we remember the stool? Ergonomics of intubation #OAA3dc2022 ImageImageImage
@mbrrace meeting 10 November. Hope to see some live tweets of key messages @SusannaStanford. “We are ALL part of the solution” #OBAnes and obesity is definitely part of the puzzle, preventing it part of the solution. #OAA3dc2022 Image
Read 11 tweets

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