Simon Ash Profile picture
Nov 10 9 tweets 11 min read
@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)
#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
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
Other #OBAnes projects low lying and ripe for implementation science: PPH, ERAC, opioids #OAA3DC2022
Team Science: Rise of Networks (an #OBAnes epic?) Amdahl’s Law applies, with multiple advantages. #OAA3DC2022
Transdisciplinary science is open to #OBAnes (more than 1 patient) both ripe with opportunity - #BridgeTheGap between OB & Paeds: it’s happened before (Apgar) Improve maternal mental health. Many lights see more - create great things.#OAA3dc2022
Can we improve maternal mortality with AI? Teaching machines to predict or at least help us do so sooner - still not there yet. Blue Sky thinkers need space too. Start on the green zone though. #OAA3dc2022
What makes a good research idea? (Getafix was #OBAnes?) Lots of things to consider - NB to check it’s novel before devoting too much time/ money. Fresh pair of eyes can change the world. #OAA3dc2022
Conclusions from @ArviPalanisamy at #OAA3dc2022

#OBAnes research future still bright

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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
@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.
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
@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
Read 11 tweets
Nov 9
Sawubona @DavidGray37! He’s presenting on Tranexamic acid at cesarean section: Drug Error Deaths. An unforeseen result of Woman trial. Potentially life saving in LMIC, deadly in drug error. Disproportionately #OBAnes in district/ rural settings. TXA a new drug there #OAA3dc2022 ImageImageImageImage
A recent situation. Warning from @ArviPalanisamy and Dr Kinsella. A characteristic presentation - unfortunately very similar to eclampsia, in an environment used to poor antenatal care & eclampsia. Both bupivacaine & TXA now generic, no control of similar packaging. #OAA3dc2022 ImageImageImageImage
And #lookalike vials are a problem, a BIG one. 7 recent cases in SA only from 2 provinces, 5 fatal & 2 major neurological morbidity. Getting worse, under reported. Guidance provided, it’s own complication though #OAA3dc2022 ImageImageImageImage
Read 4 tweets

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