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Simon Ash

May 4, 2023 • 13 tweets • 15 min read • Read on X

Dr Veronica Gillespie-Bell presents on Addressing the Maternal Health Crisis at #SOAPAM2023 - she speaks fast so bare with a delay 😉

Maternal M&M is a public health crisis. Scope of problem in USA, worst performing developed country, consistently increasing. #OBAnes #SOAPAM2023

Racial disparity is starkly demonstrated, it’s worsening. Maternity Care deserts is a very real problem (also in Canada). Cardiovascular conditions are leading cause of pregnancy-related deaths. #SOAPAM2023

Moving beyond the numbers - what do Maternal Mortality Review Committees (MMRC) do? Louisiana as example going forward. Process overview. #SOAPAM2023

@mbrrace

Definitions. A Snapshot of Louisiana MMRC #OBAnes findings. Leading causes Pregnancy-associated vs Pregnancy-related. Compare to @mbrrace? #SOAPAM2023

@mbrrace

Disparities in care based on race worsening for Black Americans, and similar to @mbrrace findings regarding social deprivation. #OBAnes #SOAPAM2023

@NOLAobgyn

@NOLAobgyn introduces recommendations for prevention of maternal M&M. Several places to intervene for numerous stakeholders. Priority areas list - surely #OBAnes can find something on this list? #SOAPAM2023

@LateralTilt

Using Data for action. Goals for prevention (priorities above) are more than just Maternal Mortality (the tip of the Iceberg). The pathway to improvement is through the lens of equity (@LateralTilt can check correct usage) Critical collaborations from the cogs in the machine… twitter.com/i/web/status/1…

LaPQC support EBM to promote safe, equitable & dignified birth in the form of a partnership with local teams #SOAPAM2023

AIM improves quality through #patientsafety bundles, of which there are multiple. Bundles share common components for respectful care. Obstetric hemorrhage as an example. #SOAPAM2023.

17 years for translational research to go into practice! Driver diagram explaining a change program. What does partnership look like? #SOAPAM2023

Reducing maternal morbidity (the iceberg that lies beneath the water). Some successes. LaPQC programs. #SOAPAM2023

@NOLAobgyn

@NOLAobgyn provides a succinct summary for a complex topic. AIM program statement. References. #SOAPAM2023

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More from @OBsleepmerchant

Simon Ash

@OBsleepmerchant

May 9

@SQuashie presents an update on anesthesia for operative delivery. Declarations. Methodology and themes. #OAA24ASM #OBAnes

Gastric USS. Oral rehydration has benefits over NPO wrt vasopressor use. #siptilsend safe, noting some patients have increased gastric volumes irrespective of starvation status. #OAA24ASM #OBAnes

@SQuashie continues at a rapid pace. To DPE or not to DPE remains a question - 16min vs 19 min, is that 3 min clinically relevant? Esketamine for supplemental analgesia - >95% had psych effects, read @rjharrison79 editorial. #OAA24ASM #OBAnes

Read 16 tweets

Simon Ash

@OBsleepmerchant

May 9

@Jamesocarroll presents an Update on Labour and Delivery. Disclosures #OAA24ASM #OBAnes

How the lecture was put together. Screening. Themes. How to interpret the slides. Very Ostheimer-esque @Jamesocarroll #OAA24ASM #OBAnes

@Jamesocarroll Clinical practice theme: intrathecal catheters & ADP. Intrathecal catheters: No decrease in PDPH, but reduction in EBP. 10mL intrathecal saline decreased PDPH & need for EBP. Of note, the percentage of epidurals requiring multiple attempts. #OAA24ASM #OBAnes

Read 17 tweets

Simon Ash

@OBsleepmerchant

May 5

8am-ish in Denver and time for a much anticipated session: PDPH beyond the guidelines. Moderated by Dr Lisa Leffert, featuring @Ropivacaine, @euklaas, @sharonOzynger and @WouterSchievink at #SOAPAM2024 #OBAnes

(HT: @Ropivacaine, bless his heart, he knows I hate missing out)

Hot off the Press? August 2023! @JAMANetworkOpen with quite an illustrious team including @Ropivacaine @robin_russell1 @KalagaraHari @LimGrapes @claralexlobo @noolslucas @NarouzeMD (please tag others if you have their handles?) #SOAPAM2024 #OBAnes

Introduction, Methods and the 10 questions. #SOAPAM2024 #OBAnes

Read 11 tweets

Simon Ash

@OBsleepmerchant

Jun 12, 2023

@ValZaph

Next up at #CASAM2023 - fittingly keeping the most important academic session to last: #OBAnes
@ValZaph moderating the Maternal Experience and Outcomes: Improving the care we provide. @DrWesleyEdwards

Bookends the 1st #OBAnes session, on intrapartum pain at cesarean section… twitter.com/i/web/status/1…

Dr Christina Lamontagne kicks off the session with: Use of Dexmedetomidine in improving maternal experience and outcomes. Nothing to disclose. Then an important disclosure: All indications discussed are OFF LABEL in Canada. Objectives.
#OBAnes #CASAM2023

Why does Dr Lamontagne use a lot of dexmedetomidine (not only in #OBAnes mind)? Clinical pharmacology of dexmedetomidine (1): highly selective alpha-2 agonist; sedation WITHOUT amnesia at locus coeruleus. #CASAM2023

Read 9 tweets

Simon Ash

@OBsleepmerchant

Jun 11, 2023

@harshamd5

Dr Ning Nan Wang introduces @harshamd5 to open the chronic pain session: Perioperative use of opioid in the context of Opioid Epidemic. #CASAM2023

twitter.com/i/web/status/1…

The opioid crisis isn’t new - China probably remembers the Opium wars that helped establish a British foothold on the continent. Opioids and OUR crisis. Is what we fear the real crisis? Are opioid-related deaths due to surgical prescriptions? No, mostly due to street fentanyl.… twitter.com/i/web/status/1…

Opioid use around the time of surgery. Understanding nociception vs pain. Does eliminating opioids during surgery make a difference - no definitive conclusions. #CASAM2023

Read 11 tweets