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Simon Ash Profile picture
@OBsleepmerchant
May 16, 2023 • 12 tweets • 14 min read • Read on X
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@DOckendenLtd presents at #Anaesthesia2023 on the Ockenden Report - a year on, have we made progress? #OBAnes ImageImage
What were the key messages of the Ockenden Report from @DOckendenLtd? Final report March 2022 (distributed amongst #OBAnes at @IWKHealth @DalAnesthesia - learnings valuable even across the pond): failures of quality of care & governance; failure of external bodies to monitor;… twitter.com/i/web/status/1… ImageImageImageImage
What did the media say? Overall coverage fair, balanced and commended by families.
And Nottingham? Maternity review is underway… themes continue.
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM) ImageImage
What are the challenges facing UK maternity services? (what are they in your country/ province/ state/ county/ town/ hospital? - pretty sure some are the same!) Short staffed & burnt out; more complex parturients; inequalities & deprivation; underfunding… all made worse by… twitter.com/i/web/status/1… Image
What themes were identified wrt #OBAnes at Shrewsbury and Telford NHS Trust? Some of these could occur in #AnyAnes practice.
How were anaesthetic cases identified? Only 68 cases (too many, while very few) and maternal deaths 😱. Look at the anaesthetic review triggers.… twitter.com/i/web/status/1… ImageImage
Are #OBAnes truly part of the MDT, or are they epidural jockeys/ gas peddlers? Just being viewed as a technician = badness. #AnyAnes consider wider picture, and should be involved early. Anaesthesia should be made aware & given time to contribute to #patientsafety. Good summary… twitter.com/i/web/status/1… ImageImage
Immediate and essential actions (FIFTEEN) for ALL maternity units - 10 key areas (3 include anaesthesia): workforce, postnatal follow up & documentation. Words of colleagues #Anaesthesia2023 #OBAnes (prelude to #OAA23ASM) ImageImage
Feedback from NHS colleagues after final @DOckendenLtd report
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM) ImageImageImage
Next steps. Across England we’re seeing change. 3 examples of maternity teams working toward the 15 IEA’s - many more, so little time. #Anaesthesia2023 #OBAnes (prelude to #OAA23ASM) ImageImageImage
We must listen to staff on the ground - drums are beating well before problems revealed. @DOckendenLtd Report has allowed staff to feel free to come forward at Nottingham. We have to also recognize the results of increasing deprivation and it’s effects on maternity care… twitter.com/i/web/status/1… ImageImage
Take aways, take home messages and hope from @DOckendenLtd! #Anaesthesia2023 #OBAnes (prelude to #OAA23ASM) ImageImageImage
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More from @OBsleepmerchant

Simon Ash Profile picture
May 9, 2024
@SQuashie presents an update on anesthesia for operative delivery. Declarations. Methodology and themes. #OAA24ASM #OBAnes

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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
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@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
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Read 16 tweets
Simon Ash Profile picture
May 9, 2024
@Jamesocarroll presents an Update on Labour and Delivery. Disclosures #OAA24ASM #OBAnes

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


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@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

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Read 17 tweets
Simon Ash Profile picture
May 5, 2024
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)

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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

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

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Read 11 tweets
Simon Ash Profile picture
Jun 12, 2023
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… Image
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 ImageImageImageImage
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 ImageImageImage
Read 9 tweets
Simon Ash Profile picture
Jun 11, 2023
Dr Ning Nan Wang introduces @harshamd5 to open the chronic pain session: Perioperative use of opioid in the context of Opioid Epidemic. #CASAM2023 ImageImageImage
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… ImageImageImage
Opioid use around the time of surgery. Understanding nociception vs pain. Does eliminating opioids during surgery make a difference - no definitive conclusions. #CASAM2023 ImageImageImage
Read 11 tweets
Simon Ash Profile picture
Jun 10, 2023
@DrLucieFilteau introduces @CMA_Docs president @AlikaMD for his keynote address at #CASAM2023 Image
@AlikaMD starts with the state of the 🇨🇦 health system, including a little history. #CASAM2023 ImageImage
The 🇨🇦 health system approach to problems, creating new problems as a result with a dangerous lack of interoperability. #CASAM2023 ImageImageImage
Read 12 tweets

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