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Simon Ash Profile picture
@OBsleepmerchant
May 21, 2023 • 10 tweets • 14 min read • Read on X
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@NoelleHealy (another 🇮🇪 representative - @ISOA_Ireland well represented!) presents on #OBAnes as a team sport - how do we perform better? at #OAA23ASM. Quite an inspiring quote, then setting the stage with @Fionafionakel et al #humanfactors guidelines in @Anaes_Journal… twitter.com/i/web/status/1… ImageImageImage
Why is teamwork important in OB/ #OBAnes? @mbrrace suggests some lessons to be learned. Prompt action is arguably reliant on good communication, within & between teams. Involving consultant/ specialist care early has been a theme for over a decade. #OAA23ASM ImageImageImage
@DOckendenLtd’ final report highlighted “conflicting agendas and poor teamwork” contribute to adverse maternal & neonatal outcomes? So how do we create good teams?

The @JulieAndrews approach may have the hills alive, but for #OBAnes we may need to start at the very beginning,… twitter.com/i/web/status/1… ImageImage
How do you create a high performance team environment? Define your “why”. 5 R’s applicable to #OBAnes too. “Buy in” - the 🐘 in the change room and operating room? #OAA23ASM ImageImage
“The disease of ME” really struck a chord with the audience at #OAA23ASM. Good teams become great when it becomes WE. There’s no I in team… although sometimes hidden in the A hole. Are you contributing or contaminating your team.

Who packs your #_OBAnes parachute? At first… twitter.com/i/web/status/1… ImageImage
Team performance is as important away from the lights as in front of them. Practice play should be as important as the important game. As per @Airwayman1 at #OAA3dc2022, you don’t rise to expectations, you sink to most basic competence level. Experts are ALWAYS made, not born.… twitter.com/i/web/status/1… ImageImageImageImage
High fidelity #OBAnes emergency simulation improves competence. Teamwork in simulation resulted in improved knowledge, skills, communication and team performance. How? Nail the basics. Protect your standards/ values and hold people accountable (this will create tension but it’s… twitter.com/i/web/status/1… ImageImage
Team conflict triggers fight/ flight response, maladaptive in high-pressure scenarios. Need FUNCTIONAL CONFLICT. @AmyCEdmondson’s psychological safety (see her “Teaming” lecture from #SOAPAM2023, on my timeline) - common misconceptions, not about being nice (necessarily) & you… twitter.com/i/web/status/1… ImageImageImageImage
How do you deal with failure? To err is human, what did we learn? Get as many perspectives as possible. We need a growth mindset! Growth mindset acquired through effort and practice, learning from setbacks. Appropriate Michael Jordan quote. #OBAnes #OAA23ASM ImageImageImage
What’s your team’s why? Secret of quality is love. #OBAnes why: #patientsafety and satisfaction. Inspiring talk by @NoelleHealy at #OAA23ASM ImageImageImage

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More from @OBsleepmerchant

Simon Ash Profile picture
Nov 4, 2024
@rjharrison79 rounds off the second labour analgesia session with “Beyond analgesia - the role of epidural in optimizing outcomes” #OAA3dc24 #3DC24 #OBAnes Image
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While I work on the thread for #OAA3dc24 #3DC24 #OBAnes, please read @rjharrison79 et al’s excellent paper in @bmj_latest

bmj.com/content/385/bm…
And the excellent accompanying editorial from @DevroeSarah @noolslucas @rex_steffen in @bmj_latest (more to come from #OAA3dc24 #3DC24 #OBAnes)

bmj.com/content/385/bm…
Read 31 tweets
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

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