Dr Amit Pawa Profile picture
Anaesthetist. Past-President RA-UK #RAUKISURA22 #Paravertebral blocks #PawaPoems #PlanABlocks #RegionalAnaesthesia #HeForShe COI:GE,Sintetica,Pacira,🦋
Dr. Maan A. Kattan, MD, FRCPCد. معن عبدالرحمن قطان Profile picture Amina Benyoucef Profile picture Jeremy Gue MD Profile picture Maan Kattan, MD, FRCPC🩺💉🩹د.معن قطان Profile picture Dr Prit Anand Singh Profile picture 7 added to My Authors
14 Nov
So I was wondering today, as an eternal student, a regional anaesthetist,and Past @RegionalAnaesUK president - what would make me want to attend #RAUKISURA22 on the 5-7th May 2002 in Edinburgh? So - Here Comes a mini thread!
@RegionalAnaesUK has been working hard to change the way we deliver education in #RegionalAnaesthesia
Check out some of highlights from #RAUK19 in Belfast organised by @LloydTurbitt @rosie_hogg @PeterMerjavy @davejohnston24 & Mike Jones ra-ukmeetings.com/past-events
The Belfast meeting was the first time we used on stage symposia to bring an engaging feel to the event, & the first time we had such a North American & Canadian presence at our meeting + #POCUS with @KiJinnChin , @shaskinsMD , @SLKoppMD, @JanBoublikMDPhD
Read 15 tweets
10 Feb
Looking forward to #POCUS webinar with @ASRA_Society with @jattarab @KalagaraHari @dr_melissabyrne and team!
@dr_melissabyrne first up on cardiac US.
When Learning a new technique...
1. Set realistic goals for learning
2. Improve workflow efficiency
3. Scan based on pathology

Use the 4W approach
When to apply pocus
Where to place probe
What do images mean
What to do next
Some clever ways to use POCUS When performing a Regional anaesthesia procedure
Read 31 tweets
9 Feb
I love regional anaesthesia and working with surgeons, & am also sad that I have finished Schitt’s Creek. Here is a thread of experiences as a regional anaesthetist..

The reaction of a new surgeon the first time you state you’d like to site a nerve block... for a trauma patient
The reaction of the anaesthetist when the surgeon states that blocks will slow the list down, and “The operation isn’t that painful anyway”
The activity in the anaesthetic room when we get the “go ahead” to put a nerve block in a patient- “as long as it’s quick and it works”
Read 12 tweets
9 Feb
In the run up to #RAUK21 -5-6th May 2021 ,& to introduce some of the many publications of our Bruce Scott Lecturer @EMARIANOMD - I thought I’d start tweeting 10 of his papers to get you inspired about #RegionalAnaesthesia #RegionalAnesthesia - I’ll add them all to this thread...
In the first of 10 of @EMARIANOMD‘s papers, lets start by looking at this one on Continuous interscalene brachial plexus block via an ultrasound-guided Posterior approach #RAUK21 #MarianoTopTen 1/10

ncbi.nlm.nih.gov/pubmed/1937235…

insights.ovid.com/anesthesia-ana…
The second of 10 of @EMARIANOMD’s papers is on #PedAnes! This paper is on the Feasibility of ultrasound-guided peripheral nerve block catheters for pain control on pediatric medical missions in developing countries. #RAUK21 #MarianoTopTen 2/10

ncbi.nlm.nih.gov/pmc/articles/P…
Read 9 tweets
25 Jan
So here is a quick thread about the #PlanABlocks from @RegionalAnaesUK that feature in the tweet below - I feature links to the RA-UK book chapter 📖, Video 🎥 & Posters in the thread below...
The concept came from an excellent editorial from @LloydTurbitt , @EMARIANOMD & @elboghdadly

One of the key points of the editorial was to focus on a small number of high-value blocks, and to train everyone in them, and then implement into pathways👇🏼

…-publications.onlinelibrary.wiley.com/doi/10.1111/an…
The First of these blocks is the Interscalene Brachial Plexus Block

RA-UK 📖: ra-uk.org/index.php/inte…

RA-UK🎥 : adobe.ly/3nTlHAX

RA-UK Poster: ra-uk.org/index.php/post… 👇🏼
Read 12 tweets
24 Jan
A lesson in keeping it simple- or as @glauncel says - KISS - Keep It Simple Stupid!

1/5

So - a member of the Pawa household dropped a plastic cap down the shower drainage hole by accident- see exhibit A below 👇🏼
2/5 Unfortunately- the shower was now unusable - a big deal for us all!
So - as someone who had been using a fibrescope on ICU recently, I had a great idea! I used my Amazon prime account and ordered a Wifi transmitting portable endoscope to get down the drain - exhibit B👇🏼
3/5 As a frustrated wanna-be surgeon (joking!) I was delighted when I inserted the endoscope, and through the gross “drain waste” , I could see the cap!

All that remained was for me to extract it with the selection of hooks provided.
After 45 mins, and Sore knees - we aborted!
Read 5 tweets
5 Oct 20
I had a desire to pen another of my #PawaPoems -this time, a non-rhyming-type. Here goes...

A whole New World

The alarm goes off at 0530,
A battle of the snooze alarm versus my state of wakefulness then ensues,
I struggle to get out of bed- that much has not changed !

1/n
I shower and dress for work - no longer wearing suits or chino-blazer combos - they don’t do well when thrust within the depths of the Washing machine during my nightly “return from work corridor strip routine”.

2/n
Heading out of the door I double check my belongings citing my Morning Mantra - “Phone, Keys, Santiser, mask”
No longer needing my wallet- when was the last time i used cash anyway?

3/n
Read 12 tweets
1 Oct 20
This time on the otherside of the webinar situation!!
Looking forward to learning from @ICUltrasonica @Wilkinsonjonny @PARADicmSHIFT and crew! 💪🏽💪🏽💪🏽
First up... @PARADicmSHIFT
Lots of TEE studies/courses available
FICE
FATE
FEEL
FUSIC
FUSIC HD
BSE level 1 and 2
Read 37 tweets
19 Sep 20
My last #ECONGRESS2020 #ESRAASRA2020 session for the day! Image
Shoulder surgery hurts!

Interscalene block is currently the gold standard

#ECONGRESS2020 #ESRAASRA2020 Image
Read 20 tweets
19 Sep 20
#ECONGRESS2020 #ESRAASRA2020
Next we are listening to the use of Ampres 2% (Chloroprocaine) from @SinteticaUK

I have never used it, but suspect there are some situations where this has a useful role.

sintetica.com/global/page/pr…

What do Peeps think?
The question I have is what operations are short enough for the use of Block with Chloroprocaine?

#ECONGRESS2020 #ESRAASRA2020
The key must clearly be the provision of pain medicine to work past the duration of the short acting block.
Is that Oral Analgesia or Local infiltration by the Surgeon?

Key must be identifying appropriate procedures & having a plan for post-op pain
#ECONGRESS2020 #ESRAASRA2020
Read 4 tweets
19 Sep 20
Finishing my #ECONGRESS2020 #ESRAASRA2020 attendance “in the hands” of my dear friend @DrEAlbrecht

A really interesting session on innovations in #RegionalAnaesthesia Image
And here they are!

@DrEAlbrecht ‘s accent has become more British though!

#ECONGRESS2020 #ESRAASRA2020 Image
First we are going to hear about Onvision from @BBraunUK .

Initially was a skeptic, but after an intial trial with it, I have had my eyes opened!
Read 8 tweets
19 Sep 20
This is where I am headed to next for #ECONGRESS2020 #ESRAASRA2020- be good to hear @docmorne talking about ERAS for Knee Arthroplasty & Ambulatory Surgery fron Seb Bloc and Laurent Delaunay Image
Great group of speakers to start this session! Image
What do Patients want after surgery?

#ECONGRESS2020 #ESRAASRA2020 Image
Read 11 tweets
19 Sep 20
Finally - @DanDirzu on the indications for Distal Blocks
#ECONGRESS2020 #ESRAASRA2020
They are certainly further away from many critical structures-

My main concern is convincing surgeon to avoid tourniquet!
Perhaps a differential block proximally with short acting drug? Image
Some potential indications...

#ECONGRESS2020 #ESRAASRA2020
Never seen a wrist tourniquet used by the way! Have u?! Image
@docmorne asks a delegate question about mixing local anaesthetics (short and long acting) - Yes or No?

It seems all the experts say “No”!

That makes me an outlier! 😂😬

#ECONGRESS2020 #ESRAASRA2020
Read 4 tweets
19 Sep 20
Next up @ESRA_Society President-Elect Thomas VOLK, Germany on hand surgery and anticoagulants #ECONGRESS2020 #ESRAASRA2020

Would you do a peripheral nerve block in an anti-coagulated patient? Image
The incidence of bleeding necessitating revision surgery is low in these situations

#ECONGRESS2020 #ESRAASRA2020 Image
In over 230,000 patients without anticoagulants, bloody tap incidence is low Image
Read 6 tweets
9 Sep 20
When Medical School is complete, What does it feel like when you first start working as a doctor?...

An Indiana Jones Gif Thread.

1. Day 1 - all knowledge inside your head, but are you actually ready to be a doctor?
2. The first day you walk onto the ward with your stethoscope around your neck and tendon hammer in pocket
3. When you get bleeped/paged to see your first patient with chest pain/abdominal pain/pyrexia/hypoxia on the ward
Read 16 tweets
3 Sep 20
Starting as a novice anaesthetic trainee. A thread of #FreshPrince Gifs

1. “Hey everyone, I am the new “baby anaesthetic trainee!” (I actually said this!)
2. When you realise that actually, you don’t know anything about any of the drugs, doses, procedures... and basically, you are a med student again!
3. When you have to cannulate all your patients with the consultant standing over you and your success rate is not so hot!
Read 15 tweets
31 Aug 20
What it’s like to be a regional anaesthetist - a thread of #starwars gifs
1. When you discover your passion for #RegionalAnaesthesia
2. When the first few blocks you place don’t seem to go according to plan
3. The first time you perform a successful brachial plexus block solo for awake upperlimb surgery
Read 12 tweets
19 Mar 20
Watching the @ButterflyNetInc #COVID19 #POCUS Webinar
@bedsidesono :

Lung Ultrasound been around since 1990s

We are learning lessons from China and Italy, but there is not lots of evidence right now in #COVID19

Information now, may not necessarily hold true in a few months now, but we have to trust the info we have now
There are lots of pathologies that cause B-lines

Be cautious if using as a screening tool.

Findings may include:-
B-lines
Thickened pleura
Skip lesions
Consolidation
Read 17 tweets
14 Mar 20
Wow - incredible work from the @AAGBI producing a webinar on #COVID19 & what we need to know on the frontline.

I have put some of my take home points together in a thread.
Bottom line- I am genuinely worried about what lies ahead, and it is clear, we are not ready for this yet
1. PPE - there are national variations & inconsistencies. Intubation is an Aerosol Generating Procedure (AGP) - maximal protection should be used - what is that though?

2. What drugs are we going to use?
Propofol & Alfentanil vs Isoflurane?
Will we have enough?
3. Equipment- we need more infusion pumps, ventilators, NIV/CPAP machines. Per hospital or Central for redistribution?

4. We are NOT ready. We need to be prepared. We have up to 15 days to get ready

5. Do we need CT scans for diagnosis in all patients? It is NOT practical
Read 13 tweets
14 Nov 19
So when my wife asks why it takes me so long to write a presentation, I have an answer! You don’t want to know how long this took to create just one slide! @SreeHPraveenKO1 @KalagaraHari @kaohesham - I am getting there! 😁
@SreeHPraveenKO1 @KalagaraHari @kaohesham .I promised I would tweet some more snippets from my #CCFRA19 lecture - so lets start with Superior Trunk #RAUK20
@SreeHPraveenKO1 @KalagaraHari @kaohesham .to follow - here is Supraclavicular #RAUK20
Read 8 tweets
12 Sep 19
#ESRA2019 @KiJinnChin @ParrasTeresa talking chest wall blocks
Breast Innervation #ESRA2019 @ParrasTeresa multiple nerves innevate the breast
Multiple fasciae in pectoral region... #ESRA2019
Read 27 tweets