Knowledge doesn’t equal immunity. Doctors face the same metabolic risks as the population with long work hours, stress, poor sleep and inactivity. #Medtwitter

Great summary of current evidence related to mixing local anesthetics from Dr @ESoffin @HSSAnesthesia at #PGA79 She also shared a free app from Johns Hopkins that can help calculate safe local anesthetic dosing when mixing local anesthetics.

Tired of spending ages going through the STOP-BANG questionnaire to assess the peri-op risk of obstructive sleep apnoea? Check out the B-APNEIC score - it has only 4 variables: • BMI > 35 kg/m-2 • BP • neck circumference > 40 cm • witnessed breathing interruptions #AnSky #MedTwitter doi.org/10.1111/anae.70102

Normal blood pressure does not rule out sepsis. Lactate ≥2 mmol/L, delayed vasopressors, fluid overload, and missed sources are where outcomes are decided. A practical 2025 guide to sepsis recognition and early management. #SepsisCare #MedTwitter #FOAMed @DrAkhilX @IhabFathiSulima #ICU

The latest MBRRACE-UK Saving Lives, Improving Mothers’ Care report on women who died during or up to a year after pregnancy between 2020 and 2022 released today. Read more:buff.ly/2HR30eT @marianfknight @npeu_oxford @oxford_ndph

FRAILTY, PERIOPERATIVE RISK & CARDIAC ARREST Frailty in NAP7 a 🧵 Frailty (ie clinical frailty scale score >4) was a big issue in the aetiology of perioperative cardiac arrest TL/DR -a high proportion of cases -frail patients’ more likely *to be emergency surgery *to be major surgery -increased complications -insufficient illogical monitoring (IMO) -low rates of DNACPR recommendations -insufficient risk assessment & communication -these patients account for a substantial proportion of cardiac arrests -risk assessment (& communication) poor -drug dosing an issue in many -periop cardiac arrest rate ≈8-fold higher than the young & fit -successful ROSC rate notably lower -overall early mortality after periop cardiac arrest 40-fold higher then in the young & fit Frailty arguably a bigger issue than older age It is a topic relevant t to -all anaesthetists, -all perioperative physicians -orthogeriatricians - those planning services & many more associationofanaesthetists-p… rcoa.ac.uk/sites/default/fil… @NAPs_RCoA @jas_soar @IainMoppett @AgeAnaesthesia @RCoANews @drrichstrong @emirakur @adk300 @CPOC_News 1/n

Non-targeted serial epidural blood patching for treatment of intracranial hypotension headache during late pregnancy: a case report 💉Serial blood patches may control symptoms/gain time for fetal maturity 💉Definitive treatment can be done post-delivery doi.org/10.1016/j.ijoa.2024.…

Systematic review of pulmonary hypertension (PH) in pregnancy: 🫁PH severity is an important outcome predictor in pregnancy 🫁Mortality continues to decrease and patients with mild disease have better outcomes 🫁Most studies define PH by echocardiography doi.org/10.1016/j.ijoa.2024.…

Total spinal anaesthesia in #ObAnes: a narrative review 🧠Spinal after epidural most common precipitant reported recently 🧠Good outcome when treated promptly 🧠Poor outcomes associated with delayed recognition and inadequate resuscitation doi.org/10.1016/j.ijoa.2024.…

#BJAEd - The difficult #spinal anaesthetic: the key to success? Dr Poots & Prof Chin elegantly describe the #paraspinous approach, why it could work well, and how to do it. An article which could change your every day practice. Read the full article at: bjaed.org/article/S2058-5349…

Total spinal anaesthesia in #ObAnes: a narrative review 🧠Spinal after epidural most common precipitant reported recently 🧠Good outcome when treated promptly 🧠Poor outcomes associated with delayed recognition and inadequate resuscitation doi.org/10.1016/j.ijoa.2024.…

Total spinal anaesthesia in #ObAnes: a narrative review 🧠Spinal after epidural most common precipitant reported recently 🧠Good outcome when treated promptly 🧠Poor outcomes associated with delayed recognition and inadequate resuscitation #SOAPAM2024 doi.org/10.1016/j.ijoa.2024.…

Medication errors are potentially avoidable & can affect maternal/neonatal outcomes & costs NAP7 found errors caused cardiac arrest in 2 obstetric patients Tageldin asks - can we have more details? @doctimcook @noolslucas 🔗associationofanaesthetists-p… x.com/Anaes_Journal/status/1…

Why don't people receive epidural analgesia in labour? Delay in: ➡️receiving information about epidural analgesia prior to hospital ➡️seeking epidural analgesia in hospital ➡️receiving epidural analgesia @AliciaTDennis @nsheridan123 🔗associationofanaesthetists-p…

Why is obstetric haemorrhage under-recognised & under-treated? ➡️relative preservation of haemodynamic vital signs during the early stages of bleeding ➡️estimate of blood loss unavailable until the end of the operation @DavidTMonks @ArviPalanisamy 🔗associationofanaesthetists-p…

⚠️Attention obstetric anaesthetists!⚠️ Outcomes from the @RCoANews NAP7 study ➡️Haemorrhage was the single leading cause of peri-operative cardiac arrest in obstetric patients ➡️Underestimated severity & inadequate early resuscitation contributed 🔗associationofanaesthetists-p…

Opportunities in Postpartum Period to Reduce CVD Risk After Adverse Pregnancy Outcomes: A Scientific Statement From @AHAScience @jennlewey @GarimaVSharmaMD @DrLaxmiMehta @HeartDocSadiya @ElizaMillerMD #CardioObstetrics ahajournals.org/doi/epub/10.…

I think a key message is that -at the point of intubation -for most non theatre settings -including in neonatology CAPNOGRAPHY is not a respiratory monitor. CAPNOGRAPHY is an AIRWAY MONITOR A positive upstroke on the capnograph shows we have alveolar ventilation (ie exhalation from alveoli engage in gas exchange). This requires a patent airway & gas flow. It’s that simple. For non anaesthetists Don’t worry about the phases of the CO2 trace. Do understand hats and caps

Is crystalloid co-loading necessary to prevent spinal hypotension during elective cesarean delivery? • Crystalloid co-loading = ⬇️phenylephrine dose to maintain BP • Cardiac output can be reduced despite normal BP @girardDev #ObAnes obstetanesthesia.com/article…

Please take a look at the programme for the virtual conference presenting the @mbrrace Perinatal Confidential Enquiry Reports 2023 Anyone with an interest in maternity care and safety is welcome to attend Book here: buff.ly/4a993Xx