@sthjournalclub.bsky.social #RCoAUpdates TIVA vs volatile - patient centred outcomes definitely better. Less sick +sore. (Sorry can’t do alt text quick enough)

Dexmedetomidine for cardiac surgery: case closed? "There remains the possibility that delirium is a complex peri-operative issue for which straightforward strategies, such as using drug A instead of B, are too simplistic." #AnSky #ICUSky #MedSky #delirium

The application of cricoid force remains controversial in modern practice. A new review by Sotiriou et al. critically assesses the anatomic, physiologic, and contemporary clinical evidence of cricoid force application: ow.ly/Mkx350WY3Zy

Ji et al. assessed whether the combination of dexmedetomidine and remifentanil, by reducing sevoflurane exposure, has any differential effect on neurodevelopmental outcomes in young children compared with sevoflurane alone. Read the new cover study: ow.ly/btn050WU27p

There is some new content up at the site - a quick bit on providing anaesthesia for CT scans in kids. You can find it nestled around here. www.justlittleadults.com/imagingandir #ansky #pedsanes

I have always been guided by the Bouvet study. I use propofol 2 mg/kg and remi 5 mcg/kg together on induction as my base. between 45-60 s after induction you see the HR drop, reflecting sympatholysis and you go. associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...

Tip of the day (via Annual Queenstown update in anaesthesia) and @anzca-fpm.bsky.social use of celecoxib perioperatively. As in we probably don’t use it enough or appropriately #ansky

I agree with this. Given that EVERY anaesthetist gives a different anaesthetic, and all our outcomes are pretty much the same, does how we give our anaesthetic matter? There’s no evidence that one technique is better than the other. Claiming superiority with no evidence is unsound.

Research suggesting our ancestors nearly went extinct ~900,000 years ago. Only 1,280 breeding individuals survived a 117,000-year bottleneck that brought early humans to the brink. This small population became the foundation of our entire species.​​​​​​​​​​​​​​​​ doi.org/10.1126/scie...

Weekend #MedSkyDebate from @benmoran.bsky.social#MedSkyDebate Controversial point for discussion, highlighted by a surgical colleague: There’s no doubt that regional analgesia techniques can be fantastic for post-operative pain. However, is this in the best interest of the patient? 1/4

I’ve got a new setup that really improves ergonomics for CVCs and regional anaesthesia in theatre. #AnSky

This is the midweek #MedSkyDebate thanks to @pieterpeach.com Do you use LA for your cannula insertions?

Hey @maffygirl.medsky.social, maybe a mid week topic for the future. “Our patients deserve better: We should use local anaesthetic infiltration for all large gauge intravenous cannulations in elective surgery.” Eg youtu.be/GXA7D7IOZOc?... #Ansky

“So remember when you're feeling very small and insecure How amazingly unlikely is your birth And pray that there's intelligent life somewhere up in space 'Cause there's bugger all down here on earth” - Monty Python youtu.be/V-S6GrwH6IQ?...

A reminder of a solid framework that has existed for social media engagement since well before social media was a thing.

🚨 Social Media Public Service Announcement 🚨 For *every* post assume: 1. It will be on the front page of your national newspaper 2. Your patients will see them 3. It will be used in court 4. It will be scraped to steal your identity or scam you Think before you post. #Ansky #Medsky

Correct Bob..a technique used routinely at the Eastman dental hospital many many years ago. Kid given 100% N2O until unconcious (hypoxia plus anaesthesia), N2O turned off, tooth rapidly whipped out by devilishly quick dentist, kid returned to parent, some vomiting and probably a headache ..then home

This hospital has implemented a policy of banning glasses with audio and video recording (eg Meta Ray Ban glasses). ❌🤓❌ I wouldn’t be surprised if other industries start following suit. #Anksy #Medsky

I have quite the topic for the #MedSkyDebate this weekend. Do you use Chat GTP and how has it affected your practise?? ChatGTP did this infographic. Is AI bad for us or can we use it to assist us? Pro’s and Con’s. This should be the best debate!!

Good luck reading the drug name and dose without augmented vision #EzDrugID #Ansky

🚨 Social Media Public Service Announcement 🚨 For *every* post assume: 1. It will be on the front page of your national newspaper 2. Your patients will see them 3. It will be used in court 4. It will be scraped to steal your identity or scam you Think before you post. #Ansky #Medsky

What a ride xkcd.com/1732/

Want to reduce your plasma forever chemical (PFAS) levels? - Donate plasma - A study of firefighters in Victoria Australia demonstrated a significant (~30%) reduction in PFAS levels after 1 year of 6 weekly plasma donations. Also, it’s free, you get lunch & it helps others doi.org/10.1001/jama...

Revisit the February 2025 Infographic in Anesthesiology - Safe or Skip? Association Between Intraoperative Midazolam in Elderly Patients and Rates of Postop Delirium 🎨 ow.ly/Z7Tx50UH1jQ

Are you a paediatric anaesthetist? Check out this great new guideline! "Consensus recommendations for paediatric airway topicalisation using lidocaine" #AnSky #MedSky #PedsAnesSky #PaedsAnaesSky #PharmSky doi.org/10.1111/anae...

Here is the midweek #MedSkyDebate, a topic provided by @drnavsidhu “You don’t need a paediatric anaesthetist to anaesthetise children” What do you think and do you have a cut off age where you will not anaesthetise them? Is it just particular cases?? Tell us what you think.

The weekend #MedSkyDebate is from Anaesthesia Journal @anaesjournal.bsky.social How do you consent for an Obstetric epidural and how can we improve this process? #MedSky #AnSky https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16697 #MedSkyDebate

Stories like these from our future selves are worth reading #Ansky

Taps the sign

I'm way more optimistic about LLM tech than a lot of people around here, and find it *personally* incredibly useful. But I also find it takes a lot of work & careful thought to make it useful, and forcing people to use it guarantees it will be used very, very badly.

I was taught 4 hours max for propofol. I’m weary however and try to minimise time between open and use. We had an unfortunate series of patients in this area years ago poisoned with bugs in multi-use propofol (a ‘clinic’ setting…).

Here is the weekend newly named #MedSkyDebate from Nicholas Chrimes @chrimsey.bsky.social of the #VortexApproach Do you draw up emergency drugs before every list/case? If so, what & why? Be very interesting to see what everyone says! #AnSky #MedSky

Today I learned about the “Obesity paradox”, where the presence of obesity in nonegenarians (90-99 years of age) is a significant protective factor against in-hospital mortality for patients admitted to ICU Prof Laurence Weinberg #RuralSIG25 #Ansky

Interesting. One of the biggest challenges I have found after returning, especially since Montgomery, is the 'compression' in the time available to speak with a patient preoperatively, as all patients - even majors - are now admitted on the day of surgery, and often staggered throughout the day.

Interesting unexpected outcome from the implementation of a high risk peri-operative clinic at Ipswich hospital. 50% of patients did not proceed to surgery after in depth discussion about benefits and risks with the patient and family. #RURALSIG25 #Ansky

Does the use of intraoperative ketamine affect the incidence of postoperative delirium? Does the dose matter? Compared with patients not receiving ketamine, a low dose (≤ 0.35 mg.kg-1) was associated with lower risks of postoperative delirium. #AnSky #PainSky #MedSky doi.org/10.1111/anae...

YOUR BRAIN ON AI: ChatGPT users had the lowest brain engagement and “consistently underperformed at neural, linguistic, and behavioral levels.” Over the course of several months, ChatGPT users got lazier with each subsequent essay, often resorting to copy-and-paste by the end of the study. 1/2

Airway Triage App update 6.5.32 is available now. Great new features. 📌paediatric EFONA 📌post intubation checklist 📌my intubations Available on the app stores #airwaytriageapp

My “Would I lie to you?” story would involve the time that I was the obstetrics anaesthetist, and I inadvertently brought the wrong dad in to watch somebody else’s caesarean section.

Do you struggle with the Ultrasound Guided Ankle block? Think it’s tricky and not worth the hassle? In this video tutorial - I try to demystify it, as if we were at an ultrasound scanning workshop. No bells & whistles (apart from a lovely machine!) #RAsky #AnSky 👇🏼 youtu.be/Bl0_x-hn3yA?...

Working with a more junior anaesthetist who felt I used ketamine more than my colleagues. I feel that in emergencies it is more forgiving than other agents (baring in mind its direct negative inotropic effects) Any other ketamine enthusiasts or do I need to stop listening to EMCrit? #AnSky

The ASA is proud to support the Overseas Development and Education Committee (ODEC) in advancing anaesthesia education, training, and capacity building across low and middle-income countries. Read highlights in our recent ODEC newsletter ow.ly/5TiO50WkO6x #GlobalHealth @snouzin.bsky.social

AI in education is a double-edged sword. On one hand, it promises personalized tutors for every student. On the other, it's creating a massive academic integrity crisis. Let's dive into this paradox.

There's a great thought to keep in mind: if you let machines do all the work, you risk becoming a slave to those who build the machines. This isn't about banning AI, but about ensuring humans remain in control of their own thinking.

Hey @hypoxicchicken.medsky.social, I’ve come across the perfect Human Factors anthem youtu.be/L3wKzyIN1yk?...

Cheeky Midweek #AnSkyMedSkyDebate from @bobfunn.bsky.social We should remove all N2O pipelines from hospitals and replace with portable cylinders. #AnSky #MedSky