I’m happy to share that I have been appointed as an Editor at @anaesjournal.bsky.social! Excited to start contributing to evidence based medicine and forwarding anaesthetic and scientific knowledge from the other side of the peer review process!

The National Safety Standards for Invasive Procedures (NatSSIPS) sequential step standards (`NatSSIPs eight´) that should be implemented for invasive procedures. #AnSky #MedSky doi.org/10.1111/anae...

#RCoAUpdates frailty - biggest subject of our times. Our largest and fastest growing surgical group is over 75’s

They routinely get them in ED on arrival here unless a contraindictation.

My group does FI or PENG blocks for hip fx. If requested, we also place FI catheters preop for continuous infusion.

Because I do GAs for hip fractures, I would always do a block (otherwise it's lots of opioid in an old person). Regardless, most (all?) colleagues I've worked with over 13 years as a resident do a block.

Great thread 👇🏻

What do (US) orthopaedic surgeons think about perioperative peripheral nerve blocks for hip fracture? Inconsistent ‘requests’, beneficial for early pain but want more research #AnSky #OrthoSky 🧵 journals.lww.com/otainternati...

#Delirium care is better if we all use the right term. This helps everyone, especially patients & families - knowing the name means we can give info leaflets, etc. Please let's all move to a consensus on this. #meded

#Delirium treatment is much more complex: treat the cause(s) - usually more than 1, optimise physiology (e.g. hydrate), detect & treat distress, prevent complications (e.g. falls, pressure sores, aspiration), communicate with family, rehabilitate, etc. #meded

Congrats @claireswarbrick.bsky.social

Well done @claireswarbrick.bsky.social !

Thanks for the references, Maffy. Timely repair of hip fracture is a provincial quality metric and we recruited for both HIP ATTACK and REGAIN. It's nice that published guidance supports us for offering a spinal to an anticoagulated patient with relevant comorbidity. Otherwise GA and FICB.

Here’s the delirium princess herself Abi Noah PhD. Beyond delighted to see her graduating today @uniofnottingham.bsky.social

Super proud to support @claireswarbrick.bsky.social graduating as PhD @uniofnottingham.bsky.social today. @rcoa-cri.bsky.social #SNAP3

I’m not sure we’ve got SONB in our list for NAP8. I’ll see if I can persuade @ajrmacfarlane.bsky.social 😉

Having said that I’d just as likely do a GA because everybody seems to think the patient will develop a massive haematoma due to the combo tiny, thin 27G spinal needle and clopidogrel.

very oddly imo - this clopidogrel angst ultimately comes from guidelines that have been printed with indelible ink that make no differentiation between tiny thin spinal needles that just go in and out and thick tuohys through which a catheter is shoved in. All just called neuraxial block.

After 12 years of watching people do a whole host of weird things to position patients with a fractured NOF for a spinal, I decided I can't be arsed and do GAs for them. Just seems like a load of faff for no benefit. Feel free to shout at me in the replies. Ad hominem attacks welcome.

Today’s #MedSkyDebate is a topic from @dr-amit-pawa.bsky.social from #BILIH with @jeffgadsden.bsky.social#MedSkyDebate#BILIH In 2025 is clopidogrel a contraindication for a spinal in an elderly patient with a #NOF?? Kindly supplied some papers as well, see below. What do you do??

New book on #delirium for families - coming out in August 2025. #newbook

There's a real gap in public information on #delirium & I'm aiming to help address this with this book. Get a pdf of Chapter 1 via this link: www.the4at.com/family-delir... #familycaregiver

Colored droplets in corn syrup seemingly blended together can be returned to their original state by reversing the direction of mixing, a form of laminar flow called "Stokes flow". Credit: UNM Physics & Astronomy

Don't miss this month's @rcoanews.bsky.social Bulletin, with plenty of @rcoa-cri.bsky.social research content including #NAP8 and #SNAP3 - lots of exciting work going on in the research department right now! @iainmoppett.bsky.social @ajrmacfarlane.bsky.social

Diagnostic error is the most costly, most common, and most dangerous of medical mistakes. Which is why teaching clinical reasoning is so important. Check out www.creme.org.uk and 👇

Took part in v considered + illuminating focus group yesterday as part of this major project on shared decision making for surgery. Really impressed by desire to properly engage with experiences + insights of patients+ carers #AnSky #MedSky #QI #PPI

Here’s the midweek #AnSkyMedSkyDebate AFOI should only be done by people who do 20+ a year. There should be a separate on call service for AFOI staffed by experienced practitioners. Thanks to @lotusgav.bsky.social for the suggestion. Not necessarily his opinion 😇 #AnSky #MedSky

"stop pulling at your IV!" "stay in bed!" "you need to stay here!" 𝑣𝑠 "your hand must be uncomfortable" "you look like you need to move" "this place is confusing, isn't it?" ➡️ reassurance works better in #delirium & dementia

We’re thrilled to have learnt that our former Anaesthesia editor, DrJohn Carlisle has been awarded an MBE in the King’s Birthday Honours. Congratulations to Dr Carlisle and all NHS colleagues who have been recognised ✨

Myth: If a patient knows their name and their date both, they are not delirious. Fact: People with #delirium can often correctly answer simple orientation questions. Use onset/fluctuation, & altered alertness, & other sources to come to a diagnosis.

Here is the weekend #AnSkyMedSkyDebate from Matt Wiles of @anaesjournal.bsky.social What is the value of CVC/CVP measurement in anaesthesia? https://doi.org/10.1111/anae.16633 #AnSkyMedSkyDebateDo we need them because we can give NA peripherally in most. Is this just a high-risk cannula?

Interesting new regular dementia statistic from @nhsenglandldn.bsky.social - a recent history of #delirium data: digital.nhs.uk/data-and-inf... (Forgive me if everyone knows about this already) @iainmoppett.bsky.social @emmavardy2.bsky.social @amaclullich.bsky.social

Only a week left to tell us about your priorities in the emergency laparotomy pathway! Take part in our survey to rank the main problems faced in the pathway: tinyurl.com/45rwkxnm @rcoanews.bsky.social @thisinstitute.cam.ac.uk @rcem-2.bsky.social @rcradiologists.bsky.social @asgbi.bsky.social

It is all happening here, next week’s #AnSkyMedSkyDebate is from Matt Wiles @sthjournalclub.bsky.social Editor In Chief of @anaesjournal.bsky.social#AnSkyMedSkyDebate Another great topic to get you all chatting, not that you need help! It’s VERY controversial so get ready!!

At #CASAM2025 for the @casupdate.bsky.social meeting representing @anaesjournal.bsky.social and the @assocanaes.bsky.social Happy to chat about potential submissions to @anaesjournal.bsky.social or @anaesthesiareports.bsky.social Looking forward to seeing the research presentations

President’s News is out 📥 Check your inboxes for the latest news and insights including: 🔹Our response to the Spending Review 🔹Submission to NHSE Training Review 🔹Free webinar on stages 2&3 of training 🔹New CPOC resources 🔹Emergency laparotomy survey

Information on #delirium for carers from the Regional Geriatric Program of Toronto. We need to make providing this kind of information the norm, not a rarity.

Great talk with Ken Catchpole, not just slaughtering sacred cows, but skewering them. #HEPS2025 @heps2025.bsky.social @carlhorsley.bsky.social @matt13.bsky.social @janekohara.bsky.social

After five years at the RCoA, our Chief Executive Jono Brüün will step down in December to become Chief Executive of the Royal College of Physicians. We're grateful to Jono, whose expertise and ambition have helped strengthen our College. 👉 ow.ly/fRvi50Wbz1s

Top global research accolade for BJA Editor, Prof Kate Leslie. Prof Leslie has been awarded the American Society of Anesthesiologists award for Excellence in Research, which recognises lifetime achievement in research in anaesthesiology and perioperative medicine. www.anzca.edu.au/news-and-saf...

"I can't remember" – The lack of recall about their experience was often accompanied by feelings of guilt and shame about their behavior while delirious and a wish to apologize for what occurred during the lost time. #delirium

"It was so real, and I was so scared. I was paralyzed on a bed and being burned alive. Just in time, someone rescued her, but suddenly, she was turned into an ice sculpture on a cruise ship buffet. Next, she was in an experiment in a lab in Japan. Then she was being attacked by cats." #delirium

30% of our patients don’t go by what’s written on the ID band. Ask them what they like to be called…

When a person has #delirium, it's important find out if they have delusions. This is one question that can help: "Are you concerned that there might be something happening on the ward that staff aren't telling you about? I'd like to address any worries." 

Do you look after patients having an emergency laparotomy? 😷 If so, we'd love your views for a trial evaluating high-dose dexamethasone. Quick survey (promise!) - t.co/wprBbMNqen @rcoanews.bsky.social @rcoa-cri.bsky.social @cpoc.bsky.social @assocanaes.bsky.social @collegeofsurgeons.bsky.social

POP-I @pop-i.bsky.social Looking back we’ve travelled a long way 772 participants so far. Looking forward we have a fair way to go. 1628 to reach our target of 2400. @nihr.bsky.social

National @pop-i.bsky.social POP-I meeting. Fantastic opportunity to meet our research teams from across the country. @nihr.bsky.social

Come on folks please engage in our weekend debate. It’s a really interesting topic. Do you use cricoid pressure and how do you feel about it?? Let’s get this site really moving as a medical education experience.

SNAP3 has just published looking at the impact of frailty and multimorbidity on outcomes after surgery in a whole UK sample of older patients. #AnSky #GeriSky #SurgSky @rcoanews.bsky.social @rcoa-cri.bsky.social @gerisoc.bsky.social @bjajournals.bsky.social @claireswarbrick.bsky.social