Ahead of my talk today at #SIVA25, I have packaged up some #PERUSEbeforeYouInfuse posters, for anyone convinced by what I'm saying, who then wants to use the check. The right things happen more often if you make them easy. Providing posters (and Blu Tack) is very much in the spirit of the talk.

Morning folks! We hope that those who attended the dinner last night had a splendid time and have woken up bright and refreshed, ready for today's #SIVA25 content! Those who have registered for the workshop, please note it starts at 0900. The first session of talks starts at 0915. See you soon!

First up in the main session today at #SIVA25 we have Professor Gavin Kenny, one of the key architects of the Diprifusor TCI system. It is no exaggeration to say modern TCI and TIVA would not exist without him. In the first of two talks he is giving today, he tells us how Diprifusor was created.

Getting ready for the second start of the day. To the folks who attended a workshop this morning, hello again! To the folks just arriving, welcome to Liverpool and #SIVA25! Our next talks are focussed around some of the practicalities of TIVA, in the "how I do it" session.

Nice view of the famous Liverpool skyline from up here! Both cathedrals, and the Radio City tower are visible. Bit chilly right now though. Liverpool is a brilliant city. We are looking forward to welcoming our delegates at tomorrow's Annual Scientific Meeting #SIVA25. See you there!

Hello Bluesky! Ahead of our Annual Scientific Meeting, which starts tomorrow, we thought we would get this account up and running. It will be curated by @robjimfleming.bsky.social for the next couple of days at least. Hopefully we will see some of you in sunny Liverpool!

"... a ‘RSI–TCI’ mode with a pre-programmed manual bolus offers a pragmatic solution for those who wish to preserve an intact pharmacokinetic model for accurate propofol delivery, while allowing the rapid induction clinicians expect from a manual bolus." #AnSky #MedSky doi.org/10.1111/anae...

Eleveld et al.'s #pharmacokinetic - #pharmacodynamic model of #remimazolam begins to pave the way for its widespread use in #sedation and anaesthesia. #BJA #model #simulation www.bjanaesthesia.org/article/S000...

I don’t think anyone considers thio part of RSI anymore but I’m certain most who’ve abandoned cricoid are still using sux/roc & many aren’t FMV. It’s definitely singled out. Again, I qtn whether the rationale for RSI is sound. This is my fav evidence FOR cricoid. journals.lww.com/anesthesia-a...

Interestingly while cricoid pressure gets mocked by those wanting to practice EBM, there’s no more evidence for any other aspect of RSI? Why has cricoid been singled out as the component to ditch when the whole thing is entirely rationale-based & incls many opportunities to cause harm.

Background reading for this week’s debate - this excellent editorial by @sthjournalclub.bsky.social & Craig Lyons in @anaesjournal.bsky.social associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10....

Ok it’s time for the very first Midweek #AnSkyMedSkyDebate, which I will call the #VortexDebate after the wonderful @chrimesy.com#AnSkyMedSkyDebate#VortexDebate Come on let’s get our opinions out and have a good robust discussion. See next comment for the topic. #AnSky #MedSky

1st SIVATrainee - BlueSky Thread! pEEG and ketamine If youve spent any time around TIVA and EEG You'll know that ketamine can increase the BIS number - Perhaps you never use ketamine because every time you do your processed EEG keeps telling you the patient's 'awake' 1/12

Are you interested in #Sustainability in #Anesthesiology and how reusing TIVA lines could help reduce greenhouse gas emissions? Per Werner Moller, originally an expert in #AppliedPhysiology and #VenousReturn, discusses their environmental paper on the #EJA podcast. open.spotify.com/episode/2RCa...

SALG Patient Safety Update has released One case reports stood out Relevant after our 'TIVA in a hyperbaric chamber' by Craig Holdstock #SIVA24 One of the few NHS funded indications for hyperbaric oxygen therapy. Delaying can be detrimental 🔗 tinyurl.com/5564rezu #salgpatientsafety @RCoANews

Goat brains on bypass If you know...you know #SIVA24 @chronotrope.bsky.social

Now the dust of #SIVA24 is settling and you've all hopefully made it home. It's time to put SIVA 2025 in your diary... Liverpool, City of Culture, home of the Beatles and the lamb banana! #SIVA25 - Save the date

The always wonderful, and dear friend @nickopotamus.co.uk speaking about TCI as a means of making adequate sedation more likely in critically ill transfers. Expert talk, as always. Also, he and I have just spent lunch talking about dogs, so he gets extra applause from me! #SIVA24

J. Robert Sneyd speaking about Remimazolam. A very entertaining talk! Remimazolam potentially has the advantages of an offset not dissimilar to propofol, with the CVS stability and reversibility of Midazolam. The best of both worlds, possibly. There is a niche for this, I suspect. #SIVA24

Why Elon has ruined social media #SIVA24

3rd and finally @cannula_service "Mirror mirror on the wall, which TCI model is the fairest of them all?"

2nd We have Joshua Etheridge On the ABCDE of Anaesthesia #SIVA24

Infographics Time 1st up Patrick Whelpdale With the benefits of TIVA #SIVA24

Some great questions coming through in the panel discussion BAS (UK Antarctica society) do not require and appendicectomy. Aus & US do! #SIVA24

Next up AntarcTIVA? Katherine Gamly on TIVA and the history of anaesthesia in the Antarctic. @katganly

Next up Craig Holdstock talking about TIVA in a hypobaric chamber #SIVA24

And we're back! Our next speaker is talking on Space TIVA (Anaesthesia in Space) I can barely anaesthetise patients on earth #SIVA24

PERUSE before you infuse from the Antipodes! #SIVA24 @robjimfleming.bsky.social

Kate Lesley dialling in remotely for the John Sear lecture on Female sex, Propofol pharmacology and awareness

NAP7 Jasmeet Soar pEEG use is increasing particularly when using TIVA #SIVA24

Mark Barley - Moving on from MAC Why does movement occur under anaesthesia despite 'nice numbers' #SIVA24

Session 2: The Science! Let's see what we've got #SIVA24

Spontaneous ventilation for airways in children How do I do it - Dr Sophie Liu #SIVA24

Can we Use pEEG to identify a space occupying lesion and get a time critical patient to be theatre quicker? #SIVA24

TIVA in pre hospital medicine In pre hospital - Time between induction and time to start sedation variable. Ketamine infusions becoming more standard 0.5-1mg/kg/Hr of standard 10mg/ml 60kg = 3-6ml/hr #SIVA24

My supporting slide set for my talk on smooth tracheal extubation for the @sivanaesthesia.bsky.social ASM in Sheffield. sthjournalclub.wordpress.com/2024/11/28/s...

1st up @sthjournalclub.bsky.social on Smooth extubation Reviewing the evidence on - Remifentanil - Lidocaine (including intra-cuff) - Dexmedetomidine #SIVA24

Top tip for high BMI children Paeds Prescribing Pro App www.paedspro.com #SIVA24

Intubating children without relaxant? Propofol bolus 3-5mcg/kg or via TCI pump Remifentanil 1-2mcg/kg (slowish 20+ secs) +/- Lignocaine spray to the vocal cords 1-2ml 1% using MAD device #SIVA24

Paedfusor V Eleveld In Kids (normal size) Eleveld gives a bigger bolus then pauses (Look at how long the pause is!) After an hour the infusion rate is the same #SIVA24

Allometric scaling If it's good enough for crabs it's good enough for humans #SIVA24

Cutler's Hall We've arrived! Hope you all found your workshops I heard fights were breaking out to get into the Eleveld sessions #SIVA24

Off to an absolute cracker of a meeting with a bang as @SIVAtrainees takes both sets of keys and leaves their wife and baby locked out the house #SIVA24