New: Guidelines for anaesthesia and sedation in patients who are breastfeeding Anaesthetic, sedative & analgesic medicines are transferred to breastmilk in only very small amounts. Patients should be advised that discarding of breastmilk after anaesthesia is not necessary Download: buff.ly/KNnL8gR

Semaglutide, fasting and gastric ultrasound Nearly 50% of patients receiving semaglutide treatment had a full stomach on pre-operative gastric ultrasound, regardless of dose, duration, route of administration or withholding time. #AnSky doi.org/10.1111/anae...

Be interested to know what their starvation time was? Patients on GLP here are now getting 24 hour fast pre-op.

Some correspondence from a retired academic lawyer on consent! "... the law, while dynamic, is almost always reactive. Expecting it to change to fit a particular narrative is likely to end in disappointment." #AnSky #LawSky doi.org/10.1111/anae...

Come work with us!

Save the date for the @SafeAirway 2026 Annual Meeting. Held in collaboration with the @anzca.bsky.social @asa-australia.bsky.social @thenzsa.bsky.social Airway Management SIG meeting, our shared theme is 'One Airway, One Team'. Get alerted when rego opens: sasevents.eventsair.site/contact-us

Registrations are now open for our Gosford Airway Workshop. Come learn HAVL, VAFI, Neck Rescue & management of trache/lary emergencies on NSW's sunny Central Coast. Qualifies for @anzca.bsky.social CICO ERM sign off & for CICM airway CPD recognition. sasevents.eventsair.site/registration

Should we use fewer arterial catheters in critical care patients? It may prevent harm from non-infective and infective complications, lower financial and environmental costs and reduce iatrogenic blood loss and blood transfusions in individual patients. #AnSky #ICUSky doi.org/10.1111/anae...

Pity they massively overdosed the ketamine arm - significant percentage > 2mg/kg / no ceiling dose ("rule of 1 ampoule") / dose per total body weight / and who gives > 0.5 mg/kg to a "sick" patient - great trial / wrong pharmacology / wrong conclusion = drugs are equivalent at equipotent doses

Hyperangulated videolaryngoscopy: stylet first until benefit of bougie is shown "...the current challenge for the wider community of anaesthetists ... is not mastery of HAVL but access to devices, routine use, gaining familiarly and developing competence." #AnSky ttps://doi.org/10.1111/anae.70062

Registrations are now open for the 1st stop on the Safe Airway Society's 2026 #AirwayWorkshopRoadshow: MELBOURNE! ½ Day workshop Sun 22nd March at Peter Mac Stations: Neck Rescue @ANZCA.bsky.social CICO ERM sign off available) HAVL/VAFI Trache/Lary Emergencies Places will sell out fast.

Incidence of peri-operative nerve injuries appears to be decreasing over time - a result of meticulous attention to pressure areas? Increasing use of ultrasound for nerve blocks? What do you think? @dr-amit-pawa.bsky.social @jeffgadsden.bsky.social

Save the dates for our 2026 #AirwayWorkshopRoadshow & annual meeting. This year our annual meeting will be held back-to-back with the @anzca.bsky.social @thenzsa.bsky.social @asa-australia.bsky.social Airway SIG meeting in Noosa Heads, QLD. Registrations open Jan 2026 More details to follow.

Australasian Anaesthesia 2025 (also known as the Blue Book) has landed! You can read a digital version, or order a hard-copy version, here: bit.ly/49JzoxX

“For clinicians who have abandoned cricoid force… the qtn to be answered is why they employ any element of RSI at all. Rather than selectively abandoning cricoid force as a component, it should perhaps be the only component we retain” From @chrimesy.com in @anaesjournal.bsky.social

"It is perverse that cricoid force has been abandoned selectively by many clinicians for not representing evidence-based practice when, compared with [other RSI elements], it is cost-free, better reasoned, has less potential for harm & more evidence of efficacy." #AnSky doi.org/10.1111/anae...

This one’s for @drmikeclifford.bsky.social Cricoid pressure has been selectively vilified out of RSI in many settings, yet it has less risks, a better rationale & more evidence for efficacy than any other cited component of RSI Why aren’t we doing it routinely for all adult tracheal intubations?

Awful. I'm just going to leave this here: yes, bronchospasm can account for a flat capnograph, but no, you can't assume that's the reason and you must take the tube out or (if that's genuinely dangerous) exclude oesophageal intubation using a bronchoscope. onlinelibrary.wiley.com/share/author...

Safe Airway Society (a not-for-profit org. in Australia & New Zealand; aiming to optimize safe, effective patient care through a collaborative, multidisciplinary approach to airway management across different healthcare roles & settings) leaves X (3.699 followers) Bluesky: @safeairwaysociety.org

International Consensus Guidelines for Preventing Unrecognised Oesophageal Intubation. Free full text in @anaesjournal.bsky.social Supported by @dasairway.bsky.social @safeairwaysociety.org @asahq.bsky.social @rcoanews.bsky.social & many more… www.universalairway.org/puoi/support

Yet another case of death from unrecognised oesophageal intubation. The circumstances of the case are tragically similar to previous cases: good clinicians succumbing to cognitive bias. Please familiarise yourself with the guidelines to avoid falling into the same trap. @anzca.bsky.social

The most important use of VL is engaging the team. They can see what is happening. Your assistant can see if their airway manoeuvres are helping or hindering. DL is a lonely game.

Absolutely massive crowd in Naarm/Melbourne today. From the river to the sea.

He’s wanted to declare martial law from day one. Bypass all checks and rule as a tyrant. Many have speculated how he’d do it. Now his gambit is clear. DC was a test. He’s using manufactured crime stats to send troops into blue states & cities. This is not a drill. Democracy is at defcon 1.

Oh..patients don’t complain when you don’t use LA they just accept it hurts! What I get is “Oh ..is it done?” Or “Wow..that was ok after all” Also they don’t move and , should you miss, they don’t get wound up if you have to redo!

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

Not doing the right thing bc it’s too hard is simply not caring enough.

If the argument for why something - literally anything - should not be done, is that it's complicated, and hard, and you don't understand, blah blah, but good on you for caring... that's literally never a good point. It's always a deflection and never engages. It's PR for inertia

While CL has its issues (mainly that no one remembers what the gradings mean) POGO is a completely useless classification system. It can only subclassify easy views (CL 1 -2a) but is unable to discriminate bw challenging views (CL 2b - 4 are all potentially POGO 0%).

Apart from my very niche case HOW LOW WILL YOU GO, or let BP go before you intervene? Thanks to @chrimesy.com for the topic.

Let’s keep up the #MedSkyDebate pace!! Weekend topic is from Nicholas Chrimes @chrimesy.com#MedSkyDebate “Permissive hypotension: how low will you go?” My personal low was a 8 hour AVM resection in a 30 year old, at 50 systolic throughout the resection Brilliant outcome, minimal deficit

You got away with it. I don’t believe hypotension is permissible. 20% drop of patient’s norm is fine, beyond that bad. “the purpose of anaesthesia is to keep everything as boring as possible” “boring” = physiological

Trump: "I was very happy to hear him say if I was president that war would've never happened." (Putin knows how to play Trump like a fiddle.)

The people who are crazy enough to think they can change the world are the ones who do.

If sustained exhaled CO2 is in doubt, oesophageal intubation must be ruled out!

The PUMA guidelines for preventing unrecognised oesophageal intubation are also supported by @rcoanews.bsky.social @assocsas.bsky.social & many other organisations internationally across anaesthesia, ICU, EM & prehospital Full list: www.universalairway.org/puoi/support @anaesjournal.bsky.social

Does attempting to meet legal requirements for informed consent have the potential to *undermine* patient autonomy? From me, @hypoxicchicken.medsky.social & @maryannturner.bsky.social. Free full text for a limited time i @anaesjournal.bsky.social

The Safe Airway Liaison Group in the UK have released a statement on displaying the waveform capnography trace in line with the @universalairway.org recommendations. The CO2 trace should be: 1. The bottom trace 2. White 3. Shaded in www.salg.ac.uk/salg-publica...

🚨We have retired "no trace, wrong place" to align with PUMA guidelines. Instead, with @assocanaes.bsky.social and @dasairway.bsky.social, our message is that if sustained exhaled CO2 is not detected, then oesophageal intubation must be ruled out. See our dedicated webpage👉 ow.ly/vOZs50WA03r

Following on from @sarahmd.bsky.social's discussion, the midweek #MedSkyDebate is what are the cultural work practices you find interesting in other countries. For me it's surgeons in the USA not putting their own surgical gloves on. That is just weird.

Was this the post you mentioned seeing a couple of weeks ago @chrimesy.com ? bsky.app/profile/anes...

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!!

Igel is the worst airway ever. The igel is a perfectly decent airway. Discuss. See if you can do it without SHOUTING like my most recent interaction 🙄 #ansky

This man is a danger to us all.

I hate this man. Why is he trying to kill all of us.

“Non maleficence “ or what some are now calling “benevolent materialism” In paediatrics - we call it putting on “the wooly cardigan “

It is more important than ever for the law to work collaboratively with clinicians to support a concept of futility... Clinicians must be empowered to hold onto professional responsibility and accountability for complex decision-making. #AnSky #ICUSky #MedSky #FreeForAWeek doi.org/10.1111/anae...

“Merely giving the patient information, rather than expert guidance, may produce suboptimal decisions & unnecessary stress” From me, @hypoxicchicken.medsky.social & @maryannturner.bsky.social. Free full text for a limited time in @anaesjournal.bsky.social 🔓🔑⏳

Get your applications in! This is a wonderful opportunity to work with our team at Anaesthesia Reports! Due 10 August

Trump saying he has the best poll numbers he’s ever had citing “Harry Emden” on CNN Harry Enten response: If we are comparing him to other presidents at this point in their presidencies, he is the second lowest on record compared only to himself.