๐ผ๐ฃ๐๐๐จ๐ฉ๐๐๐จ๐๐ is the official journal of
@Assoc_Anaes
with comprehensive coverage in peri-operative medicine, critical care and pain. IF 7.5.
The live author interview with
@doctimcook
,
@sarah_massey_1
and
@LeeVarney2000
will now be on Thursday 11th July at 0900.
The full paper will be free to download from this time also using this link.....
See you there!
๐This new prospective study was able to develop a multivariable lasso regression model and simplified VIDIAC score that associates videolaryngoscopic intubation characteristics with subsequent issuing of a difficult airway alert.
#OpenAccess
๐
๐Recommendations for standards of monitoring during anaesthesia and recovery 2021.
Incredibly important paper for all that sets new standards for clinical practice in the peri-operative period.
@doctimcook
@drtimmeek
@amit_pawa
@Assoc_Anaes
๐
๐Today, we are publishing this
#FOAMed
paper from
@maxsorbello
and colleagues from Italy on recommendations from the the Italian
#COVID19
outbreak.
We encourage all our readers and followers to study carefully its contents.
๐
๐Is COVID-19 airborne?
This study from
@CoVcast
;
@Marks1Guy
,
@doctimcook
and
@EuanTovey
is the first to explore near-complete exhaled respiratory emissions under a range of experimental conditions.
Time to target physiologically
generated aerosols?
๐
๐The VIDIAC score to predict difficult airway alerts demonstrates high discrimination and outperformed the CormackโLehane classification.
Will your department be using it?
#OpenAccess
#FreeForever
๐
โญ๏ธAnaphylaxis algorithmโญ๏ธ
Specifically written for the peri-operative setting!
BUT how does it differ from other algorithms?!
โญ๏ธEarly IV adrenaline in small doses, titrated to effect, before establishing a low-dose IV adrenaline infusion if neededโญ๏ธ
๐
This new multi-centre qualitative study by
@IainMoppett
et al. finds a colour-coded compartmentalised anaesthesia drug storage tray to be feasible and effective. Can its introduction prevent drug errors and increase awareness of drug safety?
Nerve blocks such as FIB for the elderly hip fracture patient should be integrated into routine multiโmodal acute pain management protocols.
This narrative review is essential reading for all who care for such patients.
๐Remifentanil for tracheal intubation without neuromuscular blocking drugs in adult patients: a systematic review and meta-analysis.
This great new paper is
#OpenAccess
and
#FreeForever
!
๐
๐ Anaemia is common and associated with increased mortality, morbidity and length of stay.
Will this new study of >60'000 patients by
@KevinTrentino
change how you think about transfusion and haemoglobin levels in postoperative surgical patients?
๐
๐Emergencies in anaesthesia - everything YOU need to know๐
-vasular
-risk
-spinal cord injury
-trauma
-human factors
-paediatrics
-obstetrics
-frailty
-haemorrhage
-....and much much more!
๐
๐There is, until now, no published guidance on ergonomics specifically aimed at anaesthetists.
This new
@Assoc_Anaes
guideline summarises existing advice developed from other industries to promote health and safety.
@amit_pawa
@drcrbailey
๐
๐Brand new for 2021 is this new
#FOAMed
@Assoc_Anaes
malignant hyperthermia guideline from
@profhop
@ukmhr
!
They are the first such guidelines to be published in a peer reviewed journal and replace the 2011 crisis management laminates.
๐
๐This new simulation study by
@josimpson11
and
@LucyVerco
finds that devices such as the aerosol box confer minimal to no benefit in containing aerosols during an aerosol-generating procedure and may increase airborne particle exposure.
๐
Our editors commissioned this excellent editorial from
@hypoxicchicken
and
@NicholasChrimes
following a discussion right here on Twitter!
Here are 12 simple rules for anaesthetists to maintain a safe medication administration process ๐
#FreeForADay
๐
๐Increasing numbers of people have cardiac implantable electronic devices.
This new guidance is relevant to the management of people with these devices who are undergoing surgical intervention.
@BHRSociety
#FOAMed
๐
We've gone through our archives and selected our best editorials, original articles, reviews and guidelines including collections in:
Obstetric anaesthesia ๐
๐
Paediatric anaesthesia ๐
๐
Enjoy!
#FOAMed
Videolaryngoscopes seem to be shaking up traditional difficult airway management strategies.
How does VL compare with AFOI for awake tracheal intubation? Look no further than this new systematic review and meta-analysis, which is the first of its kind!
Direct oral anticoagulants (eg apixaban, rivaroxaban) & hip fracture.
๐ฉธ When is it safe do a nerve block?
๐ฉธ When should surgery performed?
๐ฉธ When should they be restarted?
Mitchell et al have created a consensus statement to help! ๐
@FF_Network
๐
๐ Dexmedetomidine has intrinsic analgesic properties as well as sedative, anxiolytic and sympatholytic effects.
This new systematic review finds it is superior to remifentanil when used for intra-operative analgesia.
@DrEAlbrecht
@DrKyleKirkham
๐
๐Nocebo refers to non-pharmacological adverse effects of an intervention.
@LauraBurgoyne1
sets out the implications for clinicians - time for phrases such as โbee stingโ and โsharp scratchโ to be thought of as clumsy verbal relics of the past?
๐
This new
#FreeForADay
narrative review is simply everything you need to know about apnoeic oxygenation, including preoxygenation, THRIVE and special patient groups.
First described in 1667, but arguably now revolutionising the practice of anaesthesia?
๐
Is there still a role for AFOI in the era of videolaryngoscopy?
A popular opinion seems to be that the real โskillโ is the technique of airway topicalisation, and
@elboghdadly
has been kind enough to provide us with his recipe...
#TheAnaesthesiaBlog
Professor Iain Moppett from Nottingham, UK is our first new
@Anaes_Journal
Editor.
His interests include patient-risk assessment, hip fracture care, delirium, frailty and the Health Service Research Centre, where he is Deputy Director.
Welcome
@IainMoppett
!
๐Anaesthetists are thought be at increased risk of suicide.
These new guidelines aim to increase awareness of suicide and its risk factors and offer support to individuals, departments and organisations in coping with a suicide.
@AAGBI
๐
"We recommend that anaesthetists should avoid mean arterial pressure < 65 mmHg during surgery, especially after induction."
What is the minimum MAP you are willing to tolerate during general anaesthesia?
@KamalMaheshwar7
We are delighted to announce our new impact factor for 2020 of 5.7!
Our aim is to provide you with the best clinically relevant content on all aspects of anaesthesia, peri-operative medicine, critical care and pain.
Thank you to all our 24.2k followers!
#onwardsandupwards
๐Negativeโpressure ventilation simulates natural lung movements, does not require tracheal intubation, and does not cause barotrauma.
The Exovent is a novel such device that supports spontaneous ventilation in conscious, healthy adult volunteers.
๐
๐Surgical patients who have recently had COVID-19 are more likely to develop potentially fatal post-operative blood clots.
-128,013 patients
-1630 hospitals
-115 countries
-โ๏ธ5๏ธโฃ risk of death in those who developed VTEs
@CovidSurg
@GlobalSurg
๐
๐Is pre-operative self-isolation a useful strategy to protect patients, hospitals and staff against nosocomial SARS-CoV-2 transmission?
-No apparent benefits
-Increased risk of postoperative pulmonary complications
-Risk rises with period of isolation
๐
๐Laryngoscopy trials: who is putting the tube in the oesophagus?
"When an inexperienced intubator is planning the airway of a critically ill patient, there should be less focus on which laryngoscope and more on finding a suitably skilled clinician."
๐
You can now find all
@AAGBI
guidelines from 2014-2017 in one place ๐
We also have Special Collections in Cardiothoracic Anaesthesia ๐
....and Hip Fracture ๐
Enjoy!
๐ Todays paper has been reported by 12 news outlets and tweeted >240 times!
Time to change how we think about transfusion and haemoglobin levels in postoperative surgical patients?
@KevinTrentino
#FreeForADay
๐
๐PPE during the
#COVID19
pandemic.
This new review from
@doctimcook
adds clarity regarding: modes of transmission; what PPE is recommended, when and why; where uncertainty exists; and a nomenclature based on mode of transmission.
@bbchealth
๐
๐Aortic dissection, aortic rupture, end-vascular treatment, open treatment, carotid endarterectomy, acute ischaemic limb, acute mesenteric ischaemia and their peri-operative complications.
This new review has it all!
@asadmirghassemi
@LizmilllerLiz
๐
๐New blocks on the kids: core basic nerve blocks in paediatric anaesthesia.
@AMEPearson
and
@LloydTurbitt
argue that the benefits of encouraging the use of a small number of high-value blocks in children are similar to those in adults.
๐
Our final new
@Anaes_Journal
Editor is Professor Ed Mariano!
We are delighted that Ed is finally joining after contributing so much to the journal as an IAP.
His interests include regional anaesthesia, education/training, paediatric anaesthesia and pain.
Welcome
@EMARIANOMD
!
๐This is the first consensus statement which aims to provide practical recommendations on the safe use of i.v. lidocaine for postoperative pain and recovery.
@ajrmacfarlane
@naveeneipe
#FOAMed
๐
๐This new
@Assoc_Anaes
guideline for the management of hip fractures from
@IainMoppett
and colleagues contains more specific recommendations about controversial areas of patient management than were made in 2011.
Available now and
#FOAMed
forever!
๐
Excessive pre-operative fasting is not only unnecessary but also detrimental.
Find out what's new for adults and children including fasting periods, carbohydrate loading and gastric ultrasound in this narrative review.
@BillFawcett
@drmarkthomas
๐
๐ Dexamethasone has several indications and is frequently administered in the periโoperative period.
This new
@cochranecollab
review concludes a single dose of dexamethasone does not increase the risk of postoperative infection.
#FreeForADay
๐
The incidence of a serious mistake in anaesthetic medication administration is ~1/133.
Time for a shift towards framing it as a systems problem and not an individual performance problem?
@NicholasChrimes
@hypoxicchicken
๐
Direct vs videolaryngoscopy for tracheal intubation
In Denmark, there are now anaesthetists who have never learned to use direct laryngoscopy and colleagues who have ceased training with it.
Strรธm et al argue DL is a crucial skill for anaesthetists.
๐
๐Patients with adrenal insufficiency can be better identified and supplemented with glucocorticoids during the peri-operative period.
This is the first national guidance on this topic and of relevant to all.
@AAGBI
@RCPLondon
@Soc_Endo
๐
๐Check out our
#FreeForever
special issue which brings together everything you need to know about peri-operative emergencies!
โ cervical spine injury
โ transport
โ human factors
โ the unwell child
โ obstetric emergencies
โ frailty
โ major haemorrhage
๐
Neuromuscular blocking drugs vs remifentanil for intubation.
The use of remifentanil (2-4 mcg/kg) makes little to no difference in terms of producing excellent tracheal intubation conditions.
Anyone changing their practice after reading this paper?
๐
๐The first results from
@RCoANews
@NAPs_RCoA
are now available!
โฌ๏ธAge and BMI has increased since NAP5 in 2013.
โฌ๏ธTIVA use has more than trebled.
โฌ๏ธpEEG use has increased more than 6-fold.
No increase in regional anaesthesia or spinals.
๐
This new RCT concludes that cuffed tubes in children are associated with less leak, higher tidal volumes and more stable ventilation parameters. Additionally, children intubated with a cuffed tube had less adverse events, sore throat and hoarse voice.
๐Major haemorrhage: past, present and future.
This great new review from
@DocAShah
,
@OxCPD
,
@SimonStanworth
and
@SeemaMosca
covers mechanisms, transfusion, pharmacological interventions and laboratory monitoring.
A must read for all!
๐
Our 2019
#FOAMed
optimisation supplement continues to be our most downloaded issue, ever! Here are some of the key papers ๐
Nutrition
Anaemia
Diabetes
Emergency laparotomy
๐A prospective observational study of the effects of sugammadex on peri-operative oestrogen and progesterone levels in women who take hormonal contraception.
This great new paper from
@DrNatalieSmith1
is now
#OpenAccess
and
#FreeForever
!
๐
Videolaryngoscopes appear to be safe for awake intubation, and can achieve overall and firstโattempt success rates comparable to fibreoptic bronchoscopy.
Check out this new systematic review and meta-analysis here
#FreeForADay
#FOAMed
๐Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis.
This great new paper from
@DrSamuelT
is now
#OpenAccess
and
#FreeForever
!
๐
๐This new review from
@drrichstrong
,
@adk300
and
@doctimcook
of 10,150 patients from centres across Asia, Europe, and North America finds that combined ICU mortality was 41.6%.
Excellent data and analysis that will be of interest to all!
๐
๐This new study, the largest of its kind and covering > 80% of all NHS cardiac surgical units, found that the risk of TOE-related complications is higher than previously reported (1:1000).
Around 40% of those with complications died.
@ACTACCUK
๐
Tanya Selak is a Senior Consultant Anaesthetist at Wollongong Hospital, Wollongong, NSW, Australia.
Did you see her chair the
@Assoc_Anaes
monitoring guideline live discussion last month?
Welcome
@GongGasGirl
!
๐ This weeks
#ClassicPaperFriday
has been cited >150 times, but has hardly received any social media attention!
Serratus plane block: a novel ultrasoundโguided thoracic wall nerve block. Great paper and more than worthy of a read and a re-tweet!
๐
๐Three conclusions from this study:
-inserting a IT catheter alone does not decrease the incidence of PDPH.
-no benefit in leaving the catheter in for 24โh postpartum.
-injection of IT saline decreases the incidence of PDPH.
@BinyaminYair
๐
๐Sugammadex and neostigmine: when better may not beย best.
"The upfront cost of sugammadex may be mitigated by the potential for faster operating theatre turnaround and more rapid discharge from the post-anaesthesia care unit."
@DASidebotham
๐