Today, we revisit a topic that was recommended to us by Dr David Tragen of the Sunshine Coast University Hospital - the perioperative management of the direct oral anticoagulant medications or DOACs.

We start with some basic revision of the mechanism of action of the DOACs and their indications before diving more closely into the recommendations for stopping and starting these medications around the time of surgery, and the implications for our anaesthetic.

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Resources for today's episode:

2021 ANZCA Blue Book: Direct Acting Oral Anticoagulants - pharmacology and perioperative considerations by Dr Kate Drummond (p147)

TGA Website

RE-ALIGN Trial

GALILEO Trial

BMJ: Coagulation assessment with the new generation of oral anticoagulants by  Charles Pollack Jr

Journal of Thrombosis and Haemostasis: Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians by J. Douxfils et al.

PAUSE Trial

Regional Anesthesia and Acute Pain: Regional anaesthesia in the patient receiving antithrombotic or thrombolytic therapy, 5th edition (ASRA 2025 Guidelines)

RE-VERSE-AD Trial

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Deep Breaths will return this year with a slightly different twist. We're taking a little break, but that doesn't mean we've forgotten about our wonderful listeners! 

We'll be recording the occasional new episode with guest interviewees that we're excited to be chatting with. We're also going to be re-releasing some of our best episodes.

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

In today's episode, we revisit challenges in the diagnosis and management of oesophageal intubation and anaesthetic crises in general. Recognising an oesophageal intubation may seem simple, but by looking at coroner's cases both here in Australia and in the UK, as well as cases in the NAP4, it can be far more complex.

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Resources for today's episode include:

NSW Coroner's Court website

Why does oesophageal intubation still go unrecognised? Lessons for prevention from the coroner’s court

National Audit Project 4

ANZCA Professional Documents

Red Man Syndrome 

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

So get ready for something a little different... this week's episode was recorded live from the ANZCA Annual Scientific Meeting 2024, in our home city of Brisbane, Australia. 

We interviewed some fascinating guests, covering topics as diverse as the role of the college moving forward, how we can be more sustainable in anaesthesia, and the future of podcasting; and we had plenty of fun along the way. 

Enjoy this interactive and entertaining discussion with Dr Chris Cokis, Professor David Story, Professor Kate Leslie, Dr Andrew Cumpstey, Professor Eugenie Kayak, and Dr Lahiru Amaratunge. 

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Today's episode is the second of our two part series on ruptured AAA repairs. We discuss the case of a 72 year old man with a ruptured abdominal aortic aneurysm that is contained, and who is scheduled for an urgent endovascular repair within the interventional radiology suite with special guest, Dr Lahiru Amaratunge.

Apologies for the audio quality in this episode - even though it sounds like we recorded on a submarine, we can assure you we were sitting in our study the entire time.

Resources for today's episode:

BJAED: Anaesthesia for endovascular repair of ruptured abdominal aortic aneurysmsby K. Berry et al.

LITFL: AAA by C. Nickson

Lancet: Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial by Patel, R. et al.

Annals of Surgery: Endovascular Repair of Abdominal Aortic Aneurysm in Patients Physically Ineligible for Open Repair: Very Long-term Follow-up in the EVAR-2 Randomized Controlled Trial by Sweeting, M. et al.

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Today - in part 1 of our 2 part series - we talk through the case of an 82 year old man with a ruptured abdominal aortic aneurysm who is scheduled for urgent open repair with special guest, Dr Lahiru Amaratunge.

Resources for today's episode:

BJAED: Anaesthesia for endovascular repair of ruptured abdominal aortic aneurysms by K. Berry et al.

LITFL: AAA by C. Nickson

Lancet: Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial by Patel, R. et al.

Annals of Surgery: Endovascular Repair of Abdominal Aortic Aneurysm in Patients Physically Ineligible for Open Repair: Very Long-term Follow-up in the EVAR-2 Randomized Controlled Trial by Sweeting, M. et al.

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

In today's episode, we cover the recently released consensus clinical practice recommendation regarding the peri-procedural use of the GLP-1 and GIP receptor antagonists. 

Enjoy this topical episode - this is sure to be an evolving area.  

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

This week we're under the pump with work and life, but we'll be with you soon and it's a cracker of an episode covering an extremely topical subject. 

Keep an eye out for our next episode dropping something in the next couple of weeks. As an apology, we'll have a bonus ep coming sometime towards the end of the season! 

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Today's episode is the final in our series on inotropic and vasopressor medications. Today, we're going to tackle some of the more obscure inotropes and vasopressors - these medications typically aren't encountered terribly often within anaesthesia. During this episode, we discuss milrinone, levosimendan, methylene blue and hydroxocobalamin (Vitamin B12). 

Resources for today's episode:

StatPearls:
Inotropes and vasopressors by D. VanValkinburgh et al.
Adrenergic Drugs by K. Farzam et al.

LITFL:
Inotropes, vasopressors and other vasoactive agents by C. Nickson
Milrinone by C. Nickson
Levosimendan by C. Nickson
Methylene blue by C. Nickson
Hydroxocobalamin by N. Long

Deranged Physiology:
Classification of inotropes and vasopressors
Milrinone
Levosimendan

DRUGBANK Online:
Milrinone
Levosimendan

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!

Today's episode - the second in our three episode series focusing on inotropic and vasopressor medications - sees us covering some more medications commonly (or uncommonly, depending on your scope of practice) encountered within anaesthesia. During this episode, we discuss vasopressin, dopamine and dobutamine. 

Resources for today's episode:

StatPearls:
Inotropes and vasopressors by D. VanValkinburgh et al.
Adrenergic Drugs by K. Farzam et al.

LITFL:
Inotropes, vasopressors and other vasoactive agents by C. Nickson
Vasopressin by C. Nickson
Dopamine by C. Nickson
Dobutamine by C. Nickson

Deranged Physiology:
Classification of inotropes and vasopressors
Vasopressin
Dobutamine

DRUGBANK Online:
Vasopressin
Dopamine
Dobutamine

BJAED:
Vasopressin and its role in critical care by A. Sharman & J. Low.

Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you!

And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.

Thanks for listening, and happy studying!