Deep Breaths

Today, we discuss several cases addressing one-lung ventilation with special guest, Dr Ivan Rapchuk.

Our first case is as follows:  a 68 year old man is scheduled for an open right upper lobectomy on your list tomorrow for a T1N0 non small cell lung carcinoma. He is an active smoker with a 30 pack year history but has cut down his consumption from 20 cigarettes daily to 5. He has moderate emphysema but walks 2km daily on flat ground without issue. Other comorbidities include hypertension and hypercholesterolaemia. He is 1.78m tall and weighs 89kg giving him a BMI of 28. 

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:

Pre-anaesthetic assessment for thoracic surgery by Peter Slinger and Gail Darling:
https://www.mcgill.ca/anesthesia/files/anesthesia/wk_1a_slinger_02_preop_assessment.pdf

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 is the final episode of our airway series where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. 

Our first case - case number 6 - is one where you are called to the intensive care unit to the bedside of a 54 year old female patient who had a percutaneous tracheostomy placed earlier that day. She is now hypoxic with oxygen saturation of 82%.

Case number 7 is a 58 year old female patient presenting for a panendoscopy after presenting  with a hoarse voice. A suspicious looking nodule was seen during a fiberoptic nasal endoscopy in the Ear, Nose and Throat outpatient clinic.

We finally end our discussion with case number eight. You have anaesthetised a 27 year old male patient for placement of a Halo traction brace for a cervical spine injury. He was initially a Cormack & Lehane grade 3 view on direct laryngoscopy with a POGO of 10% after changing to a C-MAC video laryngoscope and a D-blade, and with excellent positioning. Now you are tasked with extubating this patient.

As a special treat for the ears, you'll hear us all chuckling at points during the interview. At our feet were two very well behaved pups that, on occasion, made us laugh and wagged their tails against the metal legs of the desk.

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!  

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 is our third of a four episode series where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. 

The first case in today's episode - case 4 - is as follows: you are called to assist a colleague who has had 3 failed attempts at intubating a 64 year old female patient for a laparoscopic hemicolectomy. Bag-mask ventilation was difficult, although not impossible, and now your colleague is able to ventilate via an LMA, iGel #3.

Case 5 consists of the following scenario: you are doing an ENT list and there is a 68 year old male patient booked for a laser excision of a laryngeal papilloma.

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!  

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 is our second of four episodes that will be released over a four-week period where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. 

Our second case is that of a 23 year old man that presents for a sub-mandibular abscess on a background history of five days of toothache. His only other medical history is that he has a BMI of 35. On clinical examination the patient is found to have mouth opening to 2cm limited by both pain and also some truisms of the masseter muscles. The remiander of his airway exam is unremarkable with the caveat that intra-oral examination is impossible with his limited mouth opening.

We then follow on with case three - a talk about how to perform a tube change in case two's 23 year old man post sub-mandibular abscess surgery, prior to transfer to ICU for overnight ventilation.

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: 

Coroner's Court of Western Australia's Record of Investigation into Death - Mr R. J. who passed away on 20 February 2001 from a hypoxic brain injury due to respiratory obstruction following surgery for a dental abscess. Please be reminded that this case is a tragedy and discretion and respect for the parties involved is a must. 

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 is our first of four episodes that will be released over a four-week period where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas.

Our first case is that of a 44 year old female patient scheduled to have a total thyroidectomy for a multi nodular goitre with moderate retrosternal extension. She has never had a general anaesthetic before and her only other history is that she has a BMI of 40. Regarding airway examination, she is found to have a mallampati score of 3 and a short thyromental distance of 4.5cm.

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:

Difficult Airway Society: Management of haematoma after thyroid surgery guidelines (includes link to original article published in Anaesthesia)

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, we discuss the joint Difficult Airway Society, British Association of Endocrine and Thyroid Surgeons, and the British Association of Otorhinolaryngology Guidelines on managing neck haematomas after thyroid surgery.

We start by revising the pathophysiology of post-thyroidectomy airway compromise before launching into a discussion about the 8 recommendations within the guidelines. 

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: 

Difficult Airway Society: Management of haematoma after thyroid surgery guidelines (includes link to original article published in Anaesthesia) 

ANZCA PG52: Guideline for transport of critically ill patients

ANZCA Critical Incident Debriefing Toolkit

ANZCA Fact Sheet: How to support a trainee or colleague who is distressed

ANZCA Doctors Support Program

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 discuss the latest updates on sepsis, courtesy of the recently released International Guidelines for the Management of Sepsis and Septic Shock 2021. This is a long guideline, but we pick out the most relevant pieces to our practise in anaesthesia. 

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:

Surviving Sepsis Campaign: International Guidelines for the Management of Sepsis and Septic Shock 2021

Surviving Sepsis Campaign home page 

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, we tackle the peri-operative management of cardiac implantable devices after the recent publication of the British Heart Rhythm Society's guidelines in the journal, Anaesthesia.

In part 2 of this 2 part series, we discuss the ten guidelines that illustrate how cardiac implantable electronic devices should be managed peri-operatively, followed by considerations that we as - anaesthetists - should have thought through prior to wheeling a patient with a CIED into theatre for induction and surgery.

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: 

Guidelines for the peri-operative management of people with cardiac implantable electronic devices - Guidelines from the British Heart Rhythm Society

The Revised NASPE/BPEG Generic Code forAntibradycardia, Adaptive-Rate, and Multisite Pacing (Auto-download of the pdf) by A.D. Bernstein et. al. 

NAPSE Policy Statement: The NAPSE/BPEG Defibrillator Code by A. D. Bernstein et. al. 

Deranged Physiology: Single and Dual Chamber Pacing Modes

Anaesthesia Tutorial of the Week #299 - Pacemakers and Implantable Cardioverter Defibrillators, part 1

Anaesthesia Tutorial of the Week #300 - Pacemakers and Implantable Cardioverter Defibrillators, part 2

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, we tackle the peri-operative management of cardiac implantable devices after the recent publication of the British Heart Rhythm Society's guidelines in the journal, Anaesthesia.

In part 1 of this 2 part series, we start with a discussion about the different types of implantable cardiac devices that may be encountered in our practice. We explain how the NGB code illustrates the way that pacemakers are programmed, as well as what happens to some of these programs when a magnet is applied in the perioperative setting. We then go on to a similar discussion where we explain how the NBD code describes the function and lead placement for implantable cardioverter defibrillators. 

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: 

Guidelines for the peri-operative management of people with cardiac implantable electronic devices - Guidelines from the British Heart Rhythm Society

The Revised NASPE/BPEG Generic Code forAntibradycardia, Adaptive-Rate, and Multisite Pacing (Auto-download of the pdf) by A.D. Bernstein et. al. 

NAPSE Policy Statement: The NAPSE/BPEG Defibrillator Code by A. D. Bernstein et. al. 

Deranged Physiology: Single and Dual Chamber Pacing Modes

Anaesthesia Tutorial of the Week #299 - Pacemakers and Implantable Cardioverter Defibrillators, part 1

Anaesthesia Tutorial of the Week #300 - Pacemakers and Implantable Cardioverter Defibrillators, part 2

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 continue our discussion about receiving a poor outcome after the ANZCA part 2 exam with two special guests - Dr Raymond Casey and Dr Aaron MacDonald.

In the second instalment of this topic, we talk to Aaron about his journey after sitting his exam for the first time. Both Raymond and Aaron then give some timely advice about how to manage the stress and emotions associated with dealing with adversity, and share some tips that ultimately helped them succeed.

Aaron has kindly offered to let trainees experiencing difficulty in coping with part 2 exam failure to contact him. If you're interested in reaching out, please email us at [email protected] and we'll connect you. 

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!

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!