Deep Breaths

In today's episode, we interview our guest Dr Michael Kerr to discuss regional anaesthesia for the lower limbs. In this episode, we cover the taxonomy of lower limb blocks, the indications for various types of blocks and discuss in detail the fascia iliaca block.

Thanks for listening, and happy studying!

Resources for this episode include:

Reading list -

Peripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature DOI: http://dx.doi.org/10.1136/rapm-2021-102750

Lower extremity regional anesthesia: essentials of our current understanding DOI: http://dx.doi.org/10.1136/rapm-2018-000019

Fascial plane blocks: a narrative review of the literature. DOI: http://dx.doi.org/10.1136/rapm-2020-101909

Regional analgesia for lower leg trauma and the risk of acute compartment syndrome. DOI: https://doi.org/10.1111/anae.15504

Regional anesthesia and acute compartment syndrome: principles for practice. DOI: http://dx.doi.org/10.1136/rapm-2021-102735

Youtube - 
1. Duke - https://www.youtube.com/channel/UCqMt0yH0ZHez6wFFP6ZfECg/featured
2. Ki Jinn Chinn - https://www.youtube.com/c/KiJinnChin
3. NYSORA - https://www.youtube.com/c/nysoravideo
4. Amit Pawa - https://www.youtube.com/c/DrAmitPawa

Societies - 
ESRA
ASRA

Journals - 
RAPM - https://rapm.bmj.com/

Wellcome library

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 a newly released consensus statement on the management of adult patients undergoing head & neck surgery with a free flap.

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:

Expert consensus statement on the perioperative management of adult patients undergoing head and neck surgery and free tissue reconstruction from the Society for Head and Neck 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!

In this episode, we're continuing our discussion about ROTEM or rotational thromboelastometry.

We start by working through the interpretation of ROTEM results for specific clotting abnormalities before going on to talk about more complex coagulopathies seen in trauma patients and in the bleeding obstetric patient. Lastly, we discuss the limitations to ROTEM interpretation. 

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:

ROTEM e-learning modules from the ROTEM website:
https://learning.rotem.de/en/ 

Normal and abnormal ROTEM temograms from the Deranged Physiology website (see this website for the images of the abnormal temograms that we work through in this episode):
https://derangedphysiology.com/main/required-reading/haematology-and-oncology/Chapter%201.2.0.1/intepretation-abnormal-rotem-data

ROTEM product information and interpretation instructions with case examples:
https://www.ttuhsc.edu/medicine/odessa/internal/documents/ttim-manual/ROTEM_Analysis.pdf 

ROTEM Interpretation Flow Diagram from the NHS Brighton and Sussex University Hospitals:
https://www.bsuh.nhs.uk/library/wp-content/uploads/sites/8/2021/12/ROTEM-interpretation.pdf 

ANZCA 2017 Blue Book:
https://www.anzca.edu.au/getattachment/5843b1ab-6599-453d-b55c-08450db9520e/Australasian-Anaesthesia-2017#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're talking about ROTEM or rotational thromboelastometry.

We start with a brief explanation of how ROTEM works, the parameters used to assess ROTEM temograms, and the different assays performed during a ROTEM test.

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:

Coagulation cascade - a short video to assist in explaining the extrinsic, intrinsic and common pathways:
Coagulation cascade animation by Thrombosis Adviser - https://www.youtube.com/watch?v=cy3a__OOa2M

ROTEM e-learning modules via the ROTEM website (note: you must apply for a login):
https://learning.rotem.de/en/

ROTEM product information and interpretation instructions with case examples:
https://www.ttuhsc.edu/medicine/odessa/internal/documents/ttim-manual/ROTEM_Analysis.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!

In today's episode, we talk with Cecil Gray prizewinner Dr Anna Pietzsch about her preparation for the ANZCA part 2 exam.

We pick her brain about the process she went through for deciding when to sit the exam, her study technique and structure, and exam day plan. She also shares with us some great advice, what she thought worked well in her own preparation, and things she wishes she'd known and changed in hindsight.

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, we're deep-diving into the very important topic of postpartum haemorrhage.

We talk about the diagnostic criteria and classification of postpartum bleeds, the four main aetiologies of postpartum haemorrhage, and both the obstetric and anaesthetic approaches to managing these patients intra-operatively. In addition, we also share our own experiences and cases that have stayed with us. We also wish to emphasise for this episode, in general, while the administration of packed red cells is appropriate for massive obstetric haemorrhage, coagulation factors should be given as soon as they become available. 

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:

RANZCOG's management guidelines for PPH:
https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Management-of-Postpartum-Haemorrhage-(C-Obs-43)-Review-July-2017.pdf?ext=.pdf 

Patient Blood Management Guidelines: Obstetrics and Maternity (2015):
https://www.blood.gov.au/system/files/documents/20180426-Module5-WEB.pdf 

QLD Clinical Guideline: Primary PPH:
https://www.health.qld.gov.au/__data/assets/pdf_file/0015/140136/g-pph.pdf 

ANZCA 2017 Blue Book article: Rotational Thromboelastometry (ROTEM) in Obstetrics:
https://www.anzca.edu.au/getattachment/5843b1ab-6599-453d-b55c-08450db9520e/Australasian-Anaesthesia-2017#page= 

Postpartum Hemorrhage by J. Bienstock et al:
https://www.nejm.org/doi/10.1056/NEJMra1513247  

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 returns next Monday with a fantastic array of topics that we're sure will make exam prep easier, and will keep your practice up to date. We'll also be joined by more wonderful guests this season and we can't wait to share their expertise with you all.

Lahiru Amaratunge's Viva Boot Camp - Anaesthesia Collective link:
https://www.anaesthesiacollective.com/viva-boot-camp/ 

Lahiru Amaratunge's Viva Boot Camp Online Course:
https://anaesthesia.thinkific.com/courses/FinalExam 
Use code: deepbreaths50 at the checkout for 50% off the price of the course. There are only 100 of these discounts available so don't miss out!

Feel free to email us at [email protected] with any questions, comments or suggestions. 

Happy studying, thanks for listening, and we'll see you on Monday February 7th!

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!

Best wishes to all of our trainees and IMGs sitting the part 2 anaesthetic vivas this week!

Deep Breaths returns on Monday February 7th with a brand new release schedule - we'll be dropping episodes every fortnight with small breaks for the June/July school holidays and the December/January holiday season. Episodes will be released more consistently throughout the year and we hope this gives a better listener experience.

Season 4 will bring all new topics designed to keep you up to date in your practice and to help study for the ANZCA part 2 anaesthetic exam. We're excited to introduce some new guests to help us unpack some interesting new content, and we're also thrilled to speak to some anaesthetists whose voices feature in previous seasons too, so be sure to tune in next year.

Feel free to email us at [email protected] with any questions, comments or suggestions. 

So until next season, happy studying and thanks for listening. 

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're doing something a little different since the ANZCA final viva exam is just days away.

Having a calm mind and knowing that there are so many people out there who believe in you and want you to succeed is immensely helpful for the day of your exam. So instead of throwing knowledge at you, we wanted to share some positive messages to help get your head in the right space for exam day. We have messages from anaesthetists you've both heard in previous episodes, and also from some who just want you to know that you can do this.

Though we can't be there on the day to cheer you on, we want you to all know that we're thinking of you and that we wish you all the best.

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

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, we're doing a re-release of our second most popular episode to date. Special guest, Dr Lahiru Amaratunge, dives into the induction techniques for five different critical cases. The cases discussed are very relevant to the upcoming viva exam and we hope that listening to them will help boost your knowledge and confidence.

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

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!