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Posted in: ATOTW > General Topics 2017 Language: english

An airway fire can be defined as a fire that occurs within a patient’s airway or that which involves an in-situ airway device or contiguous breathing circuit. Though uncommon event since the discontinuation of older more flammable anaesthetic agents, they are nonetheless associated with potentially devastating patient morbidity and mortality. An awareness of its risk factors is important for anesthesia providers in order to minimize its occurrence and to provide prompt and effective treatment should it arise.

Posted in: ATOTW > Paediatric Anaesthesia 2017 Language: english

Prolonged fasting in children, especially infants can result in dehydration, hypoglycaemia, hypovolaemia, hypotension, and other metabolic complications. A lot of debate in the recent years has risen about the usefulness of prolonged periods of fasting. Ideally children should not be starved for longer than absolutely necessary. This article explores the new guidelines surrounding this issue.

Posted in: ATOTW > General Topics 2017 Language: english

Bone Cement Implantation Syndrome (BCIS) is a potentially fatal complication of orthopaedic surgery involving pressurised bone cement. This tutorial describes the clinical features and classification of BCIS, along with its incidence and proposed pathophysiological mechanisms. It also covers the prevention, recognition and management of BCIS, which is important for every anaesthesia provider.

This tutorial discusses the feasibility of neuraxial anesthesia in a parturient with scoliosis or previous spinal surgery with emphasis on the challenges, practical tips as well as alternative approaches to labor analgesia.

Posted in: ATOTW > Regional Anaesthesia 2017 Language: english

Ultrasound is a favourite tool of the anaesthetist, but is seldom used in neuraxial anaesthesia. This tutorial aims to enlighten the reader; show the evidence behind neuraxial ultrasound, and guide them through the process of performing ultrasound guided neuraxial blocks, so they may consider integrating it into their own practice.

Posted in: ATOTW > Cardiothoracic Anaesthesia 2017 Language: english

Minimally invasive aortic valve replacement using transcatheter techniques has become commonplace in health centre’s worldwide. As experience of the technique and valve technology rapidly progress anaesthesiologists are increasingly required to help facilitate safe care in hybrid operating theatres. This tutorial aims to provide a summary on the perioperative management of patients for this procedure.

Posted in: ATOTW > Pain & General Topics 2017 Language: english

Intrathecal opioids provide effective analgesia for a variety of surgical procedures. This tutorial provides an overview of the clinical indications, complications and recommendations on their safe and effective use.

Posted in: ATOTW > Regional Anaesthesia 2017 Language: english

PECS blocks are regional fascial blocks that block the pectoral and intercostal nerves and provides analgesia for breast surgery and other procedures involving the thoracic wall. This tutorial covers the anatomy, technique and tips for performing PECS blocks.

Posted in: ATOTW > Obstetric Anaesthesia 2017 Language: english

Management of pregnant women with haemoglobinopathies and thrombophilia disorders can be challenging. This tutorial provides an overview of clinical presentation and key elements of anaesthetic management of these patients.

Posted in: ATOTW > General Topics & Patient Safety 2016 Language: english

An update on learning from recent anaesthesia-related patient safety incidents reported in the UK. This tutorial covers three areas featured in these reports: complications of vascular access, local anaesthetic systemic toxicity, and anaphylaxis.

Posted in: ATOTW > Intensive Care Medicine & General Topics 2016 Language: english

Accurate risk prediction allows identification of high risk patients and improves decision making including allocation of critical care resources. This article below describes both surgery and patient specific risk stratification tools and their applicability and limitations.

The applications of remifentanil for anaesthesia and intensive care medicine are rapidly expanding. In this tutorial we discuss these applications and the properties of remifentanil that make it so versatile. Considerations for the safe use of remifentanil are also covered as well as the Minto model for target controlled infusions.

Posted in: ATOTW > Intensive Care Medicine 2016 Language: english

Heat stroke is a cause of significant morbidity and mortality worldwide. Rapid cooling and resuscitative treatments are the mainstays of treatment. This tutorial discusses the diagnosis, risk factors and the different cooling methods that are used in the management of heat stroke.

Posted in: ATOTW > General Topics 2016 Language: english

Air embolism is associated with significant morbidity and mortality. In this tutorial, we discuss the role of an anaesthetist in the prevention, monitoring and management of air embolism during the perioperative period.

Posted in: ATOTW > Paediatric Anaesthesia & General Topics 2016 Language: english

Typhoid intestinal perforation is a surgical emergency. The child presents acutely ill with fluid and electrolyte derangement and a full stomach. This tutorial covers the assessment, pre-anaesthetic optimization, intraoperative management and post-operative care of a child with typhoid intestinal perforation.

Posted in: ATOTW > Paediatric Anaesthesia 2016 Language: english

Typhoid enteric fever is a bacterial infection of the gastrointestinal tract common in the low resource setting and can be fatal if not treated promptly. This tutorial provides a comprehensive summary of the disease including epidemiology, pathophysiology, signs and symptoms, complications, diagnosis, medical management, and prevention.

This article is based on the Patient Safety Update published by the Safe Anaesthesia Liason Group (SALG), UK. It contains case reports associated with severe harm to patients. In this tutorial, we highlight learning points from incident reports of gastric aspiration, patient access and corneal abrasions.

Posted in: ATOTW > General Topics 2016 Language: english

This article outlines the management of the obstructed airway, including diagnosis, different airway management options and key lessons learnt from the 4th UK National audit project of major airway complications (NAP 4).

Posted in: ATOTW > General Topics 2016 Language: english

Deep brain stimulation is an increasingly common treatment for Parkinson’s disease and other disorders. The procedure involves placement of electrodes into appropriate brain locations for clinical testing and connection to an implanted stimulator. This tutorial will review current anaesthetic techniques and recommendations for insertion and management of deep brain stimulators.

Posted in: ATOTW > Paediatric Anaesthesia 2016 Language: english

In this week’s tutorial we focus on the use of epidurals in children, highlighting the important anatomical and physiological considerations. The tutorial discusses some of the newer developments in this area and the important post-operative management considerations.