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Posted in: ATOTW > Obstetric Anaesthesia 2018 Language: english

Failed tracheal intubation is more common in the obstetric population despite widespread adoption of failed intubation drills and equipment advances. This tutorial provides a practical approach to safe obstetric airway management and the actions to take when problems arise including measures to maintain oxygenation and appropriate decision making.

Posted in: ATOTW > Paediatric Anaesthesia 2018 Language: english

There are numerous clinical indications and benefits of using propofol-based total intravenous anaesthesia (TIVA) in children. While many aspects of TIVA can be translated from adults to children, there are some important considerations and limitations that anaesthetists should be aware of. This tutorial will discuss a practical approach to providing propofol-based TIVA for children.

Posted in: ATOTW > General Topics 2018 Language: english

The tutorial covers anatomy and physiology of the pancreas and the pathophysiology and perioperative management of patients with pancreatic adenocarcinoma and neuroendocrine tumours. Risk stratification, management of preoperative anaemia and role of enhanced recovery programme for Whipple’s procedure are discussed.

Posted in: ATOTW > General Topics 2018 Language: english

This tutorial discusses the importance of blood conservation techniques and the strategies to achieve this during the pre-operative, intra-operative and post-operative period of patient journey.

Posted in: ATOTW > General Topics 2018 Language: english

Anaemia is a common, modifiable risk factor contributing to post-operative morbidity and mortality. A complex range of aetiologies can often co-exist in an individual patient, leading to confusing and conflicting results. This tutorial discusses screening, diagnosis, and management of pre-operative anaemia.

Posted in: ATOTW > Obstetric Anaesthesia 2018 Language: english

Accidental Awareness during General Anaesthesia (AAGA) has been demonstrated to be more common in obstetric practice than in any other area of anaesthesia. Factors contributing to this increased risk include maternal stress or anxiety, emergency surgery and the “intravenous-inhalational” interval. This tutorial describes some strategies for managing this increased risk.

Posted in: ATOTW > Obstetric Anaesthesia 2018 Language: english

The management of the pregnant woman with a history of addiction or substance abuse can be challenging. This tutorial focuses on the pathophysiological effects of drug addiction, providing safe perioperative care and achieving effective analgesia both during labour and post-caesarean section.

Posted in: ATOTW > General Topics 2018 Language: english

Trans-Oral Robotic Surgery (TORS) is used for minimally invasive procedure for head and neck surgery. Potentially difficult airway and stimulating nature of the procedure requires a specific anaesthetic technique. Opioid based multi-modal analgesia is required for possible severe post-operative pain. This tutorial presents anaesthesia management for TORS.

Posted in: ATOTW > General Topics 2018 Language: english

The tutorial describes post-operative cognitive disorders and the implications on anaesthesia practice. An understanding of post-operative delirium and use of preventative strategies can improve morbidity and mortality in this vulnerable patient group.

Posted in: ATOTW > Regional Anaesthesia 2018 Language: english

This tutorial is a practical guide to ultrasound guided supraclavicular brachial plexus block. Relevant anatomy and indications for the block are described in detail. It also contains useful advice on which local anaesthetic to use, relevant doses, potential complications and side effects.

Posted in: ATOTW > Obstetric Anaesthesia 2018 Language: english

The Maternal Early Warning Score (MEWS) is a system designed to help early detection of sick mothers and potentially allows the opportunity to intervene and prevent deterioration. This tutorial discusses the application of MEWS and the evidence behind its use.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: english

Ventilator-associated pneumonia is a significant cause of morbidity and mortality in critically unwell patients who undergo invasive mechanical ventilation via an endotracheal tube or tracheostomy. Throughout this article we will discuss the incidence, scoring systems, pathophysiology, prevention, risk factors, diagnosis and treatment of this condition.

Posted in: ATOTW > General Topics 2018 Language: english

A review of the evidence and utility of ketamine. This includes discussion of its role as an anaesthetic and analgesic drug for use in the pre-hospital environment, emergency department, operating theatre and critical care unit.

Posted in: ATOTW > Obstetric Anaesthesia 2018 Language: english

Intraoperative cell salvage in obstetrics is a safe adjunct or alternative treatment to allogenic blood transfusions during a postpartum hemorrhage. This tutorial will describe how the cell salvage circuit works and review the indications, contraindications, advantages, disadvantages and risks of intraoperative cell salvage in obstetrics.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: english

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery as an effective multimodality treatment option for selected patients with peritoneal surface malignancies. This tutorial discusses the anaesthetic considerations and physiological impacts of the procedure.

Posted in: ATOTW > Patient Safety 2018 Language: english

This case report describes a number of risk factors that are associated with potential deformation or fracture of spinal needles during subarachnoid anaesthesia, followed by some practical tips on how to avoid this complication and how to deal with it if it occurs.

Posted in: ATOTW > General Topics & Intensive Care Medicine 2018 Language: english

This tutorial aims to provide the reader with a framework for approaching the complex physiologic changes and challenges of liver transplant anesthesiology. After reading this article the reader should be able to understand the common perioperative issues surrounding the patient with liver failure and recognize that outcomes are dependent on a multidisciplinary approach to management.

Posted in: ATOTW > Regional Anaesthesia & Pain 2018 Language: english

This tutorial covers ultrasound-guided paravertebral nerve block. It discusses the basic anatomy, indications and complications associated with this peripheral regional anaesthesia. The article goes into detail the preparation required to carry out this block and discusses 3 common ultrasound-guided approaches that can be utilized.

Posted in: ATOTW > General Topics 2018 Language: english

This article highlights factors that make patients at high risk of perioperative myocardial ischaemia. It also discusses evidence for anaesthetic technique for this high-risk group and the management of intra-operative myocardial ischaemia.

Posted in: ATOTW > Patient Safety 2018 Language: english

This tutorial is based on learning from incidents reported to the National Health Service England and Wales National Reporting and Learning System, and covers infusion safety, preoperative assessment and bone cement implantation syndrome.

Posted in: ATOTW > Cardiothoracic Anaesthesia 2018 Language: english

This tutorial describes the conduct of Deep Hypothermic Circulatory Arrest and its relevance to the anaesthetist, using the latest available evidence. The concept of therapeutic hypothermia, options for intraoperative monitoring and the different neuroprotective strategies are discussed.

The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients.

Posted in: Guidelines & Standards > Patient Safety 2018 Language: english

The aim of these guidelines is to provide a comprehensive range of evidence-based recommendations for interventions to be applied during the pre-, intra- and postoperative periods for the prevention of SSI, while also considering aspects related to resource availability and values and preferences.

Angela Enright, MB, FRCPC, Kate Grady, BSc, MB, BS, FRCA, FFPMRCA, FRCOG, Faye Evans, MD Journal of Obstetrics and Gynaecology Canada (Oct 2015)

Posted in: ATOTW > Intensive Care Medicine 2018 Language: english

Liberation from mechanical ventilation and the artificial airway support in the intensive care unit is difficult and challenging. Success hinges on the perfect blend of art and science. An algorithmic evidence based approach along with a very strong clinical acumen is possibly the best recipe for success. This tutorial attempts to summarise the currently accepted guidelines in this area.

About the Library

WFSA's virtual library is a resource hub made up of our own publications and other open source material that we recommend for anaesthesia providers around the world. It contains a variety of media and can be searched according to keyword, publication and specialist category ensuring that the user finds the most relevant resource for their needs.

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The WFSA Virtual Library is for use by qualified anaesthesia providers and those pursuing a qualification in anaesthesia. Its content is supplementary to more formal education and is offered for informational purposes only. Whilst the WFSA has taken every care to ensure that content is accurate we can not be held responsible for any loss, damage or inconvenience caused as a result of any error or inaccuracy within the library.

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