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Posted in: ATOTW > Anaesthesia 2020 Language: english

Test your knowledge across the board of anaesthesia specialities with our ATOTW Quarterly quiz!

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

This article will briefly review mitochondrial biology, mitochondrial diseases and anaesthetic implications. This includes the preoperative assessment, intraoperative and postoperative management, and a review of the literature to assess the safety of commonly used intraoperative drugs.

Posted in: ATOTW > Intensive Care Medicine 2020 Language: english

Propofol infusion syndrome is a rare but potentially fatal condition associated with the use of propofol for longer term sedation in the critically ill patient. Prevention is the best form of management as there is no specific treatment other than the use of alternative sedation and supportive care. With propofol being one of the most widely used sedation agents in critical care, it is important that providers are aware of the prevention, diagnosis and management of this rare complication.

Posted in: ATOTW > COVID-19 2020 Language: english

In the face of an unprecedented pandemic, facemasks became part of our daily lives, and yet we know little about this seemingly low-tech piece of device. This tutorial reviews the composition of a facemask, the essential properties that offer protection to healthcare workers, as well as the various methods of extending its availability at times of limited supply.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Quadratus lumborum blocks (QLB) offer adjuvant analgesia for multiple surgeries including abdominal, orthopaedic, gynaecology and urology. QLB is a variation on a transversus abdominis plane (TAP) block which is performed with a USS using the curvilinear probe. There are 4 approaches to the QLB.

Posted in: ATOTW > COVID-19 & Obstetric Anaesthesia 2020 Language: english

The COVID-19 pandemic presents the potential to encounter pregnant patients with confirmed or suspected COVID-19. This tutorial covers the anaesthetic management of pregnant patients with COVID-19, including an overview of effects of COVID-19 on the mother and fetus, management considerations, labour analgesia and anaesthesia for caesarean section and obstetric procedures.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Test your knowledge across the board of anaesthesia specialities with the September 2020 ATOTW Quarterly quiz

Posted in: ATOTW > General Topics 2020 Language: english

As the march of ‘globesity’ continues, bariatric surgery is becoming common. This tutorial describes some of the unique challenges faced in the perioperative care of the bariatric surgery patient, including preoperative assessment and optimization with a focus on intraoperative airway management, monitoring and drug dosing and early post-operative care.

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

Paediatric Enhanced Recovery After Surgery (ERAS) has lagged significantly behind their adult surgical compatriots. This article will look at the arguments for and against paediatric ERAS, discuss the multidisciplinary approach to a patient-centred model, review the progress that has been made to date, and conclude with future aspirations for ERAS to improve paediatric surgical care worldwide and potentially become a new standard of care for paediatric surgery.

Posted in: ATOTW > Basic Sciences 2020 Language: english

From the X-ray machine in the rural clinic to the brachytherapy suite in the specialist cancer centre, sources of ionising radiation are ever more ubiquitous. This article explores the basic science of ionising radiation, the risks it poses to the anaesthetists and other healthcare providers and emphasizes on how such risks can be ameliorated.

Posted in: ATOTW > Basic Sciences 2020 Language: english

This tutorial explores the basic science and physiology of the endogenous hormone vasopressin, and the uses of vasopressin and its synthetic analogues in modern medical practice.

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

O uso da cirurgia laparoscópica atualmente é o padrão de terapia para muitos procedimentos abdominais e pélvicos em crianças de todas as idades. Oferece vantagens em comparação a procedimentos abertos em pacientes adultos e pediátricos, incluindo tempos de internação mais curtos, custos mais baixos, menos infecções e complicações (1.2). Os procedimentos aos quais a laparascopia pode ser aplicada incluem várias indicações abdominais, pélvicas e urológicas, como mostrado na Tabela 1. O manejo perioperatório dessas cirurgias apresenta desafios únicos ao anestesista, e os pacientes pediátricos em particular exigem considerações especiais quando comparados a adultos. Isso exige uma compreensão abrangente da fisiologia pediátrica e das nuances do procedimento cirúrgico. Após concluir este tutorial, o aprendiz entenderá o escopo de cirurgias laparoscópicas pediátricas, as alterações fisiológicas associadas e o manejo anestésico de tais casos.

Posted in: ATOTW > Regional Anaesthesia 2020 Language: english

Introduced by Blanco et al, serratus plane block is a novel form of ultrasound guided regional anaesthesia which can achieve complete paraesthesia of the hemithorax. In this tutorial, we will provide an overview of the serratus plane block, considering the anatomy, indications, sonoanatomy and technique.

Posted in: ATOTW > COVID-19 2020 Language: english

As the COVID-19 pandemic continues to place unprecedented demands on healthcare systems across the globe our understanding of how best to care for these patients continues to evolve and presents many fresh challenges. Here we present a systems-based, practical guide for the management of COVID-19 patients in intensive care.

Posted in: ATOTW > Pain 2020 Language: english

This tutorial covers basic physiology and the principles of pain management including assessment, pharmacologic and regional analgesia techniques in elderly patients.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Overview of traumatic rib fracture management including common mechanism of injury, associated complications and predictors of poorer outcomes. Appropriate work-up and clinical assessment including scoring systems used to guide ongoing management. Summary of key treatment modalities including pharmacological, non-pharmacologcial and regional anaesthetic techniques which may be appropriate.

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

Paediatric radiotherapy is an area of practice that possesses its own unique challenges. This tutorial details the various types of radiotherapy, in practical terms how they are delivered and the environmental and anaesthetic considerations that are required for safe anaesthetic practice.

Posted in: ATOTW > Regional Anaesthesia 2020 Language: english

Although nerve injuries associated with peripheral nerve blockade (PNB) are often temporary, the potential long-term consequences of nerve injury following PNB include sensory and motor deficits, neuropathic pain, and permanent disability, with an associated decrease in a patients’ quality of life. This article aims to explore the pathophysiology of nerve injury from PNB, suggest preventative strategies therein, and provide a common sense approach to their management.

Posted in: ATOTW > General Topics 2020 Language: english

COVID-19 has become a pandemic. Anaesthesiologists play significant role in patient care, infection control in the perioperative period and airway management. Caring for patients with COVID-19 requires multi-disciplinary effort. Disease transmission can be minimised when perioperative care is thoroughly planned.

Posted in: ATOTW > Intensive Care Medicine 2020 Language: english

Cocaine toxicity has a myriad of end organ complications, both in acute ingestion and chronic abuse. An appreciation for nuances of this presentation is required to provide excellent critical care.

Posted in: ATOTW > Pain 2020 Language: english

Opioids are a cornerstone of anaesthetic practice. This tutorial will discuss a common opioid side effect - Opioid-induced Hyperalgesia (OIH). OIH is a phenomenon for which we have an increasing appreciation. We will discuss its proposed mechanism, clinical relevance and, lastly, evidence on its management strategies.

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

This tutorial is a succinct guide to current practices in patient blood management for the pediatric population. It gives practical guidelines for bleeding concerns and management in the perioperative period and emphasizes care related to massive transfusion in the pediatric population.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Test your knowledge across the board of anaesthesia specialities with our ATOTW Quarterly quiz!

Posted in: ATOTW > Paediatric Anaesthesia 2020 Language: english

The tutorial will describe the anaesthetic management of paediatric patients undergoing laparoscopic surgery. The reader will be guided through the physiologic changes that occur during laparoscopy as well as appropriate perioperative management, from the pre-operative interview until discharge from the post-anaesthesia care unit.

Posted in: ATOTW > Anaesthesia 2020 Language: english

Between September 2017 and January 2019, WFSA conducted an online survey to evaluate the utility of ATOTW. We are delighted to present the survey report to demonstrate ATOTW’s impact and also highlight areas for improvement and expansion of this valuable resource.