Had to do a urinary catheter yesterday as the CEPOD anaesthetist

Took every fibre of my being not to write 'penis was intubated on a grade 1 view' in the notes

The classic new trust, new payroll dispute emergency tax code debate!

This cannot be an efficient way for the NHS to run in terms of person hours to fix.

Image of coffee beans, with the article type listed (Clinical Focus Review). The article title is Caffeine in the Perioperative Setting.

There are emerging roles for caffeine in the perioperative setting, and anesthesiologists should be familiar with the ways that caffeine may be able to improve postoperative recovery for adults. Read the new review by Bowers et al.: journals.lww.com/anesthesiolo...

Honestly I long for the days when regions have a centralised payroll system for rotating doctors.

The amount of wasted admin time spent getting these things right is astronomical!

Saw this excellent beastie yesterday

#catsky

I thought about this for a hot minute but I felt by moonlight wasn't the right time for my first go at an intra thecal catheter so I did a different level!

Another time perhaps and with the daylight hours 😇

It's really tricky as I feel the trough cortisol levels in both the epiduralist and epiduralee results in both increased complications and increased requests for neuraxial analgesia

Of course but holy moly the flow!!

Accidental dural puncture is a real humbling moment isn't it?

#Ansky

Waiting for exam results is painful

First commute needing to rummage for the winter cycling kit!!

Is this a thing?

When you're waiting to meet someone in public and all you see is their resemblance in other people walking past

Post exam feels are really something!
Periodically remembering questions and trying not to look up what the answer was!!

A high end bakery near me are selling a Chicago town pizza by the slice as if it's some all butter multilayered pastry goodness.

Friend I was a student for 8 years! I recognise that pizza anywhere.

Still have mine, it lives in my car as a backup of all my music from the pre-spotify era!

I feel it's from a time when things were built to last a bit longer

A satirical cartoon of a passenger on a plane saying the pilot has lost touch with regular passengers before adding: “who thinks I should fly the plane?” Everyone puts their hands up.

cartoon of the day

My partner and I caved and got a subscription to Planthood honestly it's excellent and really takes away a lot of the thought from cooking each week!

Hey #ansky any one got a good summary for apnoeic mass transfer oxygenation?

Yeah I've thought about this a lot but rarely seen it be an issue outside of people with very severe bronchospasm on ICU where their time constant of expiration is prooooolooonged!

That's unusual, were they talking about IPPV or using something like APRV mode?

This is a picture of ventilator waveforms on a volume controlled ventilator mode. The line represents flow of gas through the lungs over unit time and is used to assess adequacy of ventilation

Most definitely, I like the flow waveforms for this so I know that with each breath it goes back to the baseline.

Aiming for the top picture and to avoid the bottom!

When I was a student I got to see ECT.

The machine they used to deliver it was called the "thymotron 4000"

This got me with 240V straight to the humour cortex.

Not up to standard but the plastic pirate ship takes the biscuit

I have the say the BEST discovery in my FRCA journey has been my local public libraries

WiFi, warmth and a welcoming feel

I don't necessarily think this is a bad thing the devil is in the detail.

Before treating a problem having an assessment of its scale and distribution can be helpful. I think the use of the words 'league table' are problematic from this perspective.

Also depends on what metrics are used

Scrolling through bluesky makes you realise how other SoMe algorithms were designed to make us hate each other.

It's much nicer here, but also a stark reminder of how bad things can get if left unchecked

We're split where I am with 2% lidocaine buffered with NaHCo3 for speed

And some using 0.75% ropivacaine for top ups.

They truly are witchcraft tho 🧹🧹

Omg the nominative determinism of being asked to put on music by Simply Red during a PPH has just hit me 😂

Does this look at the incidence of PDPH after the dural puncture epidural?

Boiled eggs, hummus and pitta is some god tier post nights food 💯💯💯