5 years ago I complained that w HAVL “I can see but I can’t get the tube in”.
@doctimcook.bsky.social pointed out “that’s a prob w the operator, not the device”.
Having since learned HAVL I’ve used it routinely for 5 years w 100% FPS & never <G1 view.
28.03.2025 22:03 — 👍 2 🔁 1 💬 2 📌 1
Time to retire ‘no trace, wrong place’ @doctimcook.bsky.social
Many UOI do have ‘a trace’
It is all about sustained exhaled carbon dioxide @universalairway.org
28.03.2025 15:46 — 👍 4 🔁 6 💬 0 📌 0
"Hello My Name Is" badge
I agree
Even as someone who had previously worked in the NHS, I found the new roles, titles and acronyms confusing at first
which prompted me to get a #HelloMyNameIs badge!
Roles should be
a) clearly visible
b) clearly stated
28.03.2025 15:15 — 👍 3 🔁 1 💬 1 📌 0
Absolutely agree with this. I have a standard patter. “Hello I’m Dr Sullivan I’m a consultant anaesthetist. What do I call you?” I think it speaks to credibility. Do you want to be anaesthetised by “ Gav” or “Dr Sullivan” ?
28.03.2025 09:17 — 👍 0 🔁 1 💬 0 📌 0
“No trace = wrong place” should be retired & replaced by the requirement to exclude oesophageal intubation if ‘sustained exhaled CO2’ is not detected.
From @doctimcook.bsky.social, Andy Higgs & me.
🔑🔓Free full text in @bjajournals.bsky.social : kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F...
24.01.2025 17:19 — 👍 15 🔁 9 💬 1 📌 1
AIRWAY RESEARCHERS!!
We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES (the core outcome set)
A 15 min survey now & again in a month (Delphi)
RESEARCHERS please complete
Recruitment ends this week
Link
redcap03.gsttdms.co.uk/redcap/surve...
Pass it on!
Thanks
04.02.2025 19:36 — 👍 3 🔁 2 💬 0 📌 0
EVER HAD AN ANAESTHETIC?
What matters to PATIENTS?
We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES
A 15 min survey now & again in a month
Looking for PATIENTS
Recruitment ends this week
Link
redcap03.gsttdms.co.uk/redcap/surve...
Thanks. Pass it on!
04.02.2025 19:32 — 👍 8 🔁 5 💬 0 📌 0
AIRWAY RESEARCHERS!!
We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES (the core outcome set)
A 15 min survey now & again in a month (Delphi)
RESEARCHERS please complete
Recruitment ends this week
Link
redcap03.gsttdms.co.uk/redcap/surve...
Pass it on!
Thanks
04.02.2025 19:36 — 👍 3 🔁 2 💬 0 📌 0
EVER HAD AN ANAESTHETIC?
What matters to PATIENTS?
We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES
A 15 min survey now & again in a month
Looking for PATIENTS
Recruitment ends this week
Link
redcap03.gsttdms.co.uk/redcap/surve...
Thanks. Pass it on!
04.02.2025 19:32 — 👍 8 🔁 5 💬 0 📌 0
Frequency gambling vs severity gambling - from @doctimcook.bsky.social, Andy Higgs & me in @bjajournals.bsky.social
kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F...
24.01.2025 13:16 — 👍 6 🔁 2 💬 0 📌 0
Court gives us the go-ahead - Anaesthetists United
Court gives us the go-ahead
@AnaesUnited is challenging the expansion of & arguing for the need of a national scope of practice & regulation for Anaesthesia Associates
This is how the legal cases is going.
Big step take already.
anaesthetistsunited.com/court-gives-...
24.01.2025 14:01 — 👍 1 🔁 1 💬 0 📌 0
Where it started, where it going
A million of anything is….lots
Very proud
18.01.2025 18:47 — 👍 2 🔁 0 💬 1 📌 0
It’s clearly described in the paper….
09.01.2025 09:15 — 👍 0 🔁 0 💬 1 📌 0
Glad that your only regret…..you’re a lucky man
08.01.2025 16:51 — 👍 1 🔁 0 💬 0 📌 0
Tube removal (+ FM/SGA ventilation) is the default action to exclude OI, not only if OI can't be excluded with FB. Tube removal + vent also necessary if desat occurs or sustained exhaled CO2 can't be restored (even if removing tube dangerous or OI apparently excluded w alternative technique).
08.01.2025 08:34 — 👍 1 🔁 1 💬 1 📌 0
I would alter “Assume no sustained exhaled CO2 = OI unless proven otherwise (by repeat VL/FOB/US/ODD)”
to
“Assume no sustained exhaled CO2 = OI. Remove tube inks unsafe. If unsafe exclude OI (by repeat VL/ & one of FOB/US/ODD)”
Current wording misrepresents the guideline.
08.01.2025 16:49 — 👍 0 🔁 0 💬 2 📌 0
I would change “Assume no sustained exhaled CO2” to
“Assume lack of sustained exhaled CO2” (or “failure to meet the criteria for….”) to avoid any possibly of conflating with “NO trace”
(Gestalt notwithstanding!)
08.01.2025 16:46 — 👍 1 🔁 0 💬 0 📌 0
Specific to
RCoA
FICM
AoA
This response to a coronial report is very clear & very explicit
www.judiciary.uk/wp-content/u...
In the case of the RCoA the guidelines were supported by council. FICM sits within RCoA (I assume!)
08.01.2025 16:41 — 👍 1 🔁 0 💬 0 📌 0
Thanks Greg
PUMA (which I’m not involved with) is an international collaboration
It includes contributors from the 51st, 52nd & 53rd states of the USofEverywhere
08.01.2025 16:23 — 👍 0 🔁 0 💬 1 📌 0
For my Canadian colleagues, PUMA guidance was developed in collaboration with the Canadian Airway Focus Group.
05.01.2025 11:51 — 👍 3 🔁 2 💬 1 📌 0
Jan is a clever bloke.
Here the relevant papers wot he wrote
associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
08.01.2025 16:20 — 👍 0 🔁 0 💬 0 📌 0
a picture of an owl with the words say what written below it
ALT: a picture of an owl with the words say what written below it
If I hear chest rising, tube misting from trainees again, I might vaporise.
I say sustained exhaled C02 is the only accurate indicator according to @doctimcook.bsky.social
05.01.2025 11:52 — 👍 2 🔁 2 💬 2 📌 0
Summary
11/11
08.01.2025 16:13 — 👍 1 🔁 0 💬 0 📌 0
In 24/25 cases the type of hospital was reported.
Interestingly all were in theatre or specialist hospitals.
No deaths were reported from DGHs
10/n
08.01.2025 16:13 — 👍 0 🔁 0 💬 1 📌 0
OBE. Keynote Speaker. Founder, Clinical Human Factors Group - promoting human factors for safer healthcare. Professional pilot, fascinated by human performance in aviation. All views personal & my own. He/him
Consultant anaesthetist in Bath; Featherstone Professor 2024; human factors; airway management; #teatrolleytraining (point of care medical education); all views my own
NIHR Doctoral Fellow in Intensive Care Medicine
Anaesthetist and Intensivist in Training
Manchester, UK
Anaesthetist | Creator Vortex Approach | Co-founder Safe Airway Society | Director Universal Airway (PUMA) Guidelines | ANZCA/ASA/NZSA Airway SIG Executive Member
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Royal United Hospitals Bath, Dept of Anaesthesia. ACSA accredited. No medical advice provided.
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