GA and block.
But if GA too high risk from Resp Compromise then spinal with small needle to minimise risk.
Consent including spinal heamatoma & consequences.
I also add in the Regional alert bracelet to pick up delayed resolution of block.
@coandaeffect.bsky.social
Consultant Anaesthetist. Obs, TIVA, QI & Patient Safety Ex-Academic (Biochem) European, Tea drinker, Left of Centre, Wannabe Photographer & Dog Mum
GA and block.
But if GA too high risk from Resp Compromise then spinal with small needle to minimise risk.
Consent including spinal heamatoma & consequences.
I also add in the Regional alert bracelet to pick up delayed resolution of block.
Long championed a max 10:1 pay ratio in companies and organisations so thrilled to see โฆโชthe High Pay Centreโฌโฉ and โฆโชEquality Trust fighting the good fight.
highpaycentre.org/high-pay-cen...
Weekend #MedSkyDebate is comingโฆ..
I am just getting it organised and waiting for contributions.
We are also going away for the weekend to see our son and daughter in law.
It is coming but may be a bit lateโฆ..
Patience Sky Peeps xx
Likely Monday #MedSkyDebate ๐ฅฐ
Growing evidence highlights significant maternal health disparities in the UK.
How do we achieve greater involvement of women from minority groups in health research?
#AnSky #MedSky #Equity #ObgynSky
doi.org/10.1111/anae...
As we celebrate 80 years since the first women were elected as Fellows of the Royal Society, Ruby Seger-Bernard, Schools Engagement Officer, and Isabelle Moss, Diversity and Inclusion Officer, reflect on the importance of inspiring girls and young women in science: royalsociety.org/blog/2025/09...
11.09.2025 14:34 โ ๐ 11 ๐ 2 ๐ฌ 1 ๐ 0Live this weekend!!
10.09.2025 13:33 โ ๐ 4 ๐ 2 ๐ฌ 0 ๐ 0But surely the phenomena wouldnโt be limited to those who are paralysed ๐คท๐ผโโ๏ธ
09.09.2025 07:10 โ ๐ 0 ๐ 0 ๐ฌ 0 ๐ 0But how would that work for any anaesthetic lasting longer than a couple of hours? That poor armโฆ..
09.09.2025 07:04 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0Given that responsiveness without recall cannot be measured at the time nor identified retrospectively with any certainty & we cannot define specific risk factors then we cannot act logically & safely to prevent it. It is essentially unavoidable with todayโs knowledge & therefore must be acceptable.
08.09.2025 22:02 โ ๐ 2 ๐ 0 ๐ฌ 1 ๐ 0But is responsiveness without recall avoidable? If itโs undetected & undetectable during an anaesthetic what could or should we do to avoid this possibility & at what cost? The risk is greater known harm. Deeper anaesthetic, more cvs instability, renal impact, more brain suppression, more pocd ๐คท๐ผโโ๏ธ
08.09.2025 21:55 โ ๐ 1 ๐ 0 ๐ฌ 1 ๐ 0Slightly diminish a book
Catch 21
Wolf Cupboard
The Handmaids Vignette
This is what we needโฆ I hope Labour are watching & start following the lead of the Green Party and not Reform.
Reform win when they can spread unrest, this is made easier when the majority of the country is disenchanted & angry at their situation. We need to improve conditions for everyone.
I think Starmer has the yips - now heโs there heโs too scared to do anything meaningful. Iโm hoping someone shakes him out of itโฆ.
08.09.2025 13:13 โ ๐ 2 ๐ 1 ๐ฌ 1 ๐ 0I have done this - itโs awful. The sad heartbreaking jobs will be over soon. Keep going
08.09.2025 13:11 โ ๐ 0 ๐ 0 ๐ฌ 0 ๐ 0Maybe & Iโll keep an eye on whatโs happening locallyโฆ.
07.09.2025 19:46 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0๐ Lots of people have said they joined the party following this interview!
๐ So in case you missed it: here's how we're going to lower people's bills, protect our NHS and fight off the far right.
youtu.be/1KsgxOrgbOA?...
I live in a Labour constituency, used to be strongly so. Not so much now. Recently the nastiness of reform has taken hold. I worry that a free vote in my area will open the door to Reform. However, a shift to PR would change that & I would vote green as they most accurately represent my views.
07.09.2025 18:58 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0Thisโฆ
07.09.2025 18:49 โ ๐ 2 ๐ 0 ๐ฌ 0 ๐ 0This is the coolest man in the UK.
It's not even close.
But what if the disabled person had a different skin colour & looked like a migrant?!?! ๐ฑ๐ฑ๐ฑ
๐๐คฆ๐ผโโ๏ธ
The sad state of the world - everyone angry at the wrong things
Was recently pointed to this powerful website about brilliant community projects that didn't make it, blocked one way or another by "officialdom".
We have to stop electing the wrong people and hoping they will do the right thing
storymaps.arcgis.com/stories/3659...
I usually say to patients that anaesthesia is like pressing pause on the recording part of their brainโฆ their brain will still be working in the background but they wonโt remember it. When they wake up the will start recording again from where they left off.
06.09.2025 22:46 โ ๐ 3 ๐ 0 ๐ฌ 1 ๐ 0I donโt think thereโs any way to reliably assess responsiveness without recall by patient or anaesthetist. Is it real? If so, is it harmful? If there is harm why are awake craniotomyโs or even โsedationโ on ITU acceptable.
Itโs not the same as implicit memory drugs change the brain chemistry.
Only Connect is on tonight! In ten minutes, in fact! Never let it be said I forget to plug the programme when itโs on.
On BBC Two, of course.
Professor Clare Burrage wins the Royal Society Rosalind Franklin Award and Lecture 2025 for her achievements in theoretical cosmology & her proposed project which aims to inspire and engage girls of all ages with physics. #RSMedals https://royalsociety.org/medals-and-prizes/rosalind-franklin-award/
31.08.2025 07:45 โ ๐ 24 ๐ 6 ๐ฌ 1 ๐ 0Essentially yes, the stylette didnโt give enough flexibility to allow the tube through the cords. Anatomy, airway distortion & oedema played a part.
31.08.2025 07:51 โ ๐ 5 ๐ 0 ๐ฌ 1 ๐ 0But user experience probably played a factor.
31.08.2025 07:47 โ ๐ 2 ๐ 0 ๐ฌ 0 ๐ 0Yes, I see your point. I think the ability to use an algorithm rather than just follow it comes with experience.
31.08.2025 07:46 โ ๐ 2 ๐ 1 ๐ฌ 1 ๐ 0It was HAVL not a mac VL.
31.08.2025 07:40 โ ๐ 2 ๐ 0 ๐ฌ 1 ๐ 0