Ilya Kantsedikas

@jjibber717 @Anaes_Journal Perhaps precalculated boluses of more CVS-stable induction agents (e.g. fentanyl, ketamine, rocuronium +/- midazolam instead of remifentanil and propofol) would achieve both CVS stability and speed of induction but ketamine end point is less clear than eg propofol. 4/n

@jjibber717 @Anaes_Journal Titrated induction would reduce the chance of haemodynamic instability but would not produce the rapid intubating conditions this PFD refers to as necessary to reduce the chances of aspiration. Not quite answer here then. 3/n

Target-controlled infusions have been criticised as too slow for RSI, due primarily to the maximum infusion rate of most pumps (~1200 ml/h). Effect-site concentrations at time-to-peak effect were nearly identical between target-controlled and manual infusions. #anaesthesia #MedTwitter doi.org/10.1111/anae.7…

@DrRJWebb They are quite open about what the blood tests are: TRAIL, IP-10 and CRP. The machine learning bit is a bit more opaque. me-med.com/memed-bv/

What is this blood test, and please tell me we’re not bleeding every febrile child who attends ED? This just reinforces over reliance on healthcare, when the majority could/should be looked after at home if health education was better.

@APAGBI @AlderHey Will there be a recording by any chance?

@AlderHey Little Lectures #pedasanes #anaesthesia Next session Monday 18th of March 2024 18:30 - 20:30 Navigating complex cases without: ... Propofol ❄️ … Sevoflurane 💤 apagbi.org.uk/sites/default/… #free #cpd

@LeylsTurk The sky was exceptionally beutiful tonight

Beauty is everywhere. Look up.

Look! A breach in the space-time continuum!

@SAS_gas_Thomas @morefluids I think if care deficiency contributed to AAGA then consent for it does not absolve the clinician who made the error of responsibility (MPS had an example where a pain procedure led to disability and while this was on the consent form, care was found deficient and indefensible).

Accidental awareness under general anaesthesia (AAGA) - how many of you routinely consent for it? #TeamAnaesthesia

@doctimcook @morefluids @SAS_gas_Thomas Our colleagues from Bristol looked into whether parents want to hear about serious complications of paediatric GA and a large number do not FWIW. (Poster from APAGBI ASM this year). Different population to adult GA of course.

@morefluids @SAS_gas_Thomas Difficult to imagine many patients wouldn’t consider -awareness -anaphylaxis -paralysis with regional -death ‘relevant complications’ so post Montgomery these need to be discussed routinely. We provide the info in information sheets before admission. Discuss on day as needed.

@JBC13Mar1967_ @sally_ghazali @TaraRampal @MedicalMidlands The term is a bit of a misnomer

@sally_ghazali @TaraRampal @MedicalMidlands Why would there be "High HRR" in cardiac disease, if HRR is heart rate reserve?

CPET pattern recognition- a guide as per @TaraRampal #CCPOM2023

🗣️Opening Plenary #ESOTcongress 🇬🇷 Defining Moment for Transplantation❕ Congratulations to all the international #LDLT_registry participating centres for an outstanding patient recruitment kick-off 📈❕ 🌐 Centre recruitment will remain open @LDLTregistry.org

@HenleywRegatta I am afraid the livestream is still down. Can you have a look please? Just missed my Club’s time trial

@michaelblyth @DrJSherrington Still beats valproate any day

@issywalker @KatPaton13 Sources of support (shamelessly stolen from my Trust’s strike WhatsApp group)

@KatPaton13 I'm an F1 on 80% LTFT. 4 days is a weeks work for me and amounts to 1/4 of my monthly pay. After bills, tax, etc - that amount is the amount I have left over for things such as food/heating as I'm on the equivalent of even less than £14/hr. Not sure what to think of this one.

I genuinely don't think I can afford to strike again. If I'm on a supernumerary job and I turn up to work, can they relocate me?

@I_of_the_raven @SageSussex @MrAhmadKMalik Could you kindly enlighten me what religious exemptions these are? The only one I can think of is Jehovah’s Witnesses who will have no blood (and for most no blood products). If a JW child needed a life saving blood transfusion the same thing would happen as here.

@SageSussex @MrAhmadKMalik Why couldn't they use the blood they wanted? People with religious exemptions do it all the time.

Welcome to the new medical dark age

It is very common that new trainees ask us why we write Orthotopic Heart Transplant in the problem list, which sounds redundant to them. I was one of them, too. Well, the reason we do so is because there are 2 ways to do a heart transplant...

@RossKerridge1 @fuzzymittens If a problem happens after discharge there is a route back in (call maternity assessment unit/triage/similar) and an anaesthetist will review. Midwives are pretty proactive about flagging up anyone with a neuro deficit (including those who didn’t have anaesthetic intervention)2/2

@RossKerridge1 @fuzzymittens Always (how many remember it is a different question altogether, mine is an unusual name and someone in a lot of pain may well have other things on their mind). Every department I worked in had day 1 or 2 post-birth follow up. 1/2

I agree that some of what we do can be harmful and non-intervention can be the better option, but I am really uncomfortable with the idea of tying this up with the issue of NHS resources. If anything helping people make better choices may need more resources (eg clinician time).