Pete Williamson

@traumagasdoc @ndavis120 @britishmuseum I have my uses!

@ndavis120 @britishmuseum It was the best advice my friend @pbw009 gave me when I was about to buy something smaller - he made me buy it.

Doing culture this evening, @britishmuseum’s Pompeii show screening right now on YouTube.

@Oesophagusuk @strachanjamie @amateursuman Not possible anymore. I CCT’d at 33 (18yr old +ICSM6 +FY2 +ST7) having gone straight through +1yr for intercalated BSc, so you could do it at 32.

@strachanjamie @amateursuman @pbw009 ??? Did you make consultant under 30. I know you were the youngest at Imperial ??

Does anyone know of a consultant anaesthetist aged under 30? Technically possible (or was I think) but I don’t know if any exist!?

@traumagasdoc @loki1706

@loki1706 It was @pbw009 who did it. Basically just two questions, does the consultant provide a supportive environment and achieve educational aims. Pete can tell you exactly.

@traumagasdoc @loki1706

@traumagasdoc @loki1706 Two ratings only (because large number of consultants - impractical to do more domains)

@paul_barlow @traumagasdoc Nope

@pbw009 @traumagasdoc What? He didn’t take a bottle on himself? #franklyastonished

Discussing with my friend @pbw009 how an anaesthetic consultant job is like Bake-off. You have your signature (your normal list), techincal challenge (on-call etc) and your showstopper (your specialist list, your “thing”). #gbbo

@paul_barlow @traumagasdoc Actually no - the server was immune to @traumagasdoc ‘s charms (much to his annoyance)

@traumagasdoc @pbw009 So, wine on the train then.

@traumagasdoc @Davidmarkpye @ajwicko @ImperialNHS @Imperial_EM @SyedSadie @CSC16 @willtube4food Was replying to Wickham

@pbw009 @Davidmarkpye @ajwicko @ImperialNHS @Imperial_EM @SyedSadie @CSC16 @willtube4food Definitely not you mean? ;)

#Anaesthetic trainee at ST5+ level from Feb ‘19? Interested in #trauma? Fancy gaining experience at @ImperialNHS MTC? Apply here: jobs.nhs.uk/xi/vacancy/d7d… More about us at smh-gas.org.uk

@traumagasdoc @Davidmarkpye @ajwicko @ImperialNHS @Imperial_EM @SyedSadie @CSC16 @willtube4food Definitely!

@Davidmarkpye @ajwicko @ImperialNHS @Imperial_EM @SyedSadie @pbw009 @CSC16 @willtube4food Does it say that?? We don’t need specialist register - promise

@escoces71 Yes! Typo during a PowerPoint avalanche...

Perhaps you mean hysterotomy? No need for hysterectomy if all you need to do is deliver the baby.

“I only have one coronary stent doc” 1) you have the risk factors to need one 2) you have coronary endothelial damage 3) you are having surgery, which is pro-thrombotic 4) you are on anticoagulants #ANES18

Physiological reserve = biggest physiological insult the patient can survive minus baseline function Frailty = loss of physiological reserve across multiple body systems (cannot be quantified by one test) Elderly trauma patients have low reserve and high frailty #ANES18

"Words have power" - Terry Pratchett Perimortem section = sounds like you are killing the mother to save the baby, people think twice Resuscitative hysterectomy = procedure necessary to save the mother and baby, people perform it Same thing though #ANES18

Performing a blood patch on someone who turns out not to have a PDPH can precipitate seizures and delirium - something to think about if you’d asked to do one at 03:00 on the postnatal ward #ANES18

Published report - but I’m not a PowerPoint Paparazzi so I missed the reference...

Lowest intra op BP which is sustained for >3min is what seems to predict cardiac risk #ANES18

There is no such thing as the "straightforward post-op surgical in-patient". If there were simple, they would be been a day case. The entire hospital population has been pre-selected as high risk #ANES18

"Standard ward care" (4-6hrly observations) misses 90% of significant desaturations and 70% of significant episodes of hypotension #ANES18

We all remember "that case" when the surgeon quietly cuts through the IVC without mentioning it, but in reality in 33% of cases the lowest sustained BP occurs before KTS - cycle NIBP frequently after induction #ANES18

Risk prediction for cardiac events: Scoring systems: everyone ends up as "intermediate risk" Ex tolerance: patients lie Stress echo: no evidence CT coronaries: only useful if it’s clear, which rarely happens BNP: probably the best #ANES18