Today is our third of a four episode series where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. The first case in today's episode - case 4 - is as follows: you are called to assist a colleague who has had 3 failed attempts at intubating a 64 year old female patient for a laparoscopic hemicolectomy. Bag-mask ventilation was difficult, although not impossible, and now your colleague is able to ventilate via an LMA, iGel #3. Case 5 consists of the fo...
Oct 09, 2022•23 min•Season 5Ep. 8
Today is our second of four episodes that will be released over a four-week period where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. Our second case is that of a 23 year old man that presents for a sub-mandibular abscess on a background history of five days of toothache. His only other medical history is that he has a BMI of 35. On clinical examination the patient is found to have mouth opening to 2cm limited by both pain and also some truisms o...
Sep 25, 2022•34 min•Season 5Ep. 7
Today is our first of four episodes that will be released over a four-week period where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. Our first case is that of a 44 year old female patient scheduled to have a total thyroidectomy for a multi nodular goitre with moderate retrosternal extension. She has never had a general anaesthetic before and her only other history is that she has a BMI of 40. Regarding airway examination, she is found to have a m...
Sep 25, 2022•23 min•Season 5Ep. 6
Today, we discuss the joint Difficult Airway Society, British Association of Endocrine and Thyroid Surgeons, and the British Association of Otorhinolaryngology Guidelines on managing neck haematomas after thyroid surgery. We start by revising the pathophysiology of post-thyroidectomy airway compromise before launching into a discussion about the 8 recommendations within the guidelines. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love h...
Sep 11, 2022•25 min•Season 5Ep. 7
In today's episode, we discuss the latest updates on sepsis, courtesy of the recently released International Guidelines for the Management of Sepsis and Septic Shock 2021. This is a long guideline, but we pick out the most relevant pieces to our practise in anaesthesia. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning s...
Aug 28, 2022•18 min•Season 5Ep. 6
Today, we tackle the peri-operative management of cardiac implantable devices after the recent publication of the British Heart Rhythm Society's guidelines in the journal, Anaesthesia. In part 2 of this 2 part series, we discuss the ten guidelines that illustrate how cardiac implantable electronic devices should be managed peri-operatively, followed by considerations that we as - anaesthetists - should have thought through prior to wheeling a patient with a CIED into theatre for induction and su...
Aug 14, 2022•19 min•Season 5Ep. 5
Today, we tackle the peri-operative management of cardiac implantable devices after the recent publication of the British Heart Rhythm Society's guidelines in the journal, Anaesthesia. In part 1 of this 2 part series, we start with a discussion about the different types of implantable cardiac devices that may be encountered in our practice. We explain how the NGB code illustrates the way that pacemakers are programmed, as well as what happens to some of these programs when a magnet is applied in...
Aug 14, 2022•15 min•Season 5Ep. 4
This week, we continue our discussion about receiving a poor outcome after the ANZCA part 2 exam with two special guests - Dr Raymond Casey and Dr Aaron MacDonald. In the second instalment of this topic, we talk to Aaron about his journey after sitting his exam for the first time. Both Raymond and Aaron then give some timely advice about how to manage the stress and emotions associated with dealing with adversity, and share some tips that ultimately helped them succeed. Aaron has kindly offered ...
Jul 31, 2022•24 min•Season 5Ep. 3
This week, we have a really open and candid discussion about receiving a poor outcome after the ANZCA part 2 exam with two special guests - Dr Raymond Casey and Dr Aaron MacDonald. In this the first of this 2-part topic, we start by talking about the work and life circumstances that both Raymond and Aaron found themselves in when preparing to sit their exam for the first time. We also talk to Raymond about everything that happened after the exam. Aaron has kindly offered to let trainees experien...
Jul 31, 2022•21 min•Season 5Ep. 2
Today, we discuss a topic recommended to us by Dr David Tragen of the Sunshine Coast University Hospital - the perioperative management of the direct oral anticoagulant medications or DOACs. We start with some basic revision of the mechanism of action of the DOACs and their indications before diving more closely into the recommendations for stopping and starting these medications around the time of surgery, and the implications for our anaesthetic. Feel free to email us at deepbreathspod@gmail.c...
Jul 17, 2022•30 min•Season 5Ep. 1
Deep Breaths returns next Monday with a fantastic array of topics that we're sure will make exam prep easier, and will keep your practice up to date. We'll also be joined by more wonderful guests this season and we can't wait to share their expertise with you all. Lahiru Amaratunge's Viva Boot Camp - Anaesthesia Collective link: https://www.anaesthesiacollective.com/viva-boot-camp/ Lahiru Amaratunge's Viva Boot Camp Online Course: https://anaesthesia.thinkific.com/courses/FinalExam Use code: dee...
Jul 10, 2022•3 min
Deep Breaths returns on Monday July 18th with our fortnightly release schedule that we hope you're all still enjoying. We hope you take the time over the June/July holiday break to recharge those batteries so that you're feeling good for the latter half of the year. Season 5 will see us tackle more new topics that we hope will keep you up to date in your practice, and to help our exam candidates prepare for the ANZCA part 2 anaesthetic exam. We've got some wonderful new guests we're excited to i...
Jun 13, 2022•2 min
Today, we join you live from the QEII Anaesthetic Conference, and this episode is a little different. We explore some of the evidence behind those little pearls that we've learned in anaesthesia and that we've shared with you all during previous episodes. Topics that we discuss include fatigue and how if affects performance, the mandibular protrusion test, and the use of dexmedetomidine in nerve blocks to name just a few. Feel free to email us at deepbreathspod@gmail.com if you have any question...
Jun 12, 2022•54 min•Season 4Ep. 12
In today's episode, we discuss c hallenges in the diagnosis and management of oesophageal intubation and anaesthetic crises in general. Recognising an oesophageal intubation may seem simple, but by looking at coroner's cases both here in Australia and in the UK, as well as cases in the NAP4, it can be far more complex. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you ...
May 29, 2022•28 min•Season 4Ep. 11
Today we discuss perioperative neurocognitive disorders - their definitions, potential pathophysiologies, diagnosis, and possible prevention & treatment strategies. Resources for this episode include: Acute peri-operative neurocognitive disorders: a narrative review Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery - 2018 Thanks for listening, and happy studying! Feel free to email us at deepbreathspod@gmail.com if you have any questions, commen...
May 15, 2022•18 min•Season 4Ep. 10
In today's episode, we interview special guest Dr Annabelle Harrocks to chat about all things allergy testing - who, why, when, what and how! Listen in for a great practical chat which covers everything you didn't know about an important service for patients who have experienced serious allergic reactions under anaesthesia. Thanks for listening, and happy studying! Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And ...
May 01, 2022•26 min•Season 4Ep. 9
In today's episode, we discuss the recently published PADDI trial (Perioperative Administration of Dexamethasone and Infection), and whether and how it will change our practice. Thanks for listening, and happy studying! NEJM article - the PADDI trial Introduction to multiplicity issues in clinical trials Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultan...
Apr 17, 2022•13 min•Season 4Ep. 8
Continuing on from episode 6, we continue our interview with Dr Michael Kerr to discuss regional anaesthesia for the lower limbs. In this episode, we cover popliteal sciatic blocks and adductor canal blocks in detail, ideas for learning/practising blocks in a resource-constrained environment, and tips for dealing with surgeons when discussing regional anaesthesia for your patients. Thanks for listening, and happy studying! Resources for this episode include: Reading list - Peripheral nerve block...
Apr 03, 2022•38 min•Season 4Ep. 7
In today's episode, we interview our guest Dr Michael Kerr to discuss regional anaesthesia for the lower limbs. In this episode, we cover the taxonomy of lower limb blocks, the indications for various types of blocks and discuss in detail the fascia iliaca block. Thanks for listening, and happy studying! Resources for this episode include: Reading list - Peripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International C...
Apr 03, 2022•38 min•Season 4Ep. 6
In today's episode we discuss a newly released consensus statement on the management of adult patients undergoing head & neck surgery with a free flap. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podc...
Mar 20, 2022•18 min•Season 4Ep. 5
In this episode, we're continuing our discussion about ROTEM or rotational thromboelastometry. We start by working through the interpretation of ROTEM results for specific clotting abnormalities before going on to talk about more complex coagulopathies seen in trauma patients and in the bleeding obstetric patient. Lastly, we discuss the limitations to ROTEM interpretation. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from y...
Mar 06, 2022•20 min•Season 4Ep. 4
Today, we're talking about ROTEM or rotational thromboelastometry. We start with a brief explanation of how ROTEM works, the parameters used to assess ROTEM temograms, and the different assays performed during a ROTEM test. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge ...
Mar 06, 2022•13 min•Season 4Ep. 3
In today's episode, we talk with Cecil Gray prizewinner Dr Anna Pietzsch about her preparation for the ANZCA part 2 exam. We pick her brain about the process she went through for deciding when to sit the exam, her study technique and structure, and exam day plan. She also shares with us some great advice, what she thought worked well in her own preparation, and things she wishes she'd known and changed in hindsight. Feel free to email us at deepbreathspod@gmail.com if you have any questions, com...
Feb 20, 2022•38 min•Season 4Ep. 2
Today, we're deep-diving into the very important topic of postpartum haemorrhage. We talk about the diagnostic criteria and classification of postpartum bleeds, the four main aetiologies of postpartum haemorrhage, and both the obstetric and anaesthetic approaches to managing these patients intra-operatively. In addition, we also share our own experiences and cases that have stayed with us. We also wish to emphasise for this episode, in general, while the administration of packed red cells is app...
Feb 06, 2022•26 min•Season 4Ep. 1
Deep Breaths returns next Monday with a fantastic array of topics that we're sure will make exam prep easier, and will keep your practice up to date. We'll also be joined by more wonderful guests this season and we can't wait to share their expertise with you all. Lahiru Amaratunge's Viva Boot Camp - Anaesthesia Collective link: https://www.anaesthesiacollective.com/viva-boot-camp/ Lahiru Amaratunge's Viva Boot Camp Online Course: https://anaesthesia.thinkific.com/courses/FinalExam Use code: dee...
Jan 30, 2022•3 min
Best wishes to all of our trainees and IMGs sitting the part 2 anaesthetic vivas this week! Deep Breaths returns on Monday February 7th with a brand new release schedule - we'll be dropping episodes every fortnight with small breaks for the June/July school holidays and the December/January holiday season. Episodes will be released more consistently throughout the year and we hope this gives a better listener experience. Season 4 will bring all new topics designed to keep you up to date in your ...
Oct 18, 2021•2 min
Today we're doing something a little different since the ANZCA final viva exam is just days away. Having a calm mind and knowing that there are so many people out there who believe in you and want you to succeed is immensely helpful for the day of your exam. So instead of throwing knowledge at you, we wanted to share some positive messages to help get your head in the right space for exam day. We have messages from anaesthetists you've both heard in previous episodes, and also from some who just...
Oct 17, 2021•12 min•Season 3Ep. 16
Today, we're doing a re-release of our second most popular episode to date. Special guest, Dr Lahiru Amaratunge, dives into the induction techniques for five different critical cases. The cases discussed are very relevant to the upcoming viva exam and we hope that listening to them will help boost your knowledge and confidence. If you have any questions, comments or suggestions, feel free to email us at deepbreathspod@gmail.com . We love hearing from you! Thanks for listening, and happy studying...
Oct 10, 2021•31 min•Season 3Ep. 15
In today's episode, we continue our discussion regarding anaesthesia for the obese patient, based on the latest evidence from the BJA. Today's episode covers the conduct of anaesthesia for obese patients, as well as how to assess the obese patient's suitability for day surgery. Resources for today's episode include: BJA Education - Anaesthesia for the obese patient Ohio Sleep Medicine Institute STOP-BANG questionnaire Australian Diabetes Society 2012 Perioperative Diabetes Management Guidelines ...
Oct 03, 2021•20 min•Season 3Ep. 14
In today's episode, we discuss anaesthesia for the obese patient, including the latest evidence from the BJA. Today's episode covers the categorisation of obesity, the potential co-morbidities associated with obesity that can affect anaesthesia, and the metabolic syndrome. Resources for today's episode include: BJA Education - Anaesthesia for the obese patient Ohio Sleep Medicine Institute STOP-BANG questionnaire Australian Diabetes Society 2012 Perioperative Diabetes Management Guidelines Perio...
Oct 03, 2021•19 min•Season 3Ep. 13
