Obstructive sleep apnoea is an ongoing challenge for anaesthetists. In this episode - another favourite - we discuss sleep apnoea in the context of anaesthesia with special guest, Dr Hamish Pollock. Reference for this episode: Perioperative considerations in the management of obstructive sleep apnoea by Holt, N. et al. 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 ...
Sep 24, 2023•27 min•Season 7Ep. 5
In today’s episode, we revisit one of our earliest and most topics - awareness. What it is, how it happens, and most importantly, how to prevent it. Resources for this episode include: National Audit Project 5 (NAP5) - https://www.nationalauditprojects.org.uk/NAP5home B-Aware trial - https://www.sciencedirect.com/science/article/pii/S0140673604163009?via%3Dihub B-Unaware trial - https://www.nejm.org/doi/full/10.1056/nejmoa0707361 BAG-RECALL trial - https://www.nejm.org/doi/full/10.1056/NEJMoa110...
Sep 10, 2023•19 min•Season 7Ep. 4
Bad Blood is a two-episode miniseries that takes a closer look at ROTEM. It's a favourite episode of ours and we hope you enjoy listening again too. References for part 2: Deranged Physiology - Interpretation of abnormal ROTEM data . ROTEM product information and interpretation instructions with case examples . NHS University Hospitals Sussex ROTEM interpretation flow diagram . ROTEM e-learning modules . Note: this website defaults to the German language. Google offers a translation service if y...
Aug 27, 2023•20 min•Season 7Ep. 3
Bad Blood is a two-episode miniseries that takes a closer look at ROTEM. It's a favourite episode of ours and we hope you enjoy listening again too. References for part 1: ROTEM e-learning modules . Note: this website defaults to German language, but can be changed. Alternatively, Google offers a translation service for the website. ROTEM product information and interpretation instructions with case examples . Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments ...
Aug 27, 2023•13 min•Season 7Ep. 2
Sweet Leaf looks at the ways in which medical marijuana impact the provision of safe and effective anaesthesia. This episode is one of our favourites, and is increasingly relevant to our clinical practice as we see more patients presenting for surgery in whom medical marijuana therapy is prescribed. 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 ...
Aug 13, 2023•22 min•Season 7Ep. 1
Deep Breaths returns next Monday August 14th with a selection of wonderful topics to help boost your exam prep, and to help keep you up to date. This season will be a little different though. We're taking a well-earned break (our first since Deep Breaths started in August 2020) and for season 7 we will be re-releasing seven of our favourite topics previously already released in earlier seasons. We'll be back with brand new episodes in season 8 next year - fully refreshed, rejuvenated, and ready ...
Aug 06, 2023•4 min
Today, we take a deep dive into the pros and cons of having the families of patients present in operating rooms beyond what is already in practice for paediatric anaesthesia and caesarean sections. Resources for today's episode: Could, Should Families Watch Their Loved One's Surgeries and, If So, When? By Quinonez, Z.A. et al. Note: ANZCA members can access this title via the ANZCA library. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We l...
Jun 11, 2023•21 min•Season 6Ep. 16
Today, we are joined by special guest Dr Shaun Roberts to discuss in-depth cases of patients with tricky cardiac conditions who require non-cardiac surgery. Resources for today's episode: ANZCA Blue Book 2021 ESC Guidelines on cardiovascular assessment and management of patients undergoing non cardiac surgery 2014 ACC/AHA guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Non-cardiac Surgery Feel free to email us at deepbreathspod@gmail.com if you have any...
May 28, 2023•1 hr 28 min•Season 6Ep. 15
Today's episode is the second and final of our obstetric cardiac disease series where we take a close look at a few case scenarios with special guest, Dr Michael Toon. Our third case takes a closer look at pulmonary hypertension in pregnancy and how this impacts the delivery and our anaesthetic options. We then end with a case in which a patient with congenital cardiac disease and a fontan circulation requires semi-urgent delivery. In our final two cases we take a close look at the pathophysiolo...
May 14, 2023•51 min•Season 6Ep. 14
Today's episode is the first of two where we take a close look at a few obstetric case scenarios that deal with major cardiac disease with special guest, Dr Michael Toon. Our first case explores a pregnancy and delivery in a patient with moderate to severe mitral stenoses. We then chase this with a case scenario revolving around a patient with a peripartum cardiomyopathy. In both cases we take a close look at the pathophysiological changes that occur with the disease process as well as its manag...
May 14, 2023•53 min•Season 6Ep. 13
Today, we finish our discussion about post obstetric nerve injury with an in-depth discussion about the different intrinsic obstetric nerve palsies that can occur as a result of the mechanisms of labour and delivery. We follow this with a chat about our approach to assessing patients with altered neurology post delivery and in whom a neuraxial anaesthetic has been performed. Resources for today's episode: Anaesthesia Cute of the Week (ATOTW): Peripartum Neurological Injury Anaesthesia Patient Sa...
Apr 30, 2023•18 min•Season 6Ep. 12
Today, we discuss post-delivery nerve injury in obstetric patients. In this first of two episodes, our discussion begins with revision of the classification of nerve injury severity, followed by a chat about the different clinical syndromes observed as a result of nerve injury during neuraxial anaesthesia. Resources for today's episode: Anaesthesia Tute of the Week (ATOTW): Peripartum Neurological Injury Anaesthesia Patient Safety Foundation (APSF): Postpartum Peripheral Nerve Injuries - What is...
Apr 30, 2023•18 min•Season 6Ep. 11
Today's episode is the second part in our discussion about anaesthesia for eye surgery with special guest, Dr Lahiru Amaratunge. We discuss two emergency eye surgeries and our options for managing these potentially challenging situations. Resources for today's episode: ABCs of anaesthesia ophthalmic anaesthesia youtube playlist (as mentioned by Dr Amaratunge during the episode): ABCs of anaesthesia specific videos: Subtenon's Block What I use for my eye block anaesthesia formula Useful articles:...
Apr 16, 2023•29 min•Season 6Ep. 10
Today's episode is the first of a 2-part series covering anaesthesia for eye surgery with special guest Dr Lahiru Amaratunge. Over the course of these two episodes, we'll hear Dr Amaratunge discussing a few different case scenarios in both elective and emergency surgery for eyes. Resources for today's episode: ABCs of anaesthesia ophthalmic anaesthesia youtube playlist (as mentioned by Dr Amaratunge during the episode): ABCs of anaesthesia specific videos: Subtenon's Block What I use for my eye ...
Apr 16, 2023•37 min•Season 6Ep. 9
Today, we take a close look at the Complex Regional Pain Syndrome (CRPS). We discuss the diagnostic criteria, pathophysiology and treatment of this condition, as well as taking a closer look at the role of opioids in the management of pain relating to CRPS. Resources for today's episode: Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 5th Edition by Harden, R.N et al. ANZCA Blue Book 2019 : The changing face of complex regional pain syndrome treatment by Russo, M.,...
Apr 02, 2023•22 min•Season 6Ep. 8
Today, we're taking a close look at one of ANZCA's latest professional documents - PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022. Resources for this episode: PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022 PG67 BP: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures Background Pape...
Mar 19, 2023•26 min•Season 6Ep. 7
Today, we're tackling the absolutely mammoth topic of hyponatremia after JAMA recently published a fantastic article about its diagnosis and management. Part 2's episode focuses on determining the cause of a patient's hypotonic hyponatremia. From here we also go on to discuss the pathophysiology of both the Syndrome of Inappropriate ADH secretion (or SIADH) and cerebral salt wasting before discussing the markedly different managements for these two conditions. Lastly, we talk through the princip...
Mar 05, 2023•30 min•Season 6Ep. 6
Today, we're tackling the absolutely mammoth topic of hyponatremia after JAMA recently published a fantastic article about its diagnosis and management. We start with a review of some relevant physiology before talking about the ways in which hyponatremia can present, and the approach to determining the underlying cause of the hyponatremia. In this episode, we specifically talk about determining whether the patient has either hypertonic, isotonic or hypotonic hyponatremia, as well as a discussio...
Mar 05, 2023•16 min•Season 6Ep. 5
Today, we share our fourth and final discussion in our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics: the research methodology for designing a clinical trial pilot trials bias and confounding ethics committees and the process of ethics approval Forest plots Resources for today's episode: Zedstatistics (youtube channel) - short videos explaining various concepts in statistics from an Australian Statistician Johns Hopkins Coursera Shor...
Feb 19, 2023•18 min•Season 6Ep. 4
Today, we share our third discussion in our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics: sensitivity and specificity positive predictive values (PPV) and negative predictive values (NPV) risk ratios odds ratios number needed to treat (NNT) and number needed to harm (NNH) And here are the calculations for Shannon's working example of sensitivity, specificity, PPV and NPV (looking at diagnostic tests for the covid-19 pandemic): Part ...
Feb 19, 2023•18 min•Season 6Ep. 3
Today, we share our second discussion in our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics: sample size, power and hypothesis testing type I and type II error (further discussion) levels of evidence and what this means the different types of clinical trials Resources for today's episode: Zedstatistics (youtube channel) - short videos explaining various concepts in statistics from an Australian Statistician Johns Hopkins Coursera Shor...
Feb 05, 2023•15 min•Season 6Ep. 2
Today, we're having our first discussion of our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics: types of data (quantitative vs qualitative) descriptive statistics (measures of central tendency and measures of variability) Central Limit Theorem hypothesis testing type I and type II error p-values parametric and non-parametric tests for data analysis Resources for today's episode: Zedstatistics (youtube channel) - short videos explainin...
Feb 05, 2023•18 min•Season 6Ep. 1
Deep Breaths returns next Monday February 6th with a wonderful selection of topics that we're sure will help with exam prep, 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, so be sure to tune in and experience the learning revolution! Lahiru Amaratunge's Viva Boot Camp (live Zoom course) - Anaesthesia Collective Link: https://www.anaesthesiacollective.com/viva-boot-camp/ Lahiru Amaratunge's...
Jan 29, 2023•3 min
Deep Breaths returns on Monday February 6th with our fortnightly release schedule that we hope you're all still enjoying. We hope you take the time over the holiday break to rest up and refill your energy stores before 2023 kicks off. Season 6 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're excited to introduce some new guest interviewees that are masters in their pract...
Nov 21, 2022•2 min
In today's episode, we discuss some recently published guidelines in the journal Anaesthesia regarding the provision of environmentally sustainable 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 session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the...
Nov 20, 2022•19 min•Season 5Ep. 14
Today, we continue our discussion about upper limb regional anaesthesia with special guest, Dr Michael Kerr. In part 2 of this series we discuss the supraclavicular and infraclavicular blocks, the axillary block and specific targeted nerve blocks within the forearm. We then go on to discuss the management of a suspected nerve injury. 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 li...
Nov 06, 2022•44 min•Season 5Ep. 13
Today, we have a fantastic and insightful discussion about upper limb regional anaesthesia with special guest, Dr Michael Kerr. In part 1 of this 2 part series, we focus on the interscalene block. 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...
Nov 06, 2022•28 min•Season 5Ep. 12
Today, we discuss several cases addressing one-lung ventilation with special guest, Dr Ivan Rapchuk. Case number 2 describes a 59 year old woman with non-small cell lung cancer of the left lung who is scheduled for a left pneumonectomy on your list later this afternoon. Her medical history includes hypertension, hyperlipidemia, type 2 diabetes and obesity with a BMI 32, weight of 85kg and a height of 1.63m. She previously smoked 10 cigarettes daily but quit when she was diagnosed with lung cance...
Oct 23, 2022•30 min•Season 5Ep. 11
Today, we discuss several cases addressing one-lung ventilation with special guest, Dr Ivan Rapchuk. Our first case is as follows: a 68 year old man is scheduled for an open right upper lobectomy on your list tomorrow for a T1N0 non small cell lung carcinoma. He is an active smoker with a 30 pack year history but has cut down his consumption from 20 cigarettes daily to 5. He has moderate emphysema but walks 2km daily on flat ground without issue. Other comorbidities include hypertension and hype...
Oct 23, 2022•30 min•Season 5Ep. 10
Today is the final episode of our airway series where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. Our first case - case number 6 - is one where you are called to the intensive care unit to the bedside of a 54 year old female patient who had a percutaneous tracheostomy placed earlier that day. She is now hypoxic with oxygen saturation of 82%. Case number 7 is a 58 year old female patient presenting for a panendoscopy after presenting with a hoars...
Oct 09, 2022•27 min•Season 5Ep. 9
