Rapid Sequence

Postoperative pulmonary complications and the supraglottic airway device

The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. This new study compares their use for elderly patients undergoing low risk surgery with a composite of postoperative pulmonary complications as the primary outcome. 

It is a fascinating trial for many reasons and we expect there will be much discussion amongst anaesthetists. Join Prof Mike Irwin and the authors to find out why they did it and a summary of the key clinical messages.

Postoperative mortality and complications in patients with and without pre-operative SARS-CoV-2 infection

Surgical decision-making after SARS-CoV-2 infection is influenced by the presence of comorbidity, infection severity and whether the surgical problem is time-sensitive.

This new paper utilised the OpenSAFELY database to look at practices and outcomes in England, and suggests that some patients can be safely operated within 2 weeks from infection. This podcast goes deeper into the associated issues and implications for clinicians, patients and hospitals. 

Patient characteristics, anaesthetic workload and techniques in the UK

Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3–4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient-level encounter data from all cases under the care of an anaesthetist.

For this podcast, Tanya Selak speaks with the authors about their work and explores some of the trends from these new data. 

Arguably the most important paper of 2023 so far and essential reading/listening for all!

Awake tracheal intubation and aerosol generation

This new paper from the AERATOR group examines the science around aerosol generation and awake tracheal intubation (ATI). Their study was performed on a single day during an ATI course on 12 anaesthetic trainees. They show that ATI without sedation generates high concentrations of respiratory aerosol. Professor Ross Hofmeyr talks to the authors about their study, its clinical implications and what the future holds for research in this area. 

Implementing human factors in anaesthesia - live at WSM 2023

We caught up with Dr Fiona Kelly, lead author of a new guideline from the Association of Anaesthetists and the Difficult Airway Society on human factors in anaesthesia. The guideline and narrative review were published and launched live at the Winter Scientific Meeting in London today and there are several actions that we can all take today to impact patient care. 

Time to place less reliance on individual and team excellence to deliver high-quality patient care? We think so. Both papers are free to access and worth reading in full for all.

The association between iron deficiency and outcomes - PREVENTT

Pre-operative anaemia is common in patients undergoing non-cardiac surgery and associated with an increased risk of blood transfusion, hospital length of stay and postoperative complications.

This podcast is all about a new secondary analysis of the PREVENTT study. We are delighted to be joined in Australia by three of the papers authors, Professor Toby Richards, Dr Anastazia Keegan and Professor Lachlan Miles.

The aim of their analysis was to determine whether specific iron deficiency phenotypes derived clinical benefits from intravenous iron before major abdominal surgery compared with placebo.

 

How to engage in social media to get your work published

Today, we were joined by three authors (Dr Alopi Patel, Dr Michelle Kars and Prof Ed Mariano) of a new paper which is all about how to use social media to get published. This forms part of a new series of articles called Reviewer Recommendations, which is very much a ‘how to’ guide for authors and readers. Enjoy!

Defining complexity in anaesthesia

Today we will be discussing this new paper which describes and validates a new anaesthetic complexity score, which is is a clinician-designed, real-world tested model of case complexity in anaesthetics. It is inclusive of, but distinct from, patient and surgical risk. 

The paper is of interest because of the methods used and also the potential implications for increasing efficiency and productivity in theatre. Joining us today we have authors Dr Elliott Ridgeon, Dr Katy Wilson and Dr Ahmed Elrefaey.

Position statement from the Editors of Anaesthesia on equity, diversity and inclusion

The Editors of Anaesthesia acknowledge the EDI problems we face in anaesthesia and medicine as a whole. Without taking action to address these problems, these issues will persist.

This newly published position statement is from the Editors of Anaesthesia, including the Editor-in-Chief.

For this podcast, the principal authors join Association of Anaesthetists CEO Nicky de Beer to discuss why and how the statement was written as well as its implications for the present and future.

Action guidance for addressing pollution from inhalational anaesthetics

Climate change is a real and accelerating existential danger. Urgent action is required to halt its progression, and everyone can contribute. Pollution mitigation represents an important opportunity for much needed leadership from the health community, addressing a threat that will directly and seriously impact the health and well-being of current and future generations.

Inhalational anaesthetics are a significant contributor to healthcare-related greenhouse gas emissions and minimising their climate impact represents a meaningful and achievable intervention. A challenge exists in translating well-established knowledge about inhalational anaesthetic pollution into practical action.

This new guideline is designed to provide a platform that engages health professionals as an active learning community, and invites sharing of success stories and evolving solutions across varied global practice settings.

For this podcast, @GongGasGirl interviews @jessahegedus about how they did it and why it is important.