Today, we discuss the rise of GLP-1 receptor agonists - what they are, how they work, and how they affect fasting during the perioperative period.  Resources for today's episode: StatPearls: Physiology, Gastrointestinal Hormonal Control by Parikh, A. & Thevenin, C. https://www.ncbi.nlm.nih.gov/books/NBK537284/ StatPearls: Glucagon-like Peptide-1 Receptor Agonists by Collins, L. & Costello, R. https://www.ncbi.nlm.nih.gov/books/NBK551568/  ANZCA PG07(A)...

It's taken almost a year, but we're finally giving you part 2 of our series on complex and uncommon cardiac conditions for non-cardiac surgery with special guest, Dr Shaun Roberts. Hold on to your earphones - this episode is a long one! If you haven't listened to part one, you can find it within season 6 - be sure to check it out before you listen to part 2. Today, we discuss anaesthesia for patient's with ventricular assist devices (or VADs), and we talk about providing anaesthetic care for...

Today, we take a close look at the SNACC guidelines for the diagnosis and treatment of neuroanaesthetic emergencies, and take a little time to discuss each of these emergencies in turn. Resources for the episode: Cognitive aids for the diagnosis and treatment of neuroanaesthetic emergencies: Consensus guidelines on behalf of the Society for Neuroscience in Anaesthesiology and Critical Care (SNACC) education committee by Hoefnagel, A.L. et al. (full journal article) SNACC cognitive aids for...

Today, in part two of our two part series looking at perioperative hypotension and acute kidney injury (AKI), we take a closer look at the methods we can adopt - as anaesthetists - to try to prevent perioperative AKI and the evidence of their effectiveness in preventing this complication. Resources for today's episode: BJA: Role of perioperative hypotension in postoperative acute kidney injury: a narrative review (sciencedirectassets.com) by Lankadeva, Y. et al. KDIGO 2012 Acute Kidney...

Today, in part one of our two part series looking at perioperative hypotension and acute kidney injury (AKI), we take a close look at the diagnostic criteria for acute kidney injury. We then briefly revise aspects of renal physiology that make the kidney particularly susceptible to hypoxic injury, as well as looking at risk factors and other facets of anaesthesia that additionally predispose the kidney to perioperative injury. In part two - which will be released in a fortnight - we will...

Today we continue our discussion regarding preoperative functional capacity assessment. We'll cover the M-DASI, the 6-minute walk test, and put it all together to figure out how this applies to our practice as anaesthetists. Resources for today's episode include: BJAED: Subjective methods for preoperative assessment of functional capacity by Silvapulle & Darvall BJA: A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis...

Today, in part one of our two part series, we're taking a close look at the methods for performing pre-operative functional capacity assessments and their utility in predicting patient outcomes. In part 1, we focus our discussion on METS, activities of daily living (ADLs) and the DASI score. In part two - which will be released in a fortnight - we'll cover the M-DASI, the 6-minute walk test. Resources for today's episode: BJAED: Subjective methods for preoperative assessment of functional...

Deep Breaths returns next Monday February 5th with all new episode 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! Links for Lahiru Amaratunge's ANZCA Part 2 exam programs: Viva Boot Camp Courses (via Anaesthesia Collective) Online Part 2 Preparation Courses and ABCs of...

Part 2 of our two-part series looking at common problems encountered in the post-anaesthetic care unit. We hope you enjoy another of our favourite topics.  Feel free to email us at [email protected] 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...

This two part series looks at some common problems we encounter in the post-anaesthetic care unit (PACU). It's another of our favourite topics and well worth the review.  Feel free to email us at [email protected] 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...

The final episode on our two-part series on cases in paediatric anaesthesia with special guest, Dr Paul Lee-Archer. Another of our favourites, we hope you enjoy it as much as we did. Resources for today's episode: Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatmentby Nair, S. & Wolf, A. Paediatric massive transfusion by Blain, S. & Paterson, N. Dilemmas in the preoperative assessment of children by Bhatia, N. & Barber, N.  Feel free to...

Our two-part series on paediatrics in which we discuss previous anaesthetic viva scenarios with special guest, Dr Paul Lee-Archer, is another favourite of ours.  Resources for today's episode: Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatment by Nair, S. & Wolf, A. Paediatric massive transfusion by Blain, S. & Paterson, N. Dilemmas in the preoperative assessment of children by Bhatia, N. & Barber, N.  Feel free to email us at...

Our second and final episode in our two-part series looking at cases involving one-lung ventilation with special guest, Dr Ivan Rapchuk. This series is one of our favourites! Resources for today's episode: Pre-anaesthetic assessment for thoracic surgery by Peter Slinger and Gail Darling. Feel free to email us at [email protected] 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...

One lung ventilation can be tricky, but our two part series with special guest Dr Ivan Rapchuk, attempts to break it down and make it easier to both approach and understand. This series is another favourite! Resources for this episode: Pre-anaesthetic assessment for thoracic surgery by Peter Slinger and Gail Darling. Feel free to email us at [email protected] if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening...

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 [email protected] if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for...

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 -...

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...

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 [email protected] if you have any questions,...

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 [email protected] 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...

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...

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 [email protected] if you have any questions, comments or...

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 [email protected]...

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...