Discover and read the best of Twitter Threads about #OAA23ASM
Most recents (20)
Just off great @dasairway @OAAinfo #OBAnes airway masterclass webinar with @silv24 chairing, @ProfEllenO @noolslucas @Chakladar_A and @DesireOnwochei giving expert opinions - lots of notes taken, tweets to follow twitter.com/i/web/status/1… 
Right, let’s get to it. The #OBAnes airway - shifting the paradigm; a @dasairway & @OAAinfo masterclass. Two Profs in the corner… this should be interesting. @noolslucas kicks off the webinar.
What is a difficult airway? @ASALifeline definition: a clinical situation, conventionally trained anesthesiologist, difficult face mask ventilation/ intubation/ both.
Complications - hypoxemia: @MariePierreBon2 et al @BJAJournals 2020, @DavidGray37 @rosshofmeyr and co, SAJAA… twitter.com/i/web/status/1…
Complications - hypoxemia: @MariePierreBon2 et al @BJAJournals 2020, @DavidGray37 @rosshofmeyr and co, SAJAA… twitter.com/i/web/status/1…
@rr_metabolicmed presents the Bruce Scott Lecture 2023 at #OAA23ASM: Obesity & diabetes in pregnancy - legacy for the child. #OBAnes
Study of 1.3 million pregnant women reveals global obesity crisis: 75% pregnant women fail to achieve healthy weight gain during pregnancy, leading to preventable adverse health consequences for both the women and their babies. Obesity has strong evidence for increased risk of… twitter.com/i/web/status/1…
Maternal obesity and offspring cardiovascular disease: maternal obesity increases offspring cardiovascular death (Hazard ratio [all cause mortality] = 1.35). At current UK maternal obesity rates, this equates to extra 650 deaths before age 50 each year. The Hazard ratio for type… twitter.com/i/web/status/1…
Causes of liver derangement in pregnancy: flare of pre-existing liver disease (known or unknown). Incidence of pregnancy in people with chronic liver disease at King’s College Hospital. Historically, cirrhotic patients have been infertile d/t anovulation. Population based data… twitter.com/i/web/status/1…
Definition of acute SMM: severe, life threatening event during pregnancy & within 6 weeks of delivery. @NPEU_UKOSS provides UK wide high quality obstetric surveillance. Deaths, while uncommon, investigated in depth.
Study Aims: operationalise definition of SMM; report incidence… twitter.com/i/web/status/1…
Study Aims: operationalise definition of SMM; report incidence… twitter.com/i/web/status/1…
Prof Donald Peebles on Embedding Maternal Medicine Networks at #OAA23ASM. Knowing who to call is half the solution to any problem? (Touched on by @elsmere_g during #OBAnes session at #Anaesthesia2023)
Direct maternal mortality rate per 100,000 maternities had been decreasing over the last 2 decades, but should a remarkable upswing since 2018, not all accounted for by #COVID19. @mbrrace outlined a case for change: most parts of UK have MDT, but make up variable most without… twitter.com/i/web/status/1…
The Maternal Medicine Network (MMN) mandate: ensure timely access to specialist advice and care at all stages of pregnancy. Development of Maternal Medicine specialist centres as regional hub & spoke model = urgent national priority (@DOckendenLtd report)
MMN Ambition and… twitter.com/i/web/status/1…
MMN Ambition and… twitter.com/i/web/status/1…
Dr Katy Sheehan and @ArcBroom present the pick of the posters at #OAA23ASM. 4 criteria for selection of #OBAnes abstracts.
A positive start, with the power of positive communication on patient satisfaction, morale & culture, and #patientsafety #OBAnes #OAA23ASM
Barriers to care. Ethnicity, Language and Socioeconomic deprivation. @mbrrace, @TheLancet, and most recently @Anaes_Journal (@LateralTilt @noolslucas @SQuashie @Marianfknight) set the stage. #OBAnes #OAA23ASM
@NoelleHealy (another 🇮🇪 representative - @ISOA_Ireland well represented!) presents on #OBAnes as a team sport - how do we perform better? at #OAA23ASM. Quite an inspiring quote, then setting the stage with @Fionafionakel et al #humanfactors guidelines in @Anaes_Journal… twitter.com/i/web/status/1…
Why is teamwork important in OB/ #OBAnes? @mbrrace suggests some lessons to be learned. Prompt action is arguably reliant on good communication, within & between teams. Involving consultant/ specialist care early has been a theme for over a decade. #OAA23ASM
@DOckendenLtd’ final report highlighted “conflicting agendas and poor teamwork” contribute to adverse maternal & neonatal outcomes? So how do we create good teams?
The @JulieAndrews approach may have the hills alive, but for #OBAnes we may need to start at the very beginning,… twitter.com/i/web/status/1…
The @JulieAndrews approach may have the hills alive, but for #OBAnes we may need to start at the very beginning,… twitter.com/i/web/status/1…
@emirakur presents an update on @NAPs_RCoA NAP7 Perioperative cardiac arrest & #OBAnes at #OAA23ASM.
The history of @NAPs_RCoA projects and key findings for #OBAnes over the years (failed intubation NAP4 1:390, recent US data 1:808 - gotten better or different methodology?) #OAA23ASM
Cardiac arrest in pregnancy. CAPS study @BJOGTweets (I see @Marianfknight?) looked at incidence, management & outcomes in UK. #OBAnes have a significant slice of the pie. @SOAPHQ serious complication repository project (incl. @RichSmileyMD @bscottsegal) provide US data: cardiac… twitter.com/i/web/status/1…
@Rose_Kearsley (@RotundaHospital - my fellowship alma mater) speaks on #OBAnes in the 4th trimester at #OAA23ASM.
At the outset, @Rose_Kearsley addresses the definition of trimester (3 months, not only “a third of”). It’s not a novel concept - in lay, academic and anesthesia literature - which makes sense when one thinks of how many pregnancy-associated disease extend beyond delivery (not… twitter.com/i/web/status/1…
#OBAnes workload. 33.3% time on procedures. NB average workload does NOT reflect ebbs & flows, more so surges of activity. @NAPs_RCoA NAP7 data: majority of labour analgesia 1800-0800; #OBAnes accounts for majority of single speciality #AnyAnes work 1800-0800; increasing obesity… twitter.com/i/web/status/1…
@LimGrapes continues her tour de force at #OAA23ASM with Decision Making and Neuraxial Anesthesia. New evidence around thrombocytopenia and how those guidelines affect decision making in #OBAnes
To start: a Case. Possible evolving HELLP. Trends are important. Discuss anesthesia options.
#OBAnes #OAA23ASM
#OBAnes #OAA23ASM
Defining the problem: preeclampsia itself results in qualitative platelet dysfunction (even before HELLP). Preeclampsia has circulating microthrombi. Platelets are pre-activated, proaggregatory and prothrombotic BUT don’t respond to exposed collagen —> perioperative bleeding… twitter.com/i/web/status/1…
@LimGrapes lays out the objectives of her talk and highlights the model for improvement applicable to #AnyAnes. Great quote! #OBAnes #OAA23ASM
@DevroeSarah presents on Anaesthesia in Pregnancy and Neurodevelopment at #OAA23ASM. Quite an outline! #OBAnes
@DevroeSarah begins with epidemiology - 0.4-1% pregnant women will have non-OB surgery during their pregnancy. Fetus = innocent bystander. Complicated question. What is the pathobiology of normal brain development? Is there a link between anaesthesia and impaired brain… twitter.com/i/web/status/1…
Mechanisms? Drug-induced vs multifactorial. Preclinical evidence of consistent association. Clinical evidence inconclusive. Preclinical findings certainly headline grabbing, which prompted a systematic review and meta-analysis from Bleeser et al (incl. @DevroeSarah @rex_steffen… twitter.com/i/web/status/1…
@RopeyP: it’s good to talk - multispeciality decision-making for the pregnant patient having urgent non-OB surgery. SLIDO. Disclosures - #OBAnes is quite welcoming though. #OAA23ASM
@rjharrison79 opens #OAA23ASM with an update on Labour Analgesia for 2023. Sir James Young Simpson remembered.
It reads like an #Ostheimer - @rjharrison79 may be a contender to fill @PervezSultanMD’s shoes? Love the QR codes! #OBAnes at #OAA23ASM has gone state of the art!
Starting with the mainstays: choice of local anaesthetic and intrathecal morphine. Prilocaine 2% has compared favourably with bupivacaine 0.5%. However, there are caveats: if prilocaine is to be considered for routine #OBAnes it is recommended a CSE be used. ITM does NOT prevent… twitter.com/i/web/status/1…
The very topical: inadequate neuraxial anaesthesia for cesarean section. See lectures from @hnixon147 and @PervezSultanMD from recent @SOAPHQ annual meeting elsewhere on my timeline - this is a widespread concern. @Jamesocarroll has initiated a large multicentre trial through the… twitter.com/i/web/status/1…
Bill Kirkup presents on the independent investigation into East Kent Maternity Services at #Anaesthesia2023 #OBAnes
Battled with how to put “In their own words…” together. 4 slides at a time doesn’t cut it. It was a very emotive experience. So I hope this works (Twitter Blue perk)
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
In their own words: FAMILIES.
Midwives, not nurses. They cut me open (@HofkampMichael @emilysharpe @ruthi_landau). He’s singing, then he died. We don’t talk about cesareans. Physician: I’m the doctor. Midwife: we won’t be doing that.
And that last one… apropos of @SQuashie’s… twitter.com/i/web/status/1…
Midwives, not nurses. They cut me open (@HofkampMichael @emilysharpe @ruthi_landau). He’s singing, then he died. We don’t talk about cesareans. Physician: I’m the doctor. Midwife: we won’t be doing that.
And that last one… apropos of @SQuashie’s… twitter.com/i/web/status/1…
@DOckendenLtd presents at #Anaesthesia2023 on the Ockenden Report - a year on, have we made progress? #OBAnes
What were the key messages of the Ockenden Report from @DOckendenLtd? Final report March 2022 (distributed amongst #OBAnes at @IWKHealth @DalAnesthesia - learnings valuable even across the pond): failures of quality of care & governance; failure of external bodies to monitor;… twitter.com/i/web/status/1…
What did the media say? Overall coverage fair, balanced and commended by families.
And Nottingham? Maternity review is underway… themes continue.
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
And Nottingham? Maternity review is underway… themes continue.
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
@SQuashie presents on ethnic disparities in #OBAnes outcomes at #Anaesthesia2023… lots in lead up to #OAA23ASM
A break down of the objectives of the talk. Census data demonstrates increases in all minorities, nationally and locally. Definitions: What is a health disparity? >10% health difference closely linked to disparity. Inequality, equality, equity and justice are linked.… twitter.com/i/web/status/1…
Race vs ethnicity - an important difference. Maternal inequalities have been subject of several reports, resulting in Maternal Disparities Taskforce and Equity & Equality guidance. Reducing inequalities focus on CORE20PLUS5: the most deprived 20% with 5 key clinical areas… twitter.com/i/web/status/1…
@elsmere_g presents on Maternal Medicine at #Anaesthesia2023. Pregnancy is stressful - it will unmask disease. Pick up the phone. Why are we worried? #OBAnes #OAA23ASM
When looking at @mbrrace reports the UK has shown some improvements in maternal mortality, however, there has been an uptick since 2018. While this is partly accounted for by a changing maternal population (older, more obese, more comorbidities, etc), start inequalities related… twitter.com/i/web/status/1…
Majority are indirect deaths. #OBAnes contributes only a small amount (not to be ignored though). Everyone has a role to play in improving maternity care and reducing mortality & morbidity. Remember majority of deaths occur AFTER delivery - recent pregnancy history shouldn’t be… twitter.com/i/web/status/1…
