Anaesthesia Tutorial of the Week

Test your knowledge on the following past tutorials: Pulse oximetry, Neuromuscular disorders and Anaesthesia, Diabetic ketoacidosis, Malignant hyperthermia, Ophthalmic anaesthesia, Lessons learned from the Confidential Enquiry for Maternal and Child Health, Preparation of Children for surgery, Paediatric Head Injury, Right heart physiology, Activated Protein C in Sepsis, Peripheral nerve blocks: Getting startedQuiz – June 2009 (140) - June 29, 2009

Down’s syndrome is the commonest chromosomal abnormality and affects many organ systems. This tutorial outlines the abnormalities and their significance for the anaesthetist.Anaesthesia for children with Down’s Syndrome (139) - June 22, 2009

This tutorial discusses the indications for central venous access, looks at the relevant anatomy and explains the practical techniques involved in cannulation.Central Venous Access (138) - June 15, 2009

Invasive arterial blood pressure measurement is an extremely useful clinical tool, offering beat-to-beat blood pressure measurement and a visible waveform, allowing a detailed analysis of the patient’s cardiovascular status to be made. This tutorial explores the physical principles underlying this measurement and gives the reader an awareness and understanding of the common sources of error.Physical Principals of Intra-arterial Blood Pressure Measurement (137) - June 8, 2009

136 Major haemorrhage part 1 Management of major haemorrhage, initial response (136) - June 1, 2009

Download the pdf: 135 Ophthalmic anaesthesia – part 1 Anaesthesia For Ophthalmic Surgery Part 1 – Anatomy & Physiology – Regional Techniques Anaesthesia Tutorial of the Week 135 25th May 2009 Dr. Kim Chishti, Specialist Registrar – Torbay Hospital, UK Dr. Andrey Varvinskiy, Consultant -Torbay Hospital, UK Correspondence to kimchishti@hotmail.com Questions Before continuing, try to answer the following questions. The answers can [...]Ophthalmic Surgery Part 1 (135) - May 25, 2009

18th May 2009 Dr Kim Russon, Consultant Anaesthetist Dr Helen Findley, ST3 Anaesthetics Dr Zoe Harclerode, ST3 Anaesthetics Rotherham General Hospital, UK Correspondence to russonkim@doctors.org.uk    QUESTIONS Before continuing, try to answer the following questions.  The answers can be found at the end of the article, together with an explanation. 1.    TRUE or FALSE: On injection of local anaesthetic a.    It safe to inject the [...]Peripheral nerve blocks – Getting started (134) - May 18, 2009

  11TH MAY 2009 Dr Richard Eve, Royal Cornwall Hospital, Cornwall, UK Dr Mike Duffy, Derriford Hospital, Plymouth, UK Correspondence to: richardlloydeve@gmail.com   QUESTIONS Before continuing, try to answer the following questions.  The answers can be found at the end of the article, together with an explanation. 1.    Severe Sepsis a.    Is associated with disordered response of innate immunity. b.    Has a mortality of between [...]Activated protein C in the treatment of severe sepsis (133) - May 11, 2009

 4TH MAY 2009 Roger Langford Birmingham Children’s Hospital Contact: rogerlangford@doctors.org.uk       QUESTIONS Before continuing, try to answer the following questions.  The answers can be found at the end of the article, together with an explanation.   1: Regarding the pre-operative psychological preparation of a five year old, the following statements are true: a: Five-year-olds readily accept surrogates instead of parents. b: It is the age [...]Preparation of children for surgery (132) - May 4, 2009

Malignant hyperthermia (MH) is an uncommon pharmacogenetic disorder of muscle induced by exposure to suxamethonium and all the volatile anaesthetic agents. This tutorial covers the pathophysiology, identification, management and investigation of MH.Malignant Hyperthermia (131) - April 27, 2009

Dr Elisa Bertoja Locum Consultant Anaesthetist University College London Hospital Dr Jane Lowery Specialist Registrar in Anaesthesia University College London Hospital Correspondence to elisa.bertoja@uclh.nhs.uk jlowery@doctors.org.uk   20th April 2009      QUESTIONS Before continuing, try to answer the following questions.  The answers can be found at the end of the article. 1.    Where does the Coronary Sinus empty? a.    In the inter-atrial septum b.    In the right atrium c.    In the [...]Right heart physiology (130) - April 20, 2009

13th April 2009   Dr David Portch, Musgrove Park Hospital, Taunton. Correspondence to davidportch@mac.com     QUESTIONS Before continuing, try to answer the following questions.  The answers and a short explanation can be found at the end of the article. 1.    Regarding the causes of maternal death, the following statements are true: a.    Thromboembolism is the most common direct cause of maternal death in the [...]Saving mothers lives’ – lessons from CEMACH (129) - April 13, 2009

 6th April 2009   William English, North Bristol NHS Trust, Bristol, UK Peter Ford, Royal Devon and Exeter Hospital, Exeter, UK. Correspondence to Peter.Ford@rdeft.nhs.uk      SELF-ASSESSMENT QUESTIONS Please read the following questions. The answers will be found in the article. 1. What are the characteristic metabolic derangements in diabetic ketoacidosis (DKA)? 2. What are the basic principles in the management of a patient [...]Diabetic ketoacidosis (128) - April 6, 2009

  Kavitha Raghavan, King’s College Hospital, London Richard Waddington, Kingston Hospital, Surrey Correspondence to kavitha_cr@hotmail.com Key Learning Points: · Severe traumatic brain injury in children is associated with a high incidence of morbidity and mortality. · The clinician can reduce the impact of secondary brain injury, especially by avoiding hypoxia and hypotension. · The most important initial interventions are control of the [...]Management of paediatric traumatic brain injury (127) - March 29, 2009

  23RD MARCH 2009 Dr. Nicola Ross, Leeds General Infirmary, UK Dr. Sarah Marsh, Leeds General Infirmary, UK Correspondence to nickiross@mac.com   INTRODUCTION The neuromuscular disorders are a heterogeneous group of diseases effecting skeletal muscle via abnormalities of the motor nerves, neuromuscular junction, cellular matrix, ion channels and metabolic derangements.  They are often grouped together in relation to anaesthesia due to common [...]Neuromuscular disorders and anaesthesia (126) - March 23, 2009

  Introduction to cardiovascular physiology ANAESTHESIA TUTORIAL OF THE WEEK 125   16th March 2009   Toby Elkington, Specialist Registrar Carl Gwinnutt, Consultant Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK Correspondence to tobyelkington@hotmail.com           This tutorial is intended as a very basic introduction to cardiovascular physiology with particular reference to anaesthesia. Once these basic principles have been mastered then it will be [...]Introduction to Cardiovascular Physiology (125) - March 16, 2009

9th March 2009   Dr. Iain Wilson Royal Devon & Exeter hospital UK Contact: iainhwilson@mac.com   The WFSA has been working on information about pulse oximery and the following tutorial is part of the material.  Feedback would be very useful and should be sent to iain.wilson@rdeft.nhs.uk The first part of this tutorial (last week) can be found here PULSE OXIMETER QUIZ The causes of [...]Pulse Oximetry – part 2 (124) - March 9, 2009

2nd March 2009 Dr. Iain Wilson Royal Devon & Exeter Hospital, UK Correspondence to iain.wilson@rdeft.nhs.uk Please note this is a two part tutorial.  The second part can be found here   INTRODUCTION   The WFSA has been working on information about pulse oximetry and the following tutorial is part of the material.  Feedback would be very useful and should be sent to iain.wilson@rdeft.nhs.uk Pulse [...]Pulse Oximetry – part 1 (123) - March 3, 2009

15th December 2008 Dr  Arnab Banerjee Hospital  Luton & Dunstable Hospital NHS Trust, UK Dr. Iain Wilson, Royal Devon & Exeter NHS trust, UK Correspondence to abanerjeeuk@doctors.org.uk Introduction Myasthenia Gravis (MG) is an autoimmune disease characterized by weakness and fatigability of skeletal muscles, with improvement following rest.  It may be localized to specific muscle groups or more generalized.  MG is caused by [...]Anaesthesia and Myasthenia Gravis (122) - December 14, 2008

ANAESTHESIA TUTORIAL OF THE WEEK 121 8TH DECEMBER 2008 Dr R Sunderland Specialist Registrar Dr S Mallory Consultant Anaesthetic Department, Great Ormond Street Hospital for Children, London, UK Correspondence to sunder@gosh.nhs.uk SELF-ASSESSMENT QUESTIONS Before reading the tutorial consider the following questions and discuss them with your colleagues What are the symptoms and signs of raised intracranial pressure? What [...]Anaesthesia for ventriculo-peritoneal shunt insertion (121) - December 8, 2008

ABDOMINAL COMPARTMENT SYNDROME TUTORIAL OF THE WEEK NUMBER  120 1ST DECEMBER 2008 William English, North Bristol NHS Trust, Bristol, UK Bruce McCormick, Royal Devon & Exeter Hospital, UK englishwilliam@hotmail.com SELF-ASSESSMENT QUESTIONS Please read the following questions. The answers will be found in the main text. 1. What is the normal pressure within the abdomen? 2. Define intra-abdominal hypertension and abdominal compartment syndrome. 3. List the [...]Abdominal compartment syndrome (120) - November 30, 2008

Download Update 24 Update in Anaesthesia, Volume 24, Number 1 (2008) - November 26, 2008

Download Update 23 Update in Anaesthesia, Volume 23 (2007) - November 25, 2008

Download Update 22 Update in Anaesthesia, Volume 22 (2007) - November 24, 2008

ANAESTHESIA FOR HYPOSPADIAS REPAIR Tutorial of the week 119 17TH NOVEMBER 2008   Dr George Thomas-Kattappurathu.  Sheffield Teaching Hospitals. Dr Catherine Wilson. Sheffield Children’s Hospital. Email: dr_georget@yahoo.co.uk   Please answer the following true or false questions to see how much you already know of the topic. Answers are given at the end.   1)       The incidence of hypospadias is almost equal in both the sexes. 2)       [...]Anaesthesia for hypospadias repair (119) - November 17, 2008

CARDIAC DISEASE IN PREGNANCY: TUTORIAL 2 ATOTW 118, 10TH NOVEMBER 2008 Download pdf: 118-cardiac-disease-in-pregnancy-2 Dr. Abbi Walker, Christchurch Hospital, New Zealand Dr. Matt Rucklidge, Royal Devon & Exeter Hospital, UK mattrucklidge@yahoo.co.uk The second of two tutorials exploring the presentation and management of pregnant women with heart disease. Tutorial 1: • Introduction and scope of the problem • [...]Cardiac disease in pregnancy 2 (118) - November 9, 2008

20TH OCTOBER 2008 Dr.K.K.Ramaswamy, Wexham Park Hospital, UK. Editor: Dr. Iain Wilson, Royal Devon & Exeter Hospital, UK Correspondence:  kramaswamy@doctors.org.uk The aim of this tutorial is to discuss the causes and management of hypothermia under anaesthesia. Please answer the following questions before reading the article. 1)    What are the problems with hypothermia in theatre? 2)    What are the mechanisms of heat [...]Perioperative hypothermia, prevention and management (117) - October 20, 2008

TUTORIAL OF THE WEEK NUMBER  115 6TH OCTOBER 2008 Dr N Niranjan, Derriford Hospital, Plymouth, UK (niraj.niranjan@yahoo.co.uk ) Dr. Mike Duffy, Derriford Hospital, Plymouth, UK Brainstem Death (115) - October 14, 2008

AIRWAY MASTERCLASS 3 – THE LARYNX TUTORIAL OF THE WEEK NUMBER 114 29TH SEPTEMBER 2008 Airway Masterclass 3 – The Larynx (114) - September 29, 2008

This tutorial covers some of the risks and physiological changes associated with anaesthesia in the prone position, and how to manage them.Anaesthesia in the prone position (112) - September 15, 2008