Obsgynaecritcare

Informações:

Synopsis

A podcast discussing critical care, anaesthesia and pain medicine in obstetrics and gynaecology

Episodes

  • 105 Nitrous oxide for labour analgesia with Graeme

    22/11/2022 Duration: 37min

    Hi everyone, This week Graeme and I sit down for the first time in nearly a year and do a bit of a deep dive on the use of nitrous oxide as an analgesic in labour. We drop a few dad jokes, discuss the history of inhaled analgesics, nitrous oxide use around the world, the evidence, the environmental concerns and other interesting anecdotes. Do you have nitrous oxide on labour ward in your part of the world? Send us a comment and let us know! Enjoy LINKS ANZCA Blue Book 2021 (Australasian Anaesthesia) - go to page 183 Developments in labour analgesia and their use in Australia 2015 Safety and Utility of Nitrous Oxide for Labor Analgesia APSF Journal June 2020

  • 104 Oral midodrine a discussion with Rheily

    05/11/2022 Duration: 20min

    Your 76 yr old patient is now two days post her laparotomy for ovarian cancer. She looks well, is starting to eat and keen to get up to the shower as well as have all the "annoying lines and tubes removed from my arms!". Unfortunately she is still on 3ml/hr of a metaraminol infusion and everytime the nurse tries to wean it off her BP drops to 70/45..... Is there anything you can do? Hi everyone, This week Rheily and I discuss the pharmacology of oral midodrine a alpha adrenergic agonist useful as an oral systemic vasoconstrictor. Join us as we discuss the ins and outs of using oral midodrine - please leave us a comment if you have some experience or tips to share! USEFUL LINKS Australasian Anaesthesia 2019 (Blue Book) Article - go to page 101

  • 103 How to perform an epidural blood patch.

    11/10/2022 Duration: 56min

    Hi everyone, This week Sneha leads a discussion with both Matt and myself where we take a deep dive into how to actually perform an epidural blood patch. Even though you can't really classify this as an uncommon procedure, as individuals we probably don't do very many and it is hard for most of us to become experienced and "expert" (whatever that is defined as). We discuss the evidence, the effectiveness, the practical considerations and some of the common problems / difficulties which may be encountered. Thanks Sneha (for organising and leading this episode) and of course you too Matt! LINKS Epidural blood patch: A narrative review - Anaesthesia Critical Care & Pain Medicine October 2022 Treatment of obstetric post-dural puncture headache. Part 2: epidural blood patch International Journal of Obstetric Anesthesia 2019

  • 102 Neuraxial anaesthesia for caesarean delivery part two

    27/09/2022 Duration: 39min

    Welcome to this podcast, the tenth in our series of obstetric anaesthesia basics. Join us for this the second part of a conversation where we discuss all things relating to neuraxial anaesthesia for Caesarean section. Due to it’s length we have split this discussion into two parts – who would have thought we could talk for so long about this! (I thought it would only be one episode and was surprised what we teased out). Thanks Shilpa, Matt & Roger! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 –

  • 101 Neuraxial anaesthesia for Caesarean section Part one

    20/09/2022 Duration: 39min

    Welcome to this podcast, the ninth in our series of obstetric anaesthesia basics. Join us for this the first part of a conversation where we discuss all things relating to neuraxial anaesthesia for Caesarean section. Due to it’s length we have split this discussion into two parts – who would have thought we could talk for so long about this! (I thought it would only be one episode and was surprised what we teased out). Thanks Shilpa, Matt & Roger! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 – A

  • 100 – Learning from real haemorrhage case discussions

    01/09/2022 Duration: 40min

    Hi everyone, Join us this week as we briefly celebrate the 100th episode - almost exactly 5 years after the first episodes aired. Then we sit down to discuss some real haemorrhage cases - a follow up on our promise from the earlier episode 97 where we discuss the basics of managing obstetric haemorrhage. Thanks Graeme, Shilpa and Matt! Links 097 Obstetric haemorrhage https://youtu.be/rc9BYcIhamA MBRRACE-UK - Maternal mortality and morbidity reports UK https://youtu.be/nqRBbXxzX6Q

  • 099 Maternal sepsis with Jess and Sneha Part 2

    27/07/2022 Duration: 40min

    Hi everyone, This is the second episode of two, where I sit down with my anaesthetic colleague Sneha and senior ICU trainee Jess to discuss the important and sometimes scary topic of maternal sepsis. Join us as in this second episode where we discuss amongst many things. antibioticsfluids & vasopressorsmulti-organ dysfunctionsource controlanecdotes & tips Thanks Sneha & Jess! If you haven't already listen to episode one first: https://www.obsgynaecritcare.org/098-maternal-sepsis-with-jess-and-sneha-part-1/?preview=true LINKS “Sepsis in Pregnancy” Burlinson et al – International Journal of Obstetric Anaesthesia 2018 “Maternal sepsis” Filetici et al – Best Pract Res Clin Anaesthesiol 2022

  • 098 Maternal sepsis with Jess and Sneha Part 1

    20/07/2022 Duration: 38min

    Hi everyone, This is the first episode of two, where I sit down with my anaesthetic colleague Sneha and senior ICU trainee Jess to discuss the important and sometimes scary topic of maternal sepsis. Join us as in this first episode where we discuss amongst many things the recent changes in how sepsis is defineddetection and recognition in pregnancycommon micro-organisms Thanks Sneha & Jess! LINKS "Sepsis in Pregnancy" Burlinson et al - International Journal of Obstetric Anaesthesia 2018 "Maternal sepsis" Filetici et al - Best Pract Res Clin Anaesthesiol 2022

  • 097 Obstetric haemorrhage

    13/07/2022 Duration: 35min

    Welcome to this podcast, the eighth in our series of obstetric anaesthesia basics. Join us for this conversation where we discuss all things relating to obstetric haemorrhage, a much feared and common obstetric emergency. Thanks Shilpa, Matt & Roger! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 – Accidental dural puncture and intrathecal catheters 4 – Post-dural puncture headaches and management 5 – Pre-eclampsia, eclampsia and hypertensive disorders 6 – General anaesthesia for Caesare

  • 096 General anaesthesia for Caesarean section part 2

    13/06/2022 Duration: 26min

    Welcome to this podcast, the seventh in our series of obstetric anaesthesia basics. Join us for this the second part of a conversation where we discuss all things relating to general anaesthesia for Caesarean section. Due to it’s length we have split this discussion into two parts – who would have thought we could talk for so long about this! (I thought it would only be one episode and was surprised what we teased out). It makes easier listening if you listen to episode one first! Thanks Laura, Matt & Roger! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural ana

  • 095 General anaesthesia for C Section part 1

    13/06/2022 Duration: 35min

    Welcome to this podcast, the sixth in our series of obstetric anaesthesia basics. Join us for this the first part of a conversation where we discuss all things relating to general anaesthesia for Caesarean section. Due to it's length we have split this discussion into two parts - who would have thought we could talk for so long about this! (I thought it would only be one episode and was surprised what we teased out). Thanks Laura, Matt & Roger! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 – Acci

  • 094 Eclampsia, pre-eclampsia and hypertensive disorders in pregnancy

    13/06/2022 Duration: 35min

    Welcome to this podcast, the fifth in our series of obstetric anaesthesia basics. Join us for this conversation where we discuss eclampsia, pre-eclampsia, hypertensive disorders and the specific issues relating to provision of obstetric anaesthesia. Thanks Laura, Graeme & Roger! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 – Accidental dural puncture and intrathecal catheters 4 – Post-dural puncture headaches and management 5 – Pre-eclampsia, eclampsia and hypertensive disorders 6 – Gen

  • 093 – Post dural puncture headaches

    19/05/2022 Duration: 34min

    Welcome to this podcast, the four in our series of obstetric anaesthesia basics. Join us for this conversation where we discuss the approach to a woman with a suspected or known post dural puncture headache. This follows our previous discussion of the incidence, significance and management of accidental dural punctures & intrathecal catheters, which you may want to listen to prior to this episode. Thanks Laura, Matt & Roger! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 – Accidental dural punctur

  • 092 – Accidental dural puncture and intrathecal catheters

    19/05/2022 Duration: 24min

    Welcome to this podcast, the third in our series of obstetric anaesthesia basics. Join us for this conversation where we discuss the incidence, significance and management of accidental dural punctures & intrathecal catheters. Thanks Laura, Matt & Roger! BASICS OF OBSTETRIC ANAESTHESIA The "Basics of Obstetric Anaesthesia" is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 - Epidural analgesia in labour part 1 2 - Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 - Accidental dural puncture and intrathecal catheters 4 - Post-dural puncture headaches and management 5 - General anaesthesia for Caesarean Delivery 6 - Pre-eclampsia, eclampsia and hypert

  • 091 – Epidural analgesia in labour part 2 pitfalls and troubleshooting

    18/05/2022 Duration: 43min

    In Part 2 of epidural analgesia in labour we discuss common problems, difficulties and how to troubleshoot issues in our epidurals on labour ward. Thanks again Matt & Shilpa! BASICS OF OBSTETRIC ANAESTHESIA The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 – Epidural analgesia in labour part 1 2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 – Accidental dural puncture and intrathecal catheters 4 – Post-dural puncture headaches and management 5 – General anaesthesia for Caesarean Delivery 6 – Pre-eclampsia, eclampsia and hypertensive disorders 7 – Neuraxial anaesthesia for caesarean delivery 8 – Postpa

  • 090 – Epidural analgesia in labour part 1

    18/05/2022 Duration: 28min

    We discuss the basics involved in epidural analgesia for labour. Join us in the next podcast where we will discuss common problems, pitfalls and how to trouble-shoot issues. Thanks Matt & Shilpa! BASICS OF OBSTETRIC ANAESTHESIA The "Basics of Obstetric Anaesthesia" is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area. 1 - Epidural analgesia in labour part 1 2 - Epidural analgesia in labour part 2, pitfalls and troubleshooting 3 - Accidental dural puncture and intrathecal catheters 4 - Post-dural puncture headaches and management 5 - General anaesthesia for Caesarean Delivery 6 - Pre-eclampsia, eclampsia and hypertensive disorders 7 - Neuraxial anaesthesia for caesarean

  • 089 – Acute pulmonary oedema with Graeme

    21/12/2021 Duration: 34min

    You get called to a code blue medical in the maternofetal assessment unit of your labour ward. A pregnant woman at 35 weeks has presented in severe respiratory distress. Her BP is 220/110, her heart rate 120/min, oxygen sats 88% despite high flow oxygen. She has a history of hypertension, diabetes and amphetamine abuse. You grab the nearby obstetric ultrasound (because it is there) and quickly scan her lungs with the curvilinear probe - all the lung fields are full of B-lines..... Hi everyone join Graeme and I as we discuss the acute management of this condition, variously known as SCAPE (sympathetic crashing acute pulmonary oedema), flash pulmonary oedema, or hypertensive pulmonary oedema. Links Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society of Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group. J Card Fail. 2016 Aug;22(8):618-27 A critical appraisal of the morphine in the acute pulm

  • 088 Guillain Barre syndrome with Dr Shilpa Desai

    14/11/2021 Duration: 29min

    A pregnant woman at 32/40 weeks gestation is rushed into your theatre for a code blue caesarean because of fetal distress. The team tell you that she has been in hospital for the last 6 weeks with Guillain Barre syndrome and has only just got out of ICU where she needed respiratory support for a number of weeks. What sort of anaesthetic are you going to give? Why is the traditional thio / sux / tube likely to go badly? If you inject local anaesthetics into her neuraxium what response will you expect from her already damaged nervous system? Will the drugs cause any further damage? What about breathing and swallowing problems afterwards? Hi everyone, This week I am joined by Dr Shilpa Desai, an anaesthetic consultant colleague and we discuss how to handle this rare but tricky group of patients and share a few dodgy dad jokes on the way! References https://resources.wfsahq.org/atotw/guillain-barre-syndrome/ Guillain Barre Syndrome - BJA Cardiac arrest after succinylcholine administrati

  • 087 Thrombocytopenia in pregnancy and platelet transfusions with Dr Simon Kavanagh Part 2

    28/10/2021 Duration: 26min

    A nulliparous woman is admitted to labour ward in established labour, she is in a lot of pain and asks for an epidural. The team note that a full blood count taken 2 days ago showed a platelet count of 48. Is this a real thrombocytopenia? What are the causes of thrombocytopenia in pregnancy? How are they treated? What about epidural or spinal anesthesia? Will she bleed? What if it falls further and she needs platelets? Hi everyone, Welcome to part 2 of our discussion on thrombocytopenia and platelets in pregnancy with Dr Simon Kavanagh a consultant haematologist. As this is a conversation split into two - if you haven't already please listen to part 1 first (see link below): Thanks Simon! https://www.obsgynaecritcare.org/thrombocytopenia-in-pregnancy/

  • 086 Thrombocytopenia in pregnancy with Dr Simon Kavanagh part 1

    19/10/2021 Duration: 33min

    A nulliparous woman is admitted to labour ward in established labour, she is in a lot of pain and asks for an epidural. The team note that a full blood count taken 2 days ago showed a platelet count of 48. Is this a real thrombocytopenia? What are the causes of thrombocytopenia in pregnancy? How are they treated? What about epidural or spinal anesthesia? Will she bleed? What if it falls further and she needs platelets? Hi everyone, This week I have a new guest on the show Dr Simon Kavanagh a consultant haematologist and we do a two part deep dive into thrombocytopenia in pregnancy, what are the causes, what to do and who to call! (hint they specialise in diseases of the blood.....) Thanks Simon! References HOW Collaborative position paper on the management of thrombocytopenia in pregnancy - ANZJOG Jan 2021 This is published by Wiley and you may need to access it via your institution / library

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