Deep Breaths
Deep Breaths is a podcast that covers topics related to the ANZCA part 2 anaesthetic exam. It provides easy-to-digest content to help listeners supercharge their exam preparation or stay up to date in the field. The podcast encourages a relaxed approach to studying, inviting listeners to take a deep breath and enjoy the material.
Episodes
S10 Ep. 5: Heart of glass, part 1 (Uncommon cardiac conditions for non-cardiac surgery), re-release
Today, we look back on one of our most-loved episodes by our listeners. 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 2021ESC Guidelines on cardiovascular assessment and management of patients undergoing non cardiac surgery2014 ACC/AHA guideline
S10 Ep. 4: Let it Be (Anaesthesia for patients at the end-of-life), re-release
Today, we go back to take a close look at one of ANZCA's latest professional documents - PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022.Resources for this episode:PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022PG67 BP: Guideline for the car
S10, Ep. 3: These arms of mine, part 1 (upper limb regional anaesthesia), re-release
Today, we look back at a fantastic and insightful discussion about upper limb regional anaesthesia with special guest, Dr Michael Kerr. If you liked this episode, you can find the second part of this episode in season 5, episode 12. In this episode, part 1, we focus on the interscalene block. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We l
S10 Ep. 2: Keep bleeding (DOACs), re-release
Today, we revisit a topic that was recommended to us by Dr David Tragen of the Sunshine Coast University Hospital - the perioperative management of the direct oral anticoagulant medications or DOACs. We start with some basic revision of the mechanism of action of the DOACs and their indications before diving more closely into the recommendations for stopping and starting these medications around t
S10 update: Headed for the future
Deep Breaths will return this year with a slightly different twist. We're taking a little break, but that doesn't mean we've forgotten about our wonderful listeners! We'll be recording the occasional new episode with guest interviewees that we're excited to be chatting with. We're also going to be re-releasing some of our best episodes.Feel free to email us at deepbre
S10 Ep. 1: Why (Oesophageal intubation), re-release
In today's episode, we revisit challenges in the diagnosis and management of oesophageal intubation and anaesthetic crises in general. Recognising an oesophageal intubation may seem simple, but by looking at coroner's cases both here in Australia and in the UK, as well as cases in the NAP4, it can be far more complex. Feel free to email us at deepbreathspod@gmail.com if you have any ques
S9 Ep. 7: Come Together (Live from the ANZCA ASM)
So get ready for something a little different... this week's episode was recorded live from the ANZCA Annual Scientific Meeting 2024, in our home city of Brisbane, Australia. We interviewed some fascinating guests, covering topics as diverse as the role of the college moving forward, how we can be more sustainable in anaesthesia, and the future of podcasting; and we had plenty of fun along th
S9 Ep. 6: Bloodstream, part 2 (Anaesthesia for ruptured AAA repair)
Today's episode is the second of our two part series on ruptured AAA repairs. We discuss the case of a 72 year old man with a ruptured abdominal aortic aneurysm that is contained, and who is scheduled for an urgent endovascular repair within the interventional radiology suite with special guest, Dr Lahiru Amaratunge.Apologies for the audio quality in this episode - even though it sounds like
S9 Ep. 5: Bloodstream, part 1 (Anaesthesia for ruptured AAA repair)
Today - in part 1 of our 2 part series - we talk through the case of an 82 year old man with a ruptured abdominal aortic aneurysm who is scheduled for urgent open repair with special guest, Dr Lahiru Amaratunge.Resources for today's episode:BJAED: Anaesthesia for endovascular repair of ruptured abdominal aortic aneurysms by K. Berry et al.LITFL: AAA by C. NicksonLancet: Endovascular versus op
S9 Ep. 4: Hungry Like the Wolf - update (GLP-1 receptor agonist guidelines)
In today's episode, we cover the recently released consensus clinical practice recommendation regarding the peri-procedural use of the GLP-1 and GIP receptor antagonists. Enjoy this topical episode - this is sure to be an evolving area. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to clai
S9 update - Better Late Than Never - delay to this week's ep
This week we're under the pump with work and life, but we'll be with you soon and it's a cracker of an episode covering an extremely topical subject. Keep an eye out for our next episode dropping something in the next couple of weeks. As an apology, we'll have a bonus ep coming sometime towards the end of the season! Feel free to email us at deepbreathspod@gmail.com if you have
S9 Ep. 3: Gimme gimme shock treatment, part 3 (Inotropes and vasopressors)
Today's episode is the final in our series on inotropic and vasopressor medications. Today, we're going to tackle some of the more obscure inotropes and vasopressors - these medications typically aren't encountered terribly often within anaesthesia. During this episode, we discuss milrinone, levosimendan, methylene blue and hydroxocobalamin (Vitamin B12). Resources for today's
S9 Ep. 2: Gimme gimme shock treatment, part 2 (Inotropes and vasopressors)
Today's episode - the second in our three episode series focusing on inotropic and vasopressor medications - sees us covering some more medications commonly (or uncommonly, depending on your scope of practice) encountered within anaesthesia. During this episode, we discuss vasopressin, dopamine and dobutamine. Resources for today's episode:StatPearls:Inotropes and vasopressors by D. Van
S9 Ep. 1: Gimme gimme shock treatment, part 1 (Inotropes and vasopressors)
Today's episode is the first in a series of three that focus on inotropic and vasopressor medications used within anaesthetic practice. During this episode, we discuss metaraminol, ephedrine, phenylephrine, noradrenaline and adrenaline. There's one section of our episode where we thought it important to clarify what we're saying, as to out ears it sounds a little confusing. During
S8 Ep. 10: True trans soul rebel (Anaesthesia for transgender and gender diverse adults)
Today, we discuss a 2023 BJA Education article titled 'Perioperative care for transgender and gender diverse adults'. We start with a discussion of words and terms that are useful to understand, before diving in to discussions about a trauma-informed care approach to minimise and hopefully eradicate negative preoperative experiences, physical, chemical and surgical options for gender af
S8 Ep. 9: The long and winding road, part 2 (Anaesthesia for post-heart-transplant patients)
Today, in part 2 of our 2 part series on anaesthesia for previous heart transplant recipients, we discuss the care of these patients for non-cardiac surgery with special guest, Dr Ivan Rapchuk.We begin by covering the electrophysiology of a transplanted heart and what you may see on the ECG, and then proceed to the management of our theoretical patient for general anaesthesia for non-cardiac surge
S8 Ep. 8: The long and winding road, part 1 (Anaesthesia for post-heart-transplant patients)
Today, in part 1 of our 2 part series on anaesthesia for previous heart transplant recipients, we discuss the care of these patients for non-cardiac surgery with special guest, Dr Ivan Rapchuk. We start our discussion with a review of how to assess whether these patients are suitable for elective surgery, and follow this with a deep-dive on the typical immunosuppressant medications that these pati
S8 Ep. 7: Hungry like the wolf (Perioperative fasting and GLP-1 receptor agonists)
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. & Coste
S8 Ep. 6: Heart of glass, part 2 (Uncommon cardiac conditions for non-cardiac surgery)
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 anaesth
S8 Ep. 5: Always on my mind (Neuroanaesthetic emergencies)
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) e
S8 Ep. 4: Have another drink, part 2 (Perioperative hypotension and AKI)
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:
S8 Ep. 3: Have another drink, part 1 (Perioperative hypotension and AKI)
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 k
S8 Ep. 2: These boots are made for walkin', part 2 (Preoperative functional capacity assessment)
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 & DarvallBJA: A simplified (mod
S8 Ep. 1: These boots are made for walkin', part 1 (Preoperative functional capacity assessment)
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 te
S8 preview: Season 8 starts on Monday 5th February - Together again
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
S7 Ep. 11: It's not over ('till it's over) part 2, re-release
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 deepbreathspod@gmail.com 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 whic
S7 Ep. 10: It's not over ('till it's over) part 1, re-release
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 deepbreathspod@gmail.com 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 l
S7 Ep. 9: Kids, part 2, re-release
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. Di
S7 Ep. 8: Kids, part 1, re-release
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 preop
S7 Ep. 7: Take my breath away, part 2, re-release
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 deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love
S7 Ep. 6: Take my breath away, part 1, re-release
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 deepbreathspod@gmail.com if you have any questions, commen
S7 Ep. 5: Daysleeper, re-release
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 deepbreathspod@gmail.com if you have any questions, c
S7 Ep. 4: Don't wake me up, re-release
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/NAP5homeB-Aware trial - https://www.sciencedirect.com/science/article/pii/S0140673604163009?via%3DihubB-Unaware trial - https://www.nejm.org/
S7 Ep. 3: Bad blood, part 2, re-release
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 mo
S7 Ep. 2: Bad blood, part 1, re-release
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 wit
S7 Ep. 1: Sweet leaf, re-release
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 deepbreathspod@gmail.com if you have any questions, comments or suggestion
Season 7 starts August 14th - Replay
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 season
S6 Ep. 16: We are family (Family presence in the OR)
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 libr
S6 Ep. 15: Heart of glass, part 1 (Uncommon cardiac conditions for non-cardiac surgery)
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 2021ESC Guidelines on cardiovascular assessment and management of patients undergoing non cardiac surgery 2014 ACC/AHA guideline on Perioperative Cardiovascular Evaluation and Management of
S6 Ep. 14: Mama's broken heart, part 2 (Obstetric cardiac disease)
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 ci
S6 Ep. 13: Mama's broken heart, part 1 (Obstetric cardiac disease)
Today's episode is the first of two where we take a close look at a few obstetric case scenarios that deal with major cardiac disease with special guest, Dr Michael Toon. Our first case explores a pregnancy and delivery in a patient with moderate to severe mitral stenoses. We then chase this with a case scenario revolving around a patient with a peripartum cardiomyopathy. In both cases we tak
S6 Ep. 12: You got a nerve, part 2 (Post obstetric nerve injury)
Today, we finish our discussion about post obstetric nerve injury with an in-depth discussion about the different intrinsic obstetric nerve palsies that can occur as a result of the mechanisms of labour and delivery. We follow this with a chat about our approach to assessing patients with altered neurology post delivery and in whom a neuraxial anaesthetic has been performed. Resources for today&ap
S6 Ep. 11: You got a nerve, part 1 (Post obstetric nerve injury)
Today, we discuss post-delivery nerve injury in obstetric patients. In this first of two episodes, our discussion begins with revision of the classification of nerve injury severity, followed by a chat about the different clinical syndromes observed as a result of nerve injury during neuraxial anaesthesia. Resources for today's episode: Anaesthesia Tute of the Week (ATOTW): Peripartum Neurol
S6 Ep. 10: Eye of the tiger, part 2 (Eye surgery anaesthesia)
Today's episode is the second part in our discussion about anaesthesia for eye surgery with special guest, Dr Lahiru Amaratunge. We discuss two emergency eye surgeries and our options for managing these potentially challenging situations. Resources for today's episode: ABCs of anaesthesia ophthalmic anaesthesia youtube playlist (as mentioned by Dr Amaratunge during the episode): ABCs of
S6 Ep. 9: Eye of the tiger, part 1 (Eye surgery anaesthesia)
Today's episode is the first of a 2-part series covering anaesthesia for eye surgery with special guest Dr Lahiru Amaratunge. Over the course of these two episodes, we'll hear Dr Amaratunge discussing a few different case scenarios in both elective and emergency surgery for eyes. Resources for today's episode: ABCs of anaesthesia ophthalmic anaesthesia youtube playlist (as mentioned
S6 Ep. 8: Hurt (CRPS)
Today, we take a close look at the Complex Regional Pain Syndrome (CRPS). We discuss the diagnostic criteria, pathophysiology and treatment of this condition, as well as taking a closer look at the role of opioids in the management of pain relating to CRPS. Resources for today's episode: Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 5th Edition by Harden, R.N
S6 Ep. 7: Let it be (Anaesthesia for patients at the end-of-life)
Today, we're taking a close look at one of ANZCA's latest professional documents - PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022. Resources for this episode: PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022 PG67 BP: Guideline for the c
S6 Ep. 6: Saltwater, part 2 (Hyponatremia)
Today, we're tackling the absolutely mammoth topic of hyponatremia after JAMA recently published a fantastic article about its diagnosis and management. Part 2's episode focuses on determining the cause of a patient's hypotonic hyponatremia. From here we also go on to discuss the pathophysiology of both the Syndrome of Inappropriate ADH secretion (or SIADH) and cerebral salt wasting
S6 Ep. 5: Saltwater, part 1 (Hyponatremia)
Today, we're tackling the absolutely mammoth topic of hyponatremia after JAMA recently published a fantastic article about its diagnosis and management. We start with a review of some relevant physiology before talking about the ways in which hyponatremia can present, and the approach to determining the underlying cause of the hyponatremia.In this episode, we specifically talk about determini
S6 Ep. 4: One in ten, part 4 (Statistics)
Today, we share our fourth and final discussion in our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics:the research methodology for designing a clinical trialpilot trialsbias and confoundingethics committees and the process of ethics approvalForest plotsResources for today's episode: Zedstatistics (youtube channel) - short videos ex
S6 Ep. 3: One in ten, part 3 (Statistics)
Today, we share our third discussion in our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics:sensitivity and specificitypositive predictive values (PPV) and negative predictive values (NPV)risk ratiosodds ratiosnumber needed to treat (NNT) and number needed to harm (NNH)And here are the calculations for Shannon's working example of s
S6 Ep. 2: One in ten, part 2 (Statistics)
Today, we share our second discussion in our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics:sample size, power and hypothesis testingtype I and type II error (further discussion)levels of evidence and what this meansthe different types of clinical trialsResources for today's episode: Zedstatistics (youtube channel) - short videos e
S6 Ep. 1: One in ten, part 1 (Statistics)
Today, we're having our first discussion of our four part series about statistics with Dr Shannon Morrison. In this episode, we discuss the following topics:types of data (quantitative vs qualitative)descriptive statistics (measures of central tendency and measures of variability)Central Limit Theoremhypothesis testingtype I and type II errorp-values parametric and non-parametric tests for da
Season 6 starts February 6th - Baby, one more time
Deep Breaths returns next Monday February 6th with a wonderful selection of 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! Lahiru Amaratunge's Viva Boot Camp (l
BREAK: Season 6 starts February 6 - Don't stop thinking about tomorrow
Deep Breaths returns on Monday February 6th with our fortnightly release schedule that we hope you're all still enjoying. We hope you take the time over the holiday break to rest up and refill your energy stores before 2023 kicks off. Season 6 will see us tackle more new topics that we hope will keep you up to date in your practice, and to help our exam candidates prepare for the ANZCA part 2
S5 Ep. 14: What a wonderful world (Environmentally sustainable anaesthesia)
In today's episode, we discuss some recently published guidelines in the journal Anaesthesia regarding the provision of environmentally sustainable anaesthesia. Feel free to email us at deepbreathspod@gmail.com 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
S5 Ep. 13: These arms of mine, part 2 (Upper limb regional anaesthesia)
Today, we continue our discussion about upper limb regional anaesthesia with special guest, Dr Michael Kerr.In part 2 of this series we discuss the supraclavicular and infraclavicular blocks, the axillary block and specific targeted nerve blocks within the forearm. We then go on to discuss the management of a suspected nerve injury. Feel free to email us at deepbreathspod@gmail.com if you have an
S5 Ep. 12: These arms of mine, part 1 (Upper limb regional anaesthesia)
Today, we have a fantastic and insightful discussion about upper limb regional anaesthesia with special guest, Dr Michael Kerr. In part 1 of this 2 part series, we focus on the interscalene block. Feel free to email us at deepbreathspod@gmail.com 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 o
S5 Ep. 11: Take my breath away, part 2 (One-lung ventilation)
Today, we discuss several cases addressing one-lung ventilation with special guest, Dr Ivan Rapchuk. Case number 2 describes a 59 year old woman with non-small cell lung cancer of the left lung who is scheduled for a left pneumonectomy on your list later this afternoon. Her medical history includes hypertension, hyperlipidemia, type 2 diabetes and obesity with a BMI 32, weight of 85kg and a height
S5 Ep. 10: Take my breath away, part 1 (One-lung ventilation)
Today, we discuss several cases addressing one-lung ventilation with special guest, Dr Ivan Rapchuk. Our first case is as follows: a 68 year old man is scheduled for an open right upper lobectomy on your list tomorrow for a T1N0 non small cell lung carcinoma. He is an active smoker with a 30 pack year history but has cut down his consumption from 20 cigarettes daily to 5. He has moderate emphysem
S5 Ep. 9: How do I breathe, part 4 (Complex airway management)
Today is the final episode of our airway series where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. Our first case - case number 6 - is one where you are called to the intensive care unit to the bedside of a 54 year old female patient who had a percutaneous tracheostomy placed earlier that day. She is now hypoxic with oxygen saturation of 82%. Case
S5 Ep. 8: How do I breathe, part 3 (Complex airway anaesthesia)
Today is our third of a four episode series where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. The first case in today's episode - case 4 - is as follows: you are called to assist a colleague who has had 3 failed attempts at intubating a 64 year old female patient for a laparoscopic hemicolectomy. Bag-mask ventilation was difficult, although
S5 Ep. 7: How do I breathe, part 2 (Complex airway anaesthesia)
Today is our second of four episodes that will be released over a four-week period where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. Our second case is that of a 23 year old man that presents for a sub-mandibular abscess on a background history of five days of toothache. His only other medical history is that he has a BMI of 35. On clinical exami
S5 Ep. 6: How do I breathe, part 1 (Complex airway anaesthesia)
Today is our first of four episodes that will be released over a four-week period where we discuss lots of wonderful and complex airway scenarios with special guest, Dr Nadia Vargas. Our first case is that of a 44 year old female patient scheduled to have a total thyroidectomy for a multi nodular goitre with moderate retrosternal extension. She has never had a general anaesthetic before and her on
S5 Ep. 7: Protect ya neck (Neck haematoma after thyroid surgery)
Today, we discuss the joint Difficult Airway Society, British Association of Endocrine and Thyroid Surgeons, and the British Association of Otorhinolaryngology Guidelines on managing neck haematomas after thyroid surgery. We start by revising the pathophysiology of post-thyroidectomy airway compromise before launching into a discussion about the 8 recommendations within the guidelines. Feel free
S5 Ep. 6: Fever (Surviving Sepsis Guidelines 2021)
In today's episode, we discuss the latest updates on sepsis, courtesy of the recently released International Guidelines for the Management of Sepsis and Septic Shock 2021. This is a long guideline, but we pick out the most relevant pieces to our practise in anaesthesia. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from
S5 Ep. 5: Shock to the system, part 2 (Cardiac implantable devices)
Today, we tackle the peri-operative management of cardiac implantable devices after the recent publication of the British Heart Rhythm Society's guidelines in the journal, Anaesthesia. In part 2 of this 2 part series, we discuss the ten guidelines that illustrate how cardiac implantable electronic devices should be managed peri-operatively, followed by considerations that we as - anaesthetist
S5 Ep. 4: Shock to the system, part 1 (Cardiac implantable devices)
Today, we tackle the peri-operative management of cardiac implantable devices after the recent publication of the British Heart Rhythm Society's guidelines in the journal, Anaesthesia. In part 1 of this 2 part series, we start with a discussion about the different types of implantable cardiac devices that may be encountered in our practice. We explain how the NGB code illustrates the way that
S5 Ep. 3: I'm still standing, part 2 (Undesirable exam outcomes)
This week, we continue our discussion about receiving a poor outcome after the ANZCA part 2 exam with two special guests - Dr Raymond Casey and Dr Aaron MacDonald. In the second instalment of this topic, we talk to Aaron about his journey after sitting his exam for the first time. Both Raymond and Aaron then give some timely advice about how to manage the stress and emotions associated with dealin
S5 Ep. 2: I'm still standing, part 1 (Undesirable exam outcomes)
This week, we have a really open and candid discussion about receiving a poor outcome after the ANZCA part 2 exam with two special guests - Dr Raymond Casey and Dr Aaron MacDonald. In this the first of this 2-part topic, we start by talking about the work and life circumstances that both Raymond and Aaron found themselves in when preparing to sit their exam for the first time. We also talk to Raym
S5 Ep. 1: Keep bleeding (DOACs)
Today, we discuss a topic recommended to us by Dr David Tragen of the Sunshine Coast University Hospital - the perioperative management of the direct oral anticoagulant medications or DOACs. We start with some basic revision of the mechanism of action of the DOACs and their indications before diving more closely into the recommendations for stopping and starting these medications around the time
Season 5 starts July 18 - Feeling good
Deep Breaths returns next Monday with a fantastic array of topics that we're sure will make exam prep easier, 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. Lahiru Amaratunge's Viva Boot Camp - Anaesthesia Collective link: https://www.anaesthesiacollective.com/viva-boot-c
BREAK: Season 5 starts July 18 - It's not over
Deep Breaths returns on Monday July 18th with our fortnightly release schedule that we hope you're all still enjoying. We hope you take the time over the June/July holiday break to recharge those batteries so that you're feeling good for the latter half of the year. Season 5 will see us tackle more new topics that we hope will keep you up to date in your practice, and to help our exam ca
S4 Ep. 12: Unwritten (QEII Anaesthetic Conference live recording)
Today, we join you live from the QEII Anaesthetic Conference, and this episode is a little different. We explore some of the evidence behind those little pearls that we've learned in anaesthesia and that we've shared with you all during previous episodes. Topics that we discuss include fatigue and how if affects performance, the mandibular protrusion test, and the use of dexmedetomidine
S4 Ep. 11: Why (Oesophageal intubation)
In today's episode, we discuss challenges in the diagnosis and management of oesophageal intubation and anaesthetic crises in general. Recognising an oesophageal intubation may seem simple, but by looking at coroner's cases both here in Australia and in the UK, as well as cases in the NAP4, it can be far more complex. Feel free to email us at deepbreathspod@gmail.com if you have any que
S4 Ep. 10: The show must go on (Perioperative neurocognitive disorders)
Today we discuss perioperative neurocognitive disorders - their definitions, potential pathophysiologies, diagnosis, and possible prevention & treatment strategies. Resources for this episode include: Acute peri-operative neurocognitive disorders: a narrative review Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery - 2018 Thanks for listening, a
S4 Ep. 9: I've got you under my skin (Allergy testing)
In today's episode, we interview special guest Dr Annabelle Harrocks to chat about all things allergy testing - who, why, when, what and how! Listen in for a great practical chat which covers everything you didn't know about an important service for patients who have experienced serious allergic reactions under anaesthesia. Thanks for listening, and happy studying! Feel free to email us
S4 Ep. 8: And the healing has begun (Dexamethasone and the PADDI trial)
In today's episode, we discuss the recently published PADDI trial (Perioperative Administration of Dexamethasone and Infection), and whether and how it will change our practice. Thanks for listening, and happy studying! NEJM article - the PADDI trialIntroduction to multiplicity issues in clinical trials Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or s
S4 Ep. 7: Drop dead legs, part 2 (Lower limb regional anaesthesia)
Continuing on from episode 6, we continue our interview with Dr Michael Kerr to discuss regional anaesthesia for the lower limbs. In this episode, we cover popliteal sciatic blocks and adductor canal blocks in detail, ideas for learning/practising blocks in a resource-constrained environment, and tips for dealing with surgeons when discussing regional anaesthesia for your patients. Thanks for lis
S4 Ep. 6: Drop dead legs, part 1 (Lower limb regional anaesthesia)
In today's episode, we interview our guest Dr Michael Kerr to discuss regional anaesthesia for the lower limbs. In this episode, we cover the taxonomy of lower limb blocks, the indications for various types of blocks and discuss in detail the fascia iliaca block. Thanks for listening, and happy studying! Resources for this episode include:Reading list - Peripheral nerve block anesthesia/analg
