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Rapid Sequence

Anaesthesia Journal

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Anaesthesia is the official journal of the Association of Anaesthetists and is international in scope and comprehensive in coverage. It publishes original, peer-reviewed articles on all aspects of general and regional anaesthesia, intensive care and pain therapy, including research on equipment. Rapid Sequence podcasts offer an insight into our journal, publications, editors, reviewers, authors and readers. Each episode is short, concise and packed full of CPD for all your educational needs.
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This podcast was recorded live at the Association of Anaesthetists Annual Congress 2024 in Harrogate. We spoke with keynote speaker Sir Julian Hartley (Chief Executive of NHS Providers) and Association of Anaesthetists President Dr Tim Meek about the role of the modern consultant in healthcare systems, HIT lists and whether or not the NHS is 'broke…
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This podcast was recorded live at the Association of Anaesthetists Annual Congress 2024 in Harrogate. We recently published a new multidisciplinary consensus statement from the Association of Anaesthetists and the British Pain Society. We were delighted to join authors Dr Helen Laycock and Prof Kariem El-Boghdadly to discuss the need for this new d…
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This podcast was recorded live at the Association of Anaesthetists Annual Congress 2024 in Harrogate. We were delighted to be joined by Dr Sarah Marsden and Dr Stuart Edwardson to talk about a new scoping review from Winter et al. Dr Marsden is the Chair of the Association of Anaesthetists Trainee Committee having taken over the role from Dr Edward…
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This podcast was recorded following the airway session at the Association of Anaesthetists Annual Congress 2024 in Harrogate. Our dissemination Editor Dr Maryann Turner was joined by Prof Kariem El-Boghdadly, Dr Emilie Hoogenboom, Prof Ed Mariano and Dr Imran Ahmad. The discussion was around difficult airway management and how the choice between te…
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The 7th National Audit Project (NAP7) of the RCoA examined peri-operative cardiac arrest and each of the three phases captured the involvement of anaesthesia associates in clinical practice. In view of current interest and controversy concerning the roles and scope of practice of anaesthesia associates, the authors aimed to share a full account of …
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There are lots of excellent papers this month which have been highlighted by our dissemination editors Maryann and Mike! This month, they discuss: Still a ‘boys’ club': a qualitative analysis of how gender affects a career in anaesthesia in Australia and Aotearoa New Zealand Successful return to work in anaesthesia after maternity leave: a qualitat…
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This month, Dr Maryann Turner is joined by Professor Kariem El-Boghdadly to discuss three papers from the June 2024 issue. Comparison of the success rate of tracheal intubation between stylet and bougie with a hyperangulated videolaryngoscope: a randomised controlled trial. The effect of a bundle intervention for ambulatory otorhinolaryngology proc…
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The Opioid PrEscRiptions and Usage After Surgery (OPERAS) study aimed to quantify the current global practice of opioid prescribing and consumption patterns in patients after discharge from common surgical procedures, and to identify factors associated with increased opioid consumption. It found that double the quantity of opioids patients consume …
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Despite a lack of supporting evidence, airway management in patients with suspected or confirmed cervical spine injury is traditionally thought to increase the risk of worsening existing neurological deficits (secondary spinal cord injury) or risk of causing a new spinal cord injury (primary spinal cord injury). Although there has been evidence syn…
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While effective for acute pain control, recent pre-clinical evidence has raised concerns regarding an association between NSAIDs and chronic pain and potential opioid use. The objective of this paper was to explore the association between peri-operative use of prescription NSAIDs and the need for continued opioid prescriptions lasting 90–180 days i…
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Gender inequity remains an issue in anaesthesia despite increasing numbers of women training and achieving fellowship in the speciality. Women are under-represented in all areas of anaesthetic research, academia and leadership. This podcast featuring Dr Seema Agarwal discusses two new qualitative papers on related topics. The first is an analysis o…
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This month, Dr Maryann Turner takes the helm to discuss three papers from the May issue with Dr Mike Charlesworth. The first is a national prospective observational cohort study of risk factors for complications after emergency surgery for paediatric appendicitis. The second is a new Resuscitation Council UK algorithm for the emergency treatment of…
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The April issue contains lots of excellent clinically-orientated papers and this month, Associate Editor Dr Nicolai Bang Foss has chosen three that caught his eye. The first is a comparison of a new intravenous agent remimazolam vs. propofol for TIVA and we talk about depth of anaesthesia, hypotension and everything inbeteeen. The second is a new P…
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This month, all the main articles in the issue come from a special collection on sustainable healthcare, climate science and the anaesthetist. All papers are free to read, forever! Our Associate Editor, Dr Ben Gibbison, has chosen three of his favourite from the issue to discuss. These include an editorial on misconceptions about sustainable anaest…
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There have been few large-scale, prospective cohort studies focusing on postoperative cardiovascular complications and their impact on postoperative mortality. This international prospective cohort study aimed to define the incidence and timing of these complications and to investigate their impact on 30-day all-cause mortality. The authors perform…
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Our new 2024 special supplement is now online! We have put together a collection of articles that are at the cutting edge of peri-operative science. Joining @GongGasGirl is Dame Julia Slingo, Miss Virginia Ledda and Ms Alifia Chakera. Their articles cover climate science, carbon literacy and The Nitrous Oxide Project. This podcast was viewed by mor…
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Welcome to this month’s Anaesthesia Journal Podcast! We are delighted to be joined by Dr Criag Lyons, who is an Editor of Anaesthesia Reports. This month, we are going to be talking about three new papers from the January 2024 issue covering regional anaesthesia, videolaryngoscopy and statistics. Three core topics for all anaesthetists. Enjoy!…
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Complications and critical incidents arising during anaesthesia due to patient, surgical or anaesthetic factors, may cause harm themselves or progress to more severe events, including cardiac arrest or death. As part of the 7th National Audit Project of the Royal College of Anaesthetists, the authors studied a prospective national cohort of unselec…
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There are two papers we are discussing today and they are the first in a series of results from probably the most important piece of peri-operative research from 2023 – NAP7! The first paper reports results from the local coordinator baseline survey. The second paper then looks at preparedness for and experiences of peri-operative cardiac arrest. T…
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Today we are going to be talking about the December 2023 issue, which is online today! This issue is really exciting because it is the first to contain papers reporting results from NAP7. This will all be dealt with separately, so instead we are going to focus on other papers in the issue. And there is a lot to choose from: prehabilitation; pain as…
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This month, we discuss three important papers from the November 2023 issue with Professor Ed Mariano. A great way to get all your CPD for the month in just half an hour! 1. Is the future of nitrous oxide as volatile as the gas itself? https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16086 2. PROSPECT methodol…
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Point-of-care gastric sonography offers an objective approach to assessing individual pulmonary aspiration risk before induction of general anaesthesia. This new paper aimed to evaluate the potential impact of routine pre-operative gastric ultrasound on peri-operative management in a cohort of adult patients undergoing elective or emergency surgery…
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Despite concerns and recommendations, modified-release opioids are still commonly used for the management of acute pain following total hip and knee arthroplasty. There is a need to compare modified-release and immediate-release opioid use following these procedures, and to determine whether the use of modified-release opioids is safe or harmful. T…
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Neuraxial labour analgesia is a safe and effective method of pain relief. Following initiation of analgesia with epidural or combined spinal-epidural, this can be maintained with continuous epidural infusion, manual intermittent boluses, patient-controlled epidural analgesia (PCEA), programmed intermittent epidural bolus (PIEB) or a combination of …
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Guidance for the timing of surgery following SARS-CoV-2 infection needed reassessment given widespread vaccination, less virulent variants, contemporary evidence and a need to increase access to safe surgery. This is the third iteration of consensus guidance around timing of surgery and risk assessment. Find out here why the update was required and…
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The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. This new study compares their use for elderly patients undergoing low risk surgery with a composite of postoperative pulmonary complications as the primary outcome. It is a fascinating trial for many reasons and we …
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Surgical decision-making after SARS-CoV-2 infection is influenced by the presence of comorbidity, infection severity and whether the surgical problem is time-sensitive. This new paper utilised the OpenSAFELY database to look at practices and outcomes in England, and suggests that some patients can be safely operated within 2 weeks from infection. T…
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Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3–4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapsho…
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This new paper from the AERATOR group examines the science around aerosol generation and awake tracheal intubation (ATI). Their study was performed on a single day during an ATI course on 12 anaesthetic trainees. They show that ATI without sedation generates high concentrations of respiratory aerosol. Professor Ross Hofmeyr talks to the authors abo…
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We caught up with Dr Fiona Kelly, lead author of a new guideline from the Association of Anaesthetists and the Difficult Airway Society on human factors in anaesthesia. The guideline and narrative review were published and launched live at the Winter Scientific Meeting in London today and there are several actions that we can all take today to impa…
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Pre-operative anaemia is common in patients undergoing non-cardiac surgery and associated with an increased risk of blood transfusion, hospital length of stay and postoperative complications. This podcast is all about a new secondary analysis of the PREVENTT study. We are delighted to be joined in Australia by three of the papers authors, Professor…
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Today, we were joined by three authors (Dr Alopi Patel, Dr Michelle Kars and Prof Ed Mariano) of a new paper which is all about how to use social media to get published. This forms part of a new series of articles called Reviewer Recommendations, which is very much a ‘how to’ guide for authors and readers. Enjoy!…
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Today we will be discussing this new paper which describes and validates a new anaesthetic complexity score, which is is a clinician-designed, real-world tested model of case complexity in anaesthetics. It is inclusive of, but distinct from, patient and surgical risk. The paper is of interest because of the methods used and also the potential impli…
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The Editors of Anaesthesia acknowledge the EDI problems we face in anaesthesia and medicine as a whole. Without taking action to address these problems, these issues will persist. This newly published position statement is from the Editors of Anaesthesia, including the Editor-in-Chief. For this podcast, the principal authors join Association of Ana…
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Climate change is a real and accelerating existential danger. Urgent action is required to halt its progression, and everyone can contribute. Pollution mitigation represents an important opportunity for much needed leadership from the health community, addressing a threat that will directly and seriously impact the health and well-being of current …
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There is very limited evidence about the relative effectiveness of emergency surgery vs. non-emergency surgery strategies for patients with common acute conditions. This lack of evidence means that there is likely to be considerable practice variation in the NHS in England. The ESORT study, which was published last night, aimed to compare the effec…
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This new guideline provides an update to the previously published consensus statement on SARS-CoV-2 infection, COVID-19 and timing of elective surgery to assist policymakers, administrative staff, clinicians and patients. It focuses on the omicron variant, which is now strongly dominant in many countries. However, the principles may also be of rele…
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Joining us today we have the authors of a new paper reporting the effect of a text message intervention on burnout in trainee anaesthetists. First we have Emily Larson who is a Senior Advisor at The Behavioural Insights Team. Emily has worked on reducing burnout and increasing wellbeing with physicians, educators and children. We also have Dr Alix …
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There were more applications for higher specialty training posts in anaesthesia in the UK starting in August 2021 than in previous years, with approximately two-thirds being unsuccessful. This new national survey is all about recruitment to higher specialty training in anaesthesia in the UK during the COVID-19 pandemic. Joining Dr C Hughes was Dr C…
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What better way to see in any new year than with a brand-new Anaesthesia Special Supplement! This year, it is all about the peri-operative and critical care management of the brain, which has been guest edited by Dr Jugdeep Dhesi and Professor Alana Flexman. Joining us also were journal Editors Professor Iain Moppett and Dr Matt Wiles. Topics inclu…
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A recent coroner’s report in the UK concluded that a healthy patient died as a result of unrecognised oesophageal intubation. This did not seem to be the result of misinterpretation of a flat end-tidal carbon dioxide trace, but an apparent omission to check the capnograph after intubation and to perform clinical checks of tracheal tube position. Th…
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Parachute (or ‘helicopter’) research is the practice of conducting primary research within a host country and subsequently publishing findings with inadequate recognition of local researchers, staff and/or supporting infrastructure. The aim is that these recommendations will be broadly applicable within academic publishing; of use to international …
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In the UK, the Getting It Right First Time (GIRFT) programme was established by the Department of Health and Social Care as an initiative to investigate variation in healthcare delivery and patient outcomes between hospital Trusts in England. Variation between Trusts is unwarranted unless justified by patient case-mix, patient preference, equivocal…
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Robust evidence is needed to enable clinicians and policymakers to minimise VTE risk in patients with SARS-CoV-2 infection. Ideally, such evidence would stratify the risk of VTE against both the duration of time between infection and surgery and presence or absence of symptoms. This study aimed to determine the VTE rate in patients with SARS-CoV-2 …
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This international prospective cohort study analysed data on > 96k patients from > 1500 hospitals in > 100 countries. They found that the overall postoperative pulmonary complication rate for all patients was 2.0%, which alone is useful to know. Perhaps more strikingly, and following adjustment for various measured confounders, patients who isolate…
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