GasCast

GAT 2013 Annual Scientific Meeting Special

rik — Wed, 01 May 2013 15:48:01 +0000

Click here for the direct download of Season 2 Episode 10. Having had probably a bit too much of a good time in Glasgow last year, we jumped at the opportunity to go again to the Group of Anaesthetists in Training Annual Scientific Meeting, held this year in Oxford. In this podcast we attempt to compress and redistribute our favourite moments and practice changing learning points from 3 full days of lectures and workshops into 90 minutes of audio; once again with the help of conference veterans June Rahman and Sibs Anwar. In addition to our discoveries and summaries we’ve got live interviews from the conference floor and two new voices in the form of Chhaya Sharma and Preea Gill lending weight and debate to our public house post-match analysis. So if you were there, have a listen and see if you agree with us; if you didn’t make it, have a listen and see what you missed….

GAT and the GATASM Program

Lectures from the conference courtesy of the AAGBI website

Operation Spanner

Danny Bryden on Twitter

Professor Popat

Sir Jonathan Michael – so important he has his own Wikipedia page!

Jonathan Fielden on Twitter

An amazing story about Andrew Hartle

Takotsubo cardiomyopathy

Season 2 Episode 9

rik — Sat, 30 Mar 2013 12:42:27 +0000

Click here for the direct download of Season 2 Episode 9. Thankfully, we’re back to our usual format for this episode with Sibs Anwar once again stepping into the breach and filling in for Frank. We find yet more reasons not to use Remifentanil when reviewing this month’s Anaesthesia and discuss the various merits and restrictions of the latest AAGBI guidelines on immediate post-anaesthesia recovery. We revisit the topic of gastric ultrasounds (it appears that Mark is just as enthusiastic about them now, as he was back in May), and collectively fail to draw meaning from a paper on prognostication in traumatic brain injury. Rants are back, there’s another legendary performance from Bex in Biology or Bunkum and several random minutes of stinky-plug-chat interspersed with some discoveries. We’re at the GATASM next week so be there or at least be somewhere better. Like the SOAP meeting in Puerto Rico.

Rescue and resuscitation or body retrieval?

Gordon Ewing Enquiry Determination – well worth reading

Off-label Prescribing – GMC Guidance

JICScast

Plugs of the World! Scroll down to type G and be proud to experience the planet’s best electrical safety.

AAGBI guidelines on immediate post-anaesthesia recovery

Cardiac arrest in an obstetric patient using a remifentanil PCA

The surprisingly controversial topic of Gastric Ultrasound

Prognostication in TBI

Super-massive fizzy drinks are OK! (but will still might kill you, possibly)

Telepathic rats with tiny colanders on their heads

Vehicular selection

Season 2 Episode 8

rik — Thu, 28 Feb 2013 11:17:01 +0000

Click here for the direct download of Season 2 Episode 8. It’s been a difficult month for us timing wise and we were forced to open the envelope labelled plan B. In it, we found a ‘quick-deploy-podcast’ plan that we last tested during our early development, with subsequently unpublishable results. Undeterred, we all met at Frank’s, gathered around his kitchen table in various states of sleep deprivation, and managed to piece together some anaesthesia related chat. This month Bex tells us about the added extras in everyone’s favourite antiarrhythmic amiodarone, I introduce my Mazda Bongo Friendee, and Mark laments the sacrifice of rain forests for the sake of medical academia. We discuss the MHRA drug safety update on post-surgical codeine prescription in children and the management of the rare syndrome of spontaneous intracranial hypotension. We attempt to demystify information governance and data encryption for health professionals, with some practical advice and a live demonstration; as usual, at Bex’s expense.

Tween & what it does to dogs

The brilliant interview Frank talks about with Magill and Scurr. We probably should have tried this format instead of kitchen style.

Some ideas for Mark to make him feel better about throwing away old journals.

Turns out someone has already told the internet how to retrieve helium balloons from high ceilings

The awesome Mazda Bongo Friendee

MHRA drug safety update on post-surgical codeine prescriptions in children, Dahan’s case study review in the BJA and an interesting reply from some Imperial trainees.

The ICO fine Brighton and Sussex, what the MDU say about cloud storage, and a how to guide on using truecrypt to protect your sensitive data

Spontaneous CSF leaks and if Carlsberg wrote case reports

Just for Bex – some omg-physics-facts!

Season 2 Episode 7

rik — Wed, 30 Jan 2013 14:18:12 +0000

Click here for the direct download of Season 2 Episode 7. You say lignocaine, I say lidocaine. Whatever your persuasion of pronunciation, we predict that lidocaine will be the ‘Ketamine of 2013′, and review some of the latest research using this humble local anaesthetic. We discuss the merits of data dredges and look at some surprising results in resuscitation airway management from one such exercise in Japan. Frank presents some broccoli research on the effect of big tidal volumes and reminds us which patients are most at risk from over-zealous ventilator settings. We’ve got some relevant discoveries, some not so relevant discoveries, and we want to hear from you about things you have discovered for future episodes. All of this plus a mid-quarterly orientated Biology or Bunkum.

Papers for iOS and Android

The Belmont Buddy Lite

The awesome Cubelets

Rebecca’s new favourite website, save the gingers video, and an actual research paper to prove the point!

Prevent spikes in ICP during endotracheal suction with lidocaine

Prehospital advanced airway management and neurological outcome

Surgeons administering IV lidocaine infusions

More problems with high tidal volumes – this time in cardiac surgery patients

An important paper in Anaesthesia – the effect of lidocaine on larygospasm in children

This month’s slight tenuous Biology or Bunkum source. Sorry.

Season 2 Episode 6

rik — Sat, 29 Dec 2012 14:25:03 +0000

Click here for the direct download of Season 2 Episode 6. For this special Christmas episode we are delighted to be joined by numbers guru and journal editor John Carlisle, who has well as helping with our discoveries, discourse and associated banter, takes us through his BJA paper on peri-operative risk modelling and the missing axis. We examine the most recent output from the Surviving Sepsis campaign in the Lancet and try to wring some meaning out of the recent NICE guidance on depth of anaesthesia monitoring. The excitement doesn’t stop there as in a never before attempted manoeuvre, Frank joins us late into the recording without causing our slightly tenuous setup to fail, and we finish off with a seasonal round of Biology or Bunkum. Pancakes are also feature.

The Global Fat Scale

Some evidence on tunnelling epidural catheters. Sort of.

Enjoy what’s happening now on Medpedia

Pancakes au Carlisle

2 eggs (not 1 – that is a critical error)
2oz plain and 2oz of self-raising cheap flour (Sainsbury’s Value preferable)
200ml milk
100ml water
2 desert spoons of melted butter
homogenise with a whisk (fork based mixing possible but not recommended)
hot pan

Garnish with Nutella, maple syrup or orange and sugar (John’s favourite)

Outcomes of the Surviving Sepsis Campaign in intensive care units in the USA and Europe: a prospective cohort study

NICE guidance on depth of anaesthesia monitors

Dexmedetomidine RCTs in JAMA

Assessing fitness, predicting outcome, and the missing axis

Diet aviators and that appetite stimulating red light

Caffeine Pants!

Season 2 Episode 5

rik — Fri, 30 Nov 2012 18:03:22 +0000

Click here for the direct download of Season 2 Episode 5. In this episode we get really excited about our discoveries and news items, apart from Mark, who remains consecutively unimpressed. Bex tells about an amazing technique called the Tsui test for working out where your epidural catheter has gone, and Mark then tells her it’s useless. I review some incredible results showing that pre-operative focused TTE may improve medium and long term outcomes in NOF patients, which Mark definitely won’t be doing. Frank telegraphs some fantastic work looking at the real science and prevalence of cephalosporin/penicillin cross reactivity and Mark looks at how often we get sued compared to other hospital specialities. We’ve got some great discoveries and after 18 Episodes, Bex is still struggling to understand how Biology or Bunkum works.

Benign Intracranial Hypertension

Adblock Plus & Eton Style

Pain Less at the Science Museum & try for a high score on Ouch!

How to dissolve Teicoplanin

A good use of 25 million pounds

A bold premise for a TV show and should we legalise organ sale?

Wonder about the location of your epidural catheters no more. Ladies and Gentleman – videos of the Tsui Test

Amazing results for focused TTE in NOF patients and the H.A.R.T. scan course

Tim Cook’s Letter in the BJA (nice email address)

Boo to Cephalosporin-Penicillin allergies

Bullet proof fly and D.melanogaster sequenced in 2000

Weaponised oxytocin

Tetragametic chimerism and IVF for mitochondrial disorders

Season 2 Episode 4

rik — Tue, 30 Oct 2012 14:16:02 +0000

Click here for the direct download of Season 2 Episode 4. Due to diary difficulties, we sadly had to record without Rebecca this month. However, standing in and doing a sterling job, we’re delighted to feature a new voice in the shape of Sibs Anwar. In this episode I review the landmark EuSOS study while Frank looks at the mounting evidence against hetastarches in the post-Boldt era. Sibs presents some of the emerging research suggesting that Remifentanil may have a role in the development of post-surgical chronic pain syndromes, and Mark attempts to persuade us that the NHS should be investing more money in helicopters. We’ve got some great discoveries, including the revelation that Mark has never managed to listen to an episode of the podcast all the way through. Can Sibs do anything to improve Rebecca’s ranking in this month’s Ig Nobel themed Biology or Bunkum? Answers at the end of another jam-packed episode.

At last – now we can find out what the plasma concentration of Propofol was 5 minutes ago!

The perioperative research trainee forum and the excellent Future Directions meeting on November 23rd.

Human splenic contraction – biology or bunkum? Potentially biology apparently.

Ben Goldacre’s new book and funnel plots

Female doctors may outnumber male doctors by 2017

Possibly the nail in the coffin for Hetastarches in NEJM

Remifentanil may cause chronic pain in cardiac surgery in the BJA

EuSOS in the Lancet, website, the Irish blog post, Lancet editorial and YouTube video

French helicopters are scientifically proven to be good in Critical Care

The Ig Nobel Prizes

Season 2 Episode 3

rik — Sun, 30 Sep 2012 16:42:40 +0000

Click here for the direct download of Season 2 Episode 3. In our big interview this month, Bex talks to anaesthetic legend Professor Peter Slinger as we hear about some lessons from lung transplant anaesthesia that can be applied to our routine daily practice. Continuing on our ventilation theme, I look at a brand new paper on bariatric ventilation and revise the useful, but often neglected recruitment manoeuvre, at the same time revealing a mild speech impediment. Frank brings us the first report from the UK national emergency laparotomy network, and Mark gets the best out of his NEJM subscription and takes us back through the evidence and use of hyperosmolar fluid therapy in traumatic brain injury. We also have a broadcastable rant this month, piles of news and more revelations about Dr. Smith’s teenage years. We round the episode off with a stomach-churning Biology or Bunkum, complete with a surprise result.

The bougie, ET Tube rotation question was answered here, but it seems the blog owner hasn’t paid their bills. Google cache has the answer.

London Trauma Conference – expensive but likely to be worth it. To see Mark if nothing else.

EXIT Procedure – Obstetrics on steroids

The awesome bronchoscopy simulator at thoracic-anesthesia.com

Prof Slinger at DAS

Ventilation strategies for the obese

First report from the UK Emergency Laparotomy Network

NEJM – Hyperosmolar Therapy for Raised ICP

Cannabis and epilepsy – straight out of Reading

Horrendous – acne and arachnids

Not as safe as you thought – the NPSA acupuncture safety report

Season 2 Episode 2 – Mythbusters

rik — Thu, 30 Aug 2012 15:01:50 +0000

Click here for the direct download of Season 2 Episode 2. This month we’re mythbusting as we take it in turns to examine the evidence behind four pieces of clinical anaesthetic dogma. Frank makes inroads into the paediatric cuffed tube debate whilst Bex successfully debunks another important epidural myth. Mark explains why he won’t be asking for cricoid pressure and I’m once again on my CVP/fluid management hobby horse. After last episode’s resounding success, it’s a swing and a miss for Mark’s Monthly but Question of the Month is back, along with the birth of a new allied health professional. Bex continues her campaign to be this year’s Biology or Bunkum champion in a predictably Old Wives’ Tale themed edition and we share some new apps, monitoring techniques and why there are no brown drug labels in our discoveries section.

Scancrit.com and the MacGyver Pharyngeal Pulse Oximeter

The Origin of Syringe Labelling

Vishal’s Primary FRCA Viva App

Don’t lie pregnant women on their backs, no effect of hip-flexion, effect on the foetus & gravity having no effect

Cuffed vs. uncuffed debate, an RCT on the subject & the shortcomings of cuffed paediatric tubes

Attention medics – central lines don’t tell you anything about fluid status!

Cricoid Pressure in the ED – Risk vs. Benefit Analysis

Excellent medical myths article in the BMJ

Season 2 Episode 1

rik — Mon, 30 Jul 2012 11:59:37 +0000

Click here for the direct download of Season 2 Episode 1. Having successfully made it through 12 episodes, we’re thrilled to be back for a second season of GasCast. In this episode the focus is firmly on the nitty gritty of the day to day, as we discuss topics of such devastating anaesthetic importance as what length of catheter to leave in the epidural space and how best to size and dispense scrubs. As if that wasn’t enough, Bex tells us about the National Tracheostomy Safety Project, Frank reviews the latest NCEPOD report and Rik talks about observational studies and the importance of lung protective ventilation. We compare epidural idiosyncrasies, enjoy some listener feedback and are collectively repulsed by a surprise present left in Mark’s scrubs. Bex decides to up the ante in Biology or Bunkum and we unveil our brilliant new feature – Mark’s Monthly.

Quadricuspid Aortic Valve

Polypill on PLoS ONE

Papers for iOS

Lung Protective Ventilation and 2 Year Survival

National Tracheostomy Safety Project

Failed Epidurals: Causes and Management

NCEPOD: Time to Intervene?

Mark’s Monthly – press coverage has already begun

The Lancet: Laziness Kills

Crazy ethics but apparently children are good for your health

And of course…. Dwayne Möhr’s excellent subclavian access US video!