Deep Breaths: Recent Episodes
Deep Breaths
Welcome to Deep Breaths, a podcast covering topics related to the ANZCA part 2 anaesthetic exam. Now take a deep breath, relax, and enjoy easy to digest content which will supercharge your exam prep, or help you keep up to date.
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 2021
ESC Guidelines on cardiovascular assessment and management of patients undergoing non cardiac surgery
2014 ACC/AHA guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Non-cardiac Surgery
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
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Thanks for listening, and happy studying!
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 2022
PG67 BP: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures Background Paper 2022
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Thanks for listening, and happy studying!
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.
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And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy by G.C. Feigl et. al.
Video: The Infraclavicular Block - Essentials of Ultrasound-Guided Regional Anesthesia by Ki-Jinn Chin
The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine: Executive Summary 2015 by J.M. Neal et. al.
Axillary block videos:
The in-depth video: Ultrasound Guided Axillary Block NYSORA Regional Anesthesia by NYSORA - Education
The short-and-sweet video: Ultrasound Guided Axillary Brachial Plexus Block NYSORA Regional Anesthesia by NYSORA - Education
The simple and fantastic video: US-guided Axillary Brachial Plexus Block - the Simple Guide by Ki-Jinn Chin
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 the time of surgery, and the implications for our anaesthetic.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
2021 ANZCA Blue Book: Direct Acting Oral Anticoagulants - pharmacology and perioperative considerations by Dr Kate Drummond (p147)
TGA Website
RE-ALIGN Trial
GALILEO Trial
BMJ: Coagulation assessment with the new generation of oral anticoagulants by Charles Pollack Jr
Journal of Thrombosis and Haemostasis: Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians by J. Douxfils et al.
PAUSE Trial
Regional Anesthesia and Acute Pain: Regional anaesthesia in the patient receiving antithrombotic or thrombolytic therapy, 5th edition (ASRA 2025 Guidelines)
RE-VERSE-AD Trial
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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 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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.
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And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode include:
NSW Coroner's Court website
Why does oesophageal intubation still go unrecognised? Lessons for prevention from the coroner’s court
National Audit Project 4
ANZCA Professional Documents
Red Man Syndrome
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And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 the way.
Enjoy this interactive and entertaining discussion with Dr Chris Cokis, Professor David Story, Professor Kate Leslie, Dr Andrew Cumpstey, Professor Eugenie Kayak, and Dr Lahiru Amaratunge.
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And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 we recorded on a submarine, we can assure you we were sitting in our study the entire time.
Resources for today's episode:
BJAED:Anaesthesia for endovascular repair of ruptured abdominal aortic aneurysmsby K. Berry et al.
LITFL: AAA by C. Nickson
Lancet: Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial by Patel, R. et al.
Annals of Surgery: Endovascular Repair of Abdominal Aortic Aneurysm in Patients Physically Ineligible for Open Repair: Very Long-term Follow-up in the EVAR-2 Randomized Controlled Trialby Sweeting, M. et al.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
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Thanks for listening, and happy studying!
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 aneurysmsby K. Berry et al.
LITFL: AAA by C. Nickson
Lancet: Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial by Patel, R. et al.
Annals of Surgery: Endovascular Repair of Abdominal Aortic Aneurysm in Patients Physically Ineligible for Open Repair: Very Long-term Follow-up in the EVAR-2 Randomized Controlled Trialby Sweeting, M. et al.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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!
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Thanks for listening, and happy studying!
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!
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Thanks for listening, and happy studying!
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 episode:
StatPearls:
Inotropes and vasopressors by D. VanValkinburgh et al.
Adrenergic Drugs by K. Farzam et al.
LITFL:
Inotropes, vasopressors and other vasoactive agents by C. Nickson
Milrinone by C. Nickson
Levosimendan by C. Nickson
Methylene blue by C. Nickson
Hydroxocobalamin by N. Long
Deranged Physiology:
Classification of inotropes and vasopressors
Milrinone
Levosimendan
DRUGBANK Online:
Milrinone
Levosimendan
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
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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. VanValkinburgh et al.
Adrenergic Drugs by K. Farzam et al.
LITFL:
Inotropes, vasopressors and other vasoactive agents by C. Nickson
Vasopressin by C. Nickson
Dopamine by C. Nickson
Dobutamine by C. Nickson
Deranged Physiology:
Classification of inotropes and vasopressors
Vasopressin
Dobutamine
DRUGBANK Online:
Vasopressin
Dopamine
Dobutamine
BJAED:
Vasopressin and its role in critical care by A. Sharman & J. Low.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 our discussion about adrenaline, we state that both noradrenaline and adrenaline have the same affinity for beta-1 adrenoceptors. We then advise that the reason for the inotropic and chronotropic effects of adrenaline - not seen with noradrenaline - are because adrenaline has much greater affinity for beta-2 adrenaceptors than noradrenaline.
Resources for today's episode:
StatPearls:
Inotropes and vasopressors by D. VanValkinburgh et al.
Adrenergic Drugs by K. Farzam et al.
LITFL:
Inotropes, vasopressors and other vasoactive agents by C. Nickson
Metaraminol by R. Buttner
Phenylephrine by C. Nickson
Noradrenaline by C. Nickson
Adrenaline by C. Nickson
Deranged Physiology:
Classification of inotropes and vasopressors
Metaraminol
Noradrenaline
Adrenaline
DRUGBANK Online:
Metaraminol
Ephedrine
Phenylephrine
Noradrenaline
Adrenaline
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 affirmation, and lastly how this can inform the provision of safe anaesthesia for transgender patients.
Resources for this episode:
BJA Education: Perioperative considerations for transgender and gender diverse adults by Harding, D. et al.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
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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 surgery.
Resources for this episode:
Oxford Handbook of Transplant Anaesthesia and Critical Care
BJAED: Anaesthesia for a patient with a cardiac transplant (2002) by Morgan-Hughes, N. & Hood, G.
Circulation (2004): Drug therapy in the heart transplant recipient by Lindenfeld, J. et al.
Indian Journal of Anaesthesia: Post cardiac transplant recipient: Implications for anaesthesia by M. Choudhury
RCEM India Learning - The ECG after cardiac transplantation
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
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Thanks for listening, and happy studying!
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 patients may be taking, as well as their mechanism of action and side effects.
Resources for this episode:
Oxford Handbook of Transplant Anaesthesia and Critical Care
BJAED: Anaesthesia for a patient with a cardiac transplant (2002) by Morgan-Hughes, N. & Hood, G.
Circulation (2004): Drug therapy in the heart transplant recipient by Lindenfeld, J. et al.
Indian Journal of Anaesthesia: Post cardiac transplant recipient: Implications for anaesthesia by M. Choudhury
RCEM India Learning - The ECG after cardiac transplantation
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
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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. & Costello, R.https://www.ncbi.nlm.nih.gov/books/NBK551568/
ANZCA PG07(A) Appendixhttps://www.anzca.edu.au/getattachment/897f5bf5-b665-4c99-a56f-e72678f19f7e/PG07(A)-Appendix-1-%E2%80%93-Fasting-guideline ADS-ANZCA Perioperative and Hyperglycaemia Guidelines (Adults)https://www.diabetessociety.com.au/wp-content/uploads/2023/03/ADS-ANZCA-Perioperative-Diabetes-and-Hyperglycaemia-Guidelines-Adults-November-2022-v2-Final.pdf
Up To Date: Glucagon-like peptide 1-based therapies for the treatment of type 2 diabetes mellitus by Dungan, K. & DeSantis, A.https://www.uptodate.com/contents/glucagon-like-peptide-1-based-therapies-for-the-treatment-of-type-2-diabetes-mellitus#:~:text=Like%20native%20GLP%2D1%2C%20all,%27Glycemic%20efficacy%27%20below.)
American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists by Joshi, G. et al.https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative
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Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
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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 anaesthesia for patient's with ventricular assist devices (or VADs), and we talk about providing anaesthetic care for a patient with a hypertrophic obstructive cardiomyopathy (or HOCM).
Resources for today's episode:
ANZCA Blue Book 2021
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
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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) education committee by Hoefnagel, A.L. et al. (full journal article)
SNACC cognitive aids for neurosurgical emergencies (cognitive aids only)
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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: a narrative review (sciencedirectassets.com) by Lankadeva, Y. et al.
KDIGO 2012 Acute Kidney Injury Guidelines
LITFL: RIFLE criteria and AKIN classification
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
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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 kidney to perioperative injury.
In part two - which will be released in a fortnight - we will 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: a narrative review (sciencedirectassets.com) by Lankadeva, Y. et al.
KDIGO 2012 Acute Kidney Injury Guidelines
LITFL: RIFLE criteria and AKIN classification
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 & Darvall
BJA: A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study by Riedel, B. et al.
BJAED: Preoperative cardiopulmonary exercise testing by Agnew. N.
BJA: Using the six-minute walk test to predict disability free survival after major surgery by Shulman, M. et al.
STAT Pearls: 6 minute walk test by Matos Casano, M. & Anjum, F.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 test.
Resources for today's episode:
BJAED: Subjective methods for preoperative assessment of functional capacity by Silvapulle & Darvall
BJA: A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study by Riedel, B. et al.
BJAED: Preoperative cardiopulmonary exercise testing by Agnew. N.
BJA: Using the six-minute walk test to predict disability free survival after major surgery by Shulman, M. et al.
STAT Pearls: 6 minute walk test by Matos Casano, M. & Anjum, F.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 programs:
Viva Boot Camp Courses (via Anaesthesia Collective)
Online Part 2 Preparation Courses and ABCs of Anaesthesia Foundation Course (via Thinkific) - don't forget to use the code DB20 for 20% off when you purchase any of the two Anaesthetic part 2 exam preparation courses or the Anaesthesia Foundation course.
If you'd like more information about any of these programs, you can email Lahiru atvivabootcamp@gmail.com.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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.
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Thanks for listening, and happy studying!
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!
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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.
Dilemmas in the preoperative assessment of children by Bhatia, N. & Barber, N.
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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 preoperative assessment of children by Bhatia, N. & Barber, N.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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, 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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, 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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/NAP5home
B-Aware trial - https://www.sciencedirect.com/science/article/pii/S0140673604163009?via%3Dihub
B-Unaware trial - https://www.nejm.org/doi/full/10.1056/nejmoa0707361
BAG-RECALL trial - https://www.nejm.org/doi/full/10.1056/NEJMoa1100403
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 modules. Note: this website defaults to the German language. Google offers a translation service if you do not speak German.
ANZCA 2017 Blue Book. There are several good articles about ROTEM in this issue of the Blue Book.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 with case examples.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 seasons. We'll be back with brand new episodes in season 8 next year - fully refreshed, rejuvenated, and ready to sink our teeth into many more interesting topics with a host of brand new as well as previously beloved guest interviewees. So watch this space!
A link to Lahiru Amaratunge's Viva Boot Camp (live zoom-based course) via the Anaesthesia Collective can be found here.
A link to Lahiru Amaratunge's Anaesthesia Final Exam Course - an online course able to be accessed anytime (great for those unable to tune in to the Viva Boot Camp) can be found here.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 library.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 2021
ESC Guidelines on cardiovascular assessment and management of patients undergoing non cardiac surgery
2014 ACC/AHA guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Non-cardiac Surgery
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 circulation requires semi-urgent delivery. In our final two cases we take a close look at the pathophysiological changes that occur with the disease process as well as its management for delivery.
Resources for today's episode:
Anaesthetic Care of the Pregnant Patient with Cardiovascular Disease: A Scientific Statement From the American Heart Association by Meng, M.L et al. (Circulation, 2023)
BJAED: Pulmonary arterial hypertension in pregnancy by Kariyawasam. S., and Brown, J. (be sure to seek access through ANZCA or your national anaesthetic college)
BJAED: Management of cardiac disease in pregnancy by Burt, C.C. & Durbridge, J.
ANZCA 2015 Blue Book: Pulmonary Hypertension: An overview for the "non cardiac" anaesthetist by Smith, I. (p 75)
ECS Guidelines: Cardiovascular Diseases During Pregnancy (Management of) Guidelines (this link includes further links to the pocket guidelines app)
Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations by Meng, M.L. & Arendt, K.W.
Obstetric anesthesia management of the patient with cardiac disease by Arendt, K.W. & Lindley, K.J.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 take a close look at the pathophysiological changes that occur with the disease process as well as its management for imminent delivery.
Resources for today's episode:
Anaesthetic Care of the Pregnant Patient with Cardiovascular Disease: A Scientific Statement From the American Heart Association by Meng, M.L et al. (Circulation, 2023)
BJAED: Pulmonary arterial hypertension in pregnancy by Kariyawasam. S., and Brown, J. (be sure to seek access through ANZCA or your national anaesthetic college)
BJAED: Management of cardiac disease in pregnancy by Burt, C.C. & Durbridge, J.
ECS Guidelines: Cardiovascular Diseases During Pregnancy (Management of) Guidelines (this link includes further links to the pocket guidelines app)
Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations by Meng, M.L. & Arendt, K.W.
Obstetric anesthesia management of the patient with cardiac disease by Arendt, K.W. & Lindley, K.J.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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's episode:
Anaesthesia Cute of the Week (ATOTW): Peripartum Neurological Injury
Anaesthesia Patient Safety Foundation (APSF): Postpartum Peripheral Nerve Injuries - What is Anaesthesia’s Role? by McCrory, E. H. et al.
BJAED: Post-natal Neurological Problems by Boyce, H. & Plaat, F.
Management of Neurological Deficit In Postpartum Patients (Northumbria Healthcare Guidelines) by Bird, R. & Backe, S.K.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 Neurological Injury
Anaesthesia Patient Safety Foundation (APSF): Postpartum Peripheral Nerve Injuries - What is Anaesthesia’s Role? by McCrory, E. H. et al.
BJAED: Post-natal Neurological Problems by Boyce, H. & Plaat, F.
Management of Neurological Deficit In Postpartum Patients (Northumbria Healthcare Guidelines) by Bird, R. & Backe, S.K.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 anaesthesia specific videos:
Subtenon's Block
What I use for my eye block anaesthesia formula
Useful articles:
BJAED: Regional anaesthesia for ophthalmic surgery by Anker, R. & Kaur, N.
BJAED: Update on anaesthesia for paediatric ophthalmic surgery by Lewis, H. & James, I.
BJAED: Intraocular pressure by Murgatroyd, H. & Bembridge, J.
ATOTW: Anaesthesia for ophthalmic surgery
ATOTW: Anaesthesia for paediatric eye surgery
Dr Lahiru Amaratunge also runs a course designed to help prepare trainees for the final anaesthetic vivas. If you're interested, here are the links to these courses:
The Anaesthesia Final Exam Course (online course only)
The Viva Bootcamp Online Course
The Viva Bootcamp Live Zoom Course links for 2023 courses (via Humanitix)
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 by Dr Amaratunge during the episode):
ABCs of anaesthesia specific videos:
Subtenon's Block
What I use for my eye block anaesthesia formula
Useful articles:
BJAED: Regional anaesthesia for ophthalmic surgery by Anker, R. & Kaur, N.
BJAED: Update on anaesthesia for paediatric ophthalmic surgery by Lewis, H. & James, I.
BJAED: Intraocular pressure by Murgatroyd, H. & Bembridge, J.
ATOTW: Anaesthesia for ophthalmic surgery
ATOTW: Anaesthesia for paediatric eye surgery
Dr Lahiru Amaratunge also runs a course designed to help prepare trainees for the final anaesthetic vivas. If you're interested, here are the links to these courses:
The Anaesthesia Final Exam Course (online course only)
The Viva Bootcamp Online Course
The Viva Bootcamp Live Zoom Course links for 2023 courses (via Humanitix)
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 et al.
ANZCA Blue Book 2019: The changing face of complex regional pain syndrome treatment by Russo, M., Georgius, P. & Santarelli, D. (p183)
Up To Date Articles:
Complex regional pain syndrome in adults: Pathogenesis, clinical manifestations and diagnosis by Abdi, S.
Complex regional pain syndrome in adults: Treatment, prognosis and prevention by Abdi, S.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 care of patients at the end-of-life who are considered for surgery or interventional procedures Background Paper 2022
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 before discussing the markedly different managements for these two conditions.
Lastly, we talk through the principles of managing hyponatremia.
Resources for today's episode:
Diagnosis and Management of Hyponatremia - A Review by Adrogue, H.J., Tucker, B.M. and Madras, N.E. (JAMA)
Hyponatremia StatPearls
Up to Date articles:
- Causes of hyponatremia without hypotonicity
- Causes of hypotonic hyponatremia in adults
- Diagnostic evaluation of adults with hyponatremia
- Overview of treatment of hyponatremia in adults
- Pathophysiology and aetiology of the syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat
- Cerebral salt wasting
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 determining whether the patient has either hypertonic, isotonic or hypotonic hyponatremia, as well as a discussion of the causes of hypertonic and isotonic hyponatremia. From here, we go on to focus on the relevant history and examination when working up a patient with hypotonic hyponatremia in order to further sub classify their hypotonic hyponatremia as being hypovolaemic, euvolaemic or hypervolaemic.
Resources for today's episode:
Diagnosis and Management of Hyponatremia - A Review by Adrogue, H.J., Tucker, B.M. and Madras, N.E. (JAMA)
Hyponatremia StatPearls
Up to Date articles:
- Causes of hyponatremia without hypotonicity
- Causes of hypotonic hyponatremia in adults
- Diagnostic evaluation of adults with hyponatremia
- Overview of treatment of hyponatremia in adults
- Pathophysiology and aetiology of the syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat
- Cerebral salt wasting
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 trial
- pilot trials
- bias and confounding
- ethics committees and the process of ethics approval
- Forest plots
Resources for today's episode:
Zedstatistics (youtube channel) - short videos explaining various concepts in statistics from an Australian Statistician
Johns Hopkins Coursera Short Course - Biostatistics in Public Health (this course has free enrolment and takes approx 4 months to complete - it commenced on January 30th)
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 specificity
- positive predictive values (PPV) and negative predictive values (NPV)
- risk ratios
- odds ratios
- number needed to treat (NNT) and number needed to harm (NNH)
And here are the calculations for Shannon's working example of sensitivity, specificity, PPV and NPV (looking at diagnostic tests for the covid-19 pandemic):
Part 1 - PCR tests for Covid-19 (2020):
Let’s say that the prevalence of COVID was 1 in 100,000 people. PCR testing has (roughly) sensitivity of 90% and specificity of 99%.
That means, if you took 1,000,000 people and did a PCR test for COVID:
- 10 people actually had COVID
- 9 of those 10 people would test positive (sensitivity 90%) - and that means 1 of those 10 people would test negative
- 999,990 people did not have COVID
- 989,990 of those people would correctly test negative (sensitivity 99%)
- So that means 10,000 people would incorrectly test positive
From those numbers:
10,009 people tested positive
9/10,009 correctly tested positive - so the PPV is 0.09%
And:
989991 people tested negative
989990/989991 correctly tested negative - so the NPV is 99.99%
Part 2 - PCR tests for Covid-19 (2022):
Now let’s say that 1 in 100 people have COVID. Let’s say we do a PCR test on one million people again.
Now:
- 10,000 people have COVID, and 9,000 of them test positive (so 1,000 of them test negative)
- 990,000 people do not have COVID - 980,100 of them test negative (and 9,900 test positive)
- PPV = 9000/(9000+9900) = 47.6%
- NPV = 99.89%
The test hasn’t changed - but now if you get a positive result, there is a 47.6% chance of it being true.
So for the same test: as the prevalence increases, the PPV increases (0.09% ⇒ 47.6%) and the NPV decreases (99.99% → 99.89%).
Part 3 - RAT tests for Covid-19:Let’s just accept an overall sensitivity of 60% and specificity of 99%.
We’re going to test a million people again.
10,000 people have COVID
6000 will correctly test positive (sensitivity 60%)
That means 4000 incorrectly test negative
990,000 people do not have COVID
980,100 of them will correctly test negative (99% specificity)
9,900 will incorrectly test positive
As the sensitivity decreases, the number of false positives don’t change, but the number of false negatives increases - in this case, from 1000 to 4000.
And (you can take my word for this one!) - as the specificity decreases, the number of false negatives doesn’t change but the number of false positives increases.
Resources for today's episode:
Zedstatistics (youtube channel) - short videos explaining various concepts in statistics from an Australian Statistician
Johns Hopkins Coursera Short Course - Biostatistics in Public Health (this course has free enrolment and takes approx 4 months to complete - it commenced on January 30th)
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 testing
- type I and type II error (further discussion)
- levels of evidence and what this means
- the different types of clinical trials
Resources for today's episode:
Zedstatistics (youtube channel) - short videos explaining various concepts in statistics from an Australian Statistician
Johns Hopkins Coursera Short Course - Biostatistics in Public Health (this course has free enrolment and takes approx 4 months to complete - it commenced on January 30th)
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 Theorem
- hypothesis testing
- type I and type II error
- p-values
- parametric and non-parametric tests for data analysis
Resources for today's episode:
Zedstatistics (youtube channel) - short videos explaining various concepts in statistics from an Australian Statistician
Johns Hopkins Coursera Short Course - Biostatistics in Public Health (this course has free enrolment and takes approx 4 months to complete - it commenced on January 30th)
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 (live Zoom course) - Anaesthesia Collective Link:
https://www.anaesthesiacollective.com/viva-boot-camp/
Lahiru Amaratunge's Viva Boot Camp online course (for those unable to make it to the live Zoom sessions):
https://anaesthesia.thinkific.com/courses/FinalExam
Please forgive us - we made an error when recording (oopsie!). The online course is actually $111.00 but is only $55.00 when the deepbreaths50 discount code is applied. There are only 100 of these discount codes available for use so book now and don't miss out!
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 anaesthetic exam. We're excited to introduce some new guest interviewees that are masters in their practice and who are keen to share what they know with us all.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Until next season, happy studying and thanks for listening.
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 session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Principles of environmentally-sustainable anaesthesia: a global consensus statement from the World Federation of Societies of Anaesthesiologists
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 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy by G.C. Feigl et. al.
Video: The Infraclavicular Block - Essentials of Ultrasound-Guided Regional Anesthesia by Ki-Jinn Chin
The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine: Executive Summary 2015 by J.M. Neal et. al.
Axillary block videos:
The in-depth video: Ultrasound Guided Axillary Block NYSORA Regional Anesthesia by NYSORA - Education
The short-and-sweet video: Ultrasound Guided Axillary Brachial Plexus Block NYSORA Regional Anesthesia by NYSORA - Education
The simple and fantastic video: US-guided Axillary Brachial Plexus Block - the Simple Guide by Ki-Jinn Chin
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 or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy by G.C. Feigl et. al.
Video: The Infraclavicular Block - Essentials of Ultrasound-Guided Regional Anesthesia by Ki-Jinn Chin
The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine: Executive Summary 2015 by J.M. Neal et. al.
Axillary block videos:
The in-depth video: Ultrasound Guided Axillary Block NYSORA Regional Anesthesia by NYSORA - Education
The short-and-sweet video: Ultrasound Guided Axillary Brachial Plexus Block NYSORA Regional Anesthesia by NYSORA - Education
The simple and fantastic video: US-guided Axillary Brachial Plexus Block - the Simple Guide by Ki-Jinn Chin
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 of 1.63m. She previously smoked 10 cigarettes daily but quit when she was diagnosed with lung cancer, and she denies any prior diagnosis of emphysema.
And our last case - number 3 - is as follows: you’re the cardiothoracic anaesthetist on call and you get phoned by the cardiothoracic surgical registrar. A 22 year old male patient was admitted 24 hours ago with a spontaneous pneumothorax. He had a chest drain inserted when he initially presented but now it’s not working and he is developing worsening shortness of breath. He is thin and has no other medical issues. The surgeons want to do an urgent bullectomy.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 emphysema but walks 2km daily on flat ground without issue. Other comorbidities include hypertension and hypercholesterolaemia. He is 1.78m tall and weighs 89kg giving him a BMI of 28.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Pre-anaesthetic assessment for thoracic surgery by Peter Slinger and Gail Darling:
https://www.mcgill.ca/anesthesia/files/anesthesia/wk_1a_slinger_02_preop_assessment.pdf
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 number 7 is a 58 year old female patient presenting for a panendoscopy after presenting with a hoarse voice. A suspicious looking nodule was seen during a fiberoptic nasal endoscopy in the Ear, Nose and Throat outpatient clinic.
We finally end our discussion with case number eight. You have anaesthetised a 27 year old male patient for placement of a Halo traction brace for a cervical spine injury. He was initially a Cormack & Lehane grade 3 view on direct laryngoscopy with a POGO of 10% after changing to a C-MAC video laryngoscope and a D-blade, and with excellent positioning. Now you are tasked with extubating this patient.
As a special treat for the ears, you'll hear us all chuckling at points during the interview. At our feet were two very well behaved pups that, on occasion, made us laugh and wagged their tails against the metal legs of the desk.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 not impossible, and now your colleague is able to ventilate via an LMA, iGel #3.
Case 5 consists of the following scenario: you are doing an ENT list and there is a 68 year old male patient booked for a laser excision of a laryngeal papilloma.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 examination the patient is found to have mouth opening to 2cm limited by both pain and also some truisms of the masseter muscles. The remiander of his airway exam is unremarkable with the caveat that intra-oral examination is impossible with his limited mouth opening.
We then follow on with case three - a talk about how to perform a tube change in case two's 23 year old man post sub-mandibular abscess surgery, prior to transfer to ICU for overnight ventilation.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Coroner's Court of Western Australia's Record of Investigation into Death - Mr R. J. who passed away on 20 February 2001 from a hypoxic brain injury due to respiratory obstruction following surgery for a dental abscess. Please be reminded that this case is a tragedy and discretion and respect for the parties involved is a must.
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 only other history is that she has a BMI of 40. Regarding airway examination, she is found to have a mallampati score of 3 and a short thyromental distance of 4.5cm.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Difficult Airway Society: Management of haematoma after thyroid surgery guidelines (includes link to original article published in Anaesthesia)
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 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Difficult Airway Society: Management of haematoma after thyroid surgery guidelines (includes link to original article published in Anaesthesia)
ANZCA PG52: Guideline for transport of critically ill patients
ANZCA Critical Incident Debriefing Toolkit
ANZCA Fact Sheet: How to support a trainee or colleague who is distressed
ANZCA Doctors Support Program
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 you!
And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Surviving Sepsis Campaign: International Guidelines for the Management of Sepsis and Septic Shock 2021
Surviving Sepsis Campaign home page
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 - anaesthetists - should have thought through prior to wheeling a patient with a CIED into theatre for induction and surgery.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Guidelines for the peri-operative management of people with cardiac implantable electronic devices - Guidelines from the British Heart Rhythm Society
The Revised NASPE/BPEG Generic Code forAntibradycardia, Adaptive-Rate, and Multisite Pacing (Auto-download of the pdf) by A.D. Bernstein et. al.
NAPSE Policy Statement: The NAPSE/BPEG Defibrillator Code by A. D. Bernstein et. al.
Deranged Physiology: Single and Dual Chamber Pacing Modes
Anaesthesia Tutorial of the Week #299 - Pacemakers and Implantable Cardioverter Defibrillators, part 1
Anaesthesia Tutorial of the Week #300 - Pacemakers and Implantable Cardioverter Defibrillators, part 2
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 pacemakers are programmed, as well as what happens to some of these programs when a magnet is applied in the perioperative setting. We then go on to a similar discussion where we explain how the NBD code describes the function and lead placement for implantable cardioverter defibrillators.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
Guidelines for the peri-operative management of people with cardiac implantable electronic devices - Guidelines from the British Heart Rhythm Society
The Revised NASPE/BPEG Generic Code forAntibradycardia, Adaptive-Rate, and Multisite Pacing (Auto-download of the pdf) by A.D. Bernstein et. al.
NAPSE Policy Statement: The NAPSE/BPEG Defibrillator Code by A. D. Bernstein et. al.
Deranged Physiology: Single and Dual Chamber Pacing Modes
Anaesthesia Tutorial of the Week #299 - Pacemakers and Implantable Cardioverter Defibrillators, part 1
Anaesthesia Tutorial of the Week #300 - Pacemakers and Implantable Cardioverter Defibrillators, part 2
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 dealing with adversity, and share some tips that ultimately helped them succeed.
Aaron has kindly offered to let trainees experiencing difficulty in coping with part 2 exam failure to contact him. If you're interested in reaching out, please email us at deepbreathspod@gmail.com and we'll connect you.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 Raymond about everything that happened after the exam.
Aaron has kindly offered to let trainees experiencing difficulty in coping with part 2 exam failure to contact him. If you're interested in reaching out, please email us at deepbreathspod@gmail.com and we'll connect you.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
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 of surgery, and the implications for our anaesthetic.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode:
2021 ANZCA Blue Book: Direct Acting Oral Anticoagulants - pharmacology and perioperative considerations by Dr Kate Drummond (p147)
TGA Website
RE-ALIGN Trial
GALILEO Trial
BMJ: Coagulation assessment with the new generation of oral anticoagulants by Charles Pollack Jr
Journal of Thrombosis and Haemostasis: Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians by J. Douxfils et al.
PAUSE Trial
Regional Anesthesia and Acute Pain: Regional anaesthesia in the patient receiving antithrombotic or thrombolytic therapy (ASRA 2018 Guidelines)
RE-VERSE-AD Trial
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-camp/ Lahiru Amaratunge's Viva Boot Camp Online Course:
https://anaesthesia.thinkific.com/courses/FinalExamUse code: deepbreaths50 at the checkout for 50% off the price of the course. There are only 100 of these discounts available so don't miss out!Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
And for consultants and provisional fellows, don't forget to claim CPD for any episodes you listen to. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Happy studying, thanks for listening, and we'll see you on Monday July 18th!
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 candidates prepare for the ANZCA part 2 anaesthetic exam. We've got some wonderful new guests we're excited to introduce, as well as some voices that you've heard and enjoyed listening to previously.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Until next season, happy studying and thanks for listening.
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 in nerve blocks to name just a few.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying.
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 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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Resources for today's episode include:
NSW Coroner's Court website
Why does oesophageal intubation still go unrecognised? Lessons for prevention from the coroner’s court
National Audit Project 4
ANZCA Professional Documents
Red Man Syndrome
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, and happy studying!
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!
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 trial
Introduction to multiplicity issues in clinical trials
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 listening, and happy studying!
Resources for this episode include:
Reading list -
Peripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature DOI: http://dx.doi.org/10.1136/rapm-2021-102750
Lower extremity regional anesthesia: essentials of our current understanding DOI: http://dx.doi.org/10.1136/rapm-2018-000019
Fascial plane blocks: a narrative review of the literature. DOI: http://dx.doi.org/10.1136/rapm-2020-101909
Regional analgesia for lower leg trauma and the risk of acute compartment syndrome. DOI: https://doi.org/10.1111/anae.15504
Regional anesthesia and acute compartment syndrome: principles for practice. DOI: http://dx.doi.org/10.1136/rapm-2021-102735
Youtube -
1. Duke - https://www.youtube.com/channel/UCqMt0yH0ZHez6wFFP6ZfECg/featured
2. Ki Jinn Chinn - https://www.youtube.com/c/KiJinnChin
3. NYSORA - https://www.youtube.com/c/nysoravideo
4. Amit Pawa - https://www.youtube.com/c/DrAmitPawa
Societies -
ESRA
ASRA
Journals -
RAPM - https://rapm.bmj.com/
Wellcome library
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/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature DOI: http://dx.doi.org/10.1136/rapm-2021-102750
Lower extremity regional anesthesia: essentials of our current understanding DOI: http://dx.doi.org/10.1136/rapm-2018-000019
Fascial plane blocks: a narrative review of the literature. DOI: http://dx.doi.org/10.1136/rapm-2020-101909
Regional analgesia for lower leg trauma and the risk of acute compartment syndrome. DOI: https://doi.org/10.1111/anae.15504
Regional anesthesia and acute compartment syndrome: principles for practice. DOI: http://dx.doi.org/10.1136/rapm-2021-102735
Youtube -
1. Duke - https://www.youtube.com/channel/UCqMt0yH0ZHez6wFFP6ZfECg/featured
2. Ki Jinn Chinn - https://www.youtube.com/c/KiJinnChin
3. NYSORA - https://www.youtube.com/c/nysoravideo
4. Amit Pawa - https://www.youtube.com/c/DrAmitPawa
Societies -
ESRA
ASRA
Journals -
RAPM - https://rapm.bmj.com/
Wellcome library
In today's episode we discuss a newly released consensus statement on the management of adult patients undergoing head & neck surgery with a free flap.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying.
Resources for today's episode:
Expert consensus statement on the perioperative management of adult patients undergoing head and neck surgery and free tissue reconstruction from the Society for Head and Neck Anaesthesia
In this episode, we're continuing our discussion about ROTEM or rotational thromboelastometry.
We start by working through the interpretation of ROTEM results for specific clotting abnormalities before going on to talk about more complex coagulopathies seen in trauma patients and in the bleeding obstetric patient. Lastly, we discuss the limitations to ROTEM interpretation.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying.
Resources for today's episode:
ROTEM e-learning modules from the ROTEM website:
https://learning.rotem.de/en/
Normal and abnormal ROTEM temograms from the Deranged Physiology website (see this website for the images of the abnormal temograms that we work through in this episode):
https://derangedphysiology.com/main/required-reading/haematology-and-oncology/Chapter%201.2.0.1/intepretation-abnormal-rotem-data
ROTEM product information and interpretation instructions with case examples:
https://www.ttuhsc.edu/medicine/odessa/internal/documents/ttim-manual/ROTEM_Analysis.pdf
ROTEM Interpretation Flow Diagram from the NHS Brighton and Sussex University Hospitals:
https://www.bsuh.nhs.uk/library/wp-content/uploads/sites/8/2021/12/ROTEM-interpretation.pdf
ANZCA 2017 Blue Book:
https://www.anzca.edu.au/getattachment/5843b1ab-6599-453d-b55c-08450db9520e/Australasian-Anaesthesia-2017#page=
Today, we're talking about ROTEM or rotational thromboelastometry.
We start with a brief explanation of how ROTEM works, the parameters used to assess ROTEM temograms, and the different assays performed during a ROTEM test.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying.
Resources for today's episode:
Coagulation cascade - a short video to assist in explaining the extrinsic, intrinsic and common pathways:
Coagulation cascade animation by Thrombosis Adviser - https://www.youtube.com/watch?v=cy3a__OOa2M
ROTEM e-learning modules via the ROTEM website (note: you must apply for a login):
https://learning.rotem.de/en/
ROTEM product information and interpretation instructions with case examples:
https://www.ttuhsc.edu/medicine/odessa/internal/documents/ttim-manual/ROTEM_Analysis.pdf
In today's episode, we talk with Cecil Gray prizewinner Dr Anna Pietzsch about her preparation for the ANZCA part 2 exam.
We pick her brain about the process she went through for deciding when to sit the exam, her study technique and structure, and exam day plan. She also shares with us some great advice, what she thought worked well in her own preparation, and things she wishes she'd known and changed in hindsight.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying!
Today, we're deep-diving into the very important topic of postpartum haemorrhage.
We talk about the diagnostic criteria and classification of postpartum bleeds, the four main aetiologies, and both the obstetric and anaesthetic approaches to managing these patients intra-operatively. We also share our own experiences and cases that have stayed with us.
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 which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.
Thanks for listening, and happy studying.
Resources for today's episode:
RANZCOG's management guidelines for PPH:
https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Management-of-Postpartum-Haemorrhage-(C-Obs-43)-Review-July-2017.pdf?ext=.pdfPatient Blood Management Guidelines: Obstetrics and Maternity (2015):
https://www.blood.gov.au/system/files/documents/20180426-Module5-WEB.pdfQLD Clinical Guideline: Primary PPH:
https://www.health.qld.gov.au/__data/assets/pdf_file/0015/140136/g-pph.pdfANZCA 2017 Blue Book article: Rotational Thromboelastometry (ROTEM) in Obstetrics:
https://www.anzca.edu.au/getattachment/5843b1ab-6599-453d-b55c-08450db9520e/Australasian-Anaesthesia-2017#page=Postpartum Hemorrhage by J. Bienstock et al:
https://www.nejm.org/doi/10.1056/NEJMra1513247
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-camp/Lahiru Amaratunge's Viva Boot Camp Online Course:
https://anaesthesia.thinkific.com/courses/FinalExamUse code: deepbreaths50 at the checkout for 50% off the price of the course. There are only 100 of these discounts available so don't miss out!Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Happy studying, thanks for listening, and we'll see you on Monday February 7th!
Best wishes to all of our trainees and IMGs sitting the part 2 anaesthetic vivas this week!
Deep Breaths returns on Monday February 7th with a brand new release schedule - we'll be dropping episodes every fortnight with small breaks for the June/July school holidays and the December/January holiday season. Episodes will be released more consistently throughout the year and we hope this gives a better listener experience.
Season 4 will bring all new topics designed to keep you up to date in your practice and to help study for the ANZCA part 2 anaesthetic exam. We're excited to introduce some new guests to help us unpack some interesting new content, and we're also thrilled to speak to some anaesthetists whose voices feature in previous seasons too, so be sure to tune in next year.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
So until next season, happy studying and thanks for listening.
Today we're doing something a little different since the ANZCA final viva exam is just days away.
Having a calm mind and knowing that there are so many people out there who believe in you and want you to succeed is immensely helpful for the day of your exam. So instead of throwing knowledge at you, we wanted to share some positive messages to help get your head in the right space for exam day. We have messages from anaesthetists you've both heard in previous episodes, and also from some who just want you to know that you can do this.
Though we can't be there on the day to cheer you on, we want you to all know that we're thinking of you and that we wish you all the best.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Today, we're doing a re-release of our second most popular episode to date. Special guest, Dr Lahiru Amaratunge, dives into the induction techniques for five different critical cases. The cases discussed are very relevant to the upcoming viva exam and we hope that listening to them will help boost your knowledge and confidence.
If you have any questions, comments or suggestions, feel free to email us at deepbreathspod@gmail.com. We love hearing from you!
Thanks for listening, and happy studying.
In today's episode, we continue our discussion regarding anaesthesia for the obese patient, based on the latest evidence from the BJA. Today's episode covers the conduct of anaesthesia for obese patients, as well as how to assess the obese patient's suitability for day surgery.
Resources for today's episode include:
BJA Education - Anaesthesia for the obese patientOhio Sleep Medicine Institute STOP-BANG questionnaireAustralian Diabetes Society 2012 Perioperative Diabetes Management GuidelinesPerioperative Management of the Surgical Patient with Diabetes 2015 (AAGBI)Joint British Diabetes Societies - Management of adults with diabetes undergoing surgery and elective procedures March 2016Pharmacokinetics of anaesthetic drugs at extremes of body weightYoutube video: How to identify the cricothyroid membrane with ultrasound (3 min 50 sec)
In today's episode, we discuss anaesthesia for the obese patient, including the latest evidence from the BJA. Today's episode covers the categorisation of obesity, the potential co-morbidities associated with obesity that can affect anaesthesia, and the metabolic syndrome.
Resources for today's episode include:
BJA Education - Anaesthesia for the obese patientOhio Sleep Medicine Institute STOP-BANG questionnaireAustralian Diabetes Society 2012 Perioperative Diabetes Management GuidelinesPerioperative Management of the Surgical Patient with Diabetes 2015 (AAGBI)Joint British Diabetes Societies - Management of adults with diabetes undergoing surgery and elective procedures March 2016Pharmacokinetics of anaesthetic drugs at extremes of body weightYoutube video: How to identify the cricothyroid membrane with ultrasound (3 min 50 sec)
In today's episode, we talk through the first two of four cases addressing common problems encountered in the post anaesthetic care unit.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
References for today's episode:
Reversal of neuromuscular block by A. Srivastava and J. Hunter:
https://academic.oup.com/bja/article/103/1/115/458792#6888775Delayed recovery of consciousness after general anaesthesia by E. Thomas, F. Martin and B. Pollard:
https://www.bjaed.org/article/S2058-5349(20)30020-2/fulltextPreoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis by M. Yang et al:
https://bmjopen.bmj.com/content/9/4/e025091Oxford Handbook of respiratory medicine 3rd ed:
https://oxfordmedicine.com/view/10.1093/med/9780198703860.001.0001/med-9780198703860-chapter-9
In today's episode, we talk through the last two of four cases addressing common problems encountered in the post anaesthetic care unit.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
References for today's episode:
Reversal of neuromuscular block by A. Srivastava and J. Hunter:
https://academic.oup.com/bja/article/103/1/115/458792#6888775Delayed recovery of consciousness after general anaesthesia by E. Thomas, F. Martin and B. Pollard:
https://www.bjaed.org/article/S2058-5349(20)30020-2/fulltextPreoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis by M. Yang et al:
https://bmjopen.bmj.com/content/9/4/e025091Oxford Handbook of respiratory medicine 3rd ed:
https://oxfordmedicine.com/view/10.1093/med/9780198703860.001.0001/med-9780198703860-chapter-9
In this episode, we take a close look at chronic post surgical pain.
We start by revising the pathophysiology of chronic post surgical pain where we specifically discuss normal acute pain physiology as well as the changes that occur in the progression of acute to chronic pain. We go on to talk about risk factors for the development of chronic post surgical pain before then having a chat about what we can do as anaesthetists to prevent our patients from developing chronic pain after surgery.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episode:
The IASP classification of chronic pain for ICD-11: chronic postsurgical or posttraumatic pain by S. Schug et al:
https://journals.lww.com/pain/Abstract/2019/01000/The_IASP_classification_of_chronic_pain_for.6.aspxCentral Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity by A. Latremoliere and C. Woolf:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750819/Transition from acute to chronic pain by A. Feizerfan and G. Sheh:
https://academic.oup.com/bjaed/article/15/2/98/248869Understanding LTP in pain pathways by J. Sandkuhler:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852298/Acute Pain Manual: Scientific Evidence 5th Ed:
www.anzca.edu.au
In today's episode, we are joined again by guest interviewee Dr Lahiru Amaratunge, who discusses the vital concept of Crisis Resource Management, or CRM.
He begins by explaining the basics of CRM, and then we go on to apply the principles of CRM to cases you could encounter in in the exam, or indeed your everyday practice.
As soon as you finish this episode, you should consider enrolling in Lahiru's online viva bootcamp course, which is being held on September 18. You can enrol by following this link:
https://www.eventbrite.com.au/e/viva-boot-camp-online-for-the-anzca-part-2-exam-2nd-sitting-2021-tickets-148117995913?ref=eios
For IMGs who are interested in Lahiru's IMG course, you can contact him here:
anzcaimg@gmail.com
We love receiving your questions, comments and suggestions at deepbreathspod@gmail.com, so please keep writing in!
Thanks for listening, and happy studying.
In today's episode, part 2 of our series about paediatric anaesthesia, we discuss the last two of three cases with special guest, Dr Paul Lee-Archer.
Spoiler alert! The cases we are discussing are the paediatric cases from the only anaesthetic viva sitting in 2020. If you want to avoid listening in order to try and receive these vivas as practice for your exam preparation, that's absolutely a great idea. Don't forget to listen after your practice vivas, though!
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episodes:
Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatment by S. Nair and A. Wolf:
https://bjaed.org/article/S2058-5349(17)30179-8/fulltext Paediatric massive transfusion by S. Blain and N. Paterson:
https://academic.oup.com/bjaed/article/16/8/269/2364823 Dilemmas in the preoperative assessment of children by N. Bhatia and N. Barber:
https://academic.oup.com/bjaed/article/11/6/214/263810
In today's episode, the first of a 2 part series about paediatric anaesthesia, we discuss the first of three cases with special guest, Dr Paul Lee-Archer.
Spoiler alert! The cases we are discussing are the paediatric cases from the only anaesthetic viva sitting in 2020. If you want to avoid listening in order to try and receive these vivas as practice for your exam preparation, that's absolutely a great idea. Don't forget to listen after your practice vivas, though!
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episodes:
Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatment by S. Nair and A. Wolf:
https://bjaed.org/article/S2058-5349(17)30179-8/fulltext Paediatric massive transfusion by S. Blain and N. Paterson:
https://academic.oup.com/bjaed/article/16/8/269/2364823 Dilemmas in the preoperative assessment of children by N. Bhatia and N. Barber:
https://academic.oup.com/bjaed/article/11/6/214/263810
In today's episode, we discuss everything you could possibly want to know about hyperthermic intraperitoneal chemotherapy, or HIPEC, with special guest, Dr Ed Pilling.
We start by talking about the preceding cryoreductive surgery as well as the principles of HIPEC, before then going on to cover the important aspects of the anaesthesia for this procedure.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying!
On this week's episode, we cover the management of glucocorticoids during the perioperative period for patients with all forms of adrenal insufficiency, based on the following guidelines published in Anaesthesia in May 2020:
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for this episode:
Guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency :https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.14963
Today, we look at different strategies to stay calm in the lead-up to the final exam with special guest, Dr Julia Slykerman.
We start by talking about those important things we should (and shouldn't) be doing in the weeks leading up to the exam. We then look at how to plan ahead for the day of the exam, and follow this with strategies and exercises to help keep you calm in the moment.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Today, we take a close look at the latest guidelines from the Association of Anaesthetists of Great Britain and Ireland that address the provision of anaesthesia and sedation in breastfeeding patients.
We discuss the author's recommendations for each of the 10 guidelines put forth in this latest publication.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episode:
Guideline on anaesthesia and sedation in breastfeeding women 2020:
https://doi.org/10.1111/anae.15179LactMed:
https://www.ncbi.nlm.nih.gov/books/NBK501922/Red Nose Co-sleeping Guidelines:
https://rednose.org.au/article/Co-sleeping_with_your_baby
Today we discuss the most up to date recommendations and evidence for the prevention and management of post operative nausea and vomiting.
We start by taking a close look at the joint American Society of Enhanced Recovery and the American Society for Ambulatory Anaesthesia Fourth Consensus Guidelines For The Management of Postoperative Nausea and Vomiting. We then talk about the results of the latest Cochrane Database of Systematic Reviews meta-analysis looking at drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episode:
Management of Postoperative Nausea and Vomiting: The 4th Consensus Guidelines (infographic):
https://journals.lww.com/anesthesia-analgesia/Fulltext/2020/08000/Management_of_Postoperative_Nausea_and_Vomiting_.15.aspxFourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting:
https://journals.lww.com/anesthesia-analgesia/Abstract/2020/08000/Fourth_Consensus_Guidelines_for_the_Management_of.16.aspxDrugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis by S. Weibel et al:
https://doi.org/10.1002/14651858.CD012859.pub2
In today's episode, we discuss almost everything you could want to know about intra-aortic balloon pumps with special guest, Dr Ivan Rapchuk.
In part 2 of this series, we talk about which patients benefit most from balloon pumps, optimal and suboptimal balloon timing, and those things to be mindful of when anaesthetising a patient with a balloon pump in situ. Lastly, we have a brief chat about the similarities and differences between intra-aortic balloon pumps and the newer Impella devices.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episode:
Principles of intra-aortic balloon pump counterpulsation by M. Krishna and K. Zacharowski.
https://academic.oup.com/bjaed/article/9/1/24/466259The normal IABP waveform:
https://derangedphysiology.com/main/required-reading/cardiothoracic-intensive-care/Chapter%206.3.4/normal-iabp-waveformThe abnormal IABP waveform:
https://derangedphysiology.com/main/required-reading/cardiothoracic-intensive-care/Chapter%206.3.4.2/pathophysiology-abnormal-iabp-arterial-waveformsThe Impella Device: historical background, clinical applications and future directions by J. Glazier and A. Kaki.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679960/Youtube video illustrating how an Impella works:
https://www.youtube.com/watch?v=GhWB7T5QxMI
In today's episode, we discuss almost everything you could want to know about intra-aortic balloon pumps with special guest, Dr Ivan Rapchuk.
In this episode, we focus on the physiology of how the pumps work to improve cardiac function.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episode:
Principles of intra-aortic balloon pump counterpulsation by M. Krishna and K. Zacharowski.
https://academic.oup.com/bjaed/article/9/1/24/466259The normal IABP waveform:
https://derangedphysiology.com/main/required-reading/cardiothoracic-intensive-care/Chapter%206.3.4/normal-iabp-waveformThe abnormal IABP waveform:
https://derangedphysiology.com/main/required-reading/cardiothoracic-intensive-care/Chapter%206.3.4.2/pathophysiology-abnormal-iabp-arterial-waveformsThe Impella Device: historical background, clinical applications and future directions by J. Glazier and A. Kaki.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679960/Youtube video illustrating how an Impella works:
https://www.youtube.com/watch?v=GhWB7T5QxMI
Deep Breaths returns next Monday with more topics that we hope will super-charge your exam prep and keep you up to date. And we get to talk to some brilliant guest interviewees so be sure to tune in.
Viva Boot Camp Eventbrite link:
https://www.eventbrite.com.au/e/viva-boot-camp-online-for-the-anzca-part-2-exam-2nd-sitting-2021-tickets-148117995913?ref=eiosAnaesthesia Collective link:
https://anaesthesiacollective.com/courses/
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Happy studying, and thanks for listening!
Best wishes to all of our trainees and IMGs sitting the part 2 anaesthetic vivas this week!
Deep breaths returns on Monday August 2nd with more topics that we hope will super-charge your exam prep. And season 3 will introduce some new guest interviewees as well as others whose voices are already familiar so be sure to tune in.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
So until next season, happy studying and thanks for listening!
Today we're following last week's episode on anaesthesia for NOF surgery with an episode focusing on post-operative delirium. These two topics go hand-in-hand but were way to big for us to tackle in just one episode.
We start by defining delirium and revising the DSM-V diagnostic criteria, and take a brief look at the different pathophysiological theories behind delirium, factors predisposing to delirium development, and the management of established delirium. We specifically address what we as anaesthetists can do pre-, intra- and post-operatively to try to reduce the risk of our patients developing post-operative delirium.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episode:
Cognitive decline after anaesthesia and critical care by D. Gwilym Lloyd et al.https://doi.org/10.1093/bjaceaccp/mks004 Postoperative delirium: treatment and prevention by T. During et al.https://doi.org/10.1097/ACO.0000000000000939 Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team by C. Peden et al.https://doi.org/10.1016/j.bja.2020.10.037
Postoperative delirium: perioperative assessment, risk reduction, and management by Z. Jin et al.https://doi.org/10.1016/j.bja.2020.06.063
Australian Commission in Health and Quality in Healthcare: Delirium Clinical Care Standardhttps://www.safetyandquality.gov.au/our-work/clinical-care-standards/delirium-clinical-care-standard
Today we are examining the latest guidelines regarding best practice anaesthesia for patients with fractured necks of femur.
Resources for today's episode are:
Guideline for the Management of Hip Fractures 2020 - https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15291ASAP-1 audit - https://www.nhfd.co.uk/20/hipfractureR.nsf/4e9601565a8ebbaa802579ea0035b25d/f085c664881d370c80257cac00266845/$FILE/onlineASAP.pdfASAP-2 audit - https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.13415Safety guideline: reducing the risk from cemented hemiarthroplasty for hip fracture 2015 - https://doi.org/10.1111/anae.13036Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
In today's episode, we are joined by guest interviewee Dr Sandra Concha-Blamey, who takes us through everything you need to know about anaesthesia for DBS, or deep brain stimulator, insertion.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Today, we discuss anaphylaxis. We look at the findings from the most recent NAP 6 regarding the incidences of anaphylaxis for specific triggers, presenting symptoms, and factors potentially predicting poorer patient outcomes. We also discuss anaphylaxis management and the anaphylaxis cards jointly developed by ANZCA and ANZAAG.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for today's episode:
The NAP6 - https://www.nationalauditprojects.org.uk/downloads/NAP6%20Report%202018.pdf
ANZCA perioperative anaphylaxis management guidelines - https://www.anzca.edu.au/resources/professional-documents/endorsed-guidelines/background-card.pdf ANZAAG referral form - http://www.anzaag.com/Docs/PDF/Anaphylaxis%20Box/ANZAAG%20Referral%20Form%20Jul17.pdf
This week, we discuss everything you could possibly want to know about Type 1 Diabetes Mellitus with special guest, Dr Amy Lawrence.
We talk about how it's diagnosed, different insulin regimens for its management and important points to discuss with patients presenting to the pre-anaesthetic clinic when preparing for elective surgery. We also look at the anaesthetic considerations when anaesthetising patients with type 1 Diabetes Mellitus and glycemic control intra-operatively.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
This week we discuss neuromuscular blockade, revise some relevant basic physiology and pharmacology, and talk about neuromuscular monitoring.
After all, it never hurts to revise a little part 1 exam knowledge, particularly when it's relevant to how you answer questions for the part 2 exam!
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
Resources for this episode:
Sugammadex: a revolutionary drug in neuromuscular pharmacology - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173552/
ANZCA PS18 Guideline on monitoring during anaesthesia - https://www.anzca.edu.au/safety-advocacy/standards-of-practice/policies,-statements,-and-guidelines
In today's episode, we talk Obstructive Sleep Apnoea, or OSA, with special guest, Dr Hamish Pollock.
We start with a definition of OSA, how it is diagnosed, complications and treatment options. From here we have a more in-depth discussion about important components of the pre-anaesthetic assessment, screening for OSA and finally how to plan a safe anaesthetic for these patients.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions for future episode topics and guest interviewees.
Thanks for listening and happy studying.
Resources for this episode:
Perioperative considerations in the management of obstructive sleep apnoea by R. Holt, G. Downey and M. Naughton:
https://www.mja.com.au/system/files/issues/211_07/mja250326.pdf
Today, we'll take the time to discuss medical cannabis, and the implications for patients on prescription cannabis therapy when they present for an anaesthetic.
We start with a brief chat about the differences between medical cannabis and recreational cannabis, the mechanism of action of the two main cannabinoids - THC (tetrahydrocannabinol) and CBD (cannabidiol), their pharmacokinetics and finally some suggestions for how to approach the anaesthetic care of these patients.
Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!
Thanks for listening, and happy studying.
In today's episode, we take a look at a recently published trial in JAMA Paediatrics which examines a possible association between labour epidurals and autism.
A huge thank you to Dr Catherine Stirzaker for providing us with much of the source material for this episode!
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying!
Resources for this episode include:
Association Between Epidural Analgesia During Labor and Risk of Autism Spectrum Disorders in Offspring - https://jamanetwork.com/journals/jamapediatrics/article-abstract/2771634 ANZCA and RANZCOG statement on epidurals for labour - https://www.anzca.edu.au/resources/professional-documents/statements/epidural-anaesthesia-joint-statement-anzca-and-ran.pdf
Today we are joined by special guest interviewee Dr Kar-Soon Lim, for a discussion regarding burns anaesthesia that spans two episodes.
In this, the second part of our discussion about burns anaesthesia, we talk about in-theatre management of burns in the context of a clinical case. We address the anaesthetic considerations for major burns cases, and the different surgical techniques and how they impact our anaesthetic care.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
References for today's episode:
Challenges in anaesthesia and pain management for burn injuries by F. Stapelberg:
https://doi.org/10.1177/0310057X20914908
Today we are joined by special guest interviewee Dr Kar-Soon Lim, for a discussion regarding burns anaesthesia that spans two episodes.
Part one of our discussion addresses how burns are assessed, factors to consider when determining whether intubating a burns patient is appropriate, and IV fluid management in the first 24 hours. We also specifically discuss electrical burns and how they differ from other major burns.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions for future episode topics and guest interviewees.
Thanks for listening and happy studying.
References for today's episode:
Challenges in anaesthesia and pain management for burn injuries by F. Stapelberg:
https://doi.org/10.1177/0310057X20914908
We continue our discussion with special guest Dr Julia Slykerman about anxiety and stress management when juggling study, work and everything life throws at you.
In this episode we further explore knowing yourself and how this relates to optimising your study. We discuss warning signs to look for in both yourself and others that may signify trouble in managing stress and anxiety, and options for seeking help.
If you or someone you know is struggling with stress and anxiety management, please reach out to your department's supervisor of training for assistance.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Wellbeing apps to assist in maintaining calm and managing anxiety:
Smiling Mind - a mindfulness meditation app for all ages, with a new specific category for health care workers; to assist people in dealing with pressure, stress, sleep and the challenges of daily life.
Headspace - provides guided meditations on managing stress and anxiety, productivity, focus, exercise, physical health and sleep for adults and kids.
Buddhify - provides guided meditations and mindfulness exercises to help overcome anxiety, stress, sleeplessness, pain and difficult emotions, in categories such as travelling, at work, waking up, eating and online; adults and kids content.
Woebot - a cognitive behavioural therapy (CBT) chatbot who checks in each day with activities and helpful information.
Happify - science based games to reduce stress, build resilience and overcome negative thoughts.
Moodfit - provides tools and information for coping with anxiety, depression and stress.
Sanvello - CBT tools: mindfulness skills, mood and health tracking tools to improve mental and physical health.
MoodMission - By Monash Uni: emotion, physical, behavioural and thought based activities (missions).
TEN (The Essential Network) - Black Dog Institute: for health professionals with COVID specific resources and evidence based tools for self-assessment, information and self-management options, to optimise mental health.
This week, we are joined by special guest Dr Julia Slykerman to discuss stress and anxiety management when studying for the part 2 exam.
Specifically, we discuss how to generate realistic expectations both for yourself whilst studying and for those around you, how to commit to upholding your own self care, and the importance of knowing yourself - how you operate best, study best, and how you plan to restore the energy you expend when studying.
If you or someone you know is struggling with stress and anxiety management, please reach out to your department's supervisor of training for assistance.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Wellbeing apps to assist in maintaining calm and managing anxiety:
Smiling Mind - a mindfulness meditation app for all ages, with a new specific category for health care workers; to assist people in dealing with pressure, stress, sleep and the challenges of daily life.
Headspace - provides guided meditations on managing stress and anxiety, productivity, focus, exercise, physical health and sleep for adults and kids.
Buddhify - provides guided meditations and mindfulness exercises to help overcome anxiety, stress, sleeplessness, pain and difficult emotions, in categories such as travelling, at work, waking up, eating and online; adults and kids content.
Woebot - a cognitive behavioural therapy (CBT) chatbot who checks in each day with activities and helpful information.
Happify - science based games to reduce stress, build resilience and overcome negative thoughts.
Moodfit - provides tools and information for coping with anxiety, depression and stress.
Sanvello - CBT tools: mindfulness skills, mood and health tracking tools to improve mental and physical health.
MoodMission - By Monash Uni: emotion, physical, behavioural and thought based activities (missions).
TEN (The Essential Network) - Black Dog Institute: for health professionals with COVID specific resources and evidence based tools for self-assessment, information and self-management options, to optimise mental health.
Today on Deep Breaths we discuss everything pre-eclampsia - what it is, how it’s diagnosed, managed, and how to manage obstetric anaesthetic patients presenting with it.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying!
Resources for today’s episode are:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61998-X/fulltexthttps://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/SOMANZ-Hypertension-Pregnancy-Guideline-April-2014.pdf?ext=.pdfhttps://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/ISSHP-classification-of-hypertensive-disorders-of-pregnancy-2014.pdf?ext=.pdfhttps://academic.oup.com/bjaed/article/16/1/33/2463142
Deep Breaths returns next Monday with more topics that we hope will super-charge your exam prep. And we get to talk to some brilliant guest interviewees from all over Australia so be sure to tune in.
EventBrite link for Viva Boot Camp course - https://www.eventbrite.com.au/e/viva-boot-camp-online-for-the-anzca-part-2-exam-tickets-138032367527
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Happy studying, and thanks for listening!
Best wishes to all of our trainees and IMGs sitting the part 2 anaesthetic vivas this week!
Deep Breaths returns next year on Monday February 22nd with more topics that we hope will super-charge your exam prep. And season 2 will see us talk to some brilliant guest interviewees from all over Australia so be sure to tune in.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
So until next year, happy studying, happy holidays, and thanks for listening!
Today, we discuss cardiopulmonary bypass with special guest, Dr Ivan Rapchuk. We expand upon the information from part 1 with a few case scenarios. In these, we talk about the sequence of events that occurs when transitioning a patient onto cardiopulmonary bypass, 'crashing' onto bypass, variations to typical cardiac bypass and how to remove a patient from cardiopulmonary bypass.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying!
Today, we discuss cardiopulmonary bypass with special guest, Dr Ivan Rapchuk. Specifically, we talk about the components of the bypass circuit and their function in maintaining safe cardiopulmonary bypass for cardiac surgery.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying!
Today we continue our discussion about the recommendations from a couple of review articles published by the British Medical Journal regarding infection control and its implications in managing the Covid-19 patient's airway. We specifically talk about non-invasive ventilation, some subspecialty anaesthesia and considerations for working in critical care.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Resources for today's episode:
Anaesthesia and Covid-19: infection control
https://bjanaesthesia.org/article/S0007-0912(20)30200-2/fulltext
Aerosol boxes and barrier enclosures for airway management in COVID-19 patients: a scoping review and narrative synthesis
https://bjanaesthesia.org/article/S0007-0912(20)30699-1/fulltext
ANZCA statement on PPE:
https://www.anzca.edu.au/getattachment/1c8b5c23-b735-4253-91ac-c29c621182a1/ANZCA-COVID-19-PPE-Statement.aspx
ANZICS Covid-19 Guidelines
https://www.anzics.com.au/wp-content/uploads/2020/04/ANZI_3367_Guidelines_V2.pdfThanks for listening, and happy studying.
Today we discuss the recommendations from a couple of review articles published by the British Medical Journal regarding infection control and its implications in managing the Covid-19 patient's airway.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Resources for today's episode:
Anaesthesia and Covid-19: infection control
https://bjanaesthesia.org/article/S0007-0912(20)30200-2/fulltext
Aerosol boxes and barrier enclosures for airway management in COVID-19 patients: a scoping review and narrative synthesis
https://bjanaesthesia.org/article/S0007-0912(20)30699-1/fulltext
ANZCA statement on PPE:
https://www.anzca.edu.au/getattachment/1c8b5c23-b735-4253-91ac-c29c621182a1/ANZCA-COVID-19-PPE-Statement.aspx
Thanks for listening, and happy studying.
In today's episode, we discuss the diagnosis, implications and management of preoperative anaemia, as well as the newly published PREVENTT trial.
Resources for today's episode are:
The PREVENTT Trial, published in The Lancet - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31539-7/fulltext
Australian National Blood Authority Patient Blood Guidelines, Perioperative Module - https://www.blood.gov.au/pbm-module-2
Australian National Blood Authority Iron Product Choice & Dose Calculation for Adults - https://www.blood.gov.au/system/files/documents/Iron%20product%20choice%20and%20dose%20calculation20052016.pdf
In today's episode, we discuss anaesthetic inductions for five different types of critically unwell patients with special guest Dr Lahiru Amaratunge. Specifically, we talk about the cardiovascular goals for each of these patients, and the drugs that we would choose to ensure that these haemodynamic targets are maintained.
If you have any comments, questions or suggestions, please be sure to email us at deelbreathspod@gmail.com.
Thanks for listening, and happy studying.
Today we have a very special guest interviewer, Dr Yasmin Whately. She will be joining us from time to time on Deep Breaths to have in-depth chats with consultant anaesthetists about how they approach various procedures in different settings. Today, she discusses all things clot retrieval for acute ischaemic stroke with her guest Dr Wendy Morris.
If you have any questions, comments or suggestions for future episodes, be sure to write to us at deepbreathspod@gmail.com.
Thanks for listening, and happy studying.
References for this episode include:
https://journals.lww.com/anesthesia-analgesia/Fulltext/2019/04000/Anesthetic_Management_of_Emergency_Endovascular.15.aspx
https://journals.lww.com/anesthesia-analgesia/Fulltext/2019/04000/Anesthetic_Management_of_Emergency_Endovascular.16.aspx
https://www.ahajournals.org/doi/10.1161/STROKEAHA.113.003412?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&
This week on Deep Breaths, we're taking a break for the long weekend (only in Queensland, sadly!).
Please join us next Monday for a brand new episode, and every Monday until the end of the year.
Stay focused, stay motivated, and we'll see you next week on Deep Breaths.
In today’s episode, we discuss the very important topic of 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/NAP5home
B-Aware trial - https://www.sciencedirect.com/science/article/pii/S0140673604163009?via%3Dihub
B-Unaware trial - https://www.nejm.org/doi/full/10.1056/nejmoa0707361
BAG-RECALL trial - https://www.nejm.org/doi/full/10.1056/NEJMoa1100403
In the second installment of our chat with Dr Anthony Hade, we continue discussing the ins & outs of regional anaesthesia for rib fractures. We talk about erector spine blocks, the pitfalls of providing chest trauma patients with regional anaesthesia, and Anthony shares with us some of the more memorable cases that he has seen.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Some resources to help with studying this topic:
https://www.nysora.com/regional-anesthesia-for-specific-surgical-procedures/abdomen/thoracic-lumbar-paravertebral-block/
https://nysoralms.com/courses/erector-spinae-plane-block/
https://www.asra.com/asra-news/article/39/how-i-do-it-erector-spinae-block-for-rib
The 2019 ANZCA Blue Book articles:
Page 139 - 'An update on the management of patients with rib fractures' by Andrew Lumley, Sean Chan and Andrew Deacon
Page 157 - 'Ultrasound-guided erector spine plane block' by Alex Grosso, Gilberto Arenas, Kate Drummond and Sam Whitehouse
https://www.anzca.edu.au/getattachment/220cc6da-3eee-463b-9b66-4e8b33861d7e/Australasian-Anaesthesia-2019#page=
This week we’re joined by Dr Anthony Hade to discuss regional anaesthesia for blunt chest trauma. We talk about the approach to the blunt chest trauma patient, the goals of regional anaesthesia for rib fractures, indications and contraindications for various types of regional anaesthesia, as well as tips and tricks for paravertebral blocks.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Some resources to help with studying this topic:
https://www.nysora.com/regional-anesthesia-for-specific-surgical-procedures/abdomen/thoracic-lumbar-paravertebral-block/
https://nysoralms.com/courses/erector-spinae-plane-block/
https://www.asra.com/asra-news/article/39/how-i-do-it-erector-spinae-block-for-rib
The 2019 ANZCA Blue Book articles:
Page 139 - 'An update on the management of patients with rib fractures' by Andrew Lumley, Sean Chan and Andrew Deacon
Page 157 - 'Ultrasound-guided erector spine plane block' by Alex Grosso, Gilberto Arenas, Kate Drummond and Sam Whitehouse
https://www.anzca.edu.au/getattachment/220cc6da-3eee-463b-9b66-4e8b33861d7e/Australasian-Anaesthesia-2019#page=
Welcome to the Deep Breaths podcast!
This week, we continue our discussion with Dr Mark Lai in this our second instalment of 'Interview with an examiner'. Join us to hear about some mistakes to avoid, qualities of successful candidates, and clues about some of the key topics to tackle in your exam preparation.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Welcome to the Deep Breaths podcast!
In the third and last instalment of our interview with Dr Mark Lai, he provides us with an insight into how to prepare for subspecialty terms, as well as some other pearls of wisdom and even a humorous anecdote about his own exam-sitting experience.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Welcome to the Deep Breaths podcast!
Today we discuss all things relating to SGLT2 receptor antagonists. Specifically, we'll touch on their mechanism of action, the pathophysiology of how they predispose to DKA in the peri-operative setting, how to diagnose euglycaemic or hyperglycaemic DKA, and finally, how these drugs should be managed in patients undergoing elective surgery.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Resources for today's episode:
https://diabetessociety.com.au/documents/ADS_DKA_SGLT2i_Alert_update_2020.pdfhttps://www.anzca.edu.au/getattachment/220cc6da-3eee-463b-9b66-4e8b33861d7e/Australasian-Anaesthesia-2019#page=https://diabetessociety.com.au/documents/August2019_ALERT-ADS_SGLT2i_PerioperativeKetoacidosisfinal.pdf
Welcome to the Deep Breaths Podcast!
Dr Mark Lai joins us this week on Deep Breaths to share his knowledge, expertise and insight as a recently retired fellowship examiner. Join us to hear what the key differences are between preparing for the primary and the final exam, and how to approach your study.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.
Welcome to the Deep Breaths podcast! We are a couple of anaesthetists from Brisbane, Australia, who want to help you study for and pass the anaesthetic part 2 exam.
Each episode will focus on one of either exam content, exam technique or advice on how to look after yourself while studying. We aim to discuss content that is high yield and highly topical, and are keen for feedback and advice regarding topics that you as a anaesthetic trainee may find useful.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
We look forward to sharing our podcast with you. Happy studying!
Welcome to the Deep Breaths podcast!
Today we discuss some important points to help you decide when to sit the ANZCA part 2 exam, and things to consider when organising yourself before opening that first textbook.
We want you to think about what worked well for you when you studied for and passed the part 1 exam. We also want you to contemplate the time and financial commitments that go hand-in-hand with this exam so that you’re well prepared for every aspect of the exam.
Lastly, we want you to think about how you’ll find colleagues that are planning to sit the exam at the same time as you. Though you may not have needed study buddies for the part 1 exam, we strongly suggest forming a study group to help keep you motivated, and to assist you in covering the breadth and depth of knowledge required of this exam.
Feel free to email us at deepbreathspod@gmail.com with any questions, comments or suggestions.
Thanks for listening, and happy studying.