Hooray, welcome back xx

This is the sort of recipe I've come across and my colleagues who use it report it works well. The 20mcg/ml of remi in this paper is more than I've seen used so far

This seems like a huge dose of remifentanil in this study.

50ml of 1%propofol mixed with 1mg of remi is way more than I've seen colleagues use.

Is vasopressor use in this method really comparable to other methods as claimed?

LEDs are so useful at all their different levels. At middle grade level their institutional experience makes on call and workforce planning so much better. They are criminally under recognised and their expansion with good candidates would help hospitals immeasurably

Agree on both points.

The #medskydebate thing was great and I learned some cool stuff and had fun with it. It seemed like hard work for @maffygirl.medsky.social though and it was sad but unsurprising that it has faded away

Thank you for all the hard work, hope to see you back xx

Love Jake & Amy and Gomez & Morticia, but my cartoon pairing would be Bandit & Chilli (Bluey and Bingo's parents).

Is it more to do with apathy though?

The RCoA data is damning, but also obvious to those in the NHS from their own experience.

They know morale is in the floor and the service is crumbling.

There seems no political willpower or ability to do anything about it though

please enjoy Discworld Elysium, everyone

this was clearly written for me personally but I think a lot of you will also like it

I do a normal RSI then once intubated start my pump low at around Cet 2 and titrate up over the case to BIS.

The effect of the initial bolus on the model being inaccurate becomes decreasingly relevant as the case goes on

Do your patients get a bairhugger preop? If so that's amazing, I can barely get this done with the patients getting colorectal cancers preop.

The one which really interests me is the theory that it might reduce postoperative delirium being studied in WHITELIT

www.fundingawards.nihr.ac.uk/award/NIHR20...

I like it for propofol sting.

For analgesia I think it's low on my list of marginal gains of multimodal. Regional, ketamine and clonidine are higher up my list of adjuncts.

The data on reduced ileus means I sometimes do for open abdominal surgery.

And Lu-tze and the yeti hunters when he introduces them to Rule 1

My favourite one off is The Truth. Small Gods is pretty good too.

The first two of the Moist trilogy (Going Postal and Making Money) are fabulous.

Obviously I would recommend the Watch series (with Night Watch often being agreed as Pterry's finest), but the backstory makes it less accessible

GA and nerve block is my default

The main outcomes in #NOF improve with orthogeries input and timely ASAP surgery. Unnecessary delay is bad.

(I will confess I'm not great at lateral spinals and worry about positioning patients with #NOF with just a block and a bit of ketamine/fentanyl)