drrobbieerskine.bsky.social
Robbie Erskine
@drrobbieerskine.bsky.social
540 followers 480 following 780 posts
Consultant Anæsthetist Derby UK 31 years BADS ESRA/RAUK. Ambulatory Spinals, Regional Anæsthesia. Family Rugby
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 2d
It WAS Thio, sux, tube in the olden days. V predictable but a little brutal 🤣
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 10d
My fave spinal drug
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 10d
Sadly not available like in Europe
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 12d
Chloroprocaine is fine for 1hour
The benefit of Prilocaine is its hyperbaric so you can use a small volume to get a saddle block for 1 ½ to 2hrs
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 12d
😘
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 12d
I’ve had to rescue far too many trainees who don’t understand exactly what Bob said above
The patients are often beefy guys/smokers/reflux.
I would often tube them to be safe before I realised that spinal Prilocaine is a safer option
(Heavy Bupi is good too)
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 12d
Never been an IV Lidocaine person (apart from 100mg bolus to sort VF!)
Bum stuff:
I give a slug if Alfentanil, a little bit of Midazolam (for pain and anxiety)
Sit(usually a bit wonky on on the less painful cheek)
Prilocaine 0.5-1ml spinal every time ..pain free and chilled and safe in 2-3minutes.
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 15d
a man says " you just gotta have to be "
ALT: a man says " you just gotta have to be "
media.tenor.com
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 15d
Were the pain management regimes equivalent in all RCTs??
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 15d
Pain score?????
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 16d
Interesting
1. Black market drugs
2. Sharing large ampoules
3. Lack of physician engagement in planning services
4. Drugs transported unsafely between centres
A good reminder for us not to mix/add other agents (water/saline) if it can possibly be avoided!
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 18d
It certainly suggests a worrying lack of judgement
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 18d
I agree ..it’s not our business to comment on his relationship with his wife which is their private business and should not be of interest to anyone else.
However I think one has a right to comment on his lack of judgement with respect to his workplace responsibilities as a medic!
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 22d
Surely one fractured neck of femur does not equal another?
A simple subcapital # has a different pain picture from a complicated inter/subtrochanteric # which has significantly greater bone and soft tissue trauma
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 23d
Ugh…I’ll contact the rep
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 23d
Yes..I just don’t like that they feel weird..
Alfentanil is “cleaner” and a powerful analgesic with predictable on and offset
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 23d
Nice approach
I do avoid Midazolam completely in this group though
Alf is pretty quick on quick out as an analgesic though
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
Yeah ..I’ve no idea what you just said but hey!🤣
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
You missed Alfentanil 👌🤪
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
I think we have to accept that there will not be a meaningful scientific answer…but that’s ok
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
I haven’t used a Q for years
I find a 27g Paramedian Sprotte is pretty consistent
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
Possibly true
I use this approach routinely (albeit with a 27 g)👌
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
There is still an underlying fear of neuraxial anaesthesia and RA that underpins our practice..”Woolley and Roe”..very understandable especially since GA has become so safe
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
100% agree
I’m a 27g Sprotte 95% (certainly for these patients)👍
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drrobbieerskine.bsky.social
Robbie Erskine @drrobbieerskine.bsky.social · 24d
Not at all
Just do what you do well😘