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Reposted by George Clews

Saul Staniforth @saulstaniforth.bsky.social · 7d

@zackpolanski.bsky.social : "I think its really problematic if someone is trying to weaponise the attack that happened yesterday to try and silence protest in this country against the genocide. They're separate issues.. we need to be clear what this govt is doing"

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George Clews @georgeclews.bsky.social · 12d

Wasn’t really convinced by lidocaine for this indication, felt much more comfortable with MAC 1.2- 1.3 and a slug of fentanyl and propofol pre-incision.

The prilocaine spinal I did for a haemorroidectomy was by far the smoothest anaesthetic for a perianal procedure.

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George Clews @georgeclews.bsky.social · 13d

I think there are valid safety concerns (people have died on wards from lidocaine infusions), there a other limited evidence multimodals you can use (looking at you magnesium, clonidine) and local is probably better used locally near the nerves!

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George Clews @georgeclews.bsky.social · 13d

Used it in ITU a couple of times, seen an infusion once intra-operatively. Tried it as a bolus once to reduce laryngospasm during a bum abscess.

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George Clews @georgeclews.bsky.social · 14d

Vital resource to help women make the right decision for themselves when it comes to analgesia and anaesthesia during childbirth!

Royal College of Anaesthetists @rcoanews.bsky.social · 15d

Our new infographics give pregnant women and people accessible information about the risks and side effects of epidural and spinal anaesthesia during childbirth.

SWIPE for insights ➡️

@oaa-anaes.bsky.social

#Ansky #Medsky

Epidural and spinal anaesthesia patient information infographics.
Logos include: RCoA, Obstetric Anaesthetists' Association and Labour Pains.

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Reposted by George Clews

John McKenna @johnodreams.bsky.social · 16d

Watching the Trump Paracetamol Autism news cycle is essentially watching Brandolini’s Law in action

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George Clews @georgeclews.bsky.social · 20d

Anyone else really into how every episode of Alien: Earth ends with a 90s/early 00s rock classic? The way episode seven uses 'Song for the Dead' by Queens of the Stone Age has got me really pumped for the last episode!

Reposted by George Clews

Kasia @scullingmonkey.bsky.social · 22d

I posted this before but it seems appropriate

In Germany, every kid learns in school how “it” was allowed to happen.

How seemingly “normal” people didn’t see “it” come

How “it” was normalised and suddenly “it” was there.

How “it” wasn’t spotted, how no one took a stand

How books burned

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Reposted by George Clews

Christian @ceebarnacles.bsky.social · 25d

Written by a doctor at St Thomas' Hospital, London after the Tommy Robinson march on 13/9.

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George Clews @georgeclews.bsky.social · 26d

Also probably depends on on your skill set. If you are someone who is very slick with a 27G spinal needle and have a good team around you to help with positioning…

But if you are digging around with a 22G quinke because you keep bending the 25G sprotte…

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George Clews @georgeclews.bsky.social · Sep 6

Sorry, one patient did remember some pain:

‘This is Dr Russell speaking’—remembers some pain in her abdomen at this time but does not know when/where this was'

George Clews @georgeclews.bsky.social · Sep 6

Pain is different to awareness (lack of analgesia rather than a lack of amnesia), and we know that pain, even in the absence of awareness, is detrimental.

I don't think any of the patients in the isolated forearm study were in pain.

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George Clews @georgeclews.bsky.social · Sep 6

If you wanted to minimise risk of awareness, we could give our patients enough anaesthesia to be at near burst suppression, but then what would be the NNT and what harms would we cause from this?

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George Clews @georgeclews.bsky.social · Sep 6

I don’t think running light is acceptable, but in the isolated forearm studies, there were patients with awareness who seemed to be anaesthetised according to the DOA and at levels of anaesthetic drug you would expect anaesthesia.

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George Clews @georgeclews.bsky.social · Sep 6

I think this is the terrifying part. What factors lead to recall at appropriate anaesthetic doses and depth of anaesthesia (either EtAA or pEEG)?

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George Clews @georgeclews.bsky.social · Sep 6

As an outcome it doesn’t seem to be patient focussed though? With no explicit or implicit recall, would patients care?

If there were any hint of it negatively affecting patients afterwards, then I would say it becomes unacceptable. But without that, then I would be tempted to say it is acceptable.

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George Clews @georgeclews.bsky.social · Sep 6

My take home from this paper is the importance of analgesia in an anaesthetic! Most of the women had an epidural and one of them had a dream about a dog dancing on her abdomen.

One boss told me about a case of awareness he had where the patient said she didn’t mind because she was comfortable.

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Reposted by George Clews

The Green Party of England & Wales @greenparty.org.uk · Sep 2

Draw the line. Join the Green Party today ⤵️

join.greenparty.org.uk?utm_source=s...

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Reposted by George Clews

Samantha Black @anaesthetistsb.bsky.social · Aug 19

My wonderful residents Tom and George @georgeclews.bsky.social

Anaesthesia @anaesjournal.bsky.social · Aug 19

Improving consent and patient education in the obstetric population

Here is a new patient infographic - it presents risk using simple, unambiguous language & numerical risk displayed in a way that patients understand, plus graphical representations.

#AnSky #ObSky #MedSky

doi.org/10.1111/anae...

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George Clews @georgeclews.bsky.social · Aug 3

We have risk calculators for surgical procedures, are there any risk calculators for forms of anaesthesia?

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George Clews @georgeclews.bsky.social · Aug 3

Difficulty is often when discussing individual risk for anaesthesia.

Lots of data on incidence of breathing issues/death in general population, but difficult to apply a number to the multi-morbid patient in front of you, so easier to go for a feeling such as ‘more likely’.

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George Clews @georgeclews.bsky.social · Aug 3

My understanding is that the words ‘common’, ‘uncommon’ and ‘rare’ are actually unhelpful, as everyone’s idea of what rate that actually means is different.

@rcoanews.bsky.social infographics pushing more towards giving actual numbers (including keeping denominators the same where possible)

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George Clews @georgeclews.bsky.social · Jul 25

A quick google brought up this paper which looked interesting (pmc.ncbi.nlm.nih.gov/articles/PMC...) until I realised it was retrospective with the block group having more ASA III patients with depressions and using a different surgical approach...

Local Infiltration Analgesia Is Superior to Regional Nerve Blocks for Total Hip Arthroplasty: Less Falls, Better Mobility, and Same-Day Discharge

Background: Multimodal analgesia in total hip arthroplasty (THA) provides better pain control, mobility, and reduced side effects compared to monotherapies. Local infiltration analgesia (LIA) and regi...

pmc.ncbi.nlm.nih.gov

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George Clews @georgeclews.bsky.social · Jul 10

Do you think the speed of onset is due to a high conc? Most interscalenes I’ve done are lower conc and higher volume than this.

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George Clews @georgeclews.bsky.social · Jul 5

Though I think it’s generally more forgiving so whilst it may not be the best drug for a situation, it’s probably a good enough drug.

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