I’m very proud to have co-ordinated and co-chaired the group that produced this guidance, rationalising the use of sterile gowns in spinal anaesthesia
Hopefully this provides international clarity and helps improve the sustainability of our practice
doi.org/10.1111/anae...
That doesn't mean anyone should be treated more or less favourably because of their religion, or that any of us should seek to impose our beliefs or world view on patients or colleagues.
Religion has a place in medicine. It has been motivation for much health provision historically in West and more recently in many LMICs. It remains a personal motivation for many health care workers. And is important for many patients.
We should respect that.
Clinical tip on #delirium: symptoms of delirium can fluctuate. A person might have lucid periods and then, an hour later, be obviously confused again. This coming and going is characterisic of delirium.
Sometimes when the triggers of #delirium are not clear on with standard history & examination, a head-to-toe approach can help to uncover causes.
On our "Frailty and the NHS" section of our Frailty Hub, you can find out more about initiatives and publications from NHS England, NICE, GIRFT, NHS RightCare and NHS Benchmarking. buff.ly/2b39dgW
Join CPOC as Board Chair
Shape the future of perioperative care!
Our Centre for Perioperative Care (CPOC) is recruiting a new Board Chair.
You will lead strategy, drive progress, and make a difference.
Volunteer with us. Deadline - 12 April.
All the details 👉 https://ow.ly/c3K150Yp1Ii
#Ansky #Medsky
Delirium is a frequent complication of critical illness and remains an important cause of short- and long-term morbidity for patients admitted to ICUs.
This review provides an overview of the current understanding of ICU delirium and its implications.
#AnSky
doi.org/10.1111/anae...
Join CPOC as Board Chair
Could you be our Centre for Perioperative Care (CPOC) next Board Chair?
If you’re passionate about improving patient care and leading change, we want to hear from you!
Learn more and apply by April 12👉 https://ow.ly/q7PW50Yp1AM
#Ansky #Medsky
⏰ Reminder! Round 1 of the National Clinical Audit of Perioperative Care (NCAPC) Delphi survey closes tomorrow.
👉 Surgeons — we need you @asgbi.bsky.social @collegeofsurgeons.bsky.social. Please find link to survey here: shusls.eu.qualtrics.com/jfe/form/SV_...
Finally, a #MedSkyDebate
How do you manage foreign bodies in men?
It has been quite the Twitter debate.
My philosophy has been not to ask but just to manage.
Does it matter why or like me just do you just do?
Privacy and respect matter.
Every patient deserves our respect.
Exactly the way you say: privacy & respect. Do what is required professionally.
(not only men btw.)
Plus speak up to those who make shaming jokes/remarks.
Become our Patient Voices Chair
There are only 3 days left to apply. Make a difference for patients!
We’re seeking a Chair for PatientsVoices@RCoA—a group that shapes our work through their insights.
Lead, inspire, and champion patient involvement.
Find out more and apply 👉 https://ow.ly/r7Zb50Yt09i
Maintain safe (not normal) physiology whilst watching for correctable causes and wait for regression to the mean. This is critical care, the rest is hubris
To our members, colleagues and friends celebrating, Happy Easter.
@iainmoppett.bsky.social shares his latest SNAP 3 paper outlining why delirium remains such an important issue
⏰ Delirium Survey extended 3rd April: Share your views to inform future research and practice.
Only 4 mins!
🔗 Survey: www.surveymonkey.com/r/WTHNBZK
#delirium #JLA #NIHR #ACHA #GMARC
Poster describing work done by a Uni of Nottingham student with Floss and Prof Katie Sheehan standing by it. Data on the poster show: physios write in the notes with phrases strongly suggestive of delirium, but don’t use the word delirium. The delay between physio suggestion and actual diagnosis was 16 hours on average but with wide variation. In response we’ve made a simple sticker which includes: ‘This patient might have delirium’; the 4AT; PINCHME; and a management plan.
Proper proud this morning to hear Floss, one of our senior medical students, presenting work at #AAAIGSConf looking at physios identifying delirium after hip fracture. (Do it well but don’t use the word). In the presence of physio royalty Prof @katiejsheehan.bsky.social @uniofnottingham.bsky.social
Mild tangent: for history-taking, we should probably divide social history into substance history (ETOH/smoking/drugs) and functional history. I'd be fascinated to see how functional histories differ when taken at admission and taken by ICU/anaesthetics.
(Cognitive function probably fits here too.)
Slide showing data on surgical site infection data following hip fracture surgery. All the data can be found here: https://www.noca.ie/audits/irish-hip-fracture-database
#AAAIGSConf Louise Brent - this is cool. Joined up working between the Irish Hip Fracture Database and the microbiologists. Breaking down silos.
2018 was a pivotal year. Slide shoes some Euro cash notes and the Golden Hip trophy.
#AAAIGSConf Louise Brent - money (best practice tariff / process performance bonus) and competition (Golden Hip award, a gift from the Scottish Hip Fracture Audit) both act a drivers for improvement. #AnSky #GeriSky
Louise Brent - using data to improve hip fracture care. The Irish Hip Fracture Database
#AAAIGSConf Louise Brent - using data to improve hip fracture care. The Irish Hip Fracture Database is brilliant. Similar but different to NHFD.
#AAAIGSConf James Harty - I’m probably over-simplifying clever peri-prosthetic fracture orthopaedics but key messages seem to be: do the right operation first time; operation should allow weight bearing; have a competent, high-volume team (surgeon); use the word ‘construct’ a lot.
Key mortality day for periprosthetic fracture: one year 13-17%; 30-day 4-7%.
#AAAIGSConf James Harty - periprosthetic fractures. Increasingly common. Outcomes poor - perhaps worse than native hip fractures.
Slide with dumbbells on it. Periprosthetic fractures and immediate weight bearing.
#AAAIGSConf Prof James Harty Weight bearing and peri-prosthetic fracture. Is his slide reinforcing an orthopaedic stereotype though?
Interesting comment from Prof Plant. Once upon a time the surgeon was the curator and custodian of the physiological response to injury and surgery. Have they given up that role now? (I paraphrased slightly). #AnSky #SurgSky #GeriSky
Communication with the cognitively impaired. Onus is on us (healthcare professionals) to support and reveal communication and decision making competence. Formal assessment may conceal non-linguistic cognitive function of people with aphasia.
#AAAIGSConf Communication with the cognitively impaired. Onus is on us (healthcare professionals) to support and reveal communication and decision making competence. How often do we assume lack of competence when with effort we could demonstrate it? #AnSky
Hospital Acquired Disability (HAD) - common; impacts on recovery; sense of isolation in older adults matters. Vulnerability in therapeutic conversations impacts on ability to take part in healthcare decision making
#AAAIGSConf Hospital Acquired Disability (HAD) - common; impacts on recovery; sense of isolation in older adults matters. Create a relationship - 'the banter matters'. Find the link - hurling, football, music, families... these are important parts of our roles. #AnSky
Dr Marcia Ward & Ms Anne Barrett Facilitating Healthcare Decision Making in Older Adults with Cognitive Communication Difficulties
#AAAIGSConf Dr Marcia Ward & Ms Anne Barrett Facilitating Healthcare Decision Making in Older Adults with Cognitive Communication Difficulties. A highly disadvantaged group - on top of (in some) cultural / historic barriers to shared decision making.
Think TROL when prescribing iv fluids: Type; Rate; intended Outcome; Limits (time / volume).
#AAAIGSConf Prof Plant: Think TROL when prescribing iv fluids: Type; Rate; intended Outcome; Limits (time / volume). But in reality frequently 'same as last bag'. #AnSky
