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

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.

a man in a plaid shirt is standing in front of a chalkboard Alt: a man in a plaid shirt is standing in front of a chalkboard

#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?

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

Slide from Prof Liam Plant: 'Disturbing thesis': Summarised as poor fluid management choices in the ill / post-surgical patient lead to AKI, electrolyte disorders & multiple adverse consequences.

#AAAIGSConf First up - Prof Liam Plant on perioperative fluid management. 'We don't allow the surgeon to touch the robot without hours of training, but any bozo can prescribe iv fluids.' Why is this form of chemotherapy prescribed (largely) unsupervised by the most junior members of the team? #AnSky

Philip Braude introducing the Age Anaesthesia conference.

Emer Ahern introducing the Age Anaesthesia conference.

#AAAIGSConf I’m at one of the best conferences - Age Anaesthesia in Cork. Joint meeting with the Irish Gerontological Society. Will try to post key bits. Please reply / comment as they come through. If I can I might even ask the presenters on your behalf. @ageanaesthesia.bsky.social

Philip Braude introducing the Age Anaesthesia conference.

Emer Ahern introducing the Age Anaesthesia conference.

#AAAIGSConf I’m at one of the best conferences - Age Anaesthesia in Cork. Joint meeting with the Irish Gerontological Society. Will try to post key bits. Please reply / comment as they come through. If I can I might even ask the presenters on your behalf. @ageanaesthesia.bsky.social