This article is written by TRIPOM and summarises recent important papers and articles on perioperative medicine from across different medical publications.
- Dr Stuart Connal, Specialty Registrar in Anaesthesia, North Central London Deanery
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Dr Richard Knight, retired anaesthetist discusses his personal experience of obstetric anaesthesia and how the practice has progressed over the last 50 years.
Two prefixes separate the same procedure: peridural in French means epidural in English. Physiologically, the French word is the more accurate.
Our first child arrived in 1968, delivered in a London hospital. My wife was nominally under the care of a consultant, but in reality the obstetric senior registrar oversaw her delivery.
She had attended antenatal classes, and was primed to request analgesia when her contractions became distressing. Entonox was a non-starter for her – she had an ether-induction for a childhood tonsillectomy and had retained a terror of an anaesthetic mask being placed on her face ever since.
This article provides an overview of the positive steps that have taken place since February 2023 to enhance the quality and effectiveness of the RCoA, FICM, and FPM examinations.
Dr Tom Burr, ST4 Anaesthetist and Dr Marie Nixon, Clinical Quality Advisor, Consultant Anaesthetist tell us how flashcard simulation helps tackle unrecognised oesophageal intubation.
The Perioperative Allergy Network describe the importance of collaboration between UK anaesthetists, allergists and immunologists when investigating perioperative allergies.
Authors:
- Dr Linda Nel, Consultant Anaesthetist, Perioperative Allergy Service, Southampton University Hospitals NHS Foundation Trust
Email Dr Nel - Dr Tomaz Garcez, Consultant Immunologist, Manchester University NHS Foundation Trust
- Dr Louise Savic, Consultant Anaesthetist, Leeds Teaching Hospitals NHS Trust
- Dr Lucy Gurr, Anaesthetic Registrar, Leeds Teaching Hospitals NHS Trust
The Perioperative Allergy Network (PAN) was set up under the joint auspices of the British Society of Allergy and Clinical Immunology (BSACI), the British Society for Immunology Clinical Immunology Professional Network (CIPN), and the Association of Anaesthetists. It represents a formal collaboration between UK anaesthetists, allergists and immunologists with an interest in perioperative hypersensitivity and is supported by the Royal Colleges of Anaesthetists, Pathologists and Physicians. It is affiliated with the International Suspected Perioperative Allergic Reactions Group (ISPAR).
Why now, and what need is being met?
This article looks at an innovative approach to improve the understanding and implementation of perioperative opioid stewardship and transform practice.
- Dr Dermot McGuckin, ST7 Anaesthesia & Pain Medicine, University College London Hospitals
Email Dr McGuckin - Dr Fausto Morell-Ducos, Consultant in Anaesthesia & Pain Medicine, University College London Hospitals
- Dr Jamie Smart, Consultant in Anaesthesia & Pain Management, University College London Hospitals
- Dr Brigitta Brandner, Consultant in Anaesthesia & Pain Management, University College London Hospitals
Opioids play an important role in facilitating recovery and return to function after surgery.
However, it is now well-established that surgery is a risk factor for persistent postoperative opioid use,1 and preoperative opioid use is associated with an increased risk of perioperative complications.2
Perioperative opioid stewardship is a practical approach providing a systemic, multi-layered framework aimed at minimising the risks associated with opioid use around the time of surgery, while allowing their safe administration to those patients most likely to benefit from them. It is increasingly regarded as a solution to the problem of prescription opioid-related harm but there is a lack of structured curricula to develop healthcare professionals’ skills in competent opioid management.
Dr Alison Pittard, OBE: "The end of my tenure brings an opportunity to reflect on the last three years. COVID-19 has dominated and it is easy to focus on the negatives, but, as an eternal optimist, I see many positives. I had three objectives when I became dean, the first of which was to promote our specialty."
COVID-19 has dominated and it is easy to focus on the negatives, but, as an eternal optimist, I see many positives. I had three objectives when I became dean, the first of which was to promote our specialty.
I think everyone now knows what we do and, as a result, we have increased training numbers, expanded capacity, and embedded enhanced care. My second objective was to develop international partnerships. Despite travel being restricted, embracing digital platforms afforded us the opportunity to work with the College of Intensive Care Medicine of Australia and New Zealand and the Apollo group in India.
This article gives an overview of the developments in equivalence and portfolio in the changing and evolving GMC pathway.
Authors:
- Dr Ros Bacon, Chair, RCoA Equivalence Committee
- Dr Ashwini Keshkamat, Deputy Chair, RCoA Equivalence Committee
- Dr Derek McLaughlin, Deputy Chair, RCoA Equivalence Committee
- Mr Russell Ampofo, RCoA Director of Education, Training and Examinations
- Ms Claudia Moran, RCoA Head of Training
The College is responsible for ensuring that anaesthetists meet the standards for Specialist Registration with the General Medical Council (GMC) and that UK and international medical professionals who seek independent practice in the UK have the necessary knowledge, skills and experience (KSE).
The increasing number of Certificate of Eligibility for Specialist Registration (CESR) applications and the GMC’s implementation of new regulatory pathways have presented challenges for the Equivalence Committee. The Equivalence Committee is committed, on behalf of the College and members, to maintaining standards. This article explores the proactive steps being taken by the College to support the Equivalence Committee and enhance the process of assessing CESR applications.
Jono Brüün, our CEO reflects on the challenges and changes he's faced in the four years since joining the College and celebrates all our achievements.
New Year is always a time of reflection, particularly as for me it is also the anniversary of my joining as CEO at the College. That is now four years ago, and I find myself looking back on the challenges the College has faced over that time, the changes that have been made and the achievements of our volunteers, elected leaders and staff team.
It has been a remarkable four years. Within a couple of months of my appointment COVID-19 hit. The challenges for our membership were enormous. The specialty was at the frontline, and anaesthetists and intensivists had to learn and adapt at pace to provide the best possible care for the patients who were most seriously ill under very challenging circumstances. The College too had to urgently adapt.
Exams, which had always been held in person, were rapidly moved to virtual platforms. It was a steep learning curve for so many of us and it didn’t all go as smoothly as we wanted, due in large part to the pressures put on so many by the pandemic. Nevertheless, I was proud of the College, its examiners and the exams team, who, along with candidates, contributed fully to the subsequent independent review of our assessment process. The review was published earlier this year. Lessons were learnt and changes have been made that have seen us continue to welcome almost 5,000 candidates per year to the College for their exams.
Jono Brüün, Chief Executive Officer of the Royal College of Anaesthetists looks at the benefits of research and why it will always be at the centre of our activities, creating significant impact for patients and the public.
Jono Brüün, Chief Executive Officer of the Royal College of Anaesthetists looks at the benefits of research and why it will always be at the centre of our activities, creating significant impact for patients and the public.