Deep Breaths

Today, we look back on one of our most-loved episodes by our listeners. We are joined by special guest Dr Shaun Roberts to discuss in-depth cases of patients with tricky cardiac conditions who require non-cardiac surgery. Resources for today's episode: ANZCA Blue Book 2021 ESC Guidelines on cardiovascular assessment and management of patients undergoing non cardiac surgery 2014 ACC/AHA guidel...

Today, we go back to take a close look at one of ANZCA's latest professional documents - PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022. Resources for this episode: PG67: Guideline for the care of patients at the end-of-life who are considered for surgery or interventional procedures 2022 PG67 BP: Guideline for the...

Today, we look back at a fantastic and insightful discussion about upper limb regional anaesthesia with special guest, Dr Michael Kerr. If you liked this episode, you can find the second part of this episode in season 5, episode 12. In this episode, part 1, we focus on the interscalene block. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We l...

Today, we revisit a topic that was recommended to us by Dr David Tragen of the Sunshine Coast University Hospital - the perioperative management of the direct oral anticoagulant medications or DOACs. We start with some basic revision of the mechanism of action of the DOACs and their indications before diving more closely into the recommendations for stopping and starting these medications around t...

Deep Breaths will return this year with a slightly different twist. We're taking a little break, but that doesn't mean we've forgotten about our wonderful listeners!  We'll be recording the occasional new episode with guest interviewees that we're excited to be chatting with. We're also going to be re-releasing some of our best episodes. Feel free to email us at deepb...

In today's episode, we revisit challenges in the diagnosis and management of oesophageal intubation and anaesthetic crises in general. Recognising an oesophageal intubation may seem simple, but by looking at coroner's cases both here in Australia and in the UK, as well as cases in the NAP4, it can be far more complex. Feel free to email us at deepbreathspod@gmail.com if you have any ques...

So get ready for something a little different... this week's episode was recorded live from the ANZCA Annual Scientific Meeting 2024, in our home city of Brisbane, Australia.  We interviewed some fascinating guests, covering topics as diverse as the role of the college moving forward, how we can be more sustainable in anaesthesia, and the future of podcasting; and we had plenty of fun along t...

Today's episode is the second of our two part series on ruptured AAA repairs. We discuss the case of a 72 year old man with a ruptured abdominal aortic aneurysm that is contained, and who is scheduled for an urgent endovascular repair within the interventional radiology suite with special guest, Dr Lahiru Amaratunge. Apologies for the audio quality in this episode - even though it sounds like...

Today - in part 1 of our 2 part series - we talk through the case of an 82 year old man with a ruptured abdominal aortic aneurysm who is scheduled for urgent open repair with special guest, Dr Lahiru Amaratunge. Resources for today's episode: BJAED: Anaesthesia for endovascular repair of ruptured abdominal aortic aneurysms by K. Berry et al. LITFL: AAA by C. Nickson Lancet: Endovascular versu...

In today's episode, we cover the recently released consensus clinical practice recommendation regarding the peri-procedural use of the GLP-1 and GIP receptor antagonists.  Enjoy this topical episode - this is sure to be an evolving area.   Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to cl...

This week we're under the pump with work and life, but we'll be with you soon and it's a cracker of an episode covering an extremely topical subject.  Keep an eye out for our next episode dropping something in the next couple of weeks. As an apology, we'll have a bonus ep coming sometime towards the end of the season!  Feel free to email us at deepbreathspod@gmail.com if you ha...

Today's episode is the final in our series on inotropic and vasopressor medications. Today, we're going to tackle some of the more obscure inotropes and vasopressors - these medications typically aren't encountered terribly often within anaesthesia. During this episode, we discuss milrinone, levosimendan, methylene blue and hydroxocobalamin (Vitamin B12).  Resources for today's...

Today's episode - the second in our three episode series focusing on inotropic and vasopressor medications - sees us covering some more medications commonly (or uncommonly, depending on your scope of practice) encountered within anaesthesia. During this episode, we discuss vasopressin, dopamine and dobutamine.  Resources for today's episode: StatPearls: Inotropes and vasopressors by D. V...

Today's episode is the first in a series of three that focus on inotropic and vasopressor medications used within anaesthetic practice. During this episode, we discuss metaraminol, ephedrine, phenylephrine, noradrenaline and adrenaline.  There's one section of our episode where we thought it important to clarify what we're saying, as to out ears it sounds a little confusing. During...

Today, we discuss a 2023 BJA Education article titled 'Perioperative care for transgender and gender diverse adults'.  We start with a discussion of words and terms that are useful to understand, before diving in to discussions about a trauma-informed care approach to minimise and hopefully eradicate negative preoperative experiences, physical, chemical and surgical options for gender af...

Today, in part 2 of our 2 part series on anaesthesia for previous heart transplant recipients, we discuss the care of these patients for non-cardiac surgery with special guest, Dr Ivan Rapchuk. We begin by covering the electrophysiology of a transplanted heart and what you may see on the ECG, and then proceed to the management of our theoretical patient for general anaesthesia for non-cardiac surg...

Today, in part 1 of our 2 part series on anaesthesia for previous heart transplant recipients, we discuss the care of these patients for non-cardiac surgery with special guest, Dr Ivan Rapchuk. We start our discussion with a review of how to assess whether these patients are suitable for elective surgery, and follow this with a deep-dive on the typical immunosuppressant medications that these pati...

Today, we discuss the rise of GLP-1 receptor agonists - what they are, how they work, and how they affect fasting during the perioperative period.  Resources for today's episode: StatPearls: Physiology, Gastrointestinal Hormonal Control by Parikh, A. & Thevenin, C. https://www.ncbi.nlm.nih.gov/books/NBK537284/ StatPearls: Glucagon-like Peptide-1 Receptor Agonists by Collins, L. & Cost...

It's taken almost a year, but we're finally giving you part 2 of our series on complex and uncommon cardiac conditions for non-cardiac surgery with special guest, Dr Shaun Roberts. Hold on to your earphones - this episode is a long one! If you haven't listened to part one, you can find it within season 6 - be sure to check it out before you listen to part 2. Today, we discuss anaest...

Today, we take a close look at the SNACC guidelines for the diagnosis and treatment of neuroanaesthetic emergencies, and take a little time to discuss each of these emergencies in turn. Resources for the episode: Cognitive aids for the diagnosis and treatment of neuroanaesthetic emergencies: Consensus guidelines on behalf of the Society for Neuroscience in Anaesthesiology and Critical Care (SNACC)...

Today, in part two of our two part series looking at perioperative hypotension and acute kidney injury (AKI), we take a closer look at the methods we can adopt - as anaesthetists - to try to prevent perioperative AKI and the evidence of their effectiveness in preventing this complication. Resources for today's episode: BJA:  Role of perioperative hypotension in postoperative acute kidney inju...

Today, in part one of our two part series looking at perioperative hypotension and acute kidney injury (AKI), we take a close look at the diagnostic criteria for acute kidney injury. We then briefly revise aspects of renal physiology that make the kidney particularly susceptible to hypoxic injury, as well as looking at risk factors and other facets of anaesthesia that additionally predispose the k...

Today we continue our discussion regarding preoperative functional capacity assessment. We'll cover the M-DASI, the 6-minute walk test, and put it all together to figure out how this applies to our practice as anaesthetists. Resources for today's episode include: BJAED: Subjective methods for preoperative assessment of functional capacity by Silvapulle & Darvall BJA: A simplified (mo...

Today, in part one of our two part series, we're taking a close look at the methods for performing pre-operative functional capacity assessments and their utility in predicting patient outcomes. In part 1, we focus our discussion on METS, activities of daily living (ADLs) and the DASI score. In part two - which will be released in a fortnight - we'll cover the M-DASI, the 6-minute walk t...

Deep Breaths returns next Monday February 5th with all new episode topics that we're sure will help with exam prep, and will keep your practice up to date. We'll also be joined by more wonderful guests this season and we can't wait to share their expertise with you all, so be sure to tune in and experience the learning revolution! Links for Lahiru Amaratunge's ANZCA Part 2 exam...