Category: Anaesthetics

Malignant Hyperthermia

Malignant Hyperthermia

Malignant hyperthermia (MH) is a rare life-threatening condition that is usually triggered by exposure to certain drugs used for general anesthesia. This module reviews malignant hyperthermia, its clinical features and presentations as well as its management during an MH crisis.

This module is largely based on the ‘Malignant hyperthermia 2020 Guidelines’ from the Association of Anaesthetists.

Length of Study: 120 min.
Difficulty: Medium
   

 

Direct vision laryngoscopes – Student Zone

Direct vision laryngoscopes

Laryngoscopes are used to aid tracheal intubation and the placement of endotracheal tubes. They allow visualisation of the larynx and are used not only in operating theatres but ITU and A&E. They can also be used to visualise the larynx for suctioning, removal of a foreign body and placing nasogastric tubes and throat packs.
This module covers conventional or direct laryngoscopes. Video laryngoscopes and fibreoptic intubation are covered in different modules.

   

Anaesthetic machines back to front – Student Zone

Anaesthetic machines back to front

The most important piece of equipment that the anaesthetist uses is the anaesthesia machine. The basic function of an anaesthesia machine is to prepare a gas mixture of precisely known, but variable composition. The gas mixture can then be delivered to a breathing system. The anaesthesic machine itself has evolved from a simple pneumatic device to a complex array of mechanical, electrical and computer–controlled components. This module breaks down the essential features of the anaesthetic machine into its parts, explaining their purpose as it goes.

  

Central Venous Lines

Understanding Central Venous Lines

This module discusses various types of central lines and central venous catheters (CVC).  They are often needed in critically ill patients or in those requiring prolonged intravenous therapies that cannot be given orally or through peripheral lines.

Length of Study: 120 min.
Difficulty: Medium
   

 

Getting the best out of videolaryngoscopy

Getting the best out of videolaryngoscopy

The benefits of videolaryngoscopy, especially in unexpected difficult intubations, are numerous but they are not just conventional laryngoscopes with screens. Many have different techniques and need specific training. This module gives tips on how it to use it to its best advantage.

Length of Study: 45 min.
Difficulty: Easy
   

Muscle Relaxants; reversal and the use of peripheral nerve stimulators.

Muscle Relaxants; reversal and the use of peripheral nerve stimulators.

This module discusses residual block, why, when and how muscle relaxants are reversed, and the importance of using a peripheral nerve stimulator when assessing the depth of block. It also covers the different patterns the stimulators use to assess how deep a neuromuscular block is.

Length of Study: 60 min.
Difficulty: Medium
   

 

Endotracheal tubes – Student Zone

Endotracheal tubes

An endotracheal tube (ETT) is inserted into the trachea for the primary purpose of establishing and maintaining a definitive patent airway and to ensure the adequate exchange of oxygen and carbon dioxide. It is the gold standard for securing an airway, allowing positive-pressure ventilation while preventing contamination of the lungs from the contents of the pharynx and stomach.

The respiratory system I – Organs and Structures of the Respiratory System -Student Zone

The respiratory system – Organs and Structures of the Respiratory System

This module covers the anatomy of the respiratory system. The major organs of the respiratory system function primarily to provide oxygen to body tissues for cellular respiration, remove the waste product carbon dioxide, and help to maintain acid-base balance. It covers both the conducting zone and a respiratory zone and describes the difference between the two.

  

Pulmonary aspiration of gastric contents

Pulmonary aspiration of gastric contents

This module discusses aspiration which is a relatively rare, but potentially fatal complication of general anaesthesia occurring most commonly in emergency patients. Prevention is the key, and there are several mandatory requirements that must be fulfilled in the at-risk patient. However, in the event of aspiration occurring, treatment is essentially supportive once the airway has been secured.

Length of Study: 60 min.
Difficulty: Easy
   

Hypothermia (Perioperative)

Perioperative Hypothermia

Inadvertent perioperative hypothermia can occur in up to 40% of surgical patients so it essential for theatre practitioners to know what causes it and how to prevent it.
A well as being very stressful and uncomfortable for patients upon waking, it has many negative consequences including delayed drug metabolism, wound healing and increased infection rates.

Length of Study: 75 min.
Difficulty: Easy
   

 

Local Anaesthetic Systemic Toxicity

Local Anaesthetic Systemic Toxicity

Local anaesthetic systemic toxicity is rare but when it does occur its onset may be sudden and life-threatening so it is prudent to spend time preventing rather than treating it. All theatre staff should be aware of the doses limits of local anaesthetics they use as well as the causes, signs and treatment of LAST.
Length of Study: 50 min.
Difficulty: Easy
   

Deep Brain Stimulators

Deep Brain Stimulators

Deep brain stimulation is an increasingly common treatment for Parkinson’s disease (PD), other movement disorders, certain psychiatric conditions, and chronic pain syndromes.
This module will review current anaesthetic techniques and recommendations for inserting and managing deep brain stimulators.
Length of Study: 45 min.
Difficulty: Medium
   

Bone Cement Implantation Syndrome

Bone Cement Implantation Syndrome

Bone cement implantation syndrome (BCIS) is a potentially fatal complication of orthopaedic surgery.
The ability to predict, recognise, and manage BCIS is important for everyone working in the perioperative environment.
Length of Study: 60 min.
Difficulty: Easy
   

Total Intravenous Anaesthesia

Total Intravenous Anaesthesia

Total intravenous anaesthesia (TIVA) is a technique of general anaesthesia which uses a combination of agents given exclusively by the intravenous route without the use of inhalation agents. This module explains how TIVA/TCI works, the popular models used and how they affect different patient groups.
Length of Study: 75 min. 
Difficulty: Medium

Compartment syndrome (Acute limb)

Acute limb compartment syndromes

Compartment syndrome (CS) is a medical emergency, which needs to be recognised by those involved with the provision of anaesthesia surgery and  critical care. This module covers its diagnosis and treatment.
Length of Study: 50 min.
Difficulty: Easy

Catastrophes of many kinds can occur in childbirth…

Catastrophes of many kinds can occur in childbirth…

This moving article is about a pregnant woman dying from amniotic fluid embolism. It is a very well written piece about how even when we do everything right, sometimes the worst happens. This should be essential reading for anyone working in obstetrics. There is not test/certificate but this is the perfect piece to base a reflective account on.

Paediatric Trauma

Paediatric Trauma

Anatomical and physiological differences in children require special consideration and most seriously injured children have multiple injuries. This module is mainly for those who may be called to A&E resus but the general principles are useful for anyone who works with children.
Length of Study: 60 min.
Difficulty: Medium

ECT (Anaesthesia for)

Anaesthesia for ECT

ECT (Electroconvulsive Therapy) is a treatment that involves sending an electric current through the brain to trigger an epileptic seizure to relieve the symptoms of some mental health problem. This module covers the anaesthetic aspects of it.
Length of Study: 45 min. 
Difficulty: Easy

Necrotising Fasciitis

Necrotising Fasciitis

This module describes the diagnosis and common management of NF. Patients need integrated, interdisciplinary management involving surgeons, intensive care physicians and microbiologists. Close monitoring and physiological support in an intensive care unit is often essential.
Length of Study: 60 min.
Difficulty: Easy

Never events: an anaesthetic perspective

Never events: an anaesthetic perspective

The term ‘Never event’ is a recent term in healthcare, but one is here to stay. This module covers the never events relevant to anaesthesia and discusses where the term originally came from.
Length of Study: 60 min.
Difficulty: Easy

Enhanced Recovery from Surgery

Enhanced Recovery From Surgery (ERAS)

Enhanced recovery is a modern evidence-based approach that helps people recover more quickly after having major surgery.  Many hospitals – although not all – have enhanced recovery programmes in place, and it’s becoming standard practice following surgery for many procedures.
Length of Study: 75 min
Difficulty: Medium

Air Embolism & anaesthesia

Air Embolism & anaesthesia

There is significant morbidity and mortality associated with air embolism. It is therefore important to have an awareness of its risk factors, presentation, means of risk reduction and management of the consequences. These are all covered in this module.
Length of Study: 60 min. 
Difficulty: Easy

Post dural puncture headache

Post dural puncture headache

Post dural puncture headache is unpleasant, it may interfere with a new mother’s
ability to care for her newborn and it may extend the length of hospital stay. This module covers both prevention and treatment options.
Length of Study:  60 min
Difficulty: Easy

Muscle Relaxants: the fundamentals

Muscle Relaxants: the fundamentals

The introduction of neuromuscular blocking drugs revolutionised the practice of anaesthesia. Before the advent of muscle relaxants, anaesthesia was induced and maintained by intravenous or inhalation agents.
This comprehensive module covers all aspects of neuromuscular muscle relaxants.
Length of Study:  90 min
Difficulty: Medium

Anaesthetic machine safety features

Anaesthetic machine safety features

This module covers the safety features built into the modern anaesthetic machine. With more theatres moving to electronic self-checking machines this is a useful reminder of where we have come from and how safety is built into all aspects of the anaesthetic machine. It is also useful for anyone new to anaesthetics.
Length of Study: 60 min
Difficulty: Easy

Awareness under Anaesthesia

Awareness under Anaesthesia

Awareness during anaesthesia can be very distressing for a patient, particularly if accompanied by recall of the painful nature of surgery. This article explores the types, incidence, consequences, causes, management and avoidance of intraoperative awareness.
Length of Study: 60 min
Difficulty: Easy

Sickle cell disease

Sickle cell disease

Sickle cell disease is a disorder of the blood caused by an inherited abnormal haemoglobin. The abnormal haemoglobin causes distorted (sickled) red blood cells. When the number of red blood cells decreases from rupture (haemolysis), anaemia is the result. The irregular sickled cells can also block blood vessels causing tissue and organ damage and pain.
Length of Study: 60 min
Difficulty: Easy

Arterial Blood Pressure Measurement – The physics

Arterial Blood Pressure Measurement – The physics and principles.

Intra-arterial blood pressure measurement is often considered to be the gold standard of blood pressure measurement. This accuracy however, depends on a number of physical principles of the systems used, which are explored in this advanced module.
The is also a separate easier module available covering setting up and using arterial lines.
Length of Study: 75 min
Difficulty: Medium

Suxamethonium Apnoea

Suxamethonium Apnoea

This module describes the action of suxamethonium, the inheritance of suxamethonium apnoea, and the non-inherited conditions that can also cause it. The presentation and treatment of the condition are discussed.
Length of Study: 45 min
Difficulty: Easy

Labour ward: an urgent call

An urgent call to the labour ward

Emergencies on the labour ward may have obstetric, anaesthetic, or general medical causes. This module covers the most common emergencies on the ward and what the response should be.
Length of Study: 90 min
Difficulty: Easy

Surgical smoke: is it safe?

Surgical smoke: is it safe?

Surgical smoke is now recognised as a hazard that is encountered in all operating theatres. Unfortunately, the dangers and health risks associated with it continue to be overlooked by many surgeons, nurses and theatre staff. It is important to be aware of the dangers of surgical smoke and for everyone to help minimise the risks.
Length of study:  60 min
Difficulty: Easy

Cardiac transplant: Anaesthesia for the patient with a cardiac transplant

Anaesthesia for the patient with a cardiac transplant

For patients who have previously received a cardiac transplant, coming to theatre for non-related surgery is no longer unusual as survival times continue to increase for transplant recipients. With altered physiology, and the effects of long term anti-rejection drugs use, their anaesthetic requirements are more complicated and it is essential to know what works and what doesn’t.
Length of Study  60 min
Difficulty: Medium

Cardiac Tamponade

Cardiac Tamponade

Cardiac tamponade is a life-threatening emergency that impairs the ability of the heart to fill and to pump. Although not strictly a perioperative condition it is something that all advanced life support responders should be aware of.
Length of Study: 90 min
Difficulty: Easy

Opioids: Peri-operative Management of Patients on Strong Opioids

Peri-operative Management of Patients on Strong Opioids

It is very common to encounter patients on strong opioid medication. These patients present particularly challenging pain management difficulties in the peri-operative period due to behavioural, psychological and pharmacological consequences of opioid treatment. This module discusses the key concepts in the anaesthetic management of patients taking strong opioids and steps that can be taken to ensure optimum peri-operative care.
Length of Study: 80 min
Difficulty: Medium

Rapid Sequence Induction

Rapid Sequence Induction

Rapid sequence induction (RSI) is a method of achieving rapid control of the airway whilst minimising the risk of regurgitation and aspiration of gastric contents. This module covers RSI, its indications and contraindications.
Length of Study: 60 min
Difficulty: Easy

Pregnancy: Changes Relevant to Anaesthesia

Changes in Pregnancy Relevant to Anaesthesia

Pregnancy causes major physiological changes to the mother’s body. An understanding of these changes is the key to safe obstetric anaesthesia. The causes of these changes are initially hormonal; metabolic and mechanical factors also contribute as the fetus develops.
Length of Study: 60 min
Difficulty: Medium