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 lines: the fundamentals

The fundamentals of arterial lines

This module covers the basic principles behind setting up, inserting and monitoring intra-arterial blood pressure lines that an anaesthetic assistant needs.
There is also an separate advanced module available which covers more of the physics indepth.
Length of Study: 90 min
Difficulty: Easy

Latex Allergies

Latex Allergies

Latex allergies can be present in both staff and patients. Perioperative workers have to be aware of the causes and consequences of latex products in the operating theatre.
Length of Study: 60 min
Difficulty: Easy

Tracheostomy fundamentals

Tracheostomy fundamentals

Tracheostomies are becoming more common and the consequences of a misplaced tube can be serious so a good understanding of them is essential.
Length of Study: 90 min
Difficulty: Medium

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

Burn patients: the anaesthetic considerations of

Burn patients: the anaesthetic considerations of

This group of patients can be challenging with profound hypermetabolism, pain management issues, potential airway problems, etc. These are all covered in this module.
Length of Study: 75 min
Difficulty: Medium

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

Vapourisers & Inhalational anaesthetics

Vapourisers & Inhalational anaesthetics

Vapourisers are specially designed devices that deliver a very accurate concentration of anaesthetics. This module discusses them and how the process of vapourisation works.
Length of Study: 60 min
Difficulty: Medium

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

Local anaesthetics: understanding them

Understanding local anaesthetics

This article discusses the pharmacology of local anaesthetic agents and then briefly describes the various additives that can be used with these agents.
Length of Study: 75 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: 75 min
Difficulty: Easy

Residual Neuromuscular Blockade

Residual Neuromuscular Blockade

This module covers all aspects of residual neuromuscular blockade, its causes, effects, how to determine its presence and its reversal. It also gives tips of effective nerve stimulator use.
Length of Study: 75 min
Difficulty: Medium

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

Pre-eclampsia and Anaesthetics

Pre-eclampsia and Anaesthetics

Pre-eclampsia is a pregnancy complication characterised by high blood pressure and signs of damage to another organ system, often the kidneys. Left untreated, pre-eclampsia can lead to serious even fatal complications for both mother and baby and the only cure is delivery.
Length of Study: 75 min
Difficulty: Easy

Arterial Blood Gas Analysis

Arterial Blood Gas Analysis

This module explains how to do a simple easy to understand arterial blood gas analysis. How to use the 5-step approach to analyse arterial blood gas results as well as explaining how respiration and metabolism are linked and how this effects the results.
Length of study:  90 min
Difficulty: Difficult

COPD and Anaesthesia

COPD and Anaesthesia

Chronic obstructive pulmonary disease (COPD) is a commonly encountered respiratory disorder. Patients with COPD pose a challenge to the anaesthetist because intraoperative and postoperative complications occur more commonly than in those without the disease, and can lead to prolonged hospital stay and increased mortality. This module provides an overview of COPD and discusses implications for the anaesthetic management of patients with the disease.
Length of Study: 75 min
Difficulty Medium

Blood Component Therapy

Blood Component Therapy

Blood products are any therapeutic substances that are prepared from human blood. These can be classified into blood components (red cell concentrates, platelet concentrates, fresh plasma and cryoprecipitate) and plasma derivatives (albumin, coagulation factors and immunoglobulins). In this module we discuss the blood components and plasma derivatives that we encounter in theatre.
Note: for haemoglobin the UK use g/dl while NZ use g/l i.e. 12 g/dl = 120 g/l.
Length of Study:  90 min
Difficulty: Difficult

Diabetes & Anaesthetic Management

Diabetes & Anaesthetic Management

This module covers the affect of diabetes on the surgical patient and why intraoperative blood glucose control and frequent measurement of blood glucose and serum potassium are key to safe practice.
Length of Study: 75 min
Difficulty: Medium

Difficult Paediatric Airway

The Difficult Paediatric Airway

There are anatomical and physiological differences between the infant, child and adult that make even the normal paediatric airway difficult for the inexperienced practitioner, particularly in children under one year of age. Good preoperative assessment and preparation is therefore key to success of the management of the difficult airway in children. This article covers this and more.
Length of Study: 75 min
Difficultly: 
Difficult

Jehovah’s Witnesses and Blood Issues

Jehovah’s Witnesses and Blood Issues

Jehovah’s Witnesses are well known for their refusal of blood transfusions. But how much do you really know? What can or can’t they have, are epidural blood patches acceptable and what rights do parents have to refuse their children blood transfusions? This article discusses these issues as well as giving background on who are Jehovah’s Witnesses and what they believe in. It also covers the area of consent in both children and adults according to New Zealand law.
Length of Study: 60 min
Difficulty: Medium

Apnoea & Pre-oxygenation

Apnoea & Pre-oxygenation

Pre-oxygenation is used in anaesthesia to prolong the time to desaturation during a period of apnoea, such as frequently happens upon induction. This can also be thought of a denitogenation. This article covers the science behind it and discusses some patient groups that need special attention.
Length of Study: 60 min
Difficulty: Easy
  

Paediatric Anaesthetic Emergencies: Pt I

Paediatric Anaesthetic Emergencies: Pt I

Paediatric anaesthetic emergencies can happen faster and leave less time to react then in adults. They present complex, potentially life-threatening situations that everyone engaged in giving paediatric anaesthetic should be aware of and be able to treat.This first article covers laryngospasm and suxamethonium apnoea.
Length of Study: 50 min
Difficulty: Medium

Paediatric Anaesthetic Emergencies: Pt II

Paediatric Anaesthetic Emergencies: Pt 2

Paediatric anaesthetic emergencies can happen faster and leave less time to react the in adults. They present complex, potentially life-threatening situations that everyone engaged in giving paediatric anaesthetic should be aware of and be able to treat.This second article covers malignant hyperthermia and anaphylaxis.
Length of Study   50min
Difficulty: Medium

Postoperative Nausea & Vomiting

Postoperative Nausea & Vomiting

PONV can be common after surgery, although some patient groups are more prone to this than others. This module discusses this and what is the most effective and appropriate treatment for PONV.
Length of Study: 75 min.
Difficulty: Easy

ECG: a review

Understanding your ECG: a review

Health professionals use the electrocardiograph (ECG) rhythm strip to systematically analyse the cardiac rhythm. Before the systematic process of ECG analysis is described it is important to understand the individual waveforms, segments and intervals of the ECG. This module reviews all these steps.
Length of Study: 90 min
Difficulty: Medium

Oxygen Saturations & Pulse Oximetery

Oxygen Saturations & Pulse Oximetery

The pulse oximeter provides an indication of oxygen status in the body. However, the link between a pulse oximeter reading and the events occurring in the body can be complex and difficult to evaluate. We all require an understanding of factors associated with oxygen uptake and delivery to be able to use pulse oximetry in a knowledgeable way.
Length of Study: 80 min
Difficulty: Easy

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 epidemiology, clinical features and presentations as well as its management during an MH crisis.
Length of Study: 90 min
Difficulty: Difficult

Parkinson’s Disease & Anaesthesia

Parkinson’s Disease & Anaesthesia

Parkinson’s disease is a degenerative disorder of the central nervous system the causes of which are poorly inderstood. This article covers its management under anaesthetic, discusses which drugs are safe for use in this patient group and whether regional or GA anaesthetic are more appropriate.
Length of Study: 60 min
Difficulty: Medium

Intraosseous Access – Understanding and establishing

Understanding & Establishing Intraosseous Access

Intraosseous (IO) access is an alternative method to providing venous administration of drugs and fluids. Commonly used by the military and pre-hospital medics,it is gaining popularity in the hospital setting where intravenous access is challenging or time critical.
Length of Study: 75 min
Difficulty: Easy

Temperature Management in Children

Temperature Management in Children

Maintenance of normothermia in children under going surgery is challenging. There is clear evidence in adults that even mild intra-operative hypothermia is associated with adverse outcome. This short article discusses the problems and what we can do about it.
Length of Study: 40 min
Difficulty: Easy

When Anaesthetics Go Wrong

When Anaesthetics Go Wrong

This one is a little different. There is no test at the end. The video is the story of Elaine Bromiley who died while under anaesthetic for a routine elective surgical procedure. Viewing this is a must for anyone working in the operating theatre and it is perfect to write up as an example of reflective practice. The PDF is an anonymous version of an Independent Report on the death of Elaine Bromiley.
Length of video: 15 minutes

Valvular Heart Disease

Valvular Heart Disease

This American review focuses on anesthetic management of the classic heart lesions: aortic stenosis (AS), aortic regurgitation (AR), mitral stenosis (MS), and mitral regurgitation (MR).
Length of Study: 90 min
Difficulty: Very Difficult

Management of Major Obstetric Haemorrhage

Management of Major Obstetric Haemorrhage

Major obstetric haemorrhage is a common cause of maternal morbidity and mortality and the recognition of major obstetric haemorrhage can be challenging. This module discusses it causes, symptoms and importantly anaesthetic management of cases.
Length of Study: 75 min
Difficulty: Medium

I.V. Induction Agents

I.V. Induction Agents

I.V. induction agents are some of the most commonly used drugs in anaesthetics. This modules shows how and where they work. It then goes to review the most common I.V. induction agents and their effects on the body.
Length of Study: 75 min
Difficulty: Medium

Perioperative Cell Salvage: an introduction

Perioperative Cell Salvage: an introduction

This module discusses basics of perioperative cell salvage or call saver. Its principles, indications, contra-indications and the various types of system available.
Length of Study: 90 min
Difficulty: 
Easy

Laryngospasm in Anaesthesia

Laryngospasm in Anaesthesia

Recognition of at-risk patients will help to prevent laryngospasm and avoid potential significant morbidity. This module discusses laryngospasm, its recognition, prevention and treatment.
Length of Study: 75 min
Difficulty: Easy

Perioperative anaphylaxis

Perioperative anaphylaxis

Perioperative anaphylaxis is not uncommon and several commonly used anaesthetic drugs can cause anaphylaxis. This modules covers latest guidelines to identifying and treating anaphylaxis in theatre as well as the post theatre care required.
Length of Study: 75 min
Difficulty: 
Medium

Amniotic Fluid Embolism

Amniotic Fluid Embolism

Amniotic Fluid Embolism (AFE) is a rare but potentially fatal syndrome that is unique to pregnancy. AFE has emerged as one of the leading causes of direct maternal death within developed countries such as Australia, the UK and the USA.
This module discusses AFE, its presentation, diagnosis and treatment.
Length of Study:  60 min
Difficulty: Difficult

Placental Abruption

Placental Abruption

Placental abruption is defined as separation of the placenta from the decidua basalis before delivery of the fetus. It is extremely serious and potentially fatal.
Length of Study: 60 min
Difficulty: Easy

Sugammadex: an overview

Sugammadex: an overview

Sugammadex is an effective and safe agent for reversing neuromuscular blockade, in particular all depths of rocuronium-induced blockade. Sugammadex provides a real alternative to neostigmine and this module covers everything you need to know.
Length of Study: 60 min
Difficulty: Easy

Physiological effects of transfer for critically ill patients

Physiological effects of transfer for critically ill patients

Critically ill patients can be exposed to significant physiological changes during transfer that can lead to significant instability with hypoxia, hypotension, arrhythmias and changes in intracranial pressure (ICP). This tutorial will explore the physiological effects that land and air transfer have on critically ill patients and describe how these adverse physiological sequelae can be avoided or reduced.
Length of Study: 75 min
Difficulty: Medium

Patient positioning during anaesthesia

Patient positioning during anaesthesia

Different patient positions are required to provide access for different surgical procedures. Each position has implications for ventilation and haemodynamics, as well as exposing patients to possible complications such as nerve injury and pressure sores.
Length of Study: 75 min
Difficulty: Easy