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

The respiratory system – The process of respiration

This module covers the physiological process of respiration, of which breathing is only the first stage. The ultimate function of the respiratory system is gas exchange which consists of supplying the body’s tissues with oxygen and removing carbon dioxide, the waste product.

There are three key elements to this process; pulmonary ventilation, external respiration, and internal respiration.

Length of Study: 60 min.
Difficulty: Beginner/student

Paediatric Pain

Good quality, effective management of pain in paediatric patients is an essential component of paediatric anaesthesia. However, achieving this can be difficult for a variety of reasons not least of which is the enormous variations that occur physiologically and psychologically throughout the range of ages encountered in the paediatric population.
Length of Study: 75 min
Difficulty: Medium

Airway adjuncts and intubation aids

Airway adjuncts are designed to increase the success rate of basic airway manoeuvres, help maintain spontaneous respiration or ensuring successful bag-mask ventilation. Intubation aids are used to help the passing of an endotracheal tube through the cords rather than to help with laryngoscopy.

Length of Study: 45 min.
Difficulty: Beginner/student

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: 45 min
Difficulty: Easy

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

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.

Length of Study: 60 min.
Difficulty: Beginner/student

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

Ketamine in anaesthetic practice

Ketamine is the only anaesthetic available which has analgesic, hypnotic and amnesic effects. When used correctly it is a very useful and versatile drug.
Length of Study: 45 min
Difficulty: Easy

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that relieve or reduce pain. Their actions are analgesic, anti-inflammatory and antipyretic.
Perioperatively, using NSAIDs avoids many of the adverse effects of opioids such as respiratory depression, sedation, nausea and vomiting and gastrointestinal stasis. Although an effective analgesic they have significant adverse effects and contraindications which the perioperative practitioner must be aware of.

Length of Study: 80 min.
Difficulty: Medium
   

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
   

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: 60 min.
Difficulty: Easy

Morphine – Still the gold standard

Still popular and widely used. This brief module reviews the basics of morphine, its uses, side effects and doses.
Length of Study: 30 min
Difficulty: Easy

General anaesthesia in obstetrics

Major advances in obstetric anesthesia have resulted in improved maternal outcomes but the failure rate is still higher than in non-obstetric anaesthetics. The consequences of a failed intubation in the obstetric patient may not only affect the mother, but also the fetus. This article gives an overview of how to conduct a GA in obstetrics safely and safely manage a failed intubation to ensure a good outcome. It contains guidance to the  OAA/DAS Obstetric Airway Guidelines.

Length of Study: 75 min.
Difficulty: Medium
   

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

Safe tracheal extubation

This article covers complications occurring during emergence, extubation and later in recovery. It details the DAS guidelines on safe extubation and explains the factors that increase the risks of
adverse events. It also describes how to optimise conditions before tracheal extubation.

Length of Study: 60 min.
Difficulty: Medium
   

Anaesthetics for obese patients

The prevalence of obesity has tripled over the past 40 yrs and there are now more than 650 million obese adults worldwide. This article offers an update of the perioperative risk and the associated morbidity that obesity causes and its impact on anaesthetic management.

Length of Study: 60 min.
Difficulty: Medium
   

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

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 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

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

Understanding capnography

This module explains the basic principles of capnography, discusses EtCO2 waveforms, and how to interpret them in the ventilated patient.
Length of Study: 60 min.
Difficulty: Medium
   

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

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

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

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

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

An Introduction to Pain Pathways

This module provides a basic overview of the important pain pathways and how they work. It also covers how pain can be modulated at different levels along the pathway. It gives a simplified view of a very complex topic.

Length of Study: 60 min.
Difficulty: Difficult
   

An Introduction to Paracetamol

Paracetamol is a commonly used medicine that can help treat pain and reduce a high temperature.  In normal doses it is considered safer than many analgesics as it has no effect on the cardiovascular and respiratory systems and unlike Non-steroidal anti-inflammatory drugs (NSAIDs) it does not cause gastric irritation or bleeding.
One caution, especially for the perioperative environment, is that as IV paracetamol has close to 100% bioavailability and IV doses must be adjusted in low weight individuals to prevent overdose.

Length of Study: 45 min.
Difficulty: Easy
   

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
   

Bronchospasm during general anaesthesia

Bronchospasm is a relatively common event during general anaesthesia. Anaesthetic assistants need to know how to identify and treat bronchospasm. Management begins with switching to 100% oxygen and calling for help early. Increasing the inspired concentration of Isoflurane and Sevoflurane will produce bronchodilatation and is a good start.

Length of Study: 60 min.
Difficulty: Medium
   

Urea & Electrolytes: a review

Urea and electrolytes (U&Es) are the most frequently requested biochemistry tests. They provide useful information about several aspects of health, such as the volume of blood and its pH. The most important aspect of U&Es is what they tell us about kidney functioning.
Length of Study: 50 min
Difficulty: Easy

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

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

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

Nerve Impulse Conduction

It is essential that perioperative practitioners have an understanding of nerve conduction, as many drugs used in the operating theatre have an impact on the nervous system and nerve conduction. The most obvious, but not the only one, being local anaesthetics which prevent pain and other nerve signals reaching the brain, by temporarily blocking nerve conduction.
This module examines how nerve cells communicate by sending signals to each other and various other tissues throughout the body. It is a simplified explanation of a complex topic.

Length of Study: 60 min.
Difficulty: Beginner/student

An introduction to the autonomic nervous system

As many procedures and drugs used in anaesthetic practice have a direct influence on the autonomic nervous system, it is essential that the anaesthetic assistant should have an understanding of its structure and function although this is a very simplified introduction of a large and complex topic.

Length of Study: 80 min.
Difficulty: Medium