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

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
   

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
   

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
   

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
   

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
   

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
   

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
   

Understanding the circle system 

Although the circle system looks relatively simple, it is a deceptively complex arrangement that needs to be fully understood to use safely, especially at low flows.
This module explains the components, setup and both advantages and disadvantages of the circle system.

Length of Study: 60 min.
Difficulty: Easy
   

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
   

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

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

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.

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

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.

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

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

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.

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
   

Emergency front of neck access in airway management

This module describes the guidance for emergency front of neck access, reviews techniques to improve decision making in the transition to eFONA and reviews the  ‘scapel, bougie,
tube’ technique when performing eFONA.

Length of Study: 45 min.
Difficulty: Easy