hi everyone this is abc's of anesthesia and today i'm going to talk about the best organizations out
there putting together really incredible summaries and guidelines for anesthesia so let's get started
now the best thing about these organizations is that they provide so much good relevant and
complex information summarized in really easily digestible form and best of all it's all free and
it's online so what we're going to go through today is a few of these organizations now the
first one is the difficult airway society and also andrew heard on youtube the american college of
cardiology and the american heart association guidelines the aagbi or the association of
anaesthesis of great britain and ireland national audit projects and the cochrane collaboration
as you all know anaesthetics is a really really practical specialty i mean you can know all the
theory in the world but if you're not able to actually bag master patient or put that iv in or
a difficult art line or even run a crisis um and do all that stuff really the theoretical
the theoretical skill doesn't really amount to much for your patient care that's one of those
privileges of anesthesia you know it's really effective but you have to be the patient side
handling the situation right there and you just can't do it with theory so look as much as i'll
i'll rave about these organizations the best thing as a junior at least is to just get out there
do the rotation get into theater and spend lots of hours you know being with patients taking care
of them and learning from your trainees from the nurses from the supervisors from the people from
the people around you because you'll learn so much just being on the job now a little plug for the
abcs of anesthesia boot camp playlist which i'll put up there obviously i'm a little bit biased
but that's the best beginner's guide to anesthesia and i just go through hours and hours of material
from the absolute basics and chronologically to make sure that in everything you need to know to
be okay in your first day of anesthesia and just get what's going on it's right there so have a
look at that playlist and you can also access the workbook which will be available i'll put the link
in the story notes as well and another link just up there now the organizations i'm going to talk
about there's going to be a lot of articles and a huge amount of resources there but you don't
need to go through everything just remember that you know to be a really good junior in these this
you just have to get to work and do do the time you don't need to read a lot that said um if you
really want to do a deep dive if something comes up in your case maybe it's something about you
know hip fractures or malignant hypothermia or a really tricky cardiovascular patient that's when
you go to these resources so you know what the nieces are talking about i guarantee you
definitely in australia most and these around the world will be aware of these organizations and
they'll get a lot of the information from them so just just imagine if you read the relevant
guideline you'd probably know in theory just as much as the anises you're working with and
you could probably have a really interesting conversation with them about whatever topic it
is so this is just so you guys know where you need to go for that information at a really high level
and for you to you know have an interesting conversation so you can learn more on the day
yeah so the first two resources are all about airway and you know managing the
airway is probably one of the most high risk and tricky and highly skilled things that
anesthetists do and it's the first one it's a difficult airway society and so the das um it
it's just an amazing resource it comes up with these amazing guidelines that really structure
the way you should manage or you should think about an airway from the point of view of you
know the way you approach it bagmas ventilation lma ventilation and intubation definitely when
i first started anesthesia there's a lot of confusion and there wasn't as much practical
step-by-step advice and the difficult ios society definitely went a long way into providing that
really simple effective advice now this website will have a lot of free flow charts free
free guidelines and so you can really look at the way a consultant analysis
would think about airway management and how they progress when things got a bit tricky
now the next resource is an australian resource and there's a doctor called andrew hurd he's a
specialist anesthetist that works in in perth in western australia and back when i was i
first started training actually just passed my first part exam and i went to this conference in
cairns and he was there speaking he literally very recently just done these experiments and published
these trials on surgical airways now the really special thing about what they did
and what he did with his experiments they took real people into real life situations
um with with animal models and see and had a look at what people would do in real life so they had a
look at what things would they would be familiar what things were a little bit more difficult and
just the effectiveness of each of these techniques so it's probably the first time that this kind of
stuff was studied so it really was revolutionary in anesthesia before that surgical airways were
very much a theater theoretical conversation and i remember having many conversations with
anaesthesis about how they'd manage a difficult airway and surgical access to the airway so you
know having a front of neck access and you know they talk about putting cannulas in but not
really talking about how you would then manage ventilation oxygenation and all the hazards and
all the problems that could happen with that and so andrew hurd and his team have done that really
really effectively now the best place for those resources he's definitely published in a lot of
in a lot of places a lot of very reputable places but also he's got a youtube channel so
i'll put the link down below and it's dr amb herd airway so that's d-r-a-m-b h-e-a-r-d-a-i-r-w-a-y
so his youtube channel is fantastic they use a model and show all the different techniques
and i'll also put some links to his resources there because again revolutionary and they were
the first time surgical airway planning was done in such a realistic way one of the main
things that they saw was that you know back in the day when people were training they found
that maybe a needle technique was better than surgical surgical airway technique or scalpel
technique because anaesthetists were just more familiar with using needles and that may have
changed now there's more data out there but it was the first time that they really explored surgical
net fronting access versus a needle and then what things would actually work and what things
would go wrong does jet ventilation really work what are the hazards how long do you need to put
the jet ventilation on and off for to avoid barrier trauma he went through a lot of
this stuff and so much good information in his videos so massive plugged for him and his team
the next organization that we're going to talk about is the american college of cardiology and
the american heart association or the acc and aha guidelines now these terms you'll probably hear a
lot as you go through your training mainly because they represent probably the most comprehensive
organization putting our guidelines on everything cardiovascular and the great thing about
anesthesia is that cardiovascular diseases are so important for the stability of our patients that
you know everything from valve lesions to heart failure to rhythm disturbances
and preoperative investigation this team covers it um it's run by expert panel of cardiologists and
other and other members and they come up with levels of evidence for each intervention and
whether you know what the evidence is and whether it's expert consensus or not um so again a really
great resource and i'll put the link down below um the main guideline that we would use time and
time again which i've got a lot of videos on and i'll probably put a link to a video there
um is the pre-operative cardiovascular evaluation guidelines the latest one being 2014 which is
still very relevant now and i do a whole lecture on that and just a summary so most of my trainees
will hear me say every anesthetist really loves morning coffee and that's my mnemonic summary of
emergency active cardiac conditions what's the risk of surgery is it low what are the mets and
does clinical testing change management so that's e-a-r-l-m-c everyone every anesthetist really
loves morning coffee and that's where that comes from that guideline again really great
read if you want to deep dive into pre-operative cardiovascular evaluation and what the evidence is
now the next organization i'm going to talk about is the association of aenesis or the aagbi which
it stands for the association venises of great britain and ireland so the relevance to you
is that it's a fantastic organization as well as a charity and what they do is they publish
some amazing guidelines as well um so they've come up with so many different
uh reports and guidelines based on everything from milk and hypothermia to neck fractures to
you know acute resuscitation plans management of glucocorticoids uh anesthesia sedation in
breastfeeding women so a lot of things and the best thing is again it's all a free resource
so let's say you have a pregnant lady who's coming for surgery and there's always a question
what are you going to do about you out of study how are you going to change things how you're
going to manage this for the safety of the mom and the baby they've come up with a guideline so
you can really do a deep dive on that or maybe one of the most common high-risk procedures you'll do
even as a junior under supervision is anesthesia for hip fracture surgery in an elderly patient now
these are incredibly high mobility and mortality throughout the whole perioperative period and
again they've got this really good well-informed evidence-based guideline just on that
so fantastic resource and i'll put the address and links down below for that
now another thing out of the uk is the national audit projects
now these again amazing amazing results i've probably said that a few times now
um so usually these are anywhere from a year-long project where they look
at really rare complications or low instance complications that are potentially serious
for patients and important for patients and anaesthetists and so you know every every few
years they come up with a different project so the most relevant ones to us are nap three to
nat 4.5 and six and they're currently running nap seven snap three was major complications of
central near axial blocking in the united kingdom nat four was airway complications
napfi was accidental awareness during anesthesia nap 6 the most recent one that was published is
pre-operative anaphylaxis and that seven which is still underway is peripheral cardiac arrest
so again if you ever want to know the data on these really low incidence things like awareness
like a natural access like you know failed airways these are low incidents it takes a long time to
study these things it's very hard to get all your data right the national audit projects
are looking at this in detail and the stuff they come up with is incredibly well evidence-based for
something that often has very little evidence so really worth a read really worth a deep dive into
now almost everyone has heard of this resource because it's not specifically
phenies this it's the cochrane collaboration now the cochrane collaboration is an international
not not-for-profit organization and the best thing is they're trying to help people to make
well-informed decisions for healthcare so not only do they have really fantastic systematic reviews
about topics anything to do with medicine and healthcare but they also have a plain
language statement which is really fantastic especially a junior doctor or a patient so the
cochrane collaboration i'll put some links to the organization itself and also to the cochran
library and again if you're ever in doubt about something a really big ticket item have a look
at that collaboration have a look at the evidence out there it's free and you can download that and
you know again have some really interesting information present some really information to
your bosses advisors to have those discussions to learn more for your patient safety
now the final organization i've already mentioned this in other videos about the best resources
it's the british journal of anesthesia education series so this is a journal that really is
just a whole bunch of summaries of really interesting anesthetic topics it's www.bjaed.org
and again if i'm ever doing a tricky case that i haven't refreshed in a while i will go to the
website type in that case whether it's a livery section or maybe something thoracics or maybe
it's a interesting medical complaint rheumatoid arthritis or multiple sclerosis whatever it is
they will have an article that summarizes a lot of the evidence right there for you
it's a fantastic resource i would use this on a weekly basis uh especially when i'm creating
you know what i love about this resource is really great for creating evidence-based vibers for any
of my training so if i'm examining them you know it's hard to remember absolutely everything for
these really niche topics but what's important is not necessarily memorizing everything but knowing
where to look and hopefully with this series of what are the best resources hopefully that's what
i'm giving you so thanks very much for watching i hope that was useful so just in conclusion
the airway stuff was a difficult airway society and andrew hurd's youtube channel
and resources the acc aha guidelines fantastic resource for everything cardiovascular you've got
the aagbi the national audit projects and the cochrane collaboration as well as the british
journal anesthesia education series so thanks for watching this abcs of anesthesia please share with
anyone who might be interested in learning more about anesthesia and see you next time
you