Hot topics Lauren Weekes

What’s this session about?

• Highlighting high yield areas

• Signposting some areas you may wish to investigate further

• Disclaimer- these are not question predictions! Simply topical subjects that might make good SAQs…

Sept 2016 paper

• Aspiration

• Brainstem death

• EVAR

• Enhanced recovery

• Ascites

• CRPS

• MR safety

Sept 2016 paper

• Aspiration CEACCP 2014

• Brainstem death CEACCP 2012

• EVAR CEACCP 2012

• Enhanced recovery CEACCP 2014

• Ascites CEACCP 2013

• CRPS CEACCP 2013

• MR safety CEACCP 2012

Feb 2016 Paper

• CV effects of laparoscopy

• Trauma major haemorrhage

• Intrathecal opioids

• CEA under LA

• Transphenoidal hypophysectomy

• Apnoeic oxygenation

• Accidental awareness

Feb 2016 Paper

• CV effects of laparoscopy CEACCP 2011

• Trauma major haemorrhage CEACCP 2014

• Intrathecal opioids CEACCP 2008

• CEA under LA CEACCP 2012

• Transphenoidal hypophysectomy CEACCP 2011

• Apnoeic oxygenation CEACCP 2009 BJAE 2016

• Accidental awareness CEACCP 2013

September 2015 Paper

• Procedural sedation

• Patients with SCI

• Regional anaesthesia shoulder

• VAP

• POCD after bypass

September 2015 Paper

• Procedural sedation CEACCP 2012

• Patients with SCI BJAE2015

• Regional anaesthesia shoulder BJAE 2015

• VAP BJAE 2015

• POCD after bypass CEACCP 2013

March 2015 Paper

• Recovery from NMB

• Autistic Spectrum Disorder

• Critical Illness Weakness

• Anticoagulation on CPB

• Liver disease

• ECT

March 2015 Paper

• Recovery from NMB CEACCP 2012

• Autistic Spectrum Disorder CEACCP 2013

• Critical Illness Weakness CEACCP 2012

• Anticoagulation on CPB CEACCP 2007

• Liver disease CEACCP 2010

• ECT CEACCP 2010

Sept 14 Paper

• Analgesia for thoracic trauma

• Surgery in early pregnancy

• Cardioplegia

• ASD in children

• Propofol infusion syndrome

• Rheumatoid disease

• Myotonic dystrophy

• Ankle block

Sept 14 Paper

• Analgesia for thoracic trauma (CEACCP 2014)

• Surgery in early pregnancy (CEACCP 2012)

• Cardioplegia (CEACCP 2009)

• ASD in children (CEACCP 2012)

• Propofol infusion syndrome (CEACCP 2013)

• Rheumatoid disease (CEACCP 2006)

• Myotonic dystrophy (CEACCP 2011)

• Ankle block (CEACCP 2013)

High yield resources • RCoA

– Chairman’s report – Their books (Guide to the Final 180 MCQ 30SBA) – The website – The Gas newsletter – The Candidate newsletter

• CEACCP/BJAE • Guidelines & publications:

– SALG – AAGBI – National Audit Projects – NICE – NCEPOD

WHERE MIGHT YOU LOOK?

Guidelines & Reports NICE:

– Prevention SSI – Low back pain – Routine preop tests – Major trauma/spinal injury – Blood transfusion – Antibiotic stewardship – Diagnosis/mx type II DM – Diabetic mothers – Pneumonia – Drug allergy – AF management – Neuropathic pain

NHS Improvement – Never events – NATSSIPS

NCEPOD – NIV – Acute pancreatitis – GI haemorrhage – Lower limb amputation – Tracheostomy care – Sepsis – Subarachnoid haemorrhage

National Audit Projects – 3: regional – 4: airway – 5: awareness – 6: anaphylaxis

AAGBI – Consent for anaesthesia – Blood components & alternatives – Management of hypertension pre-op – Safe vascular access – Peri-operative management of the surgical patient with diabetes – Reducing risk from cemented hemiarthroplasty (in March 2015 paper)

– Perioperative management of the obese pt – Skin antisepsis prior to neuraxial anaesthesia – Perioperative Care of the Elderly (esp. delirium) – Regional anaesthesia in pts with abnormal coag. – Dental damage (SALG) – Epidural haematoma (SALG)

RCoA – Remote site anaesthesia – Child protection (in Feb 2016)

– Safe sedation (Sept 2015)

– Diabetes – Epidurals in chronic pain

BJA Education (from April 2015-formerly CEACCP)

• Heart failure

• The spleen

• Extubation of difficult airway

• Renal replacement therapy

• Antibiotic stewardship

• Management acute UGI bleeding

• Opioid tolerant patients

• Parkinsons

• Connective tissue disorder/vasculitides

• Sudden cardiac death/ventricular arrythmias

• Free flap surgery

• Blood management & periop anaemia

• Interventional stroke therapies

• Mitral valve disease

• Adult epilepsy and anaesthesia

• Major obstetric haemorrhage

• Periop hypertension/Antihypertensive drugs (see also BJA)

• DKA in adults

• Pain after thoracotomy

• Pain after amputation (&PSP in general)

• Perioperative care of patients with sleep disorders

• Rib fracture management

• Principles of total intravenous anaesthesia

CEACCP

• Sepsis in obstetrics

• Children with renal disease

• Foreign body inhalation

• Periop AKI

• Opioid receptors

• Pain in day-case surgery

• Iatrogenic airway injury

• LA toxicity

• Perioperative SVT

• Tracheostomy management

• Awake intubation

CEACCP cont

• Inherited disorders coagulation

• Major spinal surgery/anaesthesia in prone position

• Rhabdomyolysis

• COPD and anaesthesia

• Traumatic brain injury

• Acute spinal cord injury

BJA & Anaesthesia editorials/review articles

• Postop pulm complications

• Fluid mx burns

• Vasospasm after SAH

• Opioid hyperalgesia

• Preoperative anaemia

• Perioperative stroke

• Cerebral perfusion pressure

• DAS Guidelines 2015

• Peripheral neuropathic pain

• CKD

• Pulmonary hypertension in non-cardiac surgery

• Periop hypertension

What’s come up in more than one place?

• Antibiotic stewardship

• Upper GI bleeding

• Diabetes

• Post-surgical pain

• Hypertension

• Community-acquired pneumonia

What would I look at?

• General/medical: – Consent – UGI bleeding (risk scoring,

medical, interventional) – Parkinsons – Hypertension- mx, agents,

guidelines – Epilepsy – Connective tissue disorders – TIVA TIVA TIVA

• Neuro – SAH – (acute SCI)

• Cardiac – MVR – Ventricular arrythmias/sudden

cardiac death syndromes

• Obs – ? sepsis

• Pain – Back pain/epidurals – Post surgical pain – Opioid tolerance – Opioid hyperalgesia

• ICU – Antibiotics – RRT

FOAMed

• BJA podcasts (BJA & BJA Education)

• Critical Care Reviews