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doctimcook.bsky.social

@doctimcook.bsky.social
543 followers 7 following 81 posts
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Anaesthesia @anaesjournal.bsky.social · 03/09/2025
Bougie or stylet: what to use when the chips are down? Is it truly possible to consistently and deliberately shape a bougie to fit a hyperangulated blade? @doctimcook.bsky.social @janhansel.bsky.social #AnSky #AirwaySky #MedSky doi.org/10.1111/anae...
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Reposted by @doctimcook.bsky.social
Anaesthesia @anaesjournal.bsky.social · 22/08/2025
Thinking of implementing default videolaryngoscopy in your department? Here are some common themes encountered & practical advice & strategies recommended by 5 UK hospitals that have made such a change! #AnSky @fionafionakel.bsky.social @doctimcook.bsky.social doi.org/10.1111/anae...
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doctimcook.bsky.social @doctimcook.bsky.social · 27/03/2025
Hello my name is…..needs rebooting with name, title & role : badges & introductions Without it -too much confusion -too much uncertainty -too much rom for obfuscation I like to think Dr Kate Grainger would agree www.bmj.com/content/388/...
bmj.com
“Hello, my name is” introductions and badges need updating to include full name, title, and role
Staff should introduce themselves with their title, name, and role and have badges clearly detailing this to avoid confusion and misdirection, writes Tim Cook The “Hello, my name is” campaign, set up...
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Nicholas Chrimes @chrimesy.com · 28/03/2025
5 years ago I complained that w HAVL “I can see but I can’t get the tube in”. @doctimcook.bsky.social pointed out “that’s a prob w the operator, not the device”. Having since learned HAVL I’ve used it routinely for 5 years w 100% FPS & never <G1 view.
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Difficult Airway Society (DAS) Residents @dasresidents.bsky.social · 28/03/2025
Time to retire ‘no trace, wrong place’ @doctimcook.bsky.social Many UOI do have ‘a trace’ It is all about sustained exhaled carbon dioxide @universalairway.org
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A Returning Doctor @returningdoctor.bsky.social · 28/03/2025
I agree Even as someone who had previously worked in the NHS, I found the new roles, titles and acronyms confusing at first which prompted me to get a #HelloMyNameIs badge! Roles should be a) clearly visible b) clearly stated
"Hello My Name Is" badge
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Dr Gavin Sullivan A.N.A.E.S.T.H.E.T.I.S.T 🇳🇿🇦🇺🇬🇧 @lotusgav.bsky.social · 28/03/2025
Absolutely agree with this. I have a standard patter. “Hello I’m Dr Sullivan I’m a consultant anaesthetist. What do I call you?” I think it speaks to credibility. Do you want to be anaesthetised by “ Gav” or “Dr Sullivan” ?
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Reposted by @doctimcook.bsky.social
Nicholas Chrimes @chrimesy.com · 24/01/2025
“No trace = wrong place” should be retired & replaced by the requirement to exclude oesophageal intubation if ‘sustained exhaled CO2’ is not detected. From @doctimcook.bsky.social, Andy Higgs & me. 🔑🔓Free full text in @bjajournals.bsky.social : kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F...
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doctimcook.bsky.social @doctimcook.bsky.social · 27/03/2025
Hello my name is…..needs rebooting with name, title & role : badges & introductions Without it -too much confusion -too much uncertainty -too much rom for obfuscation I like to think Dr Kate Grainger would agree www.bmj.com/content/388/...
bmj.com
“Hello, my name is” introductions and badges need updating to include full name, title, and role
Staff should introduce themselves with their title, name, and role and have badges clearly detailing this to avoid confusion and misdirection, writes Tim Cook The “Hello, my name is” campaign, set up...
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Reposted by @doctimcook.bsky.social
doctimcook.bsky.social @doctimcook.bsky.social · 04/02/2025
AIRWAY RESEARCHERS!! We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES (the core outcome set) A 15 min survey now & again in a month (Delphi) RESEARCHERS please complete Recruitment ends this week Link redcap03.gsttdms.co.uk/redcap/surve... Pass it on! Thanks
redcap03.gsttdms.co.uk
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Reposted by @doctimcook.bsky.social
doctimcook.bsky.social @doctimcook.bsky.social · 04/02/2025
EVER HAD AN ANAESTHETIC? What matters to PATIENTS? We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES A 15 min survey now & again in a month Looking for PATIENTS Recruitment ends this week Link redcap03.gsttdms.co.uk/redcap/surve... Thanks. Pass it on!
redcap03.gsttdms.co.uk
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doctimcook.bsky.social @doctimcook.bsky.social · 04/02/2025
AIRWAY RESEARCHERS!! We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES (the core outcome set) A 15 min survey now & again in a month (Delphi) RESEARCHERS please complete Recruitment ends this week Link redcap03.gsttdms.co.uk/redcap/surve... Pass it on! Thanks
redcap03.gsttdms.co.uk
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doctimcook.bsky.social @doctimcook.bsky.social · 04/02/2025
EVER HAD AN ANAESTHETIC? What matters to PATIENTS? We’re researching WHICH FACTORS SHOULD BE REPORTED IN ANAESTHETIC AIRWAY STUDIES A 15 min survey now & again in a month Looking for PATIENTS Recruitment ends this week Link redcap03.gsttdms.co.uk/redcap/surve... Thanks. Pass it on!
redcap03.gsttdms.co.uk
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doctimcook.bsky.social @doctimcook.bsky.social · 28/01/2025
PAEDIATRIC DEATHS DURING ANESTHESIA & SURGERY - LESSONS FROM NAP7 Great to see this published Link attached www.bjanaesthesia.org/article/S000...
bjanaesthesia.org
NAP7: high mortality risk in neonates and very low risk in children
Editor—We congratulate Lyne and colleagues1 on their initiative to explore and improve consent around perioperative mortality in children. Providing such data for families and clinicians is a key purp...
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Reposted by @doctimcook.bsky.social
Nicholas Chrimes @chrimesy.com · 24/01/2025
Frequency gambling vs severity gambling - from @doctimcook.bsky.social, Andy Higgs & me in @bjajournals.bsky.social kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F...
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doctimcook.bsky.social @doctimcook.bsky.social · 24/01/2025
@AnaesUnited is challenging the expansion of & arguing for the need of a national scope of practice & regulation for Anaesthesia Associates This is how the legal cases is going. Big step take already. anaesthetistsunited.com/court-gives-...
anaesthetistsunited.com
Court gives us the go-ahead - Anaesthetists United
Court gives us the go-ahead
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doctimcook.bsky.social @doctimcook.bsky.social · 24/01/2025
The issue of the expansion, scope of practice & regulation of MAPs, & for anaesthetists AAs, remains front & centre of the agenda. @AnaesUnited continue to pursue a legal challenge This is worth reading anaesthetistsunited.com/our-legal-ca...
anaesthetistsunited.com
Our legal case - Anaesthetists United
We are less than four months away from the final hearing in our fight against the GMC’s failure to set proper standards for Physician Associates (PAs) and Anaesthesia Associates (AAs) to treat patient...
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doctimcook.bsky.social @doctimcook.bsky.social · 18/01/2025
Where it started, where it going A million of anything is….lots Very proud
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doctimcook.bsky.social @doctimcook.bsky.social · 09/01/2025
A new resource from @rcoanews.bsky.social Good get better rcoa.ac.uk/patients/pat...
rcoa.ac.uk
Risks associated with general anaesthesia
Everyone is different; it is impossible to know who will have a side effect or risk. These numbers are averages from research studies. The people in the studies usually had routine surgery, were a hea...
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doctimcook.bsky.social @doctimcook.bsky.social · 05/01/2025
The PUMA guidelines for prevention of oesophageal intubation are supported by -RCOA -AoA -FICM -ICS -CODP -DAS This is true of no other airway guidance I am aware of & make them the de facto UK National guidance associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
associationofanaesthetists-publications.onlinelibrary.wiley.com
Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies*
Across multiple disciplines undertaking airway management globally, preventable episodes of unrecognised oesophageal intubation result in profound hypoxaemia, brain injury and death. These events occ....
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Nicholas Chrimes @chrimesy.com · 08/01/2025
Tube removal (+ FM/SGA ventilation) is the default action to exclude OI, not only if OI can't be excluded with FB. Tube removal + vent also necessary if desat occurs or sustained exhaled CO2 can't be restored (even if removing tube dangerous or OI apparently excluded w alternative technique).
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Greg Bryson @glbryson.bsky.social · 05/01/2025
For my Canadian colleagues, PUMA guidance was developed in collaboration with the Canadian Airway Focus Group.
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Dr Mary-Ann Fox BMBS FANZCA GChPOM @maffygirl.medsky.social · 05/01/2025
If I hear chest rising, tube misting from trainees again, I might vaporise. I say sustained exhaled C02 is the only accurate indicator according to @doctimcook.bsky.social
media.tenor.com
a picture of an owl with the words say what written below it
ALT: a picture of an owl with the words say what written below it
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doctimcook.bsky.social @doctimcook.bsky.social · 08/01/2025
Responding to an article about consent for anaesthesia in children we analysed (all cause) PAEDIATRIC PERIOPERATIVE MORTALITY in NAP7 Really low for older children Low for infants High for neonates (80x) (Small numbers & wide CIs) www.bjanaesthesia.org/article/S000... 1/n
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doctimcook.bsky.social @doctimcook.bsky.social · 05/01/2025
The PUMA guidelines for prevention of oesophageal intubation are supported by -RCOA -AoA -FICM -ICS -CODP -DAS This is true of no other airway guidance I am aware of & make them the de facto UK National guidance associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
associationofanaesthetists-publications.onlinelibrary.wiley.com
Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies*
Across multiple disciplines undertaking airway management globally, preventable episodes of unrecognised oesophageal intubation result in profound hypoxaemia, brain injury and death. These events occ....
22619
Reposted by @doctimcook.bsky.social
Stu Marshall @hypoxicchicken.medsky.social · 28/12/2024
1/9 This is a really interesting observational study looking at VL and DL use. Comparison of success rates is flawed - the choice to use VL or DL was dependent on the complexity of the case - the populations aren't comparable But I think there are other lessons analogous to surgical technique #AnSky
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doctimcook.bsky.social @doctimcook.bsky.social · 21/12/2024
The @rcoa is to be congratulated on navigating the treacherous path defining scope of practice for Anaesthesia Associates via -huge surveys of opinion -aiding #Nap7 analysing real life practice -Cochrane review -professional liaison/listening -pragmatic approach to patient safety & existing AAs 1/2
rcoa.ac.uk
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Anaesthesia @anaesjournal.bsky.social · 12/12/2024
What are the disadvantages of 'total videoscopic tracheal intubation'? • ⬆️ stress response • ⬆️ risk of airway trauma • awkward ergonomics • prevents airway operator managing other aspects of induction @chrimesy.com @doctimcook.bsky.social #AnSky #MedSky #AirwaySky buff.ly/4gyjwy7
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doctimcook.bsky.social @doctimcook.bsky.social · 07/12/2024
HYPERANGULATED VL: OPTIMISING TECHNIQUE As ever, I think the answer lies with careful attention to some simple tips 1/7
media.tenor.com
a woman with blue hair and glasses is making a funny face .
ALT: a woman with blue hair and glasses is making a funny face .
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Rhys Thomas @drgetafix.bsky.social · 05/12/2024
Also, consciousness is a slippery concept without an agreed definition/mechanism, hence Chalmers “hard problem of consciousness”. Amnesia however is easier to define and measure and a lack of it is what we actually look for when assessing patients post-op or testing things like BIS and Entropy. 2/2
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doctimcook.bsky.social @doctimcook.bsky.social · 04/12/2024
Delighted that Ben Dallyn from @RUHBath won the 1st prize for oral presentation @dasairway He presented A MANIKIN STUDY OF STYLETS & BOUGIES (static & dynamic)….. 1/4
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doctimcook.bsky.social @doctimcook.bsky.social · 03/12/2024
t’s interesting how people define anaesthesia I ask every new resident what anaesthesia is. When they offer me a triad of -Unconsciousness -Muscle relaxation -Analgesia I give them 1 out of 3 Why is that? Am I right?
media.tenor.com
a close up of a man 's face with a jacket that says ' a ' on it
ALT: a close up of a man 's face with a jacket that says ' a ' on it
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doctimcook.bsky.social @doctimcook.bsky.social · 28/11/2024
Great slide in the ETHICS section of #DAS2024 @dasairway from Catriona Ferguson Lovely summary - including the inherent conflicts within the law
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doctimcook.bsky.social @doctimcook.bsky.social · 03/12/2024
DAS ORAL PRESENTATIONS Great to see David Irwin & Sam Gunning 2nd VL TO TEACH DL: SYSTEMATIC REVIEW & METANALYSIS -VL improves FPS -Point estimates of time & overall success favour VL (n/s) -sensitivity analyses support VL -the overall evidence is weak & further good quality study would be good
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Fiona Kelly @fionafionakel.bsky.social · 27/11/2024
Thrilled that our @anaesjournal.bsky.social human factors guideline paper has passed 40 000 views! Thank you to @dasairway.bsky.social @assocanaes.bsky.social and all of the authors @drkevinfong.bsky.social @doctimcook.bsky.social @tmeek.bsky.social et al #ansky search.app/UvkCbeESwrcf...
search.app
Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals
Human factors is an evidence-based scientific discipline used in safety critical industries to improve safety and worker well-being. The implementation of human factors strategies in anaesthesia has ...
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doctimcook.bsky.social @doctimcook.bsky.social · 28/11/2024
Great slide in the ETHICS section of #DAS2024 @dasairway from Catriona Ferguson Lovely summary - including the inherent conflicts within the law
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Anaesthesia @anaesjournal.bsky.social · 25/11/2024
It's time for some new airway terminology! Introducing "flextension" - flexion of the lower cervical spine & extension of the upper cervical spine It is the optimal position for non-infant airway management #AnSky #MedSky #AirwaySky @chrimesy.com @doctimcook.bsky.social buff.ly/4eSw2Yo
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Nicholas Chrimes @chrimesy.com · 23/11/2024
Brilliant stuff. Supplementary points: @doctimcook.bsky.social & I have just published on suggesting the term #Flextension to replace 'sniffing position'. bsky.app/profile/chri...
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doctimcook.bsky.social @doctimcook.bsky.social · 28/11/2024
Celebrating the airway! Difficult Airway Society 2024
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Nicholas Chrimes @chrimesy.com · 23/11/2024
#CriticalLanguage Time to move from ‘sniffing position’ to the more descriptive #flextension which prompts both base-of-neck flexion & atlanto-occipital extension. @doctimcook.bsky.social @anaesjournal.bsky.social associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
associationofanaesthetists-publications.onlinelibrary.wiley.com
‘Flextension’: a new term to describe optimal head and neck positioning for airway management
Click on the article title to read more.
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doctimcook.bsky.social @doctimcook.bsky.social · 14/11/2024
Let’s see what happens….
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