iiinova — where your digital self keeps evolving

Reposted by George Clews

Centre for Perioperative Care (CPOC) @cpoc.bsky.social · 16/09/2026

Today, marks the inaugural World Prehabilitation Day. Prehabilitation can improve recovery, reduce complications and help patients achieve better outcomes. Read the Prehabilitation for people with cancer guidelines www.macmillan.org.uk/dfsmedia/1a6... #WorldPrehabDay #Prehabilitation #CPOC

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George Clews @georgeclews.bsky.social · 04/08/2026

Great work from @rcoanews.bsky.social and DAS! TL DR; there are various elements to an RSI that you may wish to add, depending on the risk of aspiration, though you should probably pre-oxygenate well/gently ventilate, use a nasogastric tube in bowel obstruction and use a video laryngoscope.

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Reposted by George Clews

Susanna Stanford @susannastanford.bsky.social · 30/07/2026

I met J-P just once. He impressed me with his willingness to engage with someone he knew nothing of. He demonstrated how much good can come from clinical leaders interacting with harmed patients with curiosity and humility rather than defensiveness. It also makes quite a good story… 1/

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George Clews @georgeclews.bsky.social · 27/07/2026

That’s a fair point and I agree with you. As a speciality, we have the potential to influence sustainability much more beyond our anaesthetic rooms, and I hope we can do that alongside limiting the carbon emissions of our anaesthetics.

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George Clews @georgeclews.bsky.social · 26/07/2026

I really want people to give anaesthetics that they believe are best for the planet, but I worry we are missing the woods for the trees.

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George Clews @georgeclews.bsky.social · 26/07/2026

Besides using regional +/- sedation, I feel the evidence base for TIVA, volatile, or any other form of delivering a general anaesthetic being greener isn't that great (besides N20 being awful).

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George Clews @georgeclews.bsky.social · 26/07/2026

I agree that you should do the things you can easily do, and I think there is a lot we can add to the patient pathway and structural changes that can reduce healthcare usage and emissions (the removal of mainline N20 being a great example).

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George Clews @georgeclews.bsky.social · 26/07/2026

We should be looking at ways to reduce hospital stays and complications (peri-operative medicine, ERAS, all that good stuff) as the best way to reduce greenhouse gas emissions Our actual anaesthetic technique is such a small part of the patient's journey (and carbon footprint)!

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George Clews @georgeclews.bsky.social · 26/07/2026

This 100000000000000% Not based on numbers, but I feel like the greatest source of greenhouse gas emissions is probably health care utilisation.

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George Clews @georgeclews.bsky.social · 15/07/2026

Absolutely not. Mad respect to my intensivist colleagues but it’s not my skill set. My diagnostic skills don’t go beyond is this an A, B or C problem. Occasionally a D problem but only when it’s causing an A problem.

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George Clews @georgeclews.bsky.social · 15/07/2026

Thanks mate. This year has been brutal with regards to rotations and exam revision. Feels like my summer can now begin!

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George Clews @georgeclews.bsky.social · 15/07/2026

FRCA ✅ 🥳 🍾 Looking forward to a life without exams and being able to learn because something is interesting or useful, rather than just because someone might quiz me about in a viva!

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Lee Hurley @hleehurley.com · 11/07/2026

Norway pay their female international players the same amount as their male players and have done since 2017.

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Reposted by George Clews

Susanna Stanford @susannastanford.bsky.social · 03/07/2026

My heart goes out to the women who shared their experiences for @theguardian.com It is important to understand the experiences of black women maternity care come in the context of lifetimes experiencing micro aggressions and discrimination. Harm is compounded and trust undermined further. 1/

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Iain Moppett OBE @iainmoppett.bsky.social · 26/06/2026

‘Pain only she knows’ is a challenging editorial. The first author @susannastanford.bsky.social is a patient with lived experience - a voice worth listening to. Some thoughts below @anaesjournal.bsky.social associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.... 1/N 🧵

associationofanaesthetists-publications.onlinelibrary.wiley.com

Pain only she knows

Reader environment loaded

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George Clews @georgeclews.bsky.social · 02/07/2026

😧 Fair point. Was someone able to perform awake video laryngoscopy to facilitate a larger tube? Awake tracheostomy sounds like it would be a bloody nightmare!

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George Clews @georgeclews.bsky.social · 01/07/2026

Was someone able to do a nasoendoscopy? AFOI with appropriate topicalisation and minimal sedation? I imagine these would act like a mediastinal mass and collapse the airways the moment the patient goes apnoeic. Maybe you have push your endotracheal tube beyond the mass?

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George Clews @georgeclews.bsky.social · 01/07/2026

It’s finally cold enough in theatres again that I need to wear a surgical gown like a cape to keep warm. Order is restored.

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George Clews @georgeclews.bsky.social · 21/06/2026

Assuming this was because it wasn’t the right fit for the original owner because no one would sell this otherwise!

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George Clews @georgeclews.bsky.social · 21/06/2026

I was in Japan recently and was tempted to buy the long sleeve version but didn’t, and now full of regrets

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George Clews @georgeclews.bsky.social · 21/06/2026

That Japan away kit is 🔥 🔥 🔥

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George Clews @georgeclews.bsky.social · 21/06/2026

People understandably have a strong aversion to the word 'cancer' and always assume a death sentence. But it's important to communicate that some of the investigations for cancer cause harm, cancer treatments can cause harm and that some people die *with* cancer rather than from cancer.

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George Clews @georgeclews.bsky.social · 21/06/2026

Pleased to see that Jeremy Clarkson is in remission, but slightly unhelpful to say that everyone should get tested, given the lack of evidence suggesting routine testing saves lives. Sir Chris Hoy's message is much more nuanced and supported by evidence; get tested if in a high-risk group!

bbc.co.uk

Jeremy Clarkson in remission from prostate cancer

The presenter shared his "aggressive" cancer diagnosis on an episode of Clarkson's Farm earlier this week.

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Reposted by George Clews

Royal College of Anaesthetists @rcoanews.bsky.social · 10/06/2026

Together with our @cpoc.bsky.social and the @apagbi.org.uk, we have published new guidelines to improve the care of children and young people awaiting surgery or anaesthetic procedures. Learn more and read the guidance 👉 ow.ly/94B350Z9VSm #Ansky #Medsky

Launching the RCoA Best Practice Guidance for Preoperative Care Services for Children and Young People

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George Clews @georgeclews.bsky.social · 29/04/2026

Blood goes in the magic bean, wee comes out the magic bean and that's how we achieve homeostasis

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George Clews @georgeclews.bsky.social · 28/04/2026

To paraphrase Richard Feynman talking about quantum mechanics: "If you think you understand renal physiology, then you don't."

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George Clews @georgeclews.bsky.social · 28/04/2026

Revising for yet another exam and I'm still not sure I understand how the kidney works...

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Sethina Watson @sethina.bsky.social · 26/04/2026

A while ago, I led a national survey on access to PHEM careers. One quote really stayed with me “I’ve never seen a Black female doctor in UK PHEM” I’ve recently started working @gwaac.bsky.social in a breaking barriers post CCT training role #representationmatters instagram.com/p/DUur0pPiAOj/…

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The Association of Anaesthetists @assocanaes.bsky.social · 17/04/2026

New guidance on sterile gown use during spinal anaesthesia aims to reduce unnecessary waste while maintaining high standards of patient safety Guidelines published in @anaesjournal.bsky.social buff.ly/rvtALwy With CAI, @ra-uk.org, @oaa-anaes.bsky.social, @rcoanews.bsky.social, @anzca.bsky.social

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George Clews @georgeclews.bsky.social · 02/04/2026

The actions that also reduce carbon emissions and energy use are probably actions that matter to patients, such as pre-habilitation to reduce hospital length of stay, identifying and treating co-morbidities pre-operatively and shared decision making regarding surgical options.

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George Clews @georgeclews.bsky.social · 02/04/2026

We need to take a more holistic, patient-centred approach to this. We know that co-morbidities can lead to complications post-surgery, prolong hospital stays, and require further surgeries, all resulting in increased energy use.

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Reposted by George Clews

The Association of Anaesthetists @assocanaes.bsky.social · 06/03/2026

👩‍⚕️Ahead of International Women’s Day, we’ve published a new brief on women in anaesthesia. Our specialty has a diverse workforce, with a growing number of women working in anaesthesia. Yet disparities in recruitment, career progression, and workplace safety remain. Read the brief: shorturl.at/Qx8v1

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George Clews @georgeclews.bsky.social · 27/02/2026

Watched Cardiac Arrest recently (as someone who was in nappies when it came out) and thought it was brilliant, though also kind of shocking that we are still dealing with the same issues 30 years on!

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George Clews @georgeclews.bsky.social · 22/02/2026

Hot takes from Final FRCA revision (T-minus 10 days): 1) Any patient with any co-morbidity should be first on the list to limit pre-operative fasting and dehydration. 2) Most situations can be improved by multi-disciplinary team involvement, shared decision making and multi-modal analgesia.

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George Clews @georgeclews.bsky.social · 18/02/2026

I don’t think you can be too fussy tbh…

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George Clews @georgeclews.bsky.social · 17/02/2026

Definitely going to try this out when I am next on labour ward!

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George Clews @georgeclews.bsky.social · 17/02/2026

When testing a neuraxial block for caesarean section, AoA guidelines recommend using light touch as the primary sensory modality, but no recommendation on *how* we should assess light touch. So what are people using? Cotton wool? Monofilaments? @assocanaes.bsky.social @oaa-anaes.bsky.social

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George Clews @georgeclews.bsky.social · 11/02/2026

Or maybe this is just a sign of how tired I am right now.

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George Clews @georgeclews.bsky.social · 11/02/2026

Random musings from covering obstetrics: does anyone else think of pushing through the ligamentum flavum like a drum roll with the release when you get loss of resistance?

media.tenor.com

a cartoon character is playing drums and the word drumroll is on the drums

ALT: a cartoon character is playing drums and the word drumroll is on the drums

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George Clews @georgeclews.bsky.social · 04/02/2026

…but I hope it’s by saving the lives of people who would otherwise die from cancer rather than finding tumours that were never going to cause harm in the first place!

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George Clews @georgeclews.bsky.social · 04/02/2026

However the interviewers kept spinning it as any man who is worried they have prostate cancer should get tested! I hope the government is able to improve cancer outcomes…

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George Clews @georgeclews.bsky.social · 04/02/2026

This is an emotive debate and often the nuance is lost. An example of this is PSA screening for prostate cancer. I listened to an interview with Chris Hoy who was advocating for PSA screening in HIGH-RISK individuals like himself (both his father and grandfather died from prostate cancer)

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George Clews @georgeclews.bsky.social · 04/02/2026

I think this comes from a good place: we have some of the worst cancer survival rates in Europe and this needs to be addressed. But they are many examples from screening programmes where more cancers are found, more successfully treated but no change in number of people who died from cancer!

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Royal College of Anaesthetists @rcoanews.bsky.social · 19/01/2026

This #HealthInformationWeek, Patient Information Forum has launched a series of Trusted Health Information collections in partnership with NHS England. Our epidural anaesthetics – risks & side effects resources have been added to the collection 🙌 View them here 👉 ow.ly/4xyh50XZEEy

The Patient Information Forum (PIF) has launched a series of Trusted Health Information collections in partnership with NHS England.

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George Clews @georgeclews.bsky.social · 16/01/2026

My thoughts too. What was the reasoning behind an intra-op epidural and a GA if the epidural had to come out? Perhaps I would have just done intrathecal (dia)morphine? When was the patient expected to ambulate post-op? Would the femoral catheter delay that?

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