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Rob Fleming @robjimfleming.bsky.social · 28/11/2025

Ahead of my talk today at #SIVA25, I have packaged up some #PERUSEbeforeYouInfuse posters, for anyone convinced by what I'm saying, who then wants to use the check. The right things happen more often if you make them easy. Providing posters (and Blu Tack) is very much in the spirit of the talk.

A "PERUSE before you Infuse" poster, resting on top of a stack of pre-packaged bundles of posters, each containing 20 posters and some Blu Tack, for putting them on walls. It is all about incentivising the good, innit?

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Society for Intravenous Anaesthesia @sivanaesthesia.bsky.social · 28/11/2025

Morning folks! We hope that those who attended the dinner last night had a splendid time and have woken up bright and refreshed, ready for today's #SIVA25 content! Those who have registered for the workshop, please note it starts at 0900. The first session of talks starts at 0915. See you soon!

Timetable for the morning of day 2 of SIVA's Annual Scientific Meeting, 2025.

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Society for Intravenous Anaesthesia @sivanaesthesia.bsky.social · 28/11/2025

First up in the main session today at #SIVA25 we have Professor Gavin Kenny, one of the key architects of the Diprifusor TCI system. It is no exaggeration to say modern TCI and TIVA would not exist without him. In the first of two talks he is giving today, he tells us how Diprifusor was created.

Professor Kenny at the lectern, in front of a slide titled "Diprofusor Design Features".

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Society for Intravenous Anaesthesia @sivanaesthesia.bsky.social · 27/11/2025

Getting ready for the second start of the day. To the folks who attended a workshop this morning, hello again! To the folks just arriving, welcome to Liverpool and #SIVA25! Our next talks are focussed around some of the practicalities of TIVA, in the "how I do it" session.

Agenda for the first half of this afternoon's SIVA ASM.

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Society for Intravenous Anaesthesia @sivanaesthesia.bsky.social · 26/11/2025

Nice view of the famous Liverpool skyline from up here! Both cathedrals, and the Radio City tower are visible. Bit chilly right now though. Liverpool is a brilliant city. We are looking forward to welcoming our delegates at tomorrow's Annual Scientific Meeting #SIVA25. See you there!

Liverpool skyline after dark. The two cathedrals are visible at the horizon, with the Radio City tower to the right.

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Society for Intravenous Anaesthesia @sivanaesthesia.bsky.social · 26/11/2025

Hello Bluesky! Ahead of our Annual Scientific Meeting, which starts tomorrow, we thought we would get this account up and running. It will be curated by @robjimfleming.bsky.social for the next couple of days at least. Hopefully we will see some of you in sunny Liverpool!

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Anaesthesia @anaesjournal.bsky.social · 01/10/2025

"... a ‘RSI–TCI’ mode with a pre-programmed manual bolus offers a pragmatic solution for those who wish to preserve an intact pharmacokinetic model for accurate propofol delivery, while allowing the rapid induction clinicians expect from a manual bolus." #AnSky #MedSky doi.org/10.1111/anae...

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British Journal of Anaesthesia @bjajournals.bsky.social · 13/06/2025

Eleveld et al.'s #pharmacokinetic - #pharmacodynamic model of #remimazolam begins to pave the way for its widespread use in #sedation and anaesthesia. #BJA #model #simulation www.bjanaesthesia.org/article/S000...

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Nicholas Chrimes @chrimesy.com · 04/06/2025

I don’t think anyone considers thio part of RSI anymore but I’m certain most who’ve abandoned cricoid are still using sux/roc & many aren’t FMV. It’s definitely singled out. Again, I qtn whether the rationale for RSI is sound. This is my fav evidence FOR cricoid. journals.lww.com/anesthesia-a...

journals.lww.com

The Effectiveness of Cricoid Pressure for Occluding the... : Anesthesia & Analgesia

al entrance with and without CP in anesthetized and paralyzed adult patients. METHODS: One hundred seven, nonobese ASA physical status I and II patients were recruited for the study. A cricoid forc...

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Nicholas Chrimes @chrimesy.com · 04/06/2025

Interestingly while cricoid pressure gets mocked by those wanting to practice EBM, there’s no more evidence for any other aspect of RSI? Why has cricoid been singled out as the component to ditch when the whole thing is entirely rationale-based & incls many opportunities to cause harm.

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Nicholas Chrimes @chrimesy.com · 04/06/2025

Background reading for this week’s debate - this excellent editorial by @sthjournalclub.bsky.social & Craig Lyons in @anaesjournal.bsky.social associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10....

associationofanaesthetists-publications.onlinelibrary.wiley.com

Rapid sequence induction: a modern‐day example of Theseus' Paradox?

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Dr Mary-Ann Fox BMBS FANZCA GChPOM @maffygirl.medsky.social · 04/06/2025

Ok it’s time for the very first Midweek #AnSkyMedSkyDebate, which I will call the #VortexDebate after the wonderful @chrimesy.com. Come on let’s get our opinions out and have a good robust discussion. See next comment for the topic. #AnSky #MedSky

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sivatrainees.bsky.social @sivatrainees.bsky.social · 07/12/2024

1st SIVATrainee - BlueSky Thread! pEEG and ketamine If youve spent any time around TIVA and EEG You'll know that ketamine can increase the BIS number - Perhaps you never use ketamine because every time you do your processed EEG keeps telling you the patient's 'awake' 1/12

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sivatrainees.bsky.social @sivatrainees.bsky.social · 02/12/2024

SALG Patient Safety Update has released One case reports stood out Relevant after our 'TIVA in a hyperbaric chamber' by Craig Holdstock #SIVA24 One of the few NHS funded indications for hyperbaric oxygen therapy. Delaying can be detrimental 🔗 tinyurl.com/5564rezu #salgpatientsafety @RCoANews

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

Now the dust of #SIVA24 is settling and you've all hopefully made it home. It's time to put SIVA 2025 in your diary... Liverpool, City of Culture, home of the Beatles and the lamb banana! #SIVA25 - Save the date

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Rob Fleming @robjimfleming.bsky.social · 29/11/2024

The always wonderful, and dear friend @nickopotamus.co.uk speaking about TCI as a means of making adequate sedation more likely in critically ill transfers. Expert talk, as always. Also, he and I have just spent lunch talking about dogs, so he gets extra applause from me! #SIVA24

Nicholas Plummer speaking about TCI in transfer.

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Rob Fleming @robjimfleming.bsky.social · 29/11/2024

J. Robert Sneyd speaking about Remimazolam. A very entertaining talk! Remimazolam potentially has the advantages of an offset not dissimilar to propofol, with the CVS stability and reversibility of Midazolam. The best of both worlds, possibly. There is a niche for this, I suspect. #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

3rd and finally @cannula_service "Mirror mirror on the wall, which TCI model is the fairest of them all?"

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

2nd We have Joshua Etheridge On the ABCDE of Anaesthesia #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

Infographics Time 1st up Patrick Whelpdale With the benefits of TIVA #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

Some great questions coming through in the panel discussion BAS (UK Antarctica society) do not require and appendicectomy. Aus & US do! #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

Next up AntarcTIVA? Katherine Gamly on TIVA and the history of anaesthesia in the Antarctic. @katganly

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

Next up Craig Holdstock talking about TIVA in a hypobaric chamber #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 29/11/2024

And we're back! Our next speaker is talking on Space TIVA (Anaesthesia in Space) I can barely anaesthetise patients on earth #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Kate Lesley dialling in remotely for the John Sear lecture on Female sex, Propofol pharmacology and awareness

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

NAP7 Jasmeet Soar pEEG use is increasing particularly when using TIVA #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Mark Barley - Moving on from MAC Why does movement occur under anaesthesia despite 'nice numbers' #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Session 2: The Science! Let's see what we've got #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Spontaneous ventilation for airways in children How do I do it - Dr Sophie Liu #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Can we Use pEEG to identify a space occupying lesion and get a time critical patient to be theatre quicker? #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

TIVA in pre hospital medicine In pre hospital - Time between induction and time to start sedation variable. Ketamine infusions becoming more standard 0.5-1mg/kg/Hr of standard 10mg/ml 60kg = 3-6ml/hr #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

1st up @sthjournalclub.bsky.social on Smooth extubation Reviewing the evidence on - Remifentanil - Lidocaine (including intra-cuff) - Dexmedetomidine #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Top tip for high BMI children Paeds Prescribing Pro App www.paedspro.com #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Intubating children without relaxant? Propofol bolus 3-5mcg/kg or via TCI pump Remifentanil 1-2mcg/kg (slowish 20+ secs) +/- Lignocaine spray to the vocal cords 1-2ml 1% using MAD device #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Paedfusor V Eleveld In Kids (normal size) Eleveld gives a bigger bolus then pauses (Look at how long the pause is!) After an hour the infusion rate is the same #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Allometric scaling If it's good enough for crabs it's good enough for humans #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 28/11/2024

Cutler's Hall We've arrived! Hope you all found your workshops I heard fights were breaking out to get into the Eleveld sessions #SIVA24

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sivatrainees.bsky.social @sivatrainees.bsky.social · 27/11/2024

Off to an absolute cracker of a meeting with a bang as @SIVAtrainees takes both sets of keys and leaves their wife and baby locked out the house #SIVA24

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