Tim Cook
@doctimcook
Bath-based anaesthetist/intensivist. I study medical complications to improve safety. Own views except where I knick others’. Insta @timcooksnaps. Airway goblin
ID: 3288470632
18-05-2015 13:51:51
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2-yrs ago I donated bone marrow to my brother, Jack, with AML. He's now back working as an ED doctor in Sydney & has reflected in The Lancet Haematology He reminds us not to shy away from providing hope for our pts even when the odds are stacked against them 🔗bit.ly/2XQZ60I
Vadim Sizov There are numerous international reports in the mainstream press of deaths during mostly plastic surgery where an 'overdose of local anaesthetic' is postulated or concluded as the cause USA nbcnews.com/news/us-news/f… Aus smh.com.au/national/nsw/c… India hindustantimes.com/lifestyle/heal…
Brian Mc Kinney Yes agree As per my original post, there is an interesting multipartite process -Surgical team ask anaesthetist how much LA they can use -Anaesthetist calculates this -Circulating nurse listens and gives draws up what can be given -Scrub nurse draws this up -Surgeon administers
Richard Sloggett I’m not saying prevention is a bad thing. I’m just seeing some pretty sloppy thinking being bandied about.
Tim Cook Catrin Jones Resus Pieces Joe Pick Calling out the BS This!!! Error and harm are not the same thing at all. Equating the two has lead us down all manner of wrong paths.
Alex Panton I would say this is pretty vocal with 80k views and many comments!
Sam Ghali, M.D. Anaesthesia, ICU, ED, PHEM CAPNOGRAPHY is THE only reliable way to confirm correct position of a tracheal tube. In life and in cardiac arrest. Clinical signs are of close to zero value. Look for sustained exhaled CO2: ie - goes up & down with ventilation - sustained - above 1
Tim Cook Association of Anaesthetists Agree with both points. Not sure I agree that a gown necessarily adds an actual layer of protection. In fact, poor gowning technique (e.g. fingers out of the cuffs and touching the gloves) may inadvertently worsen antisepsis. Not convinced there is a clear benefit.
Tim Cook Addy Sam Ghali, M.D. Strong agree with this. I'm sure many will've seen a tube where ultrasound would have confirmed it was in the trachea, but due to say, a mucus plug obstruction etc, that might not be obvious on US, but capnography gave a heads up before the situation was critical and tube pulled.
Tim Cook Addy Sam Ghali, M.D. All of the above. Plus, if you're not using it routinely in real time to watch the tube go in, just the delay for our US to 'boot up' (after having retrieved it) would be unacceptable for use as a 'valid alternative technique' when sustained exhaled CO2 is absent.