Library guides: News: Latest news

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ANZCA E-News (17 March 2023)

Journal coverage extended

The journal coverage for Pediatric Anesthesia and Emergency Medicine Australasia has now been extended, with both titles now available from 1991. For Pediatric Anaesthesia, this now means we have full online access from volume 1.

Pediatric Anesthesia
Online: Vol. 1, 1991 - current
>> Alternate/direct access via Wiley.
Print held: Vol. 6, 1996 - current
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Devoted to the dissemination of research of interest and importance to practising anaesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, historical vignettes, correspondence, case presentations and book reviews.
EMA: Emergency Medicine Australasia
Online: Vol. 3, 1991 - current
>> Alternate/direct access via Wiley.
Print held: Vol. 24, 2012 - Vol. 31, 2019
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Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine.

Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.

Recent articles of interest

A round-up of recent articles of interest:

Basile ER, Byrd H, Powell-Williams M, Polania Gutierrez JJ, Riveros-Perez E. Gender Gap: A Qualitative Study of Women and Leadership Acquisition in Anesthesiology. Anesth Analg. 2023;136(1):6-12.
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Abstract
Background: The representation of women among leaders in the field of anesthesia continues to trail that of their male counterparts. This qualitative study was conducted to understand the pathway of leadership acquisition among women in the field of anesthesiology.

Methods: Using constructivist grounded theory, we sought to determine whether there were specific internal or external factors that were common to women in leadership in the specialty field of anesthesiology, and specifically, how they obtained leadership positions. Semistructured interviews were conducted for data collection. A total of 26 women in leadership positions in anesthesiology participated in this study.

Results: The analysis of these interviews resulted in the development of 4 common themes related to career pathways for these women in leadership. Each theme was examined in depth to determine the qualities necessary for individuals to advance in the field and the pathway to obtaining leadership positions. The findings of this study showed that early-career, high-value mentorship and sponsorship were important factors in leadership acquisition. Most participants (n = 20; 76%) had early mentors. Of those with early mentorship, 13 (65%) had high-value mentors, who we define as someone with power or authority. Sponsorship was the leading factor contributing to leadership acquisition.

Conclusions: The results of this qualitative study may serve as a guide for encouraging female anesthesiologists with leadership aspirations. We suggest that the specialty field of anesthesiology institute targeted measures to help increase the percentage of women leadership with formal sponsorship programs at the local and national levels.

Audio-Digest lectures

Spotlight on a recent Audio-Digest lecture of interest:

Approaches to Improving the Well-Being of Clinicians (21 Nov 2022)
This program aims to improve the well-being of anesthesiologists by addressing the causes of burnout among healthcare providers in anesthesiology.

Please Note: Free registration is required to access the above audio lecture.

FPM Training E-News (9 March 2023)

Pain medicine training guide/ETA essentials update

The library - in conjunction with the Faculty of Pain Management - has recently updated access to the FPM Essential Topic Areas Reference lists. The content for the lists has been thoroughly revised to match the updated FPM curriculum.

The updated reference content has moved to online access - where available - to ensure the most current version of the resource is available to trainees. The FPM Essentials tab of the Pain Medicine training guide is now the primary access point for all FPM Essential Topic Areas (ETAs) reference content.

The list has also been embedded in the new Learn@ANZCA portal for ease of access, and can also be accessed from the Training & Exams hub: Pain Medicine Training & Exams section.

ANZCA E-News (17 February 2023)

Recently added titles

Alongside the newly launched RGA course, the ANZCA library is undertaking a 12 month trial subscription to The Australian Journal of Rural Health. AJRH includes articles on anaesthesia, pain medicine, medical education and indigenous health practice in a rural/remote context.

AJRH: The Australian Journal of Rural Health
Online: Vol. 5, 1997 - current
>> Alternate/direct access via Wiley.
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The Australian Journal of Rural Health (AJRH) is a multidisciplinary journal, which aims to facilitate the formation of interdisciplinary networks to build and advance rural practice for all health professionals. It includes articles on anaesthesia, pain medicine, medical education and indigenous health practice in a rural/remote context.

A number of new e-book titles have recently been added to the library collection, including Elsevier’s 2023 Intravenous Medications (formerly Gahart's Intravenous Medications).

Cases in Pre-Hospital and Retrieval Medicine, 2e by Daniel Ellis; Matthew Hooper; Neel Bhanderi; Fran Lockie This highly regarded case-based book focuses on the principles of pre-hospital and retrieval medicine and the continuum of care provided for critically ill or injured patients in the field. The second edition has been extensively re-written and updated to keep up with the rapidly expanding sub-speciality of Pre-Hospital and Retrieval Medicine (PHRM)/Pre-Hospital Emergency Medicine (PHEM). Written by leading specialists in PHRM, each question and discussion is usually illustrated with a photograph from author archives and real events. The cases are divided into the following themes: pre-hospital medicine; retrieval medicine; service development and special circumstances; and a new section on Paediatric and Neonatal retrieval.
ISBN: 9780729543620
Publication Date: 2022-12-11
Elsevier’s 2023 Intravenous Medications: A Handbook for Nurses and Health Professionals, 39e by Shelly Rainforth Collins For nearly 50 years, Elsevier's Intravenous Medications: A Handbook for Nurses and Health Professionals has been a trusted resource for complete, accurate drug information in a concise, quick-access format. New to the 2023 edition are nine monographs of the most recent IV drugs to be approved by the FDA, in addition to updated drug uses, interactions, precautions, alerts, and patient teaching instructions for all current IV drugs.
ISBN: 9780323931809
Publication Date: 2022-07-19

See the complete new titles listing

Recent articles of interest

A round-up of recent articles of interest, including a special issue of MJA focussing on health inequities in Australia.

Special Issue: Equity & Inequity in Australia's Health System (MJA)
Equity and inequity in Australia's health system are major themes in this latest issue of the MJA. From the beginning, when research is funded, through to how clinical guidelines are developed, how research is conducted, and, finally, in health outcomes, the articles in this issue explore gender and racial inequities from several angles, including what progress has been made, and where deficiencies remain.
Reece-Nguyen TL, Tollinche L, Van Rooyen C, Roque RA. Current challenges faced by transgender and gender-diverse patients and providers in anesthesiology. Int Anesthesiol Clin. 2023;61(1):26-33. REVIEW ARTICLES - No abstract available
Gilchrist PT, Walters L, Ward P. The safety of anaesthesia delivered by rural generalist anaesthetists: a scoping review of the literature. Rural Remote Health. 2023;23(1):7358. Keywords: Australia; generalist; safety; Anaesthesia.
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Introduction: Rural generalist anaesthetists (RGAs) are central to the delivery of health care in much of rural and remote Australia. This article details a systematic review of the literature specifically asking the question, 'What is the current evidence of the 'safety' of anaesthesia delivered by RGAs?'

Methods: Six databases were searched using terms including 'safety', 'rural', 'anaesthetics', 'general practitioners', and associated search terms. Relevant articles were assessed for rigour, and information was summarised using qualitative grid analysis that included information on the study setting, participants, methods, limitations and key result areas. The primary author developed key themes from the data, which were refined in discussion with other authors.

Results: The safety of RGAs was described using five concepts: appropriate training and leadership, rates of complications, volume or scope of practice, access to equipment, and case selection.

Conclusion: RGAs are pivotal in the delivery of health care in rural and remote communities. The sparse literature available on RGA safety is broadly grouped into five areas. There is a need to characterise and describe the role of RGAs, review and revise training and education, recognise RGA scope of practice and understand how RGAs lead the management of safety and risk in their practice.

AudioDigest collection update

Keep up-to-date on the latest anaesthesia and pain medicine research and practice, in your car, office, home, gym or while travelling.

AudioDigest provides instant online and mobile access to 245+ accredited audio lectures and board reviews presented by experts from leading institutions, providing trainees with a convenient "learning on the run experience".

The collection has been fully updated for 2023 and includes many new and topical lectures covering managing COVID-patients in the theatre, anaesthetic complications and airway management.

See our updated AudioDigest guide for further information including full access details.

Training E-News (1 February 2023)

Keep up-to-date on the latest anaesthesia and pain medicine research and practice, in your car, office, home, gym or while travelling.

AudioDigestprovides instant online and mobile access to 245+ accredited audio lectures and board reviews presented by experts from leading institutions, providing trainees with a convenient "learning on the run experience".

The collection has been fully updated for 2023 and includes many new and topical lectures covering managing COVID-patients in the theatre, anaesthetic complications and airway management.

Seeour updatedAudioDigest guide for further information including full access details.

Latest books

ANZCA fellow Lachlan Rathie has written a new book aimed at Primary Exam trainees. The library has multiple copies now available for loan. In addition, the latest edition of Goodman & Gilman's is now available online and in print.

The ANZCA Primary Exam Companion by Lachlan Rathie
Call Number: 610.96 RAT
>> REQUEST PRINT LOAN <<
ISBN: 9798359914079
Publication Date: 2022-10-26
The only ANZCA Primary Exam primer book written by an examiner. This book addresses all components of the anaesthetics primary exam with a focus on the vivas. Exam resources, exam technique, diagrams, opening viva questions, practice SAQs, a study template and 500 short format questions and answers that traverse the entire curriculum are contained within this book.
Goodman and Gilman's: The Pharmacological Basis of Therapeutics, 14e by Laurence Brunton; Bjorn Knollmann
Call Number: 615.7 GOO
>> REQUEST PRINT LOAN <<
ISBN: 9781264258079
Publication Date: 2022-11-01
The go-to pharmacology reference that medical and health science professionals have relied upon for more than 50 Years! The fourteenth edition features more than 600 colour illustrations, including 50 new figures on mechanism of drug actions which emphasizes the link between basic mechanisms of action of drug action, pathophysiology of disease, and therapeutic use of drugs
Anesthesia Student Survival Guide: A Case-Based Approach, 3e by Jesse M. Ehrenfeld; Richard D. Urman; B. Scott Segal [eds]
ISBN: 9783030986742
Publication Date: 2022-10-20
This comprehensive update of the previous two successful editions covers both basic and advanced anesthesia topics. These include pharmacology, procedures, monitoring, equipment, subspecialty anesthesia, safety, professionalism, pain management, and more.

See the complete new titles listing

Recent articles of interest

A round-up of recent articles of interest:

Jamaleddin Surani SA, Budiman M, Azman M, Abdul Rahman R. Assessment of Awareness of Local Anaesthetic Systemic Toxicity (LAST) among Postgraduate Trainees. Int J Clin Pract. 2022;2022:4090444. Published 2022 Nov 12.
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Abstract
Introduction: Although uncommon, local anaesthetic systemic toxicity (LAST) may impose fatal risk to the patients. We investigated the awareness of LAST and knowledge on local anaesthetics among our postgraduate trainees.

Materials and methods: A total of 134 postgraduate trainees from the departments of general surgery (Surgical), orthopaedic surgery (Ortho), otorhinolaryngology (ENT), obstetrics and gynaecology (OBGYN), as well as anaesthesiology and intensive care (Anaesth) were recruited. A validated questionnaire was used to assess awareness and knowledge. All participants attended a medical-education session and completed the questionnaire as preassessment and postassessment. Data were analysed, and comparisons between disciplines were conducted.

Results: The trainees' awareness of LAST was overall poor at preassessment which improved almost 6-folds at postassessment. Surprisingly, only 20 (45.5%) participants from the anaesthesiology group had awareness of LAST at preassessment, and none of the participants were from surgical, orthopaedic, and obstetrics and gynaecology departments. Preassessment scores were significantly higher in the anaesth group as compared to all other groups; with a difference in the average score for Anaesth vs Surgical of 3.46 (95%, CI:2.17, 4.74), Anaesth vs Ortho of 3.64 (95%, CI:2.64, 4.64), Anaesth vs ENT of 3.43 (95%, CI:2.20, 4.67), and Anaesth vs OBGYN of 6.93 (95%, CI:5.64, 8.21). However, there was no significant difference of awareness scores between all participants at postassessment scores.

Conclusion: The overall level of awareness was poor. However, the implementation of an education session significantly improved the knowledge and awareness across all disciplines.
Kim CJ, Lever N, Cooper JO. Antiarrhythmic drugs and anaesthesia: part 1. mechanisms of cardiac arrhythmias. BJA Educ. 2023;23(1):8-16. Keywords: anti-arrhythmic agents; arrhythmias; cardiac; cardiac electrophysiology.
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Perioperative arrhythmias are extremely common, usually transient and typically require no intervention. Persistent arrhythmias with associated haemodynamic instability may reflect an underlying pathological process. Indeed, the clinical scenario outlined of a patient with sepsis who develops rapid atrial fibrillation describes a situation that anaesthetists and intensivists frequently encounter. In some situations, the primary cause of the arrhythmia may be evident. However, in many cases the cause is multifactorial, relating to coexisting disease, acute physiological disturbance, medications or the surgical procedure itself (e.g. cardiac or thoracic surgery).

Training and exams hub:

SOT E-News (1 February 2023)

Latest books

ANZCA fellow Lachlan Rathie has written a new book aimed at Primary Exam trainees. The library has multiple copies now available for loan.

The ANZCA Primary Exam Companion by Lachlan Rathie
Call Number: 610.96 RAT
>> REQUEST PRINT LOAN <<
ISBN: 9798359914079
Publication Date: 2022-10-26
The only ANZCA Primary Exam primer book written by an examiner. This book addresses all components of the anaesthetics primary exam with a focus on the vivas. Exam resources, exam technique, diagrams, opening viva questions, practice SAQs, a study template and 500 short format questions and answers that traverse the entire curriculum are contained within this book.
Teaching Evidence-Based Medicine: A Toolkit for Educators by Daniella A. Zipkin [ed]
ISBN: 9783031111730
Publication Date: 2022-12-24
Practicing evidence-based medicine is widely regarded both as best clinical practice, and as the cornerstone of meeting the ACGME competencies in Practice-Based Learning and Improvement. This book provides a modular curriculum structure for instructors, with each topic area taking up one section, or one hour of instructional time. This is an ideal guide for residency program directors and core faculty, either within internal medicine or more broadly in family medicine, paediatrics, surgery, OB-gyn, as well as medical school faculty for use with students.
Handbook of Open, Distance and Digital Education by Olaf Zawacki-Richter; Insung Jung [eds]
ISBN: 9789811920790
Publication Date: 2023-01-02
This handbook offers a one-stop-shop for both new and established researchers, educators, policy makers and administrators in the field of open, distance and digital education (ODDE) to gain a comprehensive overview of the history, theory and practice at all levels of ODDE, and at the same time stimulates in-depth discussions on various themes and issues of ODDE for today and future. Researchers, scholars and students in the field of ODDE can use this handbook as a major reference to conduct their own research and learning agendas.

See the complete new titles listing

Recent articles of interest

A round-up of recent articles of interest:

Hoyler MM, Pryor KO, Gotian R, Brumberger ED, Chan JM. Resident Physicians as Clinical Educators in Anesthesiology: A Narrative Review. Anesth Analg. November 04, 2022
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Abstract
The importance of resident physicians as clinical educators is widely acknowledged in many clinical specialties and by national accreditation organizations for medical education. Within anesthesiology training programs, there is growing attention to the role of trainees as clinical educators. This narrative review describes the theoretical and demonstrated benefits of clinical teaching by residents in anesthesiology and other medical fields, summarizes current efforts to support and promote residents as educators, and suggests ways in which anesthesiology training programs can further assess and develop the role of residents as clinical educators.
Melvin MT, Siddiqui NT, Wild E, Parotto M, Perelman VS, You-Ten KE. Achieving Competency in Fiber-Optic Intubation Among Resident Physicians After Higher- Versus Lower-Fidelity Task Training: A Randomized Controlled Study [epub ahead of print, 2022 Nov 29
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Abstract
Background: The high-fidelity ORSIM (Airway Simulation Ltd) and the low-fidelity wooden-block fiber-optic task trainers allow users to familiarize themselves with the psychomotor skills required to manipulate the fiber-optic scope.

Methods: This single-center study aimed to compare residents' performance of fiber-optic intubation after 2 different types of task training. Twenty-four residents with experience of <8 fiber-optic intubations were randomized to either the ORSIM or a wooden-block task trainer. In a single teaching session, the resident performed 20 fiber-optic intubations on their assigned task trainer. This implied simulator competence. In the 4 months after this training, all subjects then attempted to perform a fiber-optic intubation on an American Society of Anesthesiologists (ASA) I or II anesthetized patient whose airway was preoperatively assessed as normal. The primary outcome was the cumulative sum (CUSUM) learning curves obtained as the residents trained on their respective task trainers. Secondary outcomes included: the mean time (in seconds) to perform each of the 20 fiber-optic intubations on their assigned task trainer, the total simulator training time, global rating scale score, checklist score, and time to carina when performing fiber-optic intubation on the patient.

Results: The CUSUM analysis showed that the ORSIM group achieved simulator competence faster. The mean time to perform fiber-optic intubation was shorter in the ORSIM group. A 2-way analysis of variance (ANOVA) test suggests that the combined effect of group (wooden-block or ORSIM) and time is statistically significant (P < .05).Total training time (mean, 899 s ± 440 s vs 1358 s ± 405 s; 95% confidence interval [CI], 100.46-818.54; P = .01) was also significantly better in the ORSIM group.No significant difference was found between the 2 groups (P > 0) in terms of global rating scale, checklist score, and time to reach the carina (P >.05) when performing the fiber-optic intubation on the patient.

Conclusions: ORSIM showed superiority in terms of the CUSUM learning curve in reaching competence faster in fewer attempts. There was no statistically significant difference in residents' performance when translated to clinical practice on a patient. This information should assist course directors when choosing task trainers for fiber-optic intubation training programs.

SOT induction modules and support hub:

A support hub has been created to highlight all the resources relevant to the SOT role, which also includes links to the new SOT induction modules.

ANZCA E-News (17 January 2023)

Recently added titles

A number of new anaesthesia-related titles have been recently added to the library collection, including the latest editions of Hagberg and Benumof's Airway Management andConn's Current Therapy. New journals include Current Anesthesiology Reportsand Journal of Clinical Monitoring and Computing.

Hagberg and Benumof's Airway Management, 5e by Carin A. Hagberg [ed] Considered the go-to reference in airway management not only in anesthesia practice but also in emergency medicine and intensive care settings, Hagberg and Benumof's Airway Management ensures that practitioners worldwide are familiar and proficient with the most recent developments in equipment and scientific knowledge in this fast-changing area. Covering all aspects of this fundamental practice, the new 5th Edition facilitates the safe performance of airway management for all airway practitioners, regardless of specialty, using a concise, how-to approach, carefully chosen illustrations, and case examples and analysis throughout.
ISBN: 9780323795388
Publication Date: 2022-11-21
Koht, Sloan, Toleikis's Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals, 3e by Christoph N. Seubert; Jeffrey R. Balzer [eds] As a single-source volume on intraoperative neurophysiological monitoring (IOM), previous editions of this celebrated resource amounted to a mission statement from the pioneer generation in intraoperative neurophysiology, converting insights, techniques, and perspectives into tools providing clinical utility for the assessment of the nervous system in patients who could not be assessed by a standard neurological examination. Now directed by a new generation of experts, this thoroughly illustrated Third Edition is updated with new case material, images, videos, practice guidelines, references, and technologies, and is intended for those who encounter IOM in the operating room and intensive care unit, including anaesthesiologists, technologists, neurophysiologists, surgeons, and nurses, as well as graduate students and trainees.
ISBN: 9783031097188
Publication Date: 2022-12-01
Conn's Current Therapy 2023 by Rick D. Kellerman; David Rakel [eds] Trusted by clinicians for more than 75 years, Conn's Current Therapy presents today's evidence-based information along with the personal experience and discernment of expert physicians. The 2023 edition is an excellent resource for a wide range of healthcare professionals, including primary care, subspecialists, and allied health, providing current treatment information in a concise yet in-depth format. Nearly 350 topics have been carefully reviewed and updated to bring you state-of-the-art content in even the most rapidly changing areas of medicine.
ISBN: 9780443105616
Publication Date: 2022-12-22

Current Anesthesiology Reports
Online: Vol. 3, 2013 - current
>> Alternate/direct access via Springer.
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Current Anesthesiology Reports offers expert review articles on significant recent developments in the field. By providing clear, insightful, balanced contributions, the journal serves all those involved in the delivery of perioperative pain management.
Journal of Clinical Monitoring and Computing
Online: Vol. 13, 1997 - current
>> Alternate/direct access via Springer.
Print held: Vol. 1, 1985 - Vol. 13, 1997 (as Journal of Clinical Monitoring)
Print held: Vol. 14, 1998 - Vol. 29, 2015
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The Journal of Clinical Monitoring and Computing is a clinical journal publishing papers related to technology in the fields of anaesthesia, intensive care medicine, emergency medicine, and peri-operative medicine.

The journal has links with numerous specialist societies, including editorial board representatives from the European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC), the Society for Technology in Anesthesia (STA), the Society for Complex Acute Illness (SCAI) and the NAVAt (NAVigating towards your Anaestheisa Targets) group.
Regional Anesthesia & Pain Medicine (RAPM)
Online: Vol. 1, 1976 - current
>> Alternate/direct access via BMJ.
Print held: Vol. 23, 1998 - Vol. 43, 2018 & Vol. 44 (11) 2019 - current
Continues: Regional Anesthesia
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Regional Anesthesia & Pain Medicine, the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine), is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, paediatric anesthesia, outcome studies, and complications.
See the complete new titles listing

Recent articles of interest

A round-up of recent articles of interest:

Sommerfield A, Farrell TR, von Ungern-Sternberg BS. Should we change women to become leaders or should we change leadership for everyone?. Paediatr Anaesth. 2023;33(1):4-5. Editorial.
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Tanya Rochelle Farrell and Britta S. von Ungern- Sternberg are both ANZCA fellows.
Tang MSS, McGain F, Bramley DE, Sheridan NM, Seglenieks R. Evaluation of propofol wastage and disposal in routine anesthesia care [epub ahead of print, 2022 Dec 15]. Anaesth Intensive Care. 2022;310057X221121832. No abstract available - correspondence
Moser JJ, Archer DP, Walker AM, et al. Association of sedation and anesthesia on cognitive outcomes in very premature infants: a retrospective observational study [epub ahead of print, 2022 Dec 19]. Can J Anaesth. 2022;10.1007/s12630-022-02353-7. Keywords: anesthetic drugs; assessment of cognitive outcome; extremely premature infants; sedative drugs.
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Abstract
Purpose: Cognitive outcomes in preterm infants may be adversely affected by use of sedation and anesthetic agents. We investigated the associations between anesthetics/sedatives and full-scale intelligence quotient (FSIQ) measured at 36 months corrected age (CA) in very preterm infants (born < 29 weeks gestational age).

Methods: This retrospective cohort study included preterm infants born at < 29 weeks of gestation between 1 January 2006 and 31 December 2012, whose cognitive outcomes were assessed at 36 months CA. Imputed and complete case univariable and adjusted multivariable linear regressions were used to investigate the associations between FSIQ [standardized to mean (standard deviation) 100 (15)] and exposure to volatile anesthetics, propofol, benzodiazepines, barbiturates, and ketamine. These agents were the subject of a 2016 warning from regulatory authorities in the USA recommending caution for administration to children and pregnant women.

Results: A total of 731 infants met the inclusion criteria. Unadjusted associations were -7 (95% confidence interval [CI], -10 to -4; P < 0.001) and -6 (95% CI, -10 to -3; P < 0.001) FSIQ points with exposure to warned medications using imputed and complete case analyses, respectively. Imputed and complete case adjusted associations between FSIQ and warned medications were -3 (95% CI, -7 to 0; P = 0.045) and -4 (95% CI, -8 to 0; P = 0.071) FSIQ points, respectively. Adjusted associations between volatile anesthetic exposure only and FSIQ were -3 (95% CI, -6 to 0; P = 0.072) and -5 (95% CI, -9 to -2; P = 0.004) FSIQ points using imputed and complete case data sets, respectively. FSIQ was not associated with opioid exposure.

Conclusion: Exposure of very preterm infants to anesthetics/sedatives on the United States Food and Drug Administration warning list was associated with a decrease in FSIQ points at 36 months CA. There was no association between opioid exposure and FSIQ.
Hughes LM, Irwin MG, Nestor CC. Alternatives to remifentanil for the analgesic component of total intravenous anaesthesia: a narrative review [epub ahead of print, 2022 Dec 23]. Anaesthesia. 2022;10.1111/anae.15952. Keywords: CSHT; Gepts; Maitre; Scott; TCI; TIVA; alfentanil; fentanyl; remifentanil; sufentanil.
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Abstract
Propfol-remifentanil-based total intravenous anaesthesia has dominated recent clinical practice due to its favourable pharmacokinetic profile. Interruption in remifentanil supply has presented an opportunity to diversify or even avoid the use of opioids and consider adjuncts to propofol-based total intravenous anaesthesia. Propofol, while a potent hypnotic, is not an effective analgesic. The administration of opioids, along with other adjuncts such as α-2 adrenoceptor agonists, magnesium, lidocaine, ketamine and nitrous oxide provide surgical anaesthesia and avoids large doses of propofol being required. We provide an overview of both target-control and manual infusion regimes for the alternative opioids: alfentanil, sufentanil and fentanyl. The optimal combination of hypnotic-opioid dose, titration sequence and anticipated additional postoperative analgesia required depend on the chosen combination. In addition, we include a brief discussion on the role of non-opioid adjuncts in total intravenous anaesthesia, suggested doses and expected reduction in propofol dose.
Burnett GW, Taree A, Martin L, Bryson EO. Propofol misuse in medical professions: a scoping review [epub ahead of print, 2022 Dec 28]. Can J Anaesth. 2022;10.1007/s12630-022-02382-2. Keywords: medical professionals; propofol; substance diversion; substance misuse.
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Abstract
Purpose: We aimed to describe the current literature concerning propofol misuse in medical professionals, specifically relating to the individual demographics of those misusing propofol and the outcomes of propofol misuse.

Methods: We conducted a retrospective scoping review of the literature using a modified PRISMA approach. We used MEDLINE, EMBASE, and PsycINFO databases to identify relevant studies based on search terms. Studies describing individual medical professionals misusing propofol were included.

Results: Twenty-four articles describing 88 individual cases of propofol misuse were included for data charting and analysis. Anesthesiologists and certified registered nurse anesthetists were most commonly identified. Death was a common method of identification of misuse, while rehabilitation and death were common final outcomes associated with propofol misuse.

Conclusions: Despite knowledge of the pharmacokinetic and pharmacodynamic properties of propofol by those misusing this medication, death was a common outcome reported in the literature. Data related to long-term outcomes including re-entry to clinical practice or success of rehabilitation were limited.
Redfern N, Bilotta F, Abramovich I, Grigoras I. Fatigue in anaesthesiology: Call for a change of culture and regulations. 2023;40(2):78-81. Editorial
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No abstract available

ANZCA E-News (16 December 2022)

NEW: Regional Anesthesia & Pain Medicine BACK ONLINE!

We are pleased to announce that the library has commenced a new online subscription to Regional Anaesthesia & Pain Medicine (RAPM) AVAILABLE NOW.

Regional Anesthesia & Pain Medicine is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, paediatric anesthesia, outcome studies, and complications.

RAPM can be accessed via our journals page, as well as BrowZine app and users can access any issue/article from Volume 1, 1976 onwards.

Regional Anesthesia & Pain Medicine (RAPM)
Online: Vol. 1, 1976 - current
>> Alternate/direct access via BMJ.
Print held: Vol. 23, 1998 - Vol. 43, 2018 & Vol. 44 (11) 2019 - current
Continues: Regional Anesthesia

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Regional Anesthesia & Pain Medicine, the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine), is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, paediatric anesthesia, outcome studies, and complications.

Der Anaesthesist has a new name

In June of this year, Der Anaesthesist changed it's name to Die Anaesthesiologie. As a result, all our journal listings have been now been updated to reflect the new name.

Die Anaesthesiologie (formerly Der Anaesthesist) [in German]
Online: Vol. 46, 1997 - current
>> Alternate/direct access via Springer.
Print held: Vol. 1, 1952 - Vol. 65, 2016

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Die Anaesthesiologie is an internationally recognized journal dealing with all aspects of anaesthesia and intensive medicine up to pain therapy. Der Anaesthesist addresses all specialists and scientists particularly interested in anaesthesiology and its’ neighbouring areas.

Latest books

ANZCA fellow Lachlan Rathie has written a new book aimed at Primary Exam trainees. The library has several copies now available for loan. The latest edition of Morgan & Mikhail's Clinical Anesthesiology is also available.

The ANZCA Primary Exam Companion by Lachlan Rathie
Call Number: 610.96 RAT
>> REQUEST PRINT LOAN <<
ISBN: 9798359914079
Publication Date: 2022-10-26
The only ANZCA Primary Exam primer book written by an examiner. This book addresses all components of the anaesthetics primary exam with a focus on the vivas. Exam resources, exam technique, diagrams, opening viva questions, practice SAQs, a study template and 500 short format questions and answers that traverse the entire curriculum are contained within this book.
Morgan & Mikhail's Clinical Anesthesiology, 7e by John F. Butterworth; David C. Mackey; John D. Wasnick Morgan & Mikhail's Clinical Anesthesiology, 7e is an essential resource for all anaesthesia students and practitioners. Hailed as the best primer on the topic, this trusted classic delivers comprehensive coverage of the field's must-know basic science and clinical topics in a clear, easy-to-understand presentation. The text is also ideal for coursework, review, or as a clinical refresher.
Call Number:
>> ANESTHESIOLOGY CASES <<
ISBN: 9781260473797
Publication Date: 2022-08-10

See the complete new titles listing

FPM Synapse E-News (12 December 2022)

NEW: Regional Anesthesia & Pain Medicine BACK ONLINE!

We are pleased to announce that the library has commenced a new online subscription to Regional Anaesthesia & Pain Medicine (RAPM) AVAILABLE NOW.

RAPM can be accessed via our journals page, as well as BrowZine app and users can access any issue/article from Volume 1, 1976 onwards.

Regional Anesthesia & Pain Medicine (RAPM)
Online: Vol. 1, 1976 - current
>> Alternate/direct access via BMJ.
Print held: Vol. 23, 1998 - Vol. 43, 2018 & Vol. 44 (11) 2019 - current
Continues: Regional Anesthesia
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Regional Anesthesia & Pain Medicine, the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine), is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, paediatric anesthesia, outcome studies, and complications.

NEW: Neuromodulation

We are pleased to announce that the library has just commenced a new online subscription to Neuromodulation: Technology at the Neural Interface.

Neuromodulation is the preeminent journal in the area of neuromodulation, providing readers with timely and rigorously peer-reviewed articles on the technology, science and clinical application of devices that interface with the nervous system to treat disease and improve function. Neuromodulation covers an ever-expanding field including pain, headache, movement disorders, spasticity, paralysis, psychiatric disorders, epilepsy, sensory deprivation, gastric dysfunction, obesity and incontinence.

Neuromodulation can be accessed via our journals page, as well as BrowZine app and users can access any issue/article from Volume 22, 2018 onwards.

Neuromodulation: Technology at the Neural Interface
Online: Vol. 22, 2019 - current
>> Alternate/direct access via ScienceDirect.
Print held: Vol. 1, 1998 - Vol. 18, 2015
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Neuromodulation: Technology at the Neural Interface is the preeminent journal in the area of neuromodulation, providing our readership with the state of the art clinical, translational and basic science research in our field and representing the needs of the broad neuromodulation community. For clinicians, engineers, scientists and members of the biotechnology industry alike, Neuromodulation provides timely and rigorously peer reviewed articles on the technology, science and clinical application of devices that interface with the nervous system to treat disease and improve function. Neuromodulation covers an ever expanding field including pain, headache, movement disorders, spasticity, paralysis, psychiatric disorders, epilepsy, sensory deprivation, gastric dysfunction, obesity and incontinence.

Latest books

The latest title in the new pain-related Waldman case-based learning series (The Ankle and the Foot) and a new e-book looking at the short-stay management of chest pain.

Bedside Pain Management Interventions by Dmitri Souza; Lynn Kohan; Imanuel R. Lerman [eds] This book describes bedside pain management interventions for basic clinical situations commonly encountered during the inpatient care. It aims to provide clinicians with real-world practical information, including patient selection, required equipment, and procedure guidance, that will optimize patient management. Each chapter addresses a particular procedure or a set of procedures, with specialties selected according to the subject matter.
ISBN: 9783031111877
Publication Date: 2022-11-24
The Ankle and Foot (Pain Medicine: A Case-Based Learning Series) by Steven D. Waldman The Case-Based Learning approach focuses learners and clinicians on the key elements for each diagnosis and helps develop a deep understanding of how to diagnose and treat each condition. Covers everyday clinical problems such as arthritis, deltoid ligament strain, Achilles tendinitis and tendon rupture, bunion and bunionette pain, plantar fasciitis, metatarsalgia, and more.
ISBN: 9780323870382
Publication Date: 2022-05-05
Short Stay Management of Chest Pain, 2e by Margarita Pena; Anwar Osborne; W. Frank Peacock [eds] The second edition of this book provides scientific and clinical insights on the management of patients who arrive at the hospital with a presentation consistent with a potential acute coronary syndrome. Focusing on the cardiology aspects of chest pain, it presents the science and methodology that has allowed the remarkable improvements in diagnostic accuracy and improved patient outcomes for the evaluation of patients presenting with suspected acute coronary syndromes.
ISBN: 9783031055195
Publication Date: 2022-08-30
Hadzic's Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia, 3e by Admir Hadzic Hadzic's is the most comprehensive colour guide to the procedures and equipment used in ultrasound guided nerve blocking. Colour drawings and photographs are bolstered by concise, step-by-step instruction from the world-renowned St. Luke's Hospital in New York. The Third Edition has been updated to include more international contributors, and better align the book's content with the New York School of Regional Anesthesia's (NYSORA) standards of practice.
Call Number: 617.964 HAD
>> REQUEST PRINT LOAN (2ND ED) <<
ISBN: 9780071838948
Publication Date: 2021-12-14

See the complete new titles listing

Te Hā – te reo (For the breath)/NZ News (8 December 2022)

NZ print exam book update

Following consultation with members of the NZ training committee, the library has purchased additional print copies of the high-use Primary Examand Exam Prep texts for use by NZ-based trainees. This includes texts such as The physics, clinical measurement, and equipment of anaesthetic practice for the FRCA; Pharmacology and physiology for anesthesia; Nunn and Lumb's applied respiratory physiology; and Dr Podcast scripts for the primary FRCA. The texts will be available to borrow from early 2023.

NZ print collection

Did you know that the NZ office has its own print collection available for loan? Requested items are delivered/returned via courier free-of-charge.

Check out the NZ exam print collection
Check out the NZ general print collection
Borrowing from the ANZCA Library
Can't find the book you're looking for - send us a recommendation

FPM Training E-News (7 December 2022)

Latest books

A new title by the author of Ace Your Medical Exams aimed specifically at junior clinicians and the latest in Waldman's Pain Medicine: Case-Based Learning Series.

Study Less and Still Blitz Your Medical Exams by Kell Tremayne; Patsy Tremayne
Call Number: 610.76 TRE
>> REQUEST PRINT LOAN <<
ISBN: 9780648548218
Publication Date: 2022
Patsy Tremayne's earlier book "Ace Your Medical Exams" distilled her vast knowledge and experience, focusing on the outcome - passing the written and clinical examinations. And it does this well.

This new book by Patsy and Kell Tremayne enters this part of the fray, aimed at the medical environment, and explicitly for junior doctors. It is based on knowledge and experience and illustrated through case-based teaching.
The Ankle and Foot (Pain Medicine: A Case-Based Learning Series) by Steven D. Waldman The Case-Based Learning approach focuses learners and clinicians on the key elements for each diagnosis and helps develop a deep understanding of how to diagnose and treat each condition. Covers everyday clinical problems such as arthritis, deltoid ligament strain, Achilles tendinitis and tendon rupture, bunion and bunionette pain, plantar fasciitis, metatarsalgia, and more.
ISBN: 9780323870382
Publication Date: 2022-05-05

See the complete new titles listing

Latest Journals: Regional Anesthesia & Pain Medicine BACK ONLINE!

We are pleased to announce that the library has commenced a new online subscription to Regional Anaesthesia & Pain Medicine (RAPM) AVAILABLE NOW.

RAPM can be accessed via our journals page, as well as BrowZine app and users can access any issue/article from Volume 1, 1976 onwards.

Regional Anesthesia & Pain Medicine (RAPM)
Online: Vol. 1, 1976 - current
>> Alternate/direct access via BMJ.
Print held: Vol. 23, 1998 - Vol. 43, 2018 & Vol. 44 (11) 2019 - current
Continues: Regional Anesthesia

more... less...

Regional Anesthesia & Pain Medicine, the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine), is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, paediatric anesthesia, outcome studies, and complications.

Training and exams hub:

The Training and Exams hub has been designed for trainees and educators participating in the ANZCA, FPM and DHM training programs to identify suitable training and exam resources. The Pain medicine training & exams section contains guides for: Pain medicine training, Conceptual basis of pain medicine, FPM Procedures Endorsement Program curriculum and the Procedures in pain medicine. In addition, the Self-Assessment tools and Roles in Practice guides provide additional resource support for training and examination purposes.

Training E-News (24 November 2022)

Latest books

A new title by the author of Ace Your Medical Exams aimed specifically at junior doctors, and a new edition of Basics of Anesthesia, now retitled: Miller’s Basics of Anesthesia, 8e.

Study Less and Still Blitz Your Medical Exams by Kell Tremayne; Patsy Tremayne
Call Number: 610.76 TRE
>> REQUEST PRINT LOAN <<
ISBN: 9780648548218
Publication Date: 2022
Patsy Tremayne's earlier book "Ace Your Medical Exams" distilled her vast knowledge and experience, focusing on the outcome - passing the written and clinical examinations. And it does this well.

This new book by Patsy and Kell Tremayne enters this part of the fray, aimed at the medical environment, and explicitly for junior doctors. It is based on knowledge and experience and illustrated through case-based teaching.
Miller's Basics of Anesthesia, 8e by Manuel Pardo [ed]
ISBN: 9780323796774
Publication Date: 2022-10-14
Long regarded as the undisputed leading text of its kind, Miller's Basics of Anesthesia provides comprehensive yet concise coverage of both basic science and clinical topics in anaesthesiology. Under the experienced editorial leadership of Dr. Manuel C. Pardo, Jr., the 8th Edition has been meticulously updated to reflect the latest advances in practice and important aspects of contemporary anaesthesia care, including pathophysiology, pharmacology, regional anaesthesia, anaesthetic management, and special problems and patient groups.

See the complete new titles listing

Training and exams hub:

SOT E-News (21 November 2022)

Recent articles of interest

A round-up of anaesthesia and pain medicine-related education articles:

Omega A, Wijaya Ramlan AA, Soenarto RF, Heriwardito A, Sugiarto A. Assessing clinical reasoning in airway related cases among anesthesiology fellow residents using Script Concordance Test (SCT). Med Educ Online. Keywords: Script concordance test; airway management; anesthesiology residents; clinical reasoning; evaluation test.
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Introduction: Clinical reasoning is a core competency for physicians. In the field of anesthesia, many situations require residents to use their clinical reasoning to make quick and appropriate decisions such as during emergency airway cases. The Script Concordance Test (SCT) is a test developed in recent years and validated that objectively assess clinical reasoning ability. However, studies involving SCT to assess clinical reasoning in airway management is scarce.

Aim: To evaluate SCT in assessing clinical reasoning for airway management in anesthesiology residents.

Method: A cross-sectional study involving residents and anesthesiology consultants from the Department of Anesthesiology and Intensive Care, Faculty of Medicine Universitas Indonesia was conducted to complete SCT. A panel of five anesthesiology consultants with more than 15 years of work experience constructed 20 SCT vignettes based on prevalent airway cases in our center from the past 10 years. Each SCT has three nested questions, with a total of 60 questions, to be answered within 120 min.

Results: The SCT of 20 case vignettes with three nested questions were tested on 99 residents from the junior, intermediate, and senior residents, compared to answers from the expert group consisting of ten anesthesiology consultants with more than 5 years of experience. There were significant differences in mean SCT scores in the junior, intermediate, senior and expert groups, 59.3 (46.1-72.8), 64.7 (39.9-74.9), 67.5 (50.6-78.3), and 79.6 (78.4-84.8); p < 0,001 consecutively. Cronbach Alpha 0.69 was obtained, indicating good reliability.

Conclusion: Our SCT was proven to be a valid and reliable test instrument to assess the clinical reasoning in airway management for anesthesiology residents. SCT was able to discriminate between groups of different clinical experiences and should be included to evaluate airway competencies in anesthesiology residents.
Verheijden M, Giroldi E, van den Eertwegh V, et al. Identifying characteristics of a skilled communicator in the clinical encounter [epub ahead of print, 2022 Oct 12]. Med Educ.
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Background: In medical communication research, there has been a shift from 'communication skills' towards 'skilled communication', the latter implying the development of flexibility and creativity to tailor communication to authentic clinical situations. However, a lack of consensus currently exists what skilled communication entails. This study therefore aims to identify characteristics of a skilled communicator, hereby contributing to theory building in communication research and informing medical training.

Method: In 2020, six nominal group technique (NGT) sessions were conducted in the context of the general practitioner (GP) training programme engaging 34 stakeholders (i.e. GPs, GP residents, faculty members and researchers) based on their experience and expertise in doctor-patient communication. Participants in each NGT session rank-ordered a 'Top 7' of characteristics of a skilled communicator. The output of the NGT sessions was analysed using mixed methods, including descriptive statistics and thematic content analysis during an iterative process.

Results: Rankings of the six sessions consisted of 191 items in total, which were organised into 41 clusters. Thematic content analysis of the identified 41 clusters revealed nine themes describing characteristics of a skilled communicator: (A) being sensitive and adapting to the patient; (B) being proficient in applying interpersonal communication; (C) self-awareness, learning ability and reflective capacity; (D) being genuinely interested; (E) being proficient in applying patient-centred communication; (F) goal-oriented communication; (G) being authentic; (H) active listening; and (I) collaborating with the patient.

Conclusions: We conceptualise a skilled communication approach based on the identified characteristics in the present study to support learning in medical training. In a conceptual model, two parallel processes are key in developing adaptive expertise in communication: (1) being sensitive and adapting communication to the patient and (2) monitoring communication performance in terms of self-awareness and reflective capacity. The identified characteristics and the conceptual model provide a base to develop a learner-centred programme, facilitating repeated practice and reflection. Further research should investigate how learners can be optimally supported in becoming skilled communicators during workplace learning.
Maggio LA, Costello JA, Ninkov AB, Frank JR, Artino AR Jr. The Voices of Medical Education Scholarship: Describing the Published Landscape [epub ahead of print, 2022 Oct 25]. Med Educ.
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Introduction: The voices of authors who publish medical education literature have a powerful impact on the field's discourses. Researchers have identified a lack of author diversity, which suggests potential epistemic injustice. This study investigates author characteristics to provide an evidence-based starting point for communal discussion with the intent to move medical education towards a future that holds space for, and values, diverse ways of knowing.

Method: The authors conducted a bibliometric analysis of all articles published in 24 medical education journals published between 2000-2020 to identify author characteristics, with an emphasis on author gender and geographic location and their intersection. Article metadata was downloaded from Web of Science. Genderize.io was used to predict author gender.

Results: The journals published 37,263 articles authored by 62,708 unique authors. Males were more prevalent across all authorship positions (n=62,828; 55.7%) than females (n=49,975; 44.3%). Authors listed affiliations in 146 countries of which 95 were classified as Global South. Few articles were written by multinational teams (n=3,765; 16.2%). Global South authors accounted for 12,007 (11.4%) author positions of which 3,594 (3.8%) were female.

Discussion: This study provides an evidence-based starting point to discuss the imbalance of author voices in medical education, especially when considering the intersection of gender and geographical location, which further suggests epistemic injustice in medical education. If the field values a diversity of perspectives, there is considerable opportunity for improvement by engaging the community in discussions about what knowledge matters in medical education, the role of journals in promoting diversity, how to best use this baseline data, and how to continue studying epistemic injustice in medical education.

SOT induction modules and support hub:

A support hub has been created to highlight all the resources relevant to the SOT role, which also includes links to the new SOT induction modules.

ANZCA E-News (17 November 2022)

Spotlight on: Airway management

ANZCA fellows and trainees are able to access a wide range of airway management-related resources via our dedicated library guide. The guide isregularly updated with the latest articles, airway resources, apps and e-books, and includes access to such titles asAnesthesia Equipment: Principles and Applications, 3e,Core Topics in Airway Management, 3eandHung's Difficult and Failed Airway Management, 3e.

Latest guides update

The library has updated the Anaesthetic Allergy guide with a full list of full-text links for the references in the updated Perioperative Anaphylaxis Management Guideline.

Latest books

A new rapid-response title for thecritically ill has been added to the intensive care collection:

Rapid Response Events in the Critically Ill: A Case-based Approach to Inpatient Medical Emergencies by Arsalan Zaidi; Kainat Saleem [eds] The first text of its kind in this important area, Rapid Response Events in the Critically Ill: A Case-Based Approach to Inpatient Medical Emergencies is designed to help you recognize the fundamental signs of deterioration in patients on medical wards and ensure that transfer is made to the ICU before the development of adverse clinical outcomes. Presents 62 real-world clinical cases hat demonstrate the principles of diagnosis and therapy, helping you develop a thorough understanding of how to diagnose and treat each condition.
ISBN: 9780323872393
Publication Date: 2022-10-12

See the complete new titles listing

ANZCA E-News (17 October 2022)

Spotlight on: Paediatric anaesthesia

ANZCA fellows and trainees are able to access a wide range of paediatric anaesthesia-related resources via our dedicated library guide. The guide has recently been fully updated to include the latest articles, educational videos, apps and e-books, and includes access to such titles as Smith's Anesthesia for Infants and Children, Gregory's Pediatric Anesthesia and A Guide to Pediatric Anesthesia. In addition, users have full to access to our subscription to Pediatric Anesthesia journal.

Litman's Basics of Pediatric Anesthesia, 3e by Ronald S. Litman; Aditee Ambardekar [eds] Written in clear, concise language for superb readability, Litman's Basics of Pediatric Anesthesia, 3e, provides a solid foundation of essential knowledge in this complex field. It covers everything from general paediatric physiology and pharmacology principles through important paediatric diseases; preoperative, intraoperative, and postoperative care; anesthesia for a full range of specific surgical procedures; pain management; and critical care.
ISBN: 9780323829021
Publication Date: 2022-09-07
The Toxicology Handbook, 4e by Jason Armstrong; Ovidiu Pascu The Toxicology Handbook, 4e is Australia's leading reference guide for quick and evidence-informed decision making on treatment of the acutely poisoned patient. The book has been streamlined and fully updated to provide a comprehensive yet concise guide for all medical practitioners and health-care professionals who deal with poisonings. It contains quickly accessible information on poisons, toxins, antidotes, envenomings and antivenoms, and uses a structured and rigorous risk assessment-based approach to guide appropriate treatment decisions.
ISBN: 9780729544368
Publication Date: 2022-08-27

See the complete new titles listing

The latest issue of Anaesthesia Research Review is here:

Anaesthesia Research Review - Issue 25 (2022)
- Situational awareness of opioid consumption
- Bolus lidocaine to prevent tourniquet-induced hypertension
- Transversus abdominis plane block vs wound infiltration after hernia repairs
- Antithrombotic drugs and the risk of bloody punctures
- Arthroscopic shoulder surgery interscalene block with levobupivacaine
- Ketamine vs dexmedetomidine plus total IV anaesthesia
- Rhomboid intercostal, erector spinae plane, or serratus plane block
- Anaesthesiologist staffing ratio and patient morbidity and mortality
- Carbetocin vs oxytocin: Low- and high-dose regimens
- General endotracheal anaesthesia vs sedation in infants
- Patient-centred surgical care for older patients

Recent articles of interest

A selection of the latest anesthesia articles:

Battaglini D, Premraj L, White N, et al. Tracheostomy outcomes in critically ill patients with COVID-19: a systematic review, meta-analysis, and meta-regression [epub ahead of print, 2022 Aug 3]. Br J Anaesth. 2022;S0007-0912(22)00426-3.
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Abstract
Background: We performed a systematic review of mechanically ventilated patients with COVID-19, which analysed the effect of tracheostomy timing and technique (surgical vs percutaneous) on mortality. Secondary outcomes included intensive care unit (ICU) and hospital length of stay (LOS), decannulation from tracheostomy, duration of mechanical ventilation, and complications.

Methods: Four databases were screened between January 1, 2020 and January 10, 2022 (PubMed, Embase, Scopus, and Cochrane). Papers were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Population or Problem, Intervention or exposure, Comparison, and Outcome (PICO) guidelines. Meta-analysis and meta-regression for main outcomes were performed.

Results: The search yielded 9024 potentially relevant studies, of which 47 (n=5268 patients) were included. High levels of between-study heterogeneity were observed across study outcomes. The pooled mean tracheostomy timing was 16.5 days (95% confidence interval [CI]: 14.7-18.4; I2=99.6%). Pooled mortality was 22.1% (95% CI: 18.7-25.5; I2=89.0%). Meta-regression did not show significant associations between mortality and tracheostomy timing, mechanical ventilation duration, time to decannulation, and tracheostomy technique. Pooled mean estimates for ICU and hospital LOS were 29.6 (95% CI: 24.0-35.2; I2=98.6%) and 38.8 (95% CI: 32.1-45.6; I2=95.7%) days, both associated with mechanical ventilation duration (coefficient 0.8 [95% CI: 0.2-1.4], P=0.02 and 0.9 [95% CI: 0.4-1.4], P=0.01, respectively) but not tracheostomy timing. Data were insufficient to assess tracheostomy technique on LOS. Duration of mechanical ventilation was 23.4 days (95% CI: 19.2-27.7; I2=99.3%), not associated with tracheostomy timing. Data were insufficient to assess the effect of tracheostomy technique on mechanical ventilation duration. Time to decannulation was 23.8 days (95% CI: 19.7-27.8; I2=98.7%), not influenced by tracheostomy timing or technique. The most common complications were stoma infection, ulcers or necrosis, and bleeding.

Conclusions: In patients with COVID-19 requiring tracheostomy, the timing and technique of tracheostomy did not clearly impact on patient outcomes.
Sommerfield A, Sommerfield D, Bell E, et al. Consumer research priorities for pediatric anesthesia and perioperative medicine [epub ahead of print, 2022 Sep 30]. Paediatr Anaesth. 2022;10.1111/pan.14564.
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Abstract
Background: Consumer driven research is increasingly being prioritized.

Aim: Our aim was to partner with consumers to identify the top ten research priorities for pediatric anesthesia and perioperative medicine. The ACORN (Anesthesia Consumer Research Network) was formed to collaborate with children and families across Australia.

Methods: A prospective online survey was developed to generate research ideas from consumers. The survey was developed in Qualtrics, a survey research platform. Consumers were invited to participate through poster advertising, social media posts, via consumer networks at participating hospitals and in addition 35 national consumer/patient representative organizations were approached. We also conducted a similar idea generating survey for clinicians through email invitation and via Twitter. A second round of surveys was conducted to prioritize the long list of research questions and a shortlist of priorities developed. A single consensus meeting was held, and a final consensus list of top ten priorities emerged.

Results: A total of 281 research ideas were submitted between 356 consumers in the idea generating survey and from four consumer/patient representative groups. 75 clinicians responded to the clinician idea generation survey. This was consolidated into 20 research ideas/themes for the second survey for each group. 566 responses we received to the consumer prioritization top ten survey and 525 responses to the clinician survey. The consensus meeting produced the final 10 consumer research priorities.

Conclusion: This study has given Australian consumers the opportunity to shape the anesthesia and perioperative medicine research agenda for pediatric patients both nationally and internationally.
Hight D, Sleigh J. Consciousness and the outside world: is there anyone listening?. Br J Anaesth. 2022;128(6):895-897.
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Abstract
Sedated patients have graded levels of consciousness and perceptual connection with the outside world. Disconnection is associated with widespread changes in the electroencephalogram, whereas full unconsciousness is linked with decreased activity specifically in the deep midline regions of the brain. These findings can be interpreted within the predictive coding model of consciousness as differences in model generation vs discrepancy detection. Anaesthetists should be cognisant that apparently unresponsive patients might still have some ongoing partially disconnected consciousness activity.
Menon R, Vasani SS, Widdicombe NJ, Lipman J. Laryngeal injury following endotracheal intubation: Have you considered reflux? [epub ahead of print, 2022 Sep 28]. Anaesth Intensive Care. 2022;310057X221102472.
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Abstract
Laryngotracheal injury is an increasingly common complication of intubation and mechanical ventilation, with an estimated 87% of intubated and ventilated patients developing a laryngotracheal injury often preventing their rehabilitation from acute illness. Laryngotracheal injuries encompass a diverse set of pathologies including inflammation and oedema in addition to vocal cord ulceration and paralysis, granuloma, stenosis, and scarring. The existing literature has identified several factors including intubation duration, endotracheal tube size, type and cuff pressures, and technical factors including the skill and experience of the endoscopist. Despite these associations, a key aspect in the sequelae of laryngotracheal injuries is due to reflux and is not clearly related to iatrogenic and mechanical factors.Laryngopharyngeal reflux is a type of reflux that contaminates the upper aerodigestive tract. The combination of patient positioning and continuous nasogastric tube feeding act to affect the upper aerodigestive tract with acidic and non-acidic refluxate that causes direct and indirect mucosal injury impeding healing.Despite laryngopharyngeal reflux being an established and recognised causative factor of upper aerodigestive tract inflammatory pathology and laryngotracheal injury, it is very understudied in critical care. Further, there is yet to be an agreed pathway to assess, manage and prevent laryngotracheal injury in intubated and ventilated patients. The incidence of laryngopharyngeal reflux in the intubated and mechanically ventilated patient in the intensive care unit is currently unknown. Prospective studies may allow us to understand further potential mechanisms of upper aerodigestive tract injury due to laryngopharyngeal reflux and herald the development of preventative and management strategies of laryngopharyngeal reflux-mediated upper aerodigestive tract injury in critically ill patients.

Te Hā – te reo (For the breath)/NZ News (13 October 2022)

ANZCA Library staff attending the NZ CSC

Library manager, John Prentice, will be amongst the ANZCA contingent who will be present at the CSC taking place in Wellington from 21-24 October 2022. Learn more about college library resources and what's being planned for 2023. You'll be able to find John and other college staff (including CPD) at booth 14/15 in theexhibition space.

NZ Print collection

Did you know that the NZ office has it's own print collection available for loan? Requested items are delivered/returned via courier free-of-charge.

Check out the NZ Print collection
Borrowing from the ANZCA Library
Can't find the book you're looking for - send us a recommendation

FPM Training E-News (12 October 2022)

FPM Essentials guide updated

The Pain medicine training: FPM essentials guide has recently been updated.

All essential readings can be directly linked to from the guide (where available) with additional readings available via the linked Course Reserves listings.

Note: The ETA3.2 reading list has yet to be updated.

Recently added journals

Interventional Pain Medicine: Educational Supplement - Essentials of Evidence Based Medicine and Clinical Research
Volume 1, Supplement 2,
2022

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Interventional Pain Medicine is the official journal of the Spine Intervention Society (SIS) and committed to publishing the highest quality peer-reviewed scientific articles devoted to the entire field of Interventional Pain Medicine.

Recently added titles

Please Note: Essential Notes in Pain Medicine is NOW AVAILABLE as an e-book.

Essential Notes in Pain Medicine by Enrique Collantes Celador; Jan Rudiger; Alifia Tameem [eds] Mapped to the syllabus for the Fellowship of the Faculty of Pain Medicine of the Royal College of Anaesthetists (FFPMRCA), Essential Notes in Pain Medicine ensures readers have all the information needed to review the subject. Written by a multidisciplinary team of over 70 international contributors, this resource provides high-quality, up-to-date guidance on 247 topics such as pain assessment, pain physiology, pain interventions, the role of psychology and physiotherapy and many more.
Call Number: 616.0472076 ESS
>> REQUEST PRINT LOAN <<
ISBN: 9780198799443
Publication Date: 2022-09-14

Training and exams hub:

Report: The path to creating a world class library (ANZCA Spring Bulletin)

As one of the only anaesthesia and pain medicine specialist libraries worldwide, the ANZCA Library is often seen as the “jewel in the crown” for ANZCA fellows and trainees

Much of this development is due to the college’s response to a 2014 library services review which sought to reposition the library in the context of its support for the “needs and expectations of the fellows and trainees, with a view to enhancing service delivery and raising awareness of the library, its collection and value to fellows and trainees”.

Recently, the library completed a follow up report to this review, detailing the numerous developments that have occurred in the intervening period.

Selected highlights from the full report provided to ANZCA Council in March 2022 may be viewed in the document attached below.

The path to creating a world class library

Training E-News (29 September 2022)

Latest books

Several new training-related titles have been added to the collection:

Essential Clinical Anesthesia Review: Keywords, Questions and Answers for the Boards by Aglio LS, Lekowski RW, Urman RD [eds] This concise, evidence-based board review book, organized according to the ABA keyword list, covers all the fundamental concepts needed to pass written and re-certification board examinations. Each chapter begins with a case scenario or clinical problem from everyday practice, followed by concise discussion and clinical review questions and answers.
ISBN: 9781107681309
Publication Date: 2015-01-08
Fundamentals of Anaesthesia, 4e by Lin T, Smith T, Pinnock C, Mowatt C [eds] Fundamentals of Anaesthesia is the gold standard text for the Primary FRCA, encapsulating the basic principles of modern anaesthesia in one easily accessible volume. Written and edited by experts with extensive FRCA examination experience, this text deliberately blends the expertise of invited authors in an unrivalled consistency of style more akin to that of a single author text. All of the subject matter required to pass the exam is condensed into an easy-to-read format. This fully updated fourth edition includes new guidelines, an improved chapter structure, and a new section on clinical ultrasound.
ISBN: 9781107612389
Publication Date: 2016-12-01

See the complete new titles listing

Self-assessment

Did you know that LWW Health Libraryhas a self-assessment tool containing over 20 quizzes based around various anesthesia-related topics?

Check out the self-assessment tools library guide for more

Training and exams hub:

FPM Synapse E-News (28 September 2022)

Recent articles of interest

A round-up of pain medicine-related articles:

Fernandez-de-Las-Penas C, Cancela-Cilleruelo I, Moro-Lopez-Menchero P, et al. Exploring the trajectory curve of long-term musculoskeletal post-COVID pain symptoms in hospitalized COVID-19 survivors: a multicenter study [eub ahead of print, 2022 Jun 13]. P
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Abstract
This multicenter cohort study investigated the prevalence of musculoskeletal post-COVID pain during the first year after the infection with mosaic plots and an exponential bar plot model and its associated risk factors. Patients hospitalized because of COVID-19 in 5 hospitals of Madrid (Spain) were scheduled for a telephone interview at 2 follow-up periods after hospitalization for collecting data about musculoskeletal post-COVID pain. Hospitalization and clinical data were collected from hospital medical records. From 2000 patients initially recruited, 1593 (44.6% women, age: 61 +/- 15 years) were assessed at T0 (hospital admission), T1 (mean: 8.0 +/- 1.5 months after discharge), and T2 (mean: 13.2 +/- 1.5 months after discharge). The prevalence of musculoskeletal pain (myalgia) was 30.3% (n = 483) at T0, increased to 43.4% (n = 692) at T1, and decreased to 37.8% (n = 603) at T2. The trajectory curve revealed a decreasing prevalence trend of musculoskeletal post-COVID pain the following years after hospitalization. According to the presence of pre-existing pain symptoms, the prevalence of new-onset post-COVID pain was 75.9%. Female sex (odds ratio [OR] 1.593, 95% confidence interval [CI] 1.148-2.211), history of musculoskeletal pain (OR 1.591, 95% CI 1.211-2.07), the presence of myalgia (OR 1.371, 95% CI 1.032-1.821) or headache (OR 2.278, 95% CI 1.622-3.199) at hospitalization, the days of hospitalization (OR 1.013, 95% CI 1.000-1.025), and the presence of post-COVID pain at T1 (OR 11.02, 95% CI 8.493-14.305) were factors associated with musculoskeletal post-COVID pain 1 year after hospitalization. In conclusion, musculoskeletal post-COVID pain remains highly prevalent 1 year after hospitalization. Female sex, previous history of pain symptoms, pain symptoms at onset, and days at hospital were factors associated with musculoskeletal post-COVID pain 1 year after hospitalization.
Miettinen T, Sverloff J, Lappalainen OP, Linton SJ, Sipilä K, Kalso E. Sleep problems in pain patients entering tertiary pain care: the role of pain-related anxiety, medication use, self-reported diseases, and sleep disorders. Pain. 2022;163(7):e812-e820.
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Abstract
Chronic pain and sleep problems frequently co-occur. Pain itself disturbs sleep, but other factors may also contribute to sleep problems in pain patients. This cross-sectional study of 473 patients (69.9% female, mean age 47 years) entering tertiary pain management compared normally sleeping pain patients with those having recurring sleep problems to determine the relationship between pain and sleep. Groups were compared for pain and pain aetiology, pain-related anxiety, childhood adversities, use of sleep and pain medications, self-reported diseases, and sleep disorders. Furthermore, the association of pain-related anxiety (cognitive anxiety, escape/avoidance, fear, and physiological anxiety) with more disturbing sleep problems was investigated in the whole cohort. The main results were that those with sleep problems more often reported multiple health conditions than those sleeping normally (depression 31.6% vs 5.0%; angina pectoris 6.5% vs 0.0%; asthma 19.6% vs 1.7%; low back problems 55.1% vs 23.3%; joint disease other than rheumatoid arthritis 32.3% vs 18.3%). Accumulations of 5 or more childhood adversities were more often present in those with sleep problems. Restless legs symptoms were more common in those with sleep problems than those sleeping normally (33.2% vs 11.7%). Patients having sleep problems reported more use of sleep and pain medications than those sleeping normally. Findings about pain-related anxiety suggest physiological reactions as significant factors for increased sleep disturbances. These factors need to be addressed in the management of the comorbidity of pain and sleep problems, and research to understand mechanisms in these is sorely needed.

Latest journals

SIS have begun publication of a new open-access journal on interventional pain medicine:

Interventional Pain Medicine
Online: Vol. 1, 2022 - current
>> Alternate/direct access via ScienceDirect.

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Interventional Pain Medicine is the official journal of the Spine Intervention Society (SIS) and committed to publishing the highest quality peer-reviewed scientific articles devoted to the entire field of Interventional Pain Medicine. This is an online-only, gold open access journal, which provides benchmark technical and content expertise in the science and clinical practice of Interventional Pain Medicine.

Latest books

Several new pain-related titles have been added to the collection:

Atlas of Anatomy of the Peripheral Nerves: The Nerves of the Limbs - Expert Edition by Philippe Rigoard This book focuses on the anatomy of the peripheral nervous system. Using the latest 3D-computer graphic modelling techniques, the author developed the innovative NEURO 3D LOCATORTM concept, which provides 3D in-vivo ultrasound images of peripheral nerve architectures, allowing readers to develop a mental real-time 3D GPS of the peripheral nervous system. This new edition is an extended version of the "Student edition" dedicated to Experts.
ISBN: 9783030491789
Publication Date: 2021-02-22
Oxford Textbook of Pediatric Pain, 2e by Bonnie J. Stevens; Gareth Hathway; William T. Zempsky [eds] The new edition of the Oxford Textbook of Pediatric Pain brings together an international team of experts to provide an authoritative and comprehensive textbook on all aspects of pain in infants, children, and youth. Divided into nine sections, the textbook analyses pain as a multifactorial problem to give the reader a comprehensive understanding of this challenging subject.
ISBN: 9780198818762
Publication Date: 2021-08-25

See the complete new titles listing

SOT E-News (26 September 2022)

Recent articles of interest

A round-up of anaesthesia and pain medicine-related education articles:

Kaur B, Taylor EM. Development of a pediatric anesthesia fellowship curriculum in Australasia by the Society for Pediatric Anesthesia of New Zealand and Australia (SPANZA) education sub committee [epub ahead of print, 2022 Jul 25]. Paediatr Anaesth. 2022; Keywords: curriculum; education; guidelines; learning.
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Abstract
There has been a recognized need to develop a curriculum for pediatric anesthesia training in Australia and New Zealand. The drivers are safe care for children, clear standards of care for children within and outside of quaternary centres, and clarity of the expertise and skill of the practitioner. Entrustable professional activities (EPAs) made up of multiple competencies and sub-competencies are useful for the description and assessment of contemporary medical education. We have developed an EPA-based curriculum that is not prescriptive in the number or range of EPAs that should be completed. Individuals can shape their learning and training to the EPAs that will support their ability to provide high-quality safe care in the wide variety of institutions that they may be employed in after their pediatric fellowship. Institutions can use the curriculum to describe the skill set required for their institution and location. This paper will explain the process behind the development of the Society for Pediatric Anesthesia in New Zealand and Australia (SPANZA) guidelines of a curriculum for paediatric anesthesia fellowship based on EPAs.
Fedoruk K, Abir G, Carvalho B. Virtual Compared to In-Person Obstetric Anesthesiology Trainee Education During the COVID-19 Pandemic: A Short Report. Cureus. 2022;14(6):e26423. Published 2022 Jun 29. Keywords: covid-19; medical education; obstetric; obstetric anesthesiology; virtual education.
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Abstract
Background: The COVID-19 pandemic brought many changes to medical training, including in-person education platforms being disbanded and replaced with virtual education. At our institution, dedicated obstetric anesthesiology teaching for residents and fellows occurs daily and is highly valued and rated. In March 2020 due to the COVID-19 pandemic, we changed the teaching platform from in-person to virtual teaching (via video communication). We subsequently surveyed residents, fellows, and attendings to determine the impact of virtual compared with in-person teaching.

Methods: To assess the impact of this change, an electronic survey was sent to 10 anesthesiology residents on their 2nd obstetric anesthesiology rotation, and 10 residents on their 1st rotation, respectively. The electronic survey was also sent to three fellows and eight obstetric anesthesiology attendings. Answers were based on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree).

Results: The results for 1st rotation residents were higher in all domains compared with 2nd rotation residents and fellows, where "quality" achieved statistical significance (p=0.009) between 1st and 2nd rotation residents. "Engagement" was overall the most impacted domain for trainees. Attendings did not feel that virtual teaching impacted their ability to provide adequate education, however, learner engagement was again the lowest rated domain, and teachers strongly favored resuming in-person teaching.

Conclusions: Virtual teaching is an appropriate alternative when in-person teaching is not possible. Future initiatives are needed to improve engagement and better facilitate virtual teaching.
Zhitny VP, Djesevic E, Lagasca G, Dhalai A, Mendelson BJ. Regional and Acute Pain Anesthesiology Post COVID-19 Assessment and Recommendations for Fellowship Web Based Platforms. Local Reg Anesth. 2022 Jul 7;15:57-60. Keywords: SARS-COV-2; acute pain anesthesiology; graduate medical education; regional anesthesia.
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Abstract
In today's applicant landscape, the SARS-COV-2 pandemic has drastically altered the traditional model of in-person interviews shifting it to an online format often conducted by web-based applications. Fellowship programs and naturally fellowship program directors face a new challenge of standardizing information to be distributed to prospective fellowship applicants through American Society of Regional Anesthesia and Pain Medicine (ASRA) common application. Here we describe a set of 11 criteria recommended by other similar studies selected for evaluation of online program training platforms, where only 13.3% of the acute and regional pain fellowship program online platforms met 75% of the criteria with limited presence in areas of research, rotation schedules, list of fellows, alumni, and life in the area. Additional considerations pertaining to the types of procedures performed, evaluation, mentorship, academic involvement, and teaching should be undertaken by the programs.
Evans FM, Krotinger AA, Lilaonitkul M, et al. Evaluation of Open Access Websites for Anesthesia Education. Anesth Analg. 2022;135(6):1233-1244.
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Abstract
Background: While the prevalence of free, open access medical education resources for health professionals has expanded over the past 10 years, many educational resources for health care professionals are not publicly available or require fees for access. This lack of open access creates global inequities in the availability and sharing of information and may have the most significant impact on health care providers with the greatest need. The extent of open access online educational websites aimed for clinicians and trainees in anesthesiology worldwide is unknown. In this study, we aimed to identify and evaluate the quality of websites designed to provide open access educational resources for anesthesia trainees and clinicians.

Methods: A PubMed search of articles published between 2009 and 2020, and a Startpage search engine web search was conducted in May 2021 to identify websites using the following inclusion criteria: (1) contain educational content relevant for anesthesia providers or trainees, (2) offer content free of charge, and (3) are written in the English language. Websites were each scored by 2 independent reviewers using a website quality evaluation tool with previous validity evidence that was modified for anesthesia (the Anesthesia Medical Education Website Quality Evaluation Tool).

Results: Seventy-five articles and 175 websites were identified; 37 websites met inclusion criteria. The most common types of educational content contained in the websites included videos (66%, 25/37), text-based resources (51%, 19/37), podcasts (35%, 13/37), and interactive learning resources (32%, 12/37). Few websites described an editorial review process (24%, 9/37) or included opportunities for active engagement or interaction by learners (30%,11/37). Scores by tertile differed significantly across multiple domains, including disclosure of author/webmaster/website institution; description of an editorial review process; relevancy to residents, fellows, and faculty; comprehensiveness; accuracy; disclosure of content creation or revision; ease of access to information; interactivity; clear and professional presentation of information; and links to external information.

Conclusions: We found 37 open access websites for anesthesia education available on the Internet. Many of these websites may serve as a valuable resource for anesthesia clinicians looking for self-directed learning resources and for educators seeking to curate resources into thoughtfully integrated learning experiences. Ongoing efforts are needed to expand the number and improve the existing open access websites, especially with interactivity, to support the education and training of anesthesia providers in even the most resource-limited areas of the world. Our findings may provide recommendations for those educators and organizations seeking to fill this needed gap to create new high-quality educational websites.

Latest books

A new education-related title hasbeen added to the collection:

International Handbook of Teaching and Learning in Health Promotion by Marco Akerman; Ana Claudia Camargo Gonçalves Germani [eds] This international handbook brings together researchers and teachers from 25 countries of the five continents to share their experiences of teaching health promotion in undergraduate and graduate courses related to different health professions. Chapter authors share teaching methodologies used in classes, discuss the competencies students need to learn and indicate research opportunities.
ISBN: 9783030960049
Publication Date: 2022-06-24

See the complete new titles listing

SOT induction modules and support hub:

A support hub has been created to house all resources relevant to the SOT role, which also includes links to the new SOT induction modules.

ANZCA E-News (15 September 2022)

It is now possible to access ANZCA Library Full-text via Ovid MEDLINE.

Access Ovid MEDLINE using the proxied ANZCA link
Search and locate an article citation
Where available, click the Access ANZCA Fulltext via LibKey link alongside the article

This will open LibKey and resolve to the article full-text

Latest books

Several new titles have been added to the collection:

Perioperative Care of the Cancer Patient by Hagberg CA, Nates JL, Riedel BP, Gottumukkala VNR, Buggy D [eds] Perioperative Care of the Cancer Patient is today's most up-to-date, authoritative, comprehensive reference on the acute care of surgical patients with cancer, from a team of international experts in this emerging and dynamic specialty. Covers current clinical practice and perioperative care guidelines during the entire cancer journey for both adult and paediatric patients.
ISBN: 9780323695848
Publication Date: 2022-07-21
The Registrar by Janakiramanan N. With the frenetic pace of a psychological thriller, The Registrar offers a rare insight into the world of a surgeon-in-the-making from one who has survived it. Told with compassion, skill and emotional heart, this gripping and moving novel goes behind the headlines to reveal the human experience of being both doctor and patient in a medical system at breaking point.
Call Number: 823.4 JAN
>> REQUEST PRINT LOAN <<
ISBN: 9781761066511
Publication Date: 2022
If you want them to listen, talk their language : communication, motivation and success in business and personal relationships using the process communication model by Feuersenger E; Naef A. This book explains not only the concepts of the Process Communication Model®, it also gives you highly practical application examples. You will learn more about how the skills to observe and decode behaviours will allow you to form and maintain relationships based on constructive communication.
Call Number: 302.2 FEU
>> REQUEST PRINT LOAN <<
ISBN: 9780473197896
Publication Date: 2011

ANZCA E-News (18 August 2022)

Latest e-books

A new title looking at post-anesthesia are has just been added to the collection.

Post-Anesthesia Care: Symptoms, Diagnosis and Management by James W. Heitz [ed] This book aids the practitioner in the clinical management of surgical patients during the often turbulent hours after surgery. After a brief introduction to PACU organization, this manual discusses the common and most serious symptoms encountered in the post-operative patient, giving guidance on diagnosis of the underlying disorder and the treatment options available.
ISBN: 9781107642218
Publication Date: 2016-08-22

Latest print books

The latest to arrive in print at the ANZCA library.

If in Doubt by Keith Wilkinson
Call Number: 617.9609 WIL
>> REQUEST PRINT LOAN <<
ISBN: 9781803690575
Publication Date: 2021-10-06
In this ground-breaking book, If In Doubt, retired consultant anaesthetist, Dr Keith Wilkinson, shares a frank and unique glimpse into this little understood profession. Drawing on anecdotes from a career that spanned nearly four decades, three of which took place in a small island hospital where he was required to know every aspect of anaesthesia, Dr Wilkinson sets out to answer the most important questions.

ANZCA Library wins innovation award

Health Libraries Australia and MedicalDirector have announced that the winner for the 2022 HLA/MedicalDirector Innovation Award is John Prentice, Library Manager, ANZCA. John was awarded for his project Automated interlibrary loan/document delivery (ILL/DD) database for health libraries.

The ILL/DD system allows ANZCA library staff to automate many of the standard searching, requesting and communication tasks associated with document delivery requests, resulting in a far quicker turnaround of requests for ANZCA users. With the help of the system, request turnaround time fell to under 1 day for the first 6 months of 2022.

What's happening with New Zealand Health?

On the 1 July 2022, new Zealand health services transitioned to Te Whatu Ora - Health New Zealand, replacing the District Health Boards (DHBs).

gt; Overview of the changes
> Te Whatu Ora website > What's happening

Te Hā – te reo (For the breath)/NZ News (11 August 2022)

Recent articles of interest

A round-up of the latest NZ-focussed articles:

Gurney JK, McLeod MA, Campbell D, et al. Anaesthetic choice for hip or knee arthroplasty in New Zealand: Risk of postoperative death and variations in use. Anaesth Intensive Care. 2022;50(3):178-188.
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Abstract
Anaesthetic choice for large joint surgery can impact postoperative outcomes, including mortality. The extent to which the impact of anaesthetic choice on postoperative mortality varies within patient populations and the extent to which anaesthetic choice is changing over time remain under-explored both internationally and in the diverse New Zealand context. In a national study of 199,211 hip and knee replacement procedures conducted between 2005 and 2017, we compared postoperative mortality among those receiving general, regional or general plus regional anaesthesia. Focusing on unilateral (n=86,467) and partial (n=13,889) hip replacements, we assessed whether some groups within the population are more likely to receive general, regional or general plus regional anaesthesia than others, and whether mortality risk varies depending on anaesthetic choice. We also examined temporal changes in anaesthetic choice over time. Those receiving regional alone or general plus regional for unilateral hip replacement appeared at increased risk of 30-day mortality compared to general anaesthesia alone, even after adjusting for differences in terms of age, ethnicity, deprivation, rurality, comorbidity, American Society of Anesthesiologists physical status score and admission type (e.g. general plus regional: adjusted hazard ratio (adj. HR)=1.94, 95% confidence intervals (CI) 1.32 to 2.84). By contrast, we observed lower 30-day mortality among those receiving regional anaesthesia alone compared to general alone for partial hip replacement (adj. HR=0.86, 95% CI 0.75 to 0.97). The latter observation contrasts with declining temporal trends in the use of regional anaesthesia alone for partial hip replacement procedures. However, we recognise that postoperative mortality is one perioperative factor that drives anaesthetic choice.
Hanning SM, Hua C, Baroutian S, et al. Quantification and composition of pharmaceutical waste in New Zealand. J Mater Cycles Waste Manag. 2022;24(4):1603-1611.
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Abstract
This study aimed to quantify the amount of pharmaceutical waste produced in New Zealand, and determine the composition of pharmaceutical waste from community pharmacies in Auckland, New Zealand. Pharmaceutical waste collected in New Zealand is increasing, peaking at 542 tonne in 2019. Pharmaceutical waste collected from hospitals and pharmacies in Auckland increased by more than fourfold from 2016 to 2020. An audit of the types of pharmaceutical waste collected from community pharmacies revealed that the most common classes of drugs identified in this waste stream belonged to the nervous system, cardiovascular system and alimentary tract, and metabolism. Following examination of the contents of 12 pharmaceutical waste bins, 475 different pharmaceutical products were identified, highlighting the breadth of drugs in this waste stream. A range of dosage forms and hence materials were identified, which could present challenges for future waste treatment approaches. Hazardous drugs were identified including cytotoxic compounds, which should go into a separate waste stream for incineration. There is a need for similar data to be collected from multiple sites to fully appreciate the magnitude and composition of pharmaceutical waste. This will allow for the suitability of current practices for managing this hazardous waste stream to be evaluated.
Kaur B, Taylor EM. Development of a pediatric anesthesia fellowship curriculum in Australasia by the Society for Pediatric Anesthesia of New Zealand and Australia (SPANZA) education sub committee [epub ahead of print, 2022 Jul 25]. Paediatr Anaesth. 2022;
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Abstract
There has been a recognized need to develop a curriculum for pediatric anesthesia training in Australia and New Zealand. The drivers are safe care for children, clear standards of care for children within and outside of quaternary centres, and clarity of the expertise and skill of the practitioner. Entrustable professional activities (EPAs) made up of multiple competencies and sub-competencies are useful for the description and assessment of contemporary medical education. We have developed an EPA-based curriculum that is not prescriptive in the number or range of EPAs that should be completed. Individuals can shape their learning and training to the EPAs that will support their ability to provide high-quality safe care in the wide variety of institutions that they may be employed in after their pediatric fellowship. Institutions can use the curriculum to describe the skill set required for their institution and location. This paper will explain the process behind the development of the Society for Pediatric Anesthesia in New Zealand and Australia (SPANZA) guidelines of a curriculum for paediatric anesthesia fellowship based on EPAs.
Taylor E, Jowsey T. Quality improvement activities of pediatric anesthesia in Australia and New Zealand: A snapshot survey [epub ahead of print, 2022 Apr 23]. Paediatr Anaesth. 2022;10.1111/pan.14469.

NZ Print collection

Did you know that the NZ office has its own print collection available for loan? Requested items are delivered/returned via courier free-of-charge.

Check out the NZ Print collection
Borrowing from the ANZCA Library
Can't find the book you're looking for - send us a recommendation

FPM Training E-News (10 August 2022)

Recently added titles

A number of new pain medicine training titles have recently been added, including Essential Notes in Pain Medicine (co-edited by FPM fellow Enrique Collantes Celador).

Please Note: Essential Notes in Pain Medicine is NOW AVAILABLE ONLINE.

Essential Notes in Pain Medicine by Enrique Collantes Celador; Jan Rudiger; Alifia Tameem [eds] Mapped to the syllabus for the Fellowship of the Faculty of Pain Medicine of the Royal College of Anaesthetists (FFPMRCA), Essential Notes in Pain Medicine ensures readers have all the information needed to review the subject. Written by a multidisciplinary team of over 70 international contributors, this resource provides high-quality, up-to-date guidance on 247 topics such as pain assessment, pain physiology, pain interventions, the role of psychology and physiotherapy and many more.
Call Number: 616.0472076 ESS
>> REQUEST PRINT LOAN <<
ISBN: 9780198799443
Publication Date: 2022-09-14
The Chest Wall and Abdomen (Pain Medicine: A Case-Based Learning Series) by Steven D. Waldman The Case-Based Learning approach focuses learners and clinicians on the key elements for each diagnosis and helps develop a deep understanding of how to diagnose and treat each condition. Covers everyday clinical problems such as costosternal syndrome, Tietze's syndrome, devil's grip, fractured ribs, post-thoracotomy pain, acute and chronic pancreatitis, diverticulitis, and more.
ISBN: 9780323846882
Publication Date: 2022-05-06
The Wrist and Hand (Pain Medicine: A Case-Based Learning Series) by Steven D. Waldman Here is the perfect text you need to provide your learners with real-life clinical scenarios that are ideal for Case-Based Learning and Discussion. Presents real-world patients in a real-world clinical setting, making learning fun and engaging.
ISBN: 9780323834537
Publication Date: 2022-05-06

Recent articles of interest:

Malik Z, Ahn J, Thompson K, Palma A. A Systematic Review of Pain Management Education in Graduate Medical Education. J Grad Med Educ. 2022;14(2):178-190.
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Background: Despite the importance of pain management across specialties and the effect of poor management on patients, many physicians are uncomfortable managing pain. This may be related, in part, to deficits in graduate medical education (GME).

Objective: We sought to evaluate the methodological rigor of and summarize findings from literature on GME interventions targeting acute and chronic non-cancer pain management.

Methods: We conducted a systematic review by searching PubMed, MedEdPORTAL, and ERIC (Education Resources Information Center) to identify studies published before March 2019 that had a focus on non-cancer pain management, majority of GME learners, defined educational intervention, and reported outcome. Quality of design was assessed with the Medical Education Research Study Quality Instrument (MERSQI) and Newcastle-Ottawa Scale-Education (NOS-E). One author summarized educational foci and methods.

Results: The original search yielded 6149 studies; 26 met inclusion criteria. Mean MERSQI score was 11.6 (SD 2.29) of a maximum 18; mean NOS-E score was 2.60 (SD 1.22) out of 6. Most studies employed a single group, pretest-posttest design (n=16, 64%). Outcomes varied: 6 (24%) evaluated reactions (Kirkpatrick level 1), 12 (48%) evaluated learner knowledge (level 2), 5 (20%) evaluated behavior (level 3), and 2 (8%) evaluated patient outcomes (level 4). Interventions commonly focused on chronic pain (n=18, 69%) and employed traditional lectures (n=16, 62%) and case-based learning (n=14, 54%).

Conclusions: Pain management education research in GME largely evaluated chronic pain management interventions by assessing learner reactions or knowledge at single sites.

Training and exams hub:

See the complete new titles listing

Training E-News (28 July 2022)

Recent articles of interest

In case you missed it, a recent issue of the RCoA's Bulletin highlighted the changing landscape of anaesthesia training.

Special Trainee Issue: The changing landscape of training in anaesthesia (RCoA Bulletin)
Resilience, flexibility and adaptation to the new environment. These are the ways we are training – and learning to train.

Did you know?

That AccessAnesthesiology has a Review Questions section where you can generate MCQs for a number of anaesthesia training titles (Exam Board & Review, Hadzic’s, Hung’s, etc).

Recently added titles

A number of new trainee-related titles have been recently added to the library collection.

Pediatric and Adult Anesthesiology Simulation Education: A Curriculum for Residents by Claire Sampankanpanich Soria; Suraj Trivedi [eds] This book helps prepare anaesthesiology residents for safe practice of paediatric anesthesia. It features 26 index cases, which are classic clinical scenarios - all covering a spectrum of paediatric anesthesia, neuro-anesthesia, cardiac anesthesia, regional anesthesia, and anesthesia and critical care medicine.
ISBN: 9783030953379
Publication Date: 2022-04-12
Decision Making in Anesthesiology: An Algorithmic Approach, 5e by Lois Bready; Susan H. Noorily; Rosemary Hickey The 5th edition of this book has been fully revised with the latest advances in anaesthesia practice. Each chapter presents a step by step decision making algorithm with explanatory text and supplemental tables, providing clinicians and trainees with answers for nearly 250 anaesthetic management problems. General principles in anaesthesia care are discussed, as well as detailed examination of preoperative problems, anaesthesia in surgical specialty areas, postoperative management, and perioperative management.
ISBN: 9789351529453
Publication Date: 2019-10-15

See the complete new titles listing

Training and exams hub:

FPM Synapse E-News (27 July 2022)

Recent articles of interest

The following pain-related articles have recently been published:

Harden RN, Oaklander AL, Burton AW, et al. Complex regional pain syndrome: practical diagnostic and treatment guidelines, 4th edition. Pain Med. 2013;14(2):180-229.
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Abstract
Objective: This is the fourth edition of diagnostic and treatment guidelines for complex regional pain syndrome (CRPS; aka reflex sympathetic dystrophy).

Methods: Expert practitioners in each discipline traditionally utilized in the treatment of CRPS systematically reviewed the available and relevant literature; due to the paucity of levels 1 and 2 studies, less rigorous, preliminary research reports were included. The literature review was supplemented with knowledge gained from extensive empirical clinical experience, particularly in areas where high-quality evidence to guide therapy is lacking.

Results: The research quality, clinical relevance, and "state of the art" of diagnostic criteria or treatment modalities are discussed, sometimes in considerable detail with an eye to the expert practitioner in each therapeutic area. Levels of evidence are mentioned when available, so that the practitioner can better assess and analyze the modality under discussion, and if desired, to personally consider the citations. Tables provide details on characteristics of studies in different subject domains described in the literature.

Conclusions: In the humanitarian spirit of making the most of all current thinking in the area, balanced by a careful case-by-case analysis of the risk/cost vs benefit analysis, the authors offer these "practical" guidelines.
Maher DP, Wong CH, Siah KW, Lo AW. Estimates of Probabilities of Successful Development of Pain Medications: An Analysis of Pharmaceutical Clinical Development Programs 2000-2020. Anesthesiology. 2022 May 3.
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Abstract
Background: We estimate the probability of successful development and duration of clinical trials for medications to treat neuropathic and nociceptive pain. We also consider the effect of the perceived abuse potential of the medication on these variables.

Methods: This study uses the Citeline database to compute the probabilities of success, duration, and survivorship of pain medication development programs between January 1, 2000, and June 30, 2020, conditioned on the phase, type of pain (nociceptive vs. neuropathic), and the abuse potential of the medication.

Results: The overall probability of successful development of all pain medications from phase 1 to approval is 10.4% (standard error (SE) of 1.5%). Medications to treat nociceptive and neuropathic pain have a probability of successful development of 13.1% (SE: 2.3%) and 7.1% (SE: 1.9%), respectively. The probability of successful development of medications with high abuse potential and low abuse potential are 27.8% (SE: 4.6%) and 4.7% (SE: 1.2%), respectively. The most common period for attrition is between phase 3 and approval.

Discussion: Our data suggest that the unique attributes of pain medications, such as their abuse potential and intended pathology, can influence the probability of successful development and duration of development.
Henderson LA, Kotsirilos V, Cairns EA, Ramachandran A, Peck CC, McGregor IS. Medicinal cannabis in the treatment of chronic pain. Aust J Gen Pract. 2021;50(10):724-732.
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Abstract
Background: Chronic pain is a major health issue, adversely affecting millions of Australians and costing billions of dollars annually. Current pharmaceutical treatments may be limiting, and in some cases ineffective, while carrying substantial liabilities. Medicinal cannabis is an increasingly popular, albeit controversial, alternative.

Objective: The aim of this article is to briefly review the scientific evidence related to medicinal cannabis for the treatment of chronic pain and update physicians on relevant issues and optimal prescribing practices.

Discussion: To date, >130,000 medicinal cannabis approvals have been issued in Australia, mostly by general practitioners, with approximately 65% of these to treat chronic non-cancer pain. Available products deliver Δ9-tetrahydrocannabinol (THC) and/or cannabidiol (CBD). Despite robust supportive data from animal models, current clinical trial evidence for THC and CBD efficacy in chronic pain is incomplete. In their prescribing decisions, doctors must balance patient demand and curiosity with caution regarding potential risks and limited efficacy.

Recently added titles:

A number of new pain medicine titles have been recently added to the library collection, including a new edition of the Practical Management of Pain.

Atlas of Pain Management Injection Techniques, 5e by Steven D. Waldman The Atlas of Pain Management Injection Techniques, 5e, helps you master the key nerve blocks you need to know to successfully treat 200 common and uncommon pain syndromes. Focusing on the "how to" details of pain management injection techniques, this bestselling atlas by Dr. Steven D. Waldman equips you to deliver safe, accurate and cost-effective pain relief to your patients using the most clinically appropriate imaging modalities.
ISBN: 9780323828260
Publication Date: 2022-05-24
Practical Management of Pain, 6e by Benzon H, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW, Chadwick AL This authoritative reference is a comprehensive, practical resource for pain diagnosis and treatment using a variety of pharmacologic and physical modalities. The fully revised 6th edition brings you fully up to date with new developments in patient evaluation, diagnosis of pain syndromes, rationales for management, treatment modalities, and much more.
Call Number: 616.0472 PRA
ISBN: 9780323711012
Publication Date: 2022-05-05
Regional Nerve Blocks in Anesthesia and Pain Therapy, 5e by Danilo Jankovic; Philip Peng [eds] This comprehensive atlas, which includes a wealth of illustrations and anatomic pictures created by the editors, covers a broad range of both regional anesthesia and pain intervention techniques, including neuromodulation. The book is unique in that it covers ultrasound and fluoroscopic-guided techniques, as well as traditional landmark-guided techniques.
ISBN: 9783030887261
Publication Date: 2022-06-01

See the complete new titles listing

ANZCA E-News (20 July 2022)

Recent articles of interest

A number of new anaesthesia-related articles have recently been published, including one offering words of encouragement to young anaesthesiologists.

Sasidharan S, Dhillon HS. An Open Letter to Young Anaesthesiologists. Turk J Anaesthesiol Reanim. 2022;50(Supp1):S79-S80.
Endlich Y, Hore PJ, Baker PA, et al. Updated guideline on equipment to manage difficult airways: Australian and New Zealand College of Anaesthetists [epub ahead of print, 2022 Jun 19]. Anaesth Intensive Care.
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Abstract
The Australian and New Zealand College of Anaesthetists (ANZCA) recently reviewed and updated the guideline on equipment to manage a difficult airway. An ANZCA-established document development group, which included representatives from the Australasian College for Emergency Medicine and the College of Intensive Care Medicine of Australia and New Zealand, performed the review, which is based on expert consensus, an extensive literature review, and bi-nationwide consultation. The guideline (PG56(A) 2021, https://www.anzca.edu.au/getattachment/02fe1a4c-14f0-4ad1-8337-c281d26bfa17/PS56-Guideline-on-equipment-to-manage-difficult-airways) is accompanied by a detailed background paper (PG56(A)BP 2021, https://www.anzca.edu.au/getattachment/9ef4cd97-2f02-47fe-a63a-9f74fa7c68ac/PG56(A)BP-Guideline-on-equipment-to-manage-difficult-airways-Background-Paper), from which the current recommendations are reproduced on behalf of, and with the permission of, ANZCA. The updated 2021 guideline replaces the 2012 version and aims to provide an updated, objective, informed, transparent, and evidence-based review of equipment to manage difficult airways.
Pursell N, Trousdale D, Azizad O. Patient-Initiated Sexual Harassment-Reflections From My Intern Year. Anesth Analg. 2022;135(1):213-215.
Ambulkar R, Patel A, Patil S, Savarkar S. Patient satisfaction with anaesthesia services in a tertiary care cancer centre. (SAY study). J Anaesthesiol Clin Pharmacol. 2022;38(1):111-117.
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Abstract
Background and aims: Patient satisfaction is an important measure of quality of health care. Its assessment leads to a balanced evaluation of the structure, process and outcome of service at an institution. The aim of our study was to assess patient satisfaction with perioperative anaesthesia services provided in our institution and identify factors leading to dissatisfaction which could be preventable or addressed to improve patient care and experience.

Material and methods: A convenient sample size of 200 patients was accrued after written informed consent. A questionnaire to suit local needs of institute was developed, validated and a language appropriate questionnaire was administered by a trained research nurse 24-48 hours post anaesthesia to accrued patients. Data was summarised in percentages and satisfaction scores were compared across demographic variables using Chi square test.

Results: A total of 96% (192/200) patients were satisfied with the overall interaction with the anaesthetists in the perioperative period; with 99% (198/200) patients being satisfied with acute pain services provided, postoperatively. As regards to recovery room, 96.5% (193/200) patients were satisfied with the services provided. Satisfaction scores of the pre-anaesthetic clinic (PAC), pain team and anaesthesia services compared across demographic variables - age, gender and education qualifications were found to be statistically non-significant.

Conclusion: High rate of patients were satisfied with perioperative anaesthesia care services at our institute. Good and effective preoperative communication with the patient, effective management of postoperative pain and complications significantly contributed towards overall high patient satisfaction.
Myles PS, Bui T. Opioid-free analgesia after surgery. Lancet. 2022;399(10343):2245-2247.
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No abstract available.
Bertolizio G, Disma N, Engelhardt T. After nectarine: how should we provide anesthesia for neonates?. Curr Opin Anaesthesiol. 2022;35(3):337-342.
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Abstract
Purpose of review: Neonates have a high risk of perioperative morbidity and mortality. The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) investigated the anesthesia practice, complications and perioperative morbidity and mortality in neonates and infants <60 weeks post menstrual age requiring anesthesia across 165 European hospitals. The goal of this review is to highlight recent publications in the context of the NECTARINE findings and subsequent changes in clinical practice.

Recent findings: A perioperative triad of hypoxia, anemia, and hypotension is associated with an increased overall mortality at 30 days. Hypoxia is frequent at induction and during maintenance of anesthesia and is commonly addressed once oxygen saturation fall below 85%.Blood transfusion practices vary widely variable among anesthesiologists and blood pressure is only a poor surrogate of tissue perfusion. Newer technologies, whereas acknowledging important limitations, may represent the currently best tools available to monitor tissue perfusion. Harmonization of pediatric anesthesia education and training, development of evidence-based practice guidelines, and provision of centralized care appear to be paramount as well as pediatric center referrals and international data collection networks.

Summary: The NECTARINE provided new insights into European neonatal anesthesia practice and subsequent morbidity and mortality.Maintenance of physiological homeostasis, optimization of oxygen delivery by avoiding the triad of hypotension, hypoxia, and anemia are the main factors to reduce morbidity and mortality. Underlying and preexisting conditions such as prematurity, congenital abnormalities carry high risk of morbidity and mortality and require specialist care in pediatric referral centers.
Morgan D. Anaesthesia and the English language. Bulletin. Royal College of Anaesthetists. 2022, 132: 26-27.

Recently added titles:

Brand new editions of Evidence-Based Practice of Anesthesiology and Rosen's Emergency Medicine are now available.

Evidence-Based Practice of Anesthesiology, 4e by Lee A. Fleisher Evidence-Based Practice of Anesthesiology, 4e, helps anaesthesiologists make sound decisions in everyday practice. World-renowned authority, Dr. Lee A. Fleisher, takes an evidence-based approach to a variety of high-impact topics related to effective perioperative patient management: preoperative assessment; monitoring and administration of anesthesia during surgery; postoperative intensive care management; and postoperative pain management.
ISBN: 9780323778466
Publication Date: 2022-06-02
Rosen's Emergency Medicine: Concepts and Clinical Practice, 10e by Ron Walls; Robert Hockberger; Marianne Gausche-Hill; Timothy B. Erickson; Susan R. Wilcox The fully revised 10th Edition delivers practical, evidence-based knowledge and specific recommendations from clinical experts in a clear, precise format, with focused writing, current references, and extensive use of illustrations to provide definitive guidance for emergency conditions.
ISBN: 9780323757898
Publication Date: 2022-06-27
Ferri's Clinical Advisor 2023 by Fred F. Ferri [ed] For 25 years, Ferri's Clinical Advisor has provided immediate answers on the myriad medical diseases and disorders you're likely to encounter in a unique, easy-to-use format. This popular "5 books in 1" reference delivers vast amounts of information in a user-friendly manner.
ISBN: 9780323755733
Publication Date: 2022-06-27

ANZCA E-News (16 June 2022)

Recent articles of interest

A number of new anaesthesia-related articles have recently been published:

Brainard AJ, Hoy LM. Total Well-Being in Anesthesiology: Looking Beyond COVID-19. Anesthesiol Clin. 2022 Jun;40(2):xv-xvi. No abstract available
Baird CR. Substance use disorder in anaesthetists: A personal perspective. Anaesth Intensive Care. 2021;49(1):12-22. Keywords: Substance abuse; alcohol; chemical dependence; death; drug abuse; intervention; professional impairment; suicide.
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Abstract
In this article, I present a firsthand account as an anaesthetist with substance use disorder who has been through rehabilitation and returned to clinical anaesthesia, followed by an overview of substance use disorder in anaesthesia. Substance use disorder is prevalent within the anaesthesia community and can result in tragic consequences, including death in many cases. The incidence is around one to two per 1000 anaesthetist years and this appears to be rising, perhaps mirroring the population-wide increase in substance use disorder as a result of the opioid epidemic. Recognising substance use disorder in a colleague and intervening to try and help them and protect patients can be immensely challenging. Carrying out a successful intervention requires careful planning and coordination in order to protect the affected individual, their colleagues and patients. Returning to clinical anaesthesia following a diagnosis of substance use disorder is also contentious, with the high abstinence rate (relative to the wider substance use disorder population) having to be balanced against the risk of death following relapse. Any return to practice must be well planned and supported, and include appropriate toxicology screening. With such measures, rehabilitation and a return to clinical anaesthesia is possible in certain cases. For the affected individual regaining, then maintaining, their professional identity can be a powerful motivator to remain abstinent. Drug diversion and substance use disorder in anaesthesia is unlikely ever to be fully preventable, but strategies such as biometric dispensing, analysis of unused drugs, random toxicology and ongoing education may help to keep it to a minimum.
Charlesworth M, Selak T. How to disseminate clinical research [epub ahead of print, 2022 Jun 8]. Anaesthesia. 2022;10.1111/anae.15781. Keywords: dissemination; impact; publishing; social media.
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Traditionally, dissemination of scientific research ends at the point where a paper is published in a peer-reviewed journal. However, most clinicians and patients to whom the work is relevant will never read it. Given the enormous resources invested, this limited reach can be disappointing to authors, patients, funders, sponsors and participants. Yet there are ways to enhance reach, which begins by first recognising that the scientific process does not finish with publication.
Jaensson M, Nilsson U, Dahlberg K. Methods and timing in the assessment of postoperative recovery: a scoping review. Br J Anaesth. 2022;129(1):92-103. Keywords: instrument; outcomes; postoperative recovery; quality; scoping review; standardised endpoint.
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Abstract
Background: There is no consensus about the type of instrument with which to assess postoperative recovery or the time points when assessments are most appropriate. It is also unclear whether instruments measure the four dimensions of postoperative recovery, that is physical, psychological, social, and habitual recovery. This scoping review had three objectives: (1) to identify and describe instruments used in clinical trials to assess postoperative recovery; (2) to determine how, when, and the number of times postoperative recovery was measured; and (3) to explore whether the four dimensions of postoperative recovery are represented in the identified instruments.

Methods: A literature search was conducted in CINAHL, MEDLINE, and Web of Science. The search terms were related to three search strands: postoperative recovery, instrument, and clinical trials. The limits were English language and publication January 2010 to November 2021. In total, 5015 studies were identified.

Results: A total of 198 studies were included in the results. We identified 20 instruments measuring postoperative recovery. Different versions of Quality of Recovery represented 81.8% of the included instruments. Postoperative recovery was often assessed at one time point (47.2%) and most often on postoperative day 1 (81.5%). Thirteen instruments had items covering all four dimensions of postoperative recovery.

Conclusions: Assessing recovery is important to evaluate and improve perioperative care. We emphasise the importance of choosing the right instrument for the concept studied and, if postoperative recovery is of interest, of assessing more than once. Ideally, instruments should include all four dimensions to cover the whole recovery process.
Ferguson MT, R Fernando J, McManus S, et al. Perioperative medicine in Australia and New Zealand: A cross-sectional survey [epub ahead of print, 2022 May 12]. Anaesth Intensive Care. Keywords: Australia; New Zealand; Perioperative
Hasselager RP, Hallas J, Gögenur I. Epidural Analgesia and Postoperative Complications in Colorectal Cancer Surgery. An Observational Registry-based Study [epub ahead of print, 2022 Jun 8]. Acta Anaesthesiol Scand. 2022;10.1111/aas.14101.
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Abstract
Background: In colorectal cancer, surgical resection is fundamental for curative treatment. Epidural analgesia mitigates the perioperative physiologic stress response caused by surgery, and reduction in perioperative stress may reduce postoperative complications. Nevertheless, epidural analgesia also causes hypotension and lower limb motor weakness that can impair postoperative recovery. Here, we aimed to assess the association between epidural analgesia and postoperative complications after colorectal cancer surgery.

Methods: We identified patients undergoing colorectal cancer surgery 2008-2018 in Denmark in the Danish Colorectal Cancer Group Database and obtained anaesthesia data from the Danish Anaesthesia Database. The Danish National Prescription Registry was used to obtain data on prescriptions filled preoperatively reflecting current comorbidities. Databases were linked using the Danish Central Person Registry number and the operation day. Patients were classified according to preoperative insertion of an epidural catheter for analgesia. Confounders were adjusted by propensity score matching. Logistic regression was used to compute effect estimates of epidural analgesia on postoperative complications.

Results: We identified 19932 individuals undergoing colorectal cancer surgery with available anaesthesia data. Propensity score matching yielded 5691 individuals in each group with balanced preoperative covariates. In the epidural analgesia group 1400 (24.6%) experienced complications compared with 1453 (25.5%) without epidural analgesia. We found no statistically significant association between epidural use and postoperative complications (OR 0.95, 95% CI 0.87-1.04).

Conclusion: In total, in this observational study based on Danish registries, we found no association between epidural analgesia and postoperative complications after colorectal cancer surgery.
Friedrichson B, Kloka JA, Neef V, Mutlak H, Old O, Zacharowski K, Piekarski F. Extracorporeal membrane oxygenation in coronavirus disease 2019: A nationwide cohort analysis of 4279 runs from Germany. Eur J Anaesthesiol. 2022 May 1;39(5):445-451.
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Abstract
Background: In the context of the coronavirus disease 2019 (COVID-19) pandemic, many retrospective single-centre or specialised centre reports have shown promising mortality rates with the use of extracorporeal membrane oxygenation (ECMO) therapy. However, the mortality rate of an entire country throughout the COVID-19 pandemic remains unknown.

Objectives: The primary objective is to determine the hospital mortality in COVID-19 patients receiving venovenous ECMO (VV-ECMO) and veno-arterial ECMO (VA-ECMO) therapy. Secondary objectives are the chronological development of mortality during the pandemic, the analysis of comorbidities, age and complications.

Design: Cohort study.

Setting: Inpatient data from January 2020 to September 2021 of all hospitals in Germany were analysed.

Participants: All COVID-19-positive patients who received ECMO therapy were analysed according to the appropriate international statistical classification of diseases and related health problem codes (ICDs) and process key codes (OPSs).

Main outcome measures: The primary outcome was the hospital mortality.

Results: In total, 4279 COVID-19-positive patients who received ECMO therapy were analysed. Among 404 patients treated with VA-ECMO and 3875 treated with VV-ECMO, the hospital mortality was high: 72% (n = 291) for VA-ECMO and 65.9% (n = 2552) for VV-ECMO. A total of 43.2% (n = 1848) of all patients were older than 60 years with a hospital mortality rate of 72.7% (n = 172) for VA-ECMO and 77.6% (n = 1301) for VV-ECMO. CPR was performed in 44.1% (n = 178) of patients with VA-ECMO and 16.4% (n = 637) of patients with VV-ECMO. The mortality rates widely varied from 48.1 to 84.4% in individual months and worsened from March 2020 (59.2%) to September 2021 (78.4%).

Conclusion: In Germany, a large proportion of elderly patients with COVID-19 were treated with ECMO, with an unacceptably high hospital mortality. Considering these data, the unconditional use of ECMO therapy in COVID-19 must be carefully considered and advanced age should be considered as a relative contraindication.

Recently added titles

A number of new anaesthesia-related titles have been recently added to the library collection, including an online version of Christine Ball's The Chloroformist, and the latest edition of Conn's Current Therapy.

The Chloroformist by Dr Christine Ball Until 1846, surgery was performed without anaesthesia: extraordinary operations, carried out on conscious, terrified patients. Surgeons of that era were bold and courageous and saved many lives, but anaesthesia changed everything. With an unconscious patient, the surgeon could take his time. Surgery became slower, more careful and more delicate. And as anaesthesia removed the pain of surgery, the medical world gave more attention to surgical infection, heralding in the use of antiseptics and eventually aseptic surgery.
Call Number: 617.960942 BAL
>> REQUEST PRINT LOAN <<
ISBN: 9780522877748
Publication Date: 3 August 2021

See the complete new titles listing

Te Hā – te reo (For the breath)/NZ News (9 June 2022)

Recent articles of interest

A number of new NZ-focussed articles have recently been published.

Ferguson MT, R Fernando J, McManus S, et al. Perioperative medicine in Australia and New Zealand: A cross-sectional survey [epub ahead of print, 2022 May 12]. Anaesth Intensive Care.
Tan E, Beck S, Haskell L, et al. Paediatric fever management practices and antipyretic use among doctors and nurses in New Zealand emergency departments [epub ahead of print, 2022 May 29]. Emerg Med Australas. 2022;10.1111/1742-6723.14022.
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Abstract
Objectives: To assess (i) paediatric fever management practices among New Zealand ED doctors and nurses, including adherence to best practice guidelines; and (ii) the acceptability of a randomised controlled trial (RCT) of antipyretics for relief of discomfort in young children.

Methods: A cross-sectional survey of doctors and nurses across 11 New Zealand EDs. The primary outcome of adherence to paediatric fever management best practice guidelines was assessed with clinical vignettes and defined as single antipyretic use for the relief of fever-related discomfort.

Results: Out of 602 participants (243 doctors, 353 nurses and six unknown; response rate 47.5%), only 64 (10.6%, 95% confidence interval [CI] 8.3-13.4%) demonstrated adherence to best practice guidelines. In a febrile settled child with normal fluid intake, the percentage of participants that would use antipyretics doubled with abnormal vital signs (33.7% vs 72.9%, difference -39.2%, 95% CI -44.4% to -34.0%). Most participants would use antipyretics for reduced fluid intake (n = 494, 82.1%, 95% CI 78.8-85.0%) in a febrile settled child. Over half (n = 339, 57.1%, 95% CI 53.0-61.1%) would advise giving antipyretics to prevent febrile convulsions. Most (n = 467, 80.0%, 95% CI 76.5-83.1%) participants agreed that a RCT of antipyretics in febrile children <2 years of age with relief of discomfort as a primary outcome is needed.

Conclusions: Just over 10% of New Zealand ED doctors and nurses demonstrated adherence to paediatric fever management best practice guidelines. A RCT of antipyretics in febrile children <2 years of age specifically addressing relief of discomfort as a primary outcome is strongly supported.
Hanning SM, Hua C, Baroutian S, et al. Quantification and composition of pharmaceutical waste in New Zealand [epub ahead of print, 2022 May 10]. J Mater Cycles Waste Manag. 2022;1-9.
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Abstract
This study aimed to quantify the amount of pharmaceutical waste produced in New Zealand, and determine the composition of pharmaceutical waste from community pharmacies in Auckland, New Zealand. Pharmaceutical waste collected in New Zealand is increasing, peaking at 542 tonne in 2019. Pharmaceutical waste collected from hospitals and pharmacies in Auckland increased by more than fourfold from 2016 to 2020. An audit of the types of pharmaceutical waste collected from community pharmacies revealed that the most common classes of drugs identified in this waste stream belonged to the nervous system, cardiovascular system and alimentary tract, and metabolism. Following examination of the contents of 12 pharmaceutical waste bins, 475 different pharmaceutical products were identified, highlighting the breadth of drugs in this waste stream. A range of dosage forms and hence materials were identified, which could present challenges for future waste treatment approaches. Hazardous drugs were identified including cytotoxic compounds, which should go into a separate waste stream for incineration. There is a need for similar data to be collected from multiple sites to fully appreciate the magnitude and composition of pharmaceutical waste. This will allow for the suitability of current practices for managing this hazardous waste stream to be evaluated.

Training E-News (26 May 2022)

Recently added titles

A number of new trainee-related titles have been recently added to the library collection.

Clinical Cases for the FRCA: Key Topics Mapped to the RCoA Curriculum by Alisha Allana
ISBN: 9781003156604
Publication Date: 2022-02-17
This book provides short, succinct clinical cases that are mapped to the RCoA curriculum and are suitable for use when teaching or as a viva revision guide. Using this guide will ensure that FRCA exam questions can be answered correctly and confidently. It is suitable primarily for candidates preparing for the Final FRCA, but also helpful for those preparing for Primary FRCA, FFICM and EDIC, as well as for those running teaching courses and simulation programmes.
Harrison's Principles of Internal Medicine, 21e by Joseph Loscalzo; Anthony S. Fauci; Dennis L. Kasper; Stephen Hauser; Dan Longo; J. Larry Jameson
Call Number: >> SELF-ASSESSMENT & BOARD REVIEW, 19E <<
ISBN: 9781264268504
Publication Date: 2022-03-28
Written and edited by the world's top experts in their respective fields, this landmark guide provides comprehensive, accurate, and essential coverage of the pathogenesis, diagnosis, and treatment of disease. Harrison's 21e includes updated content that reflects new approved therapeutics and new practice-changing guidelines and evidence summaries.
Netter Atlas of Human Anatomy: Classic Regional Approach, 8e by Frank H. Netter
ISBN: 9780323680424
Publication Date: 2022-04-08
For students and clinical professionals who are learning anatomy, participating in a dissection lab, sharing anatomy knowledge with patients, or refreshing their anatomy knowledge, the Netter Atlas of Human Anatomy illustrates the body, region by region, in clear, brilliant detail from a clinician's perspective. Unique among anatomy atlases, it contains illustrations that emphasize anatomic relationships that are most important to the clinician in training and practice.

Primary Exam Print Update

Following unprecedented demand, the library has recently purchased additional PRINT copies for the majority of primary exam texts, including additional copies of West's Respiratory Physiology: The Essentials, 11e and The physics, clinical measurement, and equipment of anaesthetic practice for the FRCA, 2e.

FPM Synapse E-News (25 May 2022)

Recent articles of interest

A new article on managing chronic pain during the COVID pandemic, co-written by Dr Steven Faux (FFPMANZCA).

Shiner CT, Gardner T, Haskelberg H, et al. The uptake and effectiveness of a multidisciplinary online program for managing chronic pain before and during the COVID-19 pandemic [epub ahead of print, 2022 Mar 21]. Pain Med. 2022;pnac049.
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Abstract
Objectives: Societal and health system pressures associated with the COVID-19 pandemic exacerbated the burden of chronic pain and limited access to pain management services for many. Online multidisciplinary pain programs offer an effective and scalable treatment option, but have not been evaluated within the context of COVID-19. This study aimed to investigate the uptake and effectiveness of the Reboot Online chronic pain program before and during the first year of the COVID-19 pandemic.

Methods: Retrospective cohort analyses were conducted on routine service users of the Reboot Online program, comparing those who commenced the program during the COVID-19 pandemic (March 2020-March 2021), to those prior to the pandemic (April 2017-March 2020). Outcomes included the number of course registrations; commencements; completion rates; and measures of pain severity, interference, self-efficacy, pain-related disability and distress.

Results: Data from 2585 course users were included (n = 1138 pre-COVID-19 and n = 1447 during-COVID-19). There was a 287% increase in monthly course registrations during COVID-19, relative to previously. Users were younger, and more likely to reside in a metropolitan area during COVID-19, but initial symptom severity was comparable. Course adherence and effectiveness were similar before and during COVID-19, with moderate effect size improvements in clinical outcomes post-treatment (g = 0.23-0.55).

Discussion: Uptake of an online chronic pain management program substantially increased during the COVID-19 pandemic. Program adherence and effectiveness were similar pre- and during-COVID. These findings support the effectiveness and scalability of online chronic pain management programs to meet increasing demand.

The latest issue ofPain Management Research Reviewis here:

Pain Management Research Review - Issue 65 (April 2022)
- Dose reductions among chronic opioid therapy recipients
- Enhanced mindfulness-based stress reduction in episodic migraine
- Effect of relevant education on long-term opioid use before spinal surgery
- Education of opioid use risk prior to elective lower-extremity surgery
- ‘Embodied’ VR intervention for low back pain
- Mindfulness-oriented recovery enhancement in patients misusing opioids for chronic pain
- Wearable TENS for knee OA pain
- ESPB for pain control after spinal surgery
- Closed-loop SCS for chronic back and leg pain: clinical and QOL outcome durability
- SCS-related adverse events reported to TGA

Recently added titles

A number of new pain-related titles have been recently added to the library collection.

Cannabis and Cannabinoid-Based Medicines in Cancer Care: A Comprehensive Guide to Medical Management by Claude Cyr; Mellar P. Davis; Danial Schecter; Paul Daeninck
ISBN: 9783030899172
Publication Date: 2022-02-12
This textbook aims to address the multiple challenges facing healthcare providers regarding the use of CBM in this vulnerable patient population. It provides insight into the latest preclinical and clinical data and offers a practical approach on the use of CBM in a rapidly evolving landscape. It answers questions regarding the prescribing process and elucidates controversies regarding cannabis' disease-modifying effects.

See the complete new titles listing

New PPR guide

A new library guidehas been designed as a means of promoting and providing curated access to relevant resources related to research in the professional practice domains.

SOT E-News (23 May 2022)

Recent articles of interest

A number of medical education-related articles have recently been added to the Medical Education guide.

Raygani S, Mangosing D, Clark KD, Luong S, Flentje A, Sarah G. Integrating LGBTQ+ health into medical education. Clin Teach. 2022;19(2):166-171.
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Abstract
Background: LGBTQ+ people experience significant barriers in accessing health care including inadequate provider knowledge and stigma in health care settings. Undergraduate medical education programs have increased efforts to integrate LGBTQ+ health topics, such as comprehensive sexual history taking and gender-affirming practices, into their curriculums to provide clinically inclusive care for LGBTQ+ patients.

Approach: A Topic Steward was appointed to oversee the integration of LGBTQ+ health topics throughout the existing undergraduate medical curriculum. The aim was to expand the LGBTQ+ health curriculum for undergraduate medical students through teaching comprehensive sexual history taking; offering specialty-specific LGBTQ+ health education through clerkships; describing the difference between sex assigned at birth, gender identity, and gender expression; describing the difference between sexual orientation and sexual behaviour; identifying health care disparities that LGBTQ+ people experience; and developing an inclusive approach to providing medical care for LGBTQ+ patients.

Evaluation: The program started in July 2017 with UCSFSOM students in their first, second, or third years (~150 medical students per year) participating in the integrated curriculum that included didactic lectures, small group discussions, and LGBTQ+ clerkship opportunities. The hours of LGBTQ+ health curriculum at the UCSFSOM increased from 4.5 hours to 15-20 hours in approximately 2 years under the Topic Steward approach.

Implications: The next step is to develop standardised tools for assessing LGBTQ+ health competencies for medical students. This involves integrating more questions regarding LGBTQ+ health topics in traditional exams at UCSFSOM and developing specialty-specific assessment instruments that other medical schools could administer to test core competencies in LGBTQ+ health.
Weissenbacher A, Bolz R, Stehr SN, Hempel G. Development and consensus of entrustable professional activities for final-year medical students in anaesthesiology. BMC Anesthesiol. 2022;22(1):128. Published 2022 Apr 29.
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Abstract
Background: The transfer of classic concepts of competency-based medical education into clinical practice has been proven to be difficult in the past, being described as partially fragmented, misleading and inadequate. At the beginning of training, novice doctors commonly feel overwhelmed, overloaded and exposed to extreme time pressure. The discrepancy between expected and actual clinical competence of doctors at the start of their speciality training jeopardizes patient safety. The framework of Entrustable Professional Activities (EPAs) is a promising instrument to effectively integrate competency-based training into clinical practice and may help to close this gap and consequently to improve patient safety.

Methods: For anaesthesiology, we developed 5 EPAs for final-year medical students. The EPAs comprised the following seven categories: 1. Title, 2. Specifications, 3. Limitations, 4. Competency domains, 5. Knowledge, abilities and skills, professional attitudes, 6. Assessment and 7. Entrustment. Based on a modified, online-based Delphi study, we further developed and refined these EPAs. Education experts were recruited from the alumni network of the Master of Medical Education (MME) degree course from the University of Heidelberg, Germany.

Results: 28 data sets were evaluated in three Delphi rounds. 82% of study participants had previous experience with EPAs. Qualitative and quantitative data formed the basis during the iterative process and resulted in complete descriptions of 5 EPAs for final-year medical students in anaesthesiology.

Conclusions: Our study including the associated description of 5 EPAs represent a further step and starting point for EPA-based curricula in medical training in Germany linking undergraduate training, to residency training and continuous medical education.

Recently added titles

A number of new medical education-related titles have recently been added to the library collection.

Challenges and Opportunities in Health Professions Education: Perspectives in the Context of Cultural Diversity by Mora Claramita; Ardi Findyartini; Dujeepa D. Samarasekera; Hiroshi Nishigori [eds]
ISBN: 9789811672316
Publication Date: 2022-02-23
This book addresses health professions educational challenges specific to non-Western cultures, implementing a shifting paradigm for educating future health professionals towards patient-cantered care.
Successful Doctoral Training in Nursing and Health Sciences: A Guide for Supervisors, Students and Advisors by Debra Jackson; Patricia M. Davidson; Kim Usher
ISBN: 9783030879457
Publication Date: 2021-12-11
This textbook is a practical, user-friendly and essential guide for doctoral students, their supervisors and advisors and administrators of doctoral programs in nursing and health sciences.

New SOT induction modules and support hub

A single point of contact (one-stop-shop) support hub has been created to house all resources relevant to the SOT role, which also includes links to the new SOT induction modules.

ANZCA E-News (17 May 2022)

Recent articles of interest

Two new anaesthesia-related articles on the use of blocks and prone positioning of patients with COVID.

Qian ET, Gatto CL, Amusina O, et al. Assessment of Awake Prone Positioning in Hospitalized Adults With COVID-19: A Nonrandomized Controlled Trial [epub ahead of print, 2022 Apr 18]. JAMA Intern Med. 2022;10.1001/jamainternmed.2022.1070.
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Abstract
Importance: Awake prone positioning may improve hypoxemia among patients with COVID-19, but whether it is associated with improved clinical outcomes remains unknown.

Objective: To determine whether the recommendation of awake prone positioning is associated with improved outcomes among patients with COVID-19-related hypoxemia who have not received mechanical ventilation.

Design, setting, and participants: This pragmatic nonrandomized controlled trial was conducted at 2 academic medical centers (Vanderbilt University Medical Center and NorthShore University HealthSystem) during the COVID-19 pandemic. A total of 501 adult patients with COVID-19-associated hypoxemia who had not received mechanical ventilation were enrolled from May 13 to December 11, 2020.

Interventions: Patients were assigned 1:1 to receive either the practitioner-recommended awake prone positioning intervention (intervention group) or usual care (usual care group).

Main outcomes and measures: Primary outcome analyses were performed using a bayesian proportional odds model with covariate adjustment for clinical severity ranking based on the World Health Organization ordinal outcome scale, which was modified to highlight the worst level of hypoxemia on study day 5.

Results: A total of 501 patients (mean [SD] age, 61.0 [15.3] years; 284 [56.7%] were male; and most [417 (83.2%)] were self-reported non-Hispanic or non-Latinx) were included. Baseline severity was comparable between the intervention vs usual care groups, with 170 patients (65.9%) vs 162 patients (66.7%) receiving oxygen via standard low-flow nasal cannula, 71 patients (27.5%) vs 62 patients (25.5%) receiving oxygen via high-flow nasal cannula, and 16 patients (6.2%) vs 19 patients (7.8%) receiving noninvasive positive-pressure ventilation. Nursing observations estimated that patients in the intervention group spent a median of 4.2 hours (IQR, 1.8-6.7 hours) in the prone position per day compared with 0 hours (IQR, 0-0.7 hours) per day in the usual care group. On study day 5, the bayesian posterior probability of the intervention group having worse outcomes than the usual care group on the modified World Health Organization ordinal outcome scale was 0.998 (posterior median adjusted odds ratio [aOR], 1.63; 95% credibility interval [CrI], 1.16-2.31). However, on study days 14 and 28, the posterior probabilities of harm were 0.874 (aOR, 1.29; 95% CrI, 0.84-1.99) and 0.673 (aOR, 1.12; 95% CrI, 0.67-1.86), respectively. Exploratory outcomes (progression to mechanical ventilation, length of stay, and 28-day mortality) did not differ between groups.

Conclusions and relevance: In this nonrandomized controlled trial, prone positioning offered no observed clinical benefit among patients with COVID-19-associated hypoxemia who had not received mechanical ventilation. Moreover, there was substantial evidence of worsened clinical outcomes at study day 5 among patients recommended to receive the awake prone positioning intervention, suggesting potential harm.
Gong WY, Zhang JY, Wang AZ, Fan K. The combination of paravertebral block and cervical vagus nerve block applied alone for anaesthesia of open appendectomy during COVID-19 [epub ahead of print, 2022 Apr 25]. Anaesth Crit Care Pain Med. 2022;101091.
Blayney MC, Stewart NI, Kaye CT, et al. Prevalence, characteristics, and longer-term outcomes of patients with persistent critical illness attributable to COVID-19 in Scotland: a national cohort study [epub ahead of print, 2022 Mar 24]. Br J Anaesth. 2022 Keywords: COVID-19; intensive care; long-term ventilation; mortality; outcome; readmission.
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Abstract
Background: Patients with COVID-19 can require critical care for prolonged periods. Patients with persistent critical Illness can have complex recovery trajectories, but this has not been studied for patients with COVID-19. We examined the prevalence, risk factors, and long-term outcomes of critically ill patients with COVID-19 and persistent critical illness.

Methods: This was a national cohort study of all adults admitted to Scottish critical care units with COVID-19 from March 1, 2020 to September 4, 20. Persistent critical illness was defined as a critical care length of stay (LOS) of ≥10 days. Outcomes included 1-yr mortality and hospital readmission after critical care discharge. Fine and Gray competing risk analysis was used to identify factors associated with persistent critical Illness with death as a competing risk.

Results: A total of 2236 patients with COVID-19 were admitted to critical care; 1045 patients were identified as developing persistent critical Illness, comprising 46.7% of the cohort but using 80.6% of bed-days. Patients with persistent critical illness used more organ support, had longer post-critical care LOS, and longer total hospital LOS. Persistent critical illness was not significantly associated with long-term mortality or hospital readmission. Risk factors associated with increased hazard of persistent critical illness included age, illness severity, organ support on admission, and fewer comorbidities.

Conclusions: Almost half of all patients with COVID-19 admitted to critical care developed persistent critical illness, with high resource use in critical care and beyond. However, persistent critical illness was not associated with significantly worse long-term outcomes compared with patients who were critically ill for shorter periods.

The latest issue ofAnaesthesia Research Reviewis here:

Anaesthesia Research Review - Issue 23 (2022)

E-journals update

The primary access point for the majority of the journals listed on our ANZCA Journals page have now been moved to our BrowZine service. This will allow ANZCA members to experience a more uniform user experience, with access to whole range of new features, including the requesting of articles not available online. A new Emergency Medicine section has also been added. See the ANZCA Journals page for more information.

Recently added titles

A number of new anaesthesia-related titles have been recently added to the library collection.

Autobiography of a Persistent Anesthesiologist by Edmond I. "Ted" Eger
ISBN: 9781975169190
Publication Date: 2021-10-09
Written both for family and friends as well as anaesthesiologists and anesthesia researchers, Autobiography of a Persistent Anesthesiologist is the fascinating story of the life and accomplishments of Dr. Edmond I. "Ted" Eger II in his own words. Both conversational and educational, this unique volume covers the family history, training, and storied career of a remarkable man and esteemed anaesthesiologist and researcher.
Depression, Burnout and Suicide in Physicians: Insights from Oncology and Other Medical Professions by Luigi Grassi; Daniel McFarland; Michelle B. Riba [eds]
ISBN: 9783030847845
Publication Date: 2021-12-01
This book provides a reference and contextual basis for depression, burnout and suicide among oncology and other medical professionals.
Capnography, 2e by J. S. Gravenstein; Michael B. Jaffe; Nikolaus Gravenstein; David A. Paulus [eds]
ISBN: 9780521514781
Publication Date: 2011-03-17
This new edition of the definitive text on capnography reviews every aspect of this valuable diagnostic technique. An introductory section summarises the basic physiology of carbon dioxide generation and transport in the body. A technical section describes how the instruments work, and a comprehensive clinical section reviews the use of capnography to diagnose a wide range of clinical disorders.
How to Practice Academic Medicine and Publish from Developing Countries?: A Practical Guide by Samiran Nundy; Atul Kakar; Zulfiqar A Bhutta
ISBN: 9789811652479
Publication Date: 2021-10-24
The book provides an overview of the state of research in developing countries - Africa, Latin America, and Asia (especially India) and why research and publications are important in these regions. It addresses budding but struggling academics in low and middle-income countries. It is written mainly by senior colleagues who have experienced and recognized the challenges with design, documentation, and publication of health research in the developing world.

See the complete new titles listing

ANZCA E-News (20 April 2022)

Recent articles of interest

A new anaesthesia-related article on the carbon footprint for TKRs, and another spotlighting female leaders in anaesthesiology.

McGain F, Sheridan N, Wickramarachchi K, Yates S, Chan B, McAlister S. Carbon Footprint of General, Regional, and Combined Anesthesia for Total Knee Replacements. Anesthesiology. 2021;135(6):976-991.
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Abstract
Background: Health care itself contributes to climate change. Anesthesia is a "carbon hotspot," yet few data exist to compare anesthetic choices. The authors examined the carbon dioxide equivalent emissions associated with general anesthesia, spinal anesthesia, and combined (general and spinal anesthesia) during a total knee replacement.

Methods: A prospective life cycle assessment of 10 patients in each of three groups undergoing knee replacements was conducted in Melbourne, Australia. The authors collected input data for anesthetic items, gases, and drugs, and electricity for patient warming and anesthetic machine. Sevoflurane or propofol was used for general anesthesia. Life cycle assessment software was used to convert inputs to their carbon footprint (in kilogram carbon dioxide equivalent emissions), with modeled international comparisons.

Results: Twenty-nine patients were studied. The carbon dioxide equivalent emissions for general anesthesia were an average 14.9 (95% CI, 9.7 to 22.5) kg carbon dioxide equivalent emissions; spinal anesthesia, 16.9 (95% CI, 13.2 to 20.5) kg carbon dioxide equivalent; and for combined anesthesia, 18.5 (95% CI, 12.5 to 27.3) kg carbon dioxide equivalent. Major sources of carbon dioxide equivalent emissions across all approaches were as follows: electricity for the patient air warmer (average at least 2.5 kg carbon dioxide equivalent [20% total]), single-use items, 3.6 (general anesthesia), 3.4 (spinal), and 4.3 (combined) kg carbon dioxide equivalent emissions, respectively (approximately 25% total). For the general anesthesia and combined groups, sevoflurane contributed an average 4.7 kg carbon dioxide equivalent (35% total) and 3.1 kg carbon dioxide equivalent (19%), respectively. For spinal and combined, washing and sterilizing reusable items contributed 4.5 kg carbon dioxide equivalent (29% total) and 4.1 kg carbon dioxide equivalent (24%) emissions, respectively. Oxygen use was important to the spinal anesthetic carbon footprint (2.8 kg carbon dioxide equivalent, 18%). Modeling showed that intercountry carbon dioxide equivalent emission variability was less than intragroup variability (minimum/maximum).

Conclusions: All anesthetic approaches had similar carbon footprints (desflurane and nitrous oxide were not used for general anesthesia). Rather than spinal being a default low carbon approach, several choices determine the final carbon footprint: using low-flow anesthesia/total intravenous anesthesia, reducing single-use plastics, reducing oxygen flows, and collaborating with engineers to augment energy efficiency/renewable electricity.
Nalley C. A Spotlight on Female Leaders in Anesthesiology. ASA Monitor 2022; 86:1–8
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As the field of anesthesiology evolves and grows, so does the important role women play in its ongoing success and development. The ASA Monitor had the privilege of speaking with three women whose leadership and expertise have had – and continue to have – a positive impact on anaesthesiology and medicine as a whole.

Recently added titles

A number of new anaesthesia-related titles have been recently added to the library collection.

Understanding Clinical Negotiation by Richard L. Kravitz; Richard L. Street Jr Patient relations, satisfaction, and engagement are more important than ever. Understanding Clinical Negotiation helps clinicians navigate patient desires toward mutually defined goals. The first guide of its kind, this important resource will equip clinicians with the insights and pragmatic skills needed to strike the right balance between care and costs, while ensuring the satisfaction and safety of every patient.
ISBN: 9781260462494
Publication Date: 2021-07-08
Anesthesia in Low-Resourced Settings: Near Misses and Lessons Learned by John G. Brock-Utne This book outlines the many anesthesia-related obstacles, concerns, and challenges that may be encountered by western trained anaesthesiologists in low-resourced settings. Each chapter presents a challenging scenario with solutions. It is therefore an essential handbook that will prepare those performing anesthesia in this milieu.
ISBN: 9783030776534
Publication Date: 2021-10-31
Quick Hits in Obstetric Anesthesia by Roshan Fernando; Pervez Sultan; Sioned Phillips [eds] This book provides easy to follow guidance on how to manage emergency situations and common problems in obstetric anesthesia. The book provides different anaesthetic recipes for obstetric procedures and describes challenges that will be encountered on a day-to-day basis. There are trouble-shooting chapters and 'what to o lists' for frequent dilemmas.
ISBN: 9783030724863
Publication Date: 2022-02-08
Cardiac Anesthesia and Postoperative Care in the 21st Century by Marc Vives; Alberto Hernandez This book provides a practical approach to cardiac perioperative care. The step-by-step format guides readers from basic concepts, such as cardiac physiology and pharmacology, to anaesthetic management of specific cardiac surgical procedures, including cardiac percutaneous interventions, management of specific cardiac disease, circulatory support, and organ protection strategies. Written by experienced cardiac anaesthesiologists in Europe, USA, Canada and Australia, this book provides an international perspective on the topic with each chapter referring the reader to the relevant key reading.
ISBN: 9783030797201
Publication Date: 2022-02-15
Oxford Handbook of Clinical Medicine, 10e by Ian B. Wilkinson; Tim Raine; Kate Wiles; Anna Goodhart; Catriona Hall; Harriet O'Neill Unique among medical texts, the Oxford Handbook of Clinical Medicine, 10e is a complete and concise guide to the core areas of medicine that also encourages thinking about the world from the patient's perspective, offering a holistic, patient-centred approach. Loved and trusted by millions for over three decades, the Oxford Handbook of Clinical Medicine continues to be a truly indispensable companion for the practice of modern medicine.
ISBN: 9780198833123
Publication Date: 2019-02-12

See the complete new titles listing

Te Hā – te reo (For the breath)/NZ News (14 April 2022)

NZ Anaesthesia & Pain Management Research Review

A new issue of NZAPMRR has just been released.

New Zealand Anaesthesia and Pain Management Research Review - Issue 27 (2022)
- Dexamethasone as an analgesic adjuvant after total knee arthroplasty
- Delirium with regional vs. general anaesthesia for hip fracture surgery in the elderly
- Balanced multi-electrolyte solution vs. saline for critically ill adults
- Opioid-free general anaesthesia for improving postoperative outcomes
- Anterior suprascapular nerve block vs. interscalene brachial plexus block for arthroscopic shoulder surgery
- QOL after nonoperative vs. operative management of proximal femoral fractures in frail patients
- Effects of booster sessions on self-management interventions in chronic musculoskeletal pain
- Primary-care CBT for long-term opioid users with chronic pain
- Persistent pain after hysterectomy, caesarean section, prostatectomy or donor nephrectomy
- Mediators of relationships between pain intensity and 3-month QOL in adolescents with chronic pain
- Relationships between pain and psychological distress during the pandemic

Recent articles of interest

A number of NZ-related articles have recently appeared.

Taylor E, Webster CS. Quality improvement in New Zealand Pediatric Anesthesia; national quality direction, patient experience, equity, and collaboration [epub ahead of print, 2022 Mar 31]. Paediatr Anaesth. 2022;10.1111/pan.14449.
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Abstract
The current priorities of the quality and safety of patient care in New Zealand at a central government level are described, with a focus on equity and patient experience. Priorities between stakeholders differ. We report the current quality activities of New Zealand pediatric anesthetists in relation to these governance aims, seeking gaps and suggesting future directions to align governance priorities and local activities. International relevance is also outlined. New Zealand Māori experience health inequity. Complex systemic factors including those of systemic racism and prejudice contribute to the inequity. The specific contributions to health inequity from pediatric anesthetists are unknown but could include aspects of cultural safety, delays in treatment and treatment deficits. Patient experience is correlated positively with other quality domains. Peri-operative patient experience tools require outcomes of interest that matter to patients, including relevant cultural safety domains. Risk identification and critical event review contribute to local learnings in departments and institutions, and more widely to national and bi-national (with Australia) learnings. Several collaborative projects in Australia and New Zealand, whilst not primarily quality improvement projects, may improve pediatric anesthesia. These collaborations include a pediatric anesthesia professional network, a curriculum for a pediatric anesthetic fellowship, contributions to a document on standards for paediatric anesthesia, and a national quality group researching key performance indicators across New Zealand.
Curtis E, Paine SJ, Jiang Y, et al. Examining emergency department inequities in Aotearoa New Zealand: Findings from a national retrospective observational study examining Indigenous emergency care outcomes. Emerg Med Australas. 2022;34(1):16-23.
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bstract
Objective: There is increasing evidence that EDs may not operate equitably for all patients, with Indigenous and minoritised ethnicity patients experiencing longer wait times for assessment, differential pain management and less evaluation and treatment of acute conditions.

Methods: This retrospective observational study used a Kaupapa Māori framework to investigate ED admissions into 18/20 District Health Boards in Aotearoa New Zealand (2006-2012). Key pre-admission variable was ethnicity (Māori:non-Māori), and outcome variables included: ED self-discharge; ED arrival to assessment time; hospital re-admission within 72 h; ED re-presentation within 72 h; ED length of stay; ward length of stay; access block and mortality (in ED or within 10 days of ED departure). Generalised linear regression models controlled for year of presentation, sex, age, deprivation, triage category and comorbidity.

Results: Despite some ED process measures favouring Māori, for example arrival to assessment time (mean difference -2.14 min; 95% confidence interval [CI] -2.42 to -1.86) and access block (odds ratio [OR] 0.89, 95% CI 0.87-0.91), others showed no difference, for example self-discharge (OR 0.98, 95% CI 0.97-1.00). Despite this, Māori mortality (OR 1.60, 95% CI 1.50-1.71) and ED re-presentation (OR 1.11, 95% CI 1.09-1.12) were higher than non-Māori.

Conclusion: To our knowledge, this is the most comprehensive investigation of acute outcomes by ethnicity to date in New Zealand. We found ED mortality inequities that are unlikely to be explained by ED process measures or comorbidities. Our findings reinforce the need to investigate health professional bias and institutional racism within an acute care context.

Recently added titles

Newly added to the collection is Indigenous Data Sovereignty and Policy, with a chapter on "Indigenous data and policy in Aotearoa New Zealand".

Indigenous Data Sovereignty and Policy by Maggie Walter; Tahu Kukutai; Stephanie Russo Carroll; Desi Rodriguez-Lonebear [eds] This book examines how Indigenous Peoples around the world are demanding greater data sovereignty, and challenging the ways in which governments have historically used Indigenous data to develop policies and programs. In the digital age, governments are increasingly dependent on data and data analytics to inform their policies and decision-making.
ISBN: 9780429273957
Publication Date: 2020-10-29

FPM Training E-News (13 April 2022)

Recent articles of interest

A number of pain-related education articles have recently appeared.

Chin A, Foster DJ, Pelecanos AM, Eley VA. A retrospective observational study of patient analgesia outcomes when regional anaesthesia procedures are performed by consultants versus supervised trainees [epub ahead of print, 2022 Mar 18]. Anaesth Intensive
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At teaching hospitals, consultants must provide effective supervision, including appropriate selection of teaching cases, such that the outcomes achieved by trainees are similar to that of consultants. Numerous studies in the surgical literature have compared patient outcomes when surgery is performed by consultant surgeons or surgical trainees but, to our knowledge, none exist in the field of anaesthesia. We aimed to compare analgesia outcomes of regional anaesthesia when performed by supervised trainees versus consultants. We designed a retrospective observational study using registry data. The primary outcome was inadequate analgesia, defined as a numerical rating scale (NRS) for pain >5 reported at any time in the post-anaesthesia care unit (PACU). Secondary outcomes included the maximum pain NRS, pain experienced in the PACU, and the requirement for systemic opioid analgesia in the PACU. Of the 1814 patients analysed, the primary proceduralist was a consultant for 514 (28.3%) patients and a trainee for 1300 (71.7%) patients. All trainees were supervised by an on-site consultant. There were no statistically significant differences between consultants and supervised trainees in terms of the primary outcome (NRS >5 in 24.9% and 24.5% of patients, respectively; P = 0.84) and secondary outcomes. Compared to trainees, consultants had a slightly higher rate of patients with a body mass index >30 kg/m2, an American Society of Anesthesiologists Physical Status Classification of 3 or 4, nerve blocks performed under general anaesthesia, paravertebral/neuraxial blocks and blocks with perineural catheter placement. Regional anaesthesia performed by supervised trainees can achieve similar analgesia outcomes to consultant-performed procedures.

Recently added titles

A new exam preparation e-book looking at regional anesthesia and chronic pain.

Anesthesiology in-Training Exam Review: Regional Anesthesia and Chronic Pain by Ratan K. Banik [ed] Focused on rotations in regional anesthesia and chronic pain, this book provides a structured review of the concepts covered in the American Board of Anesthesiology in-training exam. The first section of the book covers regional anesthesia with dedicated chapters on basic science, acute postoperative pain, and nerve blocks for neuraxial, lower and upper extremity blocks, and head and neck. The second section on chronic pain includes chapters on basic science and common pain conditions - including craniofacial pain, CRPS, neuropathic pain, and cancer pain. This section closes on multimodal analgesia and other treatment approaches.
ISBN: 9783030872656
Publication Date: 2022-02-12
Headache and Facial Pain (Pain Medicine: A Case-Based Learning Series) by Steven D. Waldman Covers everyday clinical problems such as migraine and other headaches, occipital neuralgia, temporal arteritis, trigeminal neuralgia, temporomandibular joint dysfunction, and more. The "perfect" text if you need to provide your learners with real-life clinical scenarios that are ideal for Case-Based Learning and Discussion.
ISBN: 9780323834568
Publication Date: 2022-03-15

Exam preparation resources

Training and exams hub:

TheTraining and Exams hub has been designed for trainees and educators participating in the ANZCA, FPM and DHM training programs to identify suitable training and exam resources. The Pain medicine training & exams section contains guides for: Pain medicine training, Conceptual basis of pain medicine, FPM Procedures Endorsement Program curriculum and the Procedures in pain medicine. In addition, the Self-Assessment tools and Roles in Practice guides provide additional resource support for training and examination purposes.

Changes to ANZCA journal access - enhancing your ANZCA journal experience! (7 April 2022)

UPDATED: The primary access point for the majority of ANZCA journals has now been moved to our BrowZine service. This will allow ANZCA members to experience a more uniform user experience, with access to whole range of new features.

Added features include:

Single point of access
Complete table of contents for each issue
Choose between direct or PDF article access (where available)
Create a personal profile and save your favourite articles from *any journal* using the My Articles feature
Track your favourite journals using the My Bookshelf feature
Easily request articles not available online
Retraction status indicator
Users will also be able to seamlessly move between the website version and the app version of BrowZine, where you can take advantage of the in-built authentication feature.
Coming soon: new issue email alerts!

In addition, a new Emergency Medicine journal section has been added to showcase the large number of journals for that area.

Note: For those users who prefer to continue to access journals direct via the platform, an alternate access vendor link is also provided.

As always, we welcome any feedback you may have to give.

Training E-News (31 Mar 2022)

New Communicator Role library guide

We’ve created a new library guide to support "communicator role" activities. These resources are available to help you establish rapport, trust, and ethical therapeutic relationships with your patients and their families.

The guide includes informative, accessible and diverse training resources such as journal articles, books, videos, websites, and framework (LAURS and NURSE) details.

Access the Communicator role library guide

Recent articles of interest

A recent article on development of an airway simulation on the out-of-operating-room management of COVID-19 patients for anaesthesiology residents.

Hong BE, Myo BCC, Huang YM, Grogan T, DF, Cannesson M. Implementing COVID-19 simulation training for anesthesiology residents. MedEdPORTAL. 18:11215.
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Abstract
Introduction: During the COVID-19 pandemic, anesthesiology residents faced increased risk of exposure to SARS-CoV-2 while performing aerosolizing procedures. We developed an airway simulation on the out-of-operating-room management of COVID-19 patients. Methods: A 90-minute simulation focused on caring for a 45-year-old COVID-19 patient provided training in donning and doffing personal protective equipment, intubation, management of postinduction hypotension, management of ICU ventilators, treatment strategies for acute respiratory distress syndrome (ARDS), interpersonal communication, and resource management. Presimulation, postsimulation, and 3-months postsimulation questionnaires measured changes in confidence, knowledge, and clinical practice. Statistical analysis was completed using related-samples Wilcoxon signed rank tests. Results: Twenty-four residents participated in the simulation. Questionnaire response rates were 100% presimulation and postsimulation and 88% 3-months postsimulation. Confidence scores (1 = not at all, 5 = extremely) improved with donning and doffing personal protective equipment (from 3.0 to 4.1, p < .001), ARDS management (from 3.1 to 4.0, p < .001), and COVID-19 airway management (from 2.8 to 4.0, p < .001). Correct answers on 10 knowledge questions increased significantly between presimulation and postsimulation (from 5.1 to 9.0, p < .001) but not between presimulation and 3-months postsimulation (from 5.1 to 5.8, p = .27). All participants who cared for COVID-19 patients at 3 months agreed or strongly agreed that their current management of COVID-19 patients was directly influenced by the simulation session (M = 4.4). Discussion: This simulation is a safe, effective method of providing the experiential training necessary to care for actual COVID-19 patients during an active pandemic.
Nasr VG, Zabala L, Twite M. Expertise in Pediatric Cardiac Anesthesia Begins With Well-Designed Training Programs. J Cardiothorac Vasc Anesth. 2022;36(3):654-656. Editorial

Recently added titles

The latest edition of Anesthesia: A Comprehensive Review is now available.

Anesthesia: A Comprehensive Review, 6e by Mayo Foundation for Medical Education; Brian A. Hall; Robert C. Chantigian
Call Number: 617.96076 ANE
>> REQUEST 5TH ED PRINT LOAN <<
ISBN: 9780323567190
Publication Date: 2019-09-23
Offering complete, up-to-date coverage of everything from basic science through current clinical practice, Hall Anesthesia: A Comprehensive Review, 6e, provides 1,000 review questions that help you improve your mastery of anaesthesiology. You'll reinforce your current knowledge, identify areas that require more study, and improve your long-term retention of the material - all while preparing for certification and re-certification examinations as well as clinical practice.
Anesthesiology in-Training Exam Review: Regional Anesthesia and Chronic Pain by Ratan K. Banik [ed]
ISBN: 9783030872656
Publication Date: 2022-02-12
Focused on rotations in regional anesthesia and chronic pain, this book provides a structured review of the concepts covered in the American Board of Anesthesiology in-training exam. The first section of the book covers regional anesthesia with dedicated chapters on basic science, acute postoperative pain, and nerve blocks for neuraxial, lower and upper extremity blocks, and head and neck. The second section on chronic pain includes chapters on basic science and common pain conditions - including craniofacial pain, CRPS, neuropathic pain, and cancer pain. This section closes on multimodal analgesia and other treatment approaches.
Improving Anesthesia Technical Staff's Skills by Nabil A. Shallik; Ahmed Ismail; Othman Al Hariri [eds]
ISBN: 9783030888480
Publication Date: 2022-02-15
This book showcases state-of-the-art techniques as well as various clinical, technical and non-technical skills. By highlighting the reliability of the new techniques compared to standard clinical methods of predicting peri-operative problems in the operating rooms, it enables better management and utilization of operating rooms. The combined use of knowledge and technology has resulted in improvements in healthcare services that are not achieved by the use of the best technology but by the best use of technology.

See the complete new titles listing

SOT E-News (28 March 2022)

Recently added titles:

A new title aimed at emerging SOTs, with Australian and UK contributions.

Practising Clinical Supervision, 2e by John Driscoll [ed]
ISBN: 9780702027796
Publication Date: 2006-12-06
Practical Clinical Supervision, 2e builds on the success of the original, which was praised for engaging readers and being a pragmatic and practice-orientated addition to the literature on clinical supervision. This edition is written in accessible style and will appeal to those both new to clinical supervision or experienced. It provides a thought-provoking, user friendly and practical guide to the subject. With contributors from the UK and Australia.

See the complete new titles listing

Recent articles of interest:

A number of education articles have

Murray A, Reece-Nguyen T, Caruso TJ. Integrated diversity, equity, and inclusion curriculum into pediatric anesthesia fellowship training: Another step forward. Paediatr Anaesth. 2022;32(3):487-488.
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Keywords: curriculum; diversity; education; equity; fellowship; inclusion.
Hamilton ARL, Dylewski Begis M, Vo V, Fuzaylov G. The role of global health opportunities for professional development during anaesthesiology training: A primary survey study [epub ahead of print, 2022 Jan 27]. Anaesth Intensive Care. 2022;310057X21105175
Pivetta B, Gai N. The use of social media among Canadian anesthesiology training programs: a historical cohort study [epub ahead of print, 2022 Feb 19]. Can J Anaesth. 2022;10.1007/s12630-022-02215-2.
Harbell MW, O'Sullivan PS. Reviving the medical lecture: practical tips for delivering effective lectures [epub ahead of print, 2022 Feb 11]. Reg Anesth Pain Med. 2022;rapm-2021-103401. [REQ ARTICLE VIA LIBRARY]
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Abstract
Large group lectures, which are widely used in continuing medical education, are susceptible to pitfalls that can negatively impact their effectiveness. In this article, we describe evidence-based best practices from the educational literature that can revive the medical lecture as an effective educational tool. We provide practical tips for both developing and delivering lectures, emphasizing the key role that learning objectives can and should have in the development of lectures, the importance of organization, effective use of visuals and application of restraint in slide design. Pause techniques to authentically engage the audience are described. We also provide practical tips for promoting attention in virtual presentations.
Nofi C, Roberts B, Demyan L, et al. A Survey of the Impact of the COVID-19 Crisis on Skill Decay Among Surgery and Anesthesia Residents. J Surg Educ. 2022;79(2):330-341.
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Abstract
Objective: The SARS-CoV-2 (COVID-19) pandemic has profoundly impacted healthcare delivery and strained medical training. This study explores resident and faculty perceptions regarding the impact of the COVID-19 crisis on technical skill decay of surgical and anesthesia residents. We hypothesized that many residents perceived that their technical abilities diminished due to a short period of interruption in their training.

Design: An IRB-exempt, web-based cross-sectional survey distributed to residents and faculty SETTING: Two large academic tertiary medical centers, North Shore University Hospital and Long Island Jewish Medical Center, of the Northwell Health System in New York.

Participants: General surgery, anesthesiology, plastic surgery, cardiothoracic surgery, orthopedic surgery, oral maxillofacial surgery, urology, podiatry residents and faculty.

Results: All residents reported a significant impact on their training. Residents (82%) and faculty (94%) reported a significant reduction in case volumes due to the COVID-19 pandemic (p < 0.05). 64% of residents reported a reduction in technical skills, and 75% of faculty perceived a decrease in resident technical skills. Residents were concerned about fulfilling ACGME case requirements, however faculty were more optimistic that residents would achieve level-appropriate proficiency by the conclusion of their training. Both residents and faculty felt that resident critical care skills improved as a result of redeployment to COVID-19 intensive care units (66% and 94%). Additionally, residents reported increased confidence in their ability to care for critically ill patients and positive impact on professional competencies.

Conclusions: Effects of the COVID-19 pandemic on residency training are multi-dimensional. The majority of surgical and anesthesia residents perceived that their technical ability diminished as a result of skill decay, whereas other skillsets improved. Longitudinal surveillance of trainees is warranted to evaluate the effect of reduced operative volume and redeployment on professional competency.
El Tahan MR, Wilkinson K, Huber J, et al. Challenges in the Cardiothoracic and Vascular Anesthesia Fellowship Program Since the Coronavirus Disease 2019 (COVID-19) Pandemic: An Electronic Survey on Potential Solutions. J Cardiothorac Vasc Anesth. 2022;36(
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Abstract
Background: The awake prone positioning strategy for patients with acute respiratory distress syndrome is a safe, simple and cost-effective technique used to improve hypoxaemia. We aimed to evaluate intubation and mortality risk in patients with coronavirus disease 2019 (COVID-19) who underwent awake prone positioning during hospitalisation.

Methods: In this retrospective, multicentre observational study conducted between 1 May 2020 and 12 June 2020 in 27 hospitals in Mexico and Ecuador, nonintubated patients with COVID-19 managed with awake prone or awake supine positioning were included to evaluate intubation and mortality risk through logistic regression models; multivariable and centre adjustment, propensity score analyses, and E-values were calculated to limit confounding.

Results: 827 nonintubated patients with COVID-19 in the awake prone (n=505) and awake supine (n=322) groups were included for analysis. Fewer patients in the awake prone group required endotracheal intubation (23.6% versus 40.4%) or died (19.8% versus 37.3%). Awake prone positioning was a protective factor for intubation even after multivariable adjustment (OR 0.35, 95% CI 0.24-0.52; p<0.0001, E=2.12), which prevailed after propensity score analysis (OR 0.41, 95% CI 0.27-0.62; p<0.0001, E=1.86) and mortality (adjusted OR 0.38, 95% CI 0.26-0.55; p<0.0001, E=2.03). The main variables associated with intubation among awake prone patients were increasing age, lower baseline peripheral arterial oxygen saturation/inspiratory oxygen fraction ratio (P aO2 /F IO2 ) and management with a nonrebreather mask.

Conclusions: Awake prone positioning in hospitalised nonintubated patients with COVID-19 is associated with a lower risk of intubation and mortality.

Trial registration: ClinicalTrials.gov NCT04407468.

FPM Synapse E-News (24 March 2022)

Recently added titles:

A number of new pain medicine titles have been recently added to the library collection.

Interventional Management of Chronic Visceral Pain Syndromes by Daniel J. Pak; Krishna Shah; Jason Yong [eds]
ISBN: 9780323757751
Publication Date: 2020-10-25
Interventional Management of Chronic Visceral Pain Syndromes is a practical, evidence-based guide for the mechanisms, presentation, diagnosis, and treatments of chronic non-malignant and malignant abdominal pain syndromes. Experienced clinicians and academic leaders in pain medicine comprehensively discuss best-practice guidelines using the newest interventional techniques, including dorsal root ganglion stimulation, high frequency spinal cord stimulation, and low-dose intrathecal infusion pumps.
Atlas of Interventional Pain Management, 5e by Steven D. Waldman
ISBN: 9780323654074
Publication Date: 2020-03-13
An essential resource for pain medicine clinicians at all levels of practice and training, Atlas of Interventional Pain Management, 5th Edition, is a comprehensive, easy-to-follow guide to delivering safe, accurate, and cost-effective relief for patients with acute and chronic pain.
Neuromodulation Techniques for Pain Treatment by Tiago da Silva Freitas; Bernardo Assumpcao de Monaco; Stanley Golovac [eds]
ISBN: 9783030847777
Publication Date: 2021-11-23
Neuromodulation implants for pain are a relatively new technique and are being increasingly used around the globe. However, technical training is not available for every implanter as there are relatively few centers in the world. Further, refresher courses for low-rate implanters are not available. This book fills that gap by offering an update on the best techniques currently used, providing a step-by-step guide on how to perform these procedures correctly.
Fundamentals of Cancer Pain Management by Andrew Leitner; Christine Chang [eds]
ISBN: 9783030815257
Publication Date: 2021-09-21
This book presents a timely and multidisciplinary update on the modalities currently available for treating the most feared symptom of patients diagnosed with cancer. The various cancer pain syndromes are explored in detail, covering those related directly to malignancy and those due to the after-effects of cancer therapy. Treatment modalities, including pharmacologic approaches, interventional procedures, and palliative surgical options, are discussed clearly and concisely, with provision of recommendations for the practitioner.

Recent articles of interest

The following pain-related articles by FPM and ANZCA fellows have recently been published:

Simpson BA, Christelis N, Russo MA, Stanton-Hicks M, Barolat G, Thomson S. Persistent Spinal Pain Syndrome: Reply to Ordia and Vaisman. Pain Med. 2022;23(2):430.
Speldewinde GC, Panwar CE. Patient Expectancy Does Not Predict Success or Failure of Thermal Neurotomy for Persistent Zygapophysial and Sacroiliac Joint Pain. Pain Med. 2021;22(9):1930-1939.
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Abstract
Objective: The placebo effect is important in determining the outcome of the treatment of pain for which expectancy and context are the main contributors. The variable success of thermal neurotomy spinal pain procedures is often seen as evidence of the placebo effect. Conversely, proponents of pain procedures explain poorer outcomes by technical procedure deficiencies, including inadequate diagnosis. This cohort study set out to determine whether patient expectancy is a contributing factor in the outcome of thermal neurotomy to the cervical, thoracic, and lumbar zygapophysial and sacroiliac joints.

Design: This single-practitioner, single-site retrospective analysis of prospectively gathered cohort data of 549 patients evaluated the impact of patient preprocedure expectancy (rated on a simple 0-10 or 0-4 numerical rating scale) on outcomes in a large consecutive series of patients who had undergone thermal neurotomy treatment between 2009 and 2019. In addition, a portion of patients were asked to what extent they hoped for or desired a good outcome.

Results: Successful pain relief (≥75% reduction from baseline) was not associated with a higher preprocedure expectancy than were failed procedures. Hope and desire demonstrated no impact on the positive or negative impact of the procedure.

Conclusions: Altogether, patient expectation of outcome, hope, and desire are not associated with the outcome of effective pain relief by thermal neurotomy that has been performed to the appropriate and commonly available technical standards. Further work is needed to determine the influence of patient expectation across a range of pain intervention modalities.
Licina A, Silvers A. Perioperative Intravenous Lidocaine Infusion for Postoperative Analgesia in Patients Undergoing Surgery of the Spine: Systematic Review and Meta-Analysis. Pain Med. 2022;23(1):45-56.
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Abstract
Objective: We conducted a systematic review and meta-analysis to examine the impact of perioperative intravenous lidocaine infusion on pain management scores, opioid consumption, adverse events, and hospital length of stay in patients undergoing spinal surgery.

Methods: We included randomized controlled trials evaluating the use of perioperative intravenous lidocaine in adult and pediatric patients undergoing spinal surgery. Primary outcomes were postoperative pain scores at rest and at 2, 4-6, 24, and 48 hours and adverse events attributable to lidocaine administration. We searched electronic databases from their inception to the present. We used Cochrane's standard methods. We used a random-effects model to synthetize data. We conducted three subgroup analyses: patients undergoing major surgery vs patients undergoing minor surgery, patients with chronic pain conditions vs patients without, and adult vs pediatric patients.

Results: A total of eight studies were included that compared patients having intravenous lidocaine (n = 349) with controls (n = 343). Intravenous lidocaine administration was associated with significantly reduced visual analog pain scores at 2 hours (mean difference [MD] = -1.13), 4-6 hours (MD = -0.79), and 24 hours (MD = -0.50) postoperatively. In the adults, efficacy of treatment was extended to 48 hours (MD = -0.72). Perioperative intravenous lidocaine administration was associated with reduced perioperative opioid consumption at 24 and 48 hours, as well as decreased hospital length of stay.

Conclusion: Perioperative intravenous lidocaine infusion consistently improves analgesic measures in adult and pediatric populations in the first 24 hours, with an effective decrease in opioid consumption noted to 48 hours. These results are most generalizable in the adult population in the first 4-6 to 24 postoperative hours.

The following pain-related articles have a significant Australian or NZ focus:

Siddall B, Ram A, Jones MD, Booth J, Perriman D, Summers SJ. Short-term impact of combining pain neuroscience education with exercise for chronic musculoskeletal pain: a systematic review and meta-analysis. Pain. 2022;163(1):e20-e30.
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Abstract
Exercise and pain neuroscience education (PNE) have both been used as standalone treatments for chronic musculoskeletal pain. The evidence supporting PNE as an adjunct to exercise therapy is growing but remains unclear. The aim of this systematic review and meta-analysis was to evaluate the effect of combining PNE and exercise for patients with chronic musculoskeletal pain, when compared with exercise alone. A systematic search of electronic databases was conducted from inception to November 6, 2020. A quality effects model was used to meta-analyze outcomes where possible. Five high-quality randomized controlled studies (n = 460) were included in this review. The PEDro scale was used to assess the quality of individual studies, and Grading of Recommendations, Assessment, Development, and Evaluation analysis was conducted to determine the quality of evidence for each outcome. Meta-analyses were performed for pain intensity, disability, kinesiophobia, and pain catastrophizing using data reported between 0 and 12 weeks postintervention. Long-term outcomes (>12 weeks) were only available for 2 studies and therefore were not suitable for meta-analysis. Meta-analysis revealed a significant difference in pain (weighted mean differences, -2.09/10; 95% confidence interval [CI], -3.38 to -0.80; low certainty), disability (standardized mean difference, -0.68; 95% CI, -1.17 to -0.20; low certainty), kinesiophobia (standardized mean difference, -1.20; CI, -1.84 to -0.57; moderate certainty), and pain catastrophizing (weighted mean differences, -7.72; 95% CI, -12.26 to -3.18; very low certainty) that favoured the combination of PNE and exercise. These findings suggest that combining PNE and exercise in the management of chronic musculoskeletal pain results in greater short-term improvements in pain, disability, kinesiophobia, and pain catastrophizing relative to exercise alone.

ANZCA E-News (18 March 2022)

Recent articles of interest:

A number of articles have

Chiem J, Libaw J, Ehie O. Diversity of anesthesia workforce - why does it matter? [epub ahead of print, 2022 Feb 11]. Curr Opin Anaesthesiol. 2022;10.1097/ACO.0000000000001113.
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Abstract
Purpose of review: Although recent census demonstrates that women comprise 50.8% and ethnic minority groups collectively consist of 42.1% of the US population, the field of anesthesiology still demonstrates disparity in representation and health outcomes across race, ethnicity, and gender. In addition, the growing percentage of people that identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ) compounded with limited representation among providers of their care can augment existing disparate outcomes within this community.

Recent findings: Compared to male colleagues, women physicians across all specialties have a decreased likelihood of professorship as well as equitable pay and leadership roles. Additionally, a 2019 study of anesthesia residents across race and ethnicity within the Accreditation Council for Graduate Medical Education established that whites were 58.9%, Asians were 24.7%, Hispanics were 7.8%, Blacks were 5.9%, multiracial groups were 3.8%, and Native Americans were 0.3% of the total 6272 residents. In a survey of members of the American Society of Anesthesiologists, self-identification as part of the sexual and gender minoritycommunity was independently associated with an increased risk of burnout. Furthermore, teams with higher diversity in cognitive styles solve problems more efficiently.

Summary: To achieve an optimized quality of healthcare, anesthesiologists and other providers should be a reflection of the communities they serve, including women, people of color, and LGBTQ. In this way, there is an increased likelihood of empathy, effective communication, and insightful perspectives on how to bridge the gap in health equity. A diverse lens is essential to ensure grassroots efforts lead to lasting transformational change.
Mathis MR, Schonberger RB, Whitlock EL, et al. Opportunities Beyond the Anesthesiology Department: Broader Impact Through Broader Thinking. Anesth Analg. 2022;134(2):242-252.
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Abstract
Ensuring a productive clinical and research workforce requires bringing together physicians and communities to improve health, by strategic targeting of initiatives with clear and significant public health relevance. Within anesthesiology, the traditional perspective of the field's health impact has focused on providing safe and effective intraoperative care, managing critical illness, and treating acute and chronic pain. However, there are limitations to such a framework for anesthesiology's public health impact, including the transient nature of acute care episodes such as the intraoperative period and critical illness, and a historical focus on analgesia alone-rather than the complex psychosocial milieu-for pain management. Due to the often episodic nature of anesthesiologists' interactions with patients, it remains challenging for anesthesiologists to achieve their full potential for broad impact and leadership within increasingly integrated health systems. To unlock this potential, anesthesiologists should cultivate new clinical, research, and administrative roles within the health system-transcending traditional missions, seeking interdepartmental collaborations, and taking measures to elevate anesthesiologists as dynamic and trusted leaders. This special article examines 3 core themes for how anesthesiologists can enhance their impact within the health care system and pursue new collaborative health missions with nonanesthesiologist clinicians, researchers, and administrative leaders. These themes include (1) reframing of traditional anesthesiologist missions toward a broader health system-wide context; (2) leveraging departmental and institutional support for professional career development; and (3) strategically prioritizing leadership attributes to enhance system-wide anaesthesiologist contributions to improving overall patient health.
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Recently added titles:

The latest edition of Oxford Handbook of Anaesthesia,

Oxford Handbook of Anaesthesia, 5e by Freedman R, Herbert L, O'Donnell A, Ross N [eds]
ISBN: 9780198853053
Publication Date: 2022-02-06
Written for anaesthetists at all stages of their careers, from trainees sitting exams through to experienced consultants as well as ODPs and nurses involved in theatre area work and pre-assessment, this comprehensive guide to the anaesthetic world is as indispensable as ever. This new edition has been completely revised and brings you the most up-to-date guidance and information to keep pace with fast-moving areas of anaesthesia, including a completely revised regional anaesthesia chapter.
Clinical Anesthesia Fundamentals, 2e by Sam R. Sharar; Bruce F. Cullen; M. Christine Stock; Rafael Ortega; Natalie Holt; Naveen Nathan; Christopher Connor [eds]
ISBN: 9781975113018
Publication Date: 2021-10-12
Clinical Anesthesia Fundamentals, 2e, is a concise, highly visual resource covering the core concepts in anaesthesiology. From physiology and pharmacology to anatomy and system-based anesthesia, it uses full-colour graphics, easy-to-read tables, and clear, concise text to convey the essential principles of the field.
Understanding Crisis in Critical Care by Ronaldo Collo Go
ISBN: 9781264258727
Publication Date: 2021-12-01
Understanding Crisis in Critical Care is a narrative on accommodating an overwhelming surge of critically ill patients from pandemics, natural disasters, or war, while ensuring the safety of the healthcare staff. A crisis standard of care is when resources are limited. Triage models are used to provide treatment based on the best level of evidence for the available resources. Inspired by coronavirus disease 2019, the narrative is driven by this pandemic. The initial approach for any crisis is similar. However, each cause of crisis can have unique challenges.
COVID-19 and the Heart: A Case-Based Pocket Guide by Muhammad Saad; Timothy J. Vittorio
ISBN: 9781264266708
Publication Date: 2021-10-08
From frontline experts on the topic--everything you need to know about COVID-19 and how it affects the heart COVID-19's effect on the cardiovascular system continues to drive increases in morbidity and mortality. Written by a team of experts who worked on the frontlines in New York City throughout the worst of the pandemic, COVID-19 and the Heart: A Cased-Based Pocket Guide is a one-of-a-kind resource for providing safe, effective care for COVID-19-related heart conditions.
Transgender and Gender Diverse Health Care: The Fenway Guide by Alex Keuroghlian; Jennifer Potter; Sari L. Reisner
ISBN: 9781260459944
Publication Date: 2021-10-08
The very first textbook of its kind delivers the evidence- and case-based review clinicians need to address the unique healthcare realities of transgender and gender diverse adults. Fenway Guide to Transgender and Gender Diverse Health Care offers everything you to provide basic, culturally responsive care that meets the primary, preventive, and specialty health needs of transgender and gender diverse adults patients.
Perioperative Medicine: Managing the Outcome, 2e by Mark F. Newman; Lee A. Fleisher; Clifford Ko; Michael (Monty) Mythen
ISBN: 9780323567244
Publication Date: 2021-03-08
Based on the most current evidence and best practices, Perioperative Medicine: Managing for Outcome, 2e, is an easy-to-follow, authoritative guide to achieving optimal outcomes in perioperative care. Written and edited by recognized authorities in anaesthesiology and surgical critical care, this fully updated edition helps you think critically about complex, long-term issues surrounding the care of the surgical patient, providing decision trees that define strategies to enhance the medical outcome of care. Focuses on what anaesthesiologists, surgeons, and intensivists need to know in order to improve outcomes through evidence- and outcome-based approaches.

See the complete new titles listing

FPM Training E-News (10 March 2022)

Recent articles of interest:

A number of pain-related education articles have recently appeared in Pain Medicine journal.

Wahezi SE, Duarte R, Kim C, et al. An Algorithmic Approach to the Physical Exam for the Pain Medicine Practitioner; A Review of the Literature with Multidisciplinary Consensus [epub ahead of print, 2022 Feb 18]. Pain Med. 2022;pnac031.
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Abstract
Background: Increased utilization of telemedicine has created a need for supplemental pain medicine education, especially for the virtual physical assessment of the pain patient. Traditional clinical training utilizes manual and tactile approaches to the physical examination. Telemedicine limits this approach and thus alternative adaptations are necessary to acquire information needed for sound clinical judgement and development of a treatment plan. Clinical assessment of pain is often challenging given the myriad of underlying etiologies contributing to the sensory experience. The Covid-19 pandemic has led to a dramatic increase in the use of virtual and telemedicine visits, further complicating the ease of assessing patients in pain. The increased reliance on telemedicine visits requires clinicians to develop skills to obtain objective information from afar. While eliciting a comprehensive history and medication assessment are performed in a standard fashion via telemedicine, a virtual targeted physical examination is a new endeavor in our current times. In order to appropriately diagnose and treat patients not directly in front of you, a pivot in education adaptations are necessary.

Objective: To summarize best care practices in the telemedicine physical exam while presenting an algorithmic approach towards virtual assessment for the pain practitioner.

Design: Review of the literature and expert multidisciplinary panel opinion.

Setting: Nationally recognized academic tertiary care centers.

Subjects: Multidisciplinary academic experts in pain medicine.

Methods: Expert consensus opinion from the literature review.

Result: An algorithm for the virtual physical exam for pain physicians was created using literature review and multidisciplinary expert opinion.

Conclusion: The authors here present simple, comprehensive algorithms for physical exam evaluations for the pain physician stemming from a review of the literature.
Adams MCB, Denizard-Thompson NM, DiGiacobbe G, Williams BL, Brooks AK. Designing Actionable Solutions and Curriculum for Pain Disparities Education. Pain Med. 2022;23(2):288-294.
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Abstract
The Liaison Committee on Medical Education (LCME) require medical schools to teach their students how to recognize and work toward eliminating health disparities. However, time constraints and a dearth of guidance for educators in teaching pain disparities curricula pose significant challenges. Herein we describe successes and lessons learned after designing, implementing, and evaluating an innovative pain disparities curriculum that was embedded in a longitudinal health equity curriculum for third year medical school students at an academic institution. Although the curriculum was developed for medical school students, the concepts may be broadly applicable to other training settings such as residency and fellowship programs.

Recently added titles:

The latest edition of Massachusetts General Hospital Handbook of Pain Managementis now available.

Contains an extensive new section on interventional approaches to pain management, as well as new chapters on radiotherapy and radiopharmaceuticals for cancer pain and ethical considerations in pain medicine.
Features new chapters on discography, epidural steroid injections; intrathecal drug delivery; peripheral nerve blocks; and sympathetic blockade.
Includes handy appendices that provide useful medication information, basic science coverage relevant to clinical strategies, and numerous tables and chapter-opening outlines for quick reference.

Massachusetts General Hospital Handbook of Pain Management, 3e by Gary Brenner; James P. Rathmell [eds]
Call Number: 616.0472 MAS
ISBN: 9781496347787
Publication Date: 2020-10-10
Offering expert guidance from seasoned clinicians at Massachusetts General Hospital, this bestselling handbook provides accurate, clinically essential information in a portable, quick-reference format. Broad-based, multidisciplinary coverage draws from the disciplines of anaesthesiology, neurology, behavioural medicine, nursing, psychiatry, and physical therapy to provide practical, evidence-based information for sound therapeutic choices.

See the complete new titles listing

Training and exams hub:

TheTraining and Exams hub has been designed for trainees and educators participating in the ANZCA, FPM and DHM training programs to identify suitable training and exam resources. The Pain medicine training & exams section contains guides for: Pain medicine training, Conceptual basis of pain medicine, FPM Procedures Endorsement Program curriculum and the Procedures in pain medicine. In addition, the Self-Assessment tools and Roles in Practice guides provide additional resource support for training and examination purposes.

CTN Educational Sessions: ANZCA Research Grant Program

A recording of the overview of the ANZCA Research Grant program presented by Professor David A. Scott onTuesday 15 February is now available to watch.
Duration: 62 mins approx.

ANZCA E-News (18 February 2022)

New journals

BJA has launched a new open-access version of it's popular BJA publication. BJA Open aims to publish high-impact original work in all branches of anaesthesia, critical care, pain medicine and perioperative medicine. Note: The new publication should also allow UK researchers to continue publishing their research using the BJA moniker in light of the UKRI-mandated announcement on Open Accesstaking effect from 1 April 2022.

Elsevier have also recently launched a new open-access intensive care title. Journal of Intensive Medicine is an open-access peer-reviewed journal that publishes high-quality review papers and original research articles related to the latest trends and advances covering all aspects of intensive care medicine.

Both titles can be accessed via the Journals page, relevant library guides and the A-Z list.

BJA Open (Elsevier OA)
Online: Vol. 1, 2022 - present
>> Alternate/direct access via ScienceDirect.

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BJA Open publishes high-impact original work in all branches of anaesthesia, critical care, pain medicine and perioperative medicine including fundamental, translational and clinical sciences, clinical practice, technology, education and training and case reports. The distinguishing feature of BJA Open is its gold open access publishing option using an Article Publishing Charge (APC) model.
Journal of Intensive Medicine (JIM)
Online: Vol. 1, 2021 - current
>> Alternate/direct access via ScienceDirect.

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Journal of Intensive Medicine is an open-access peer-reviewed journal that publishes high-quality review papers and original research articles related to the latest trends and advances covering all aspects of intensive care medicine.

This journal aims to provide a forum for communication among all practitioners involved in intensive care.

Recent articles of interest:

New articles on webAIRS and livestreaming surgical education.

Gibbs NM, Culwick MD, Endlich Y, Merry AF. A cross-sectional overview of the second 4000 incidents reported to webAIRS, a de-identified web-based anaesthesia incident reporting system in Australia and New Zealand. Anaesth Intensive Care. 2021;49(6):422-42
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Abstract
This cross-sectional overview of the second 4000 incidents reported to webAIRS has findings that are very similar to the previous overview of the first 4000 incidents. The distribution of patient age, body mass index and American Society of Anesthesiologists physical status was similar, as was anaesthetist gender, grade, location and time of day of incidents. About 35% of incidents occurred during non-elective procedures (vs. 33% in the first 4000 incidents). The proportion of incidents in the various main categories was also similar, with respiratory/airway being most common, followed by cardiovascular, medication-related and medical device or equipment-related incidents. Together these categories made up about 78% of all incidents in both overviews. The immediate outcome was comparable with reports of harm in about a quarter of incidents and a similar rate of deaths (4.7% vs. 4.2%). However, the proportion of patients who had received total intravenous anaesthesia was higher (17.6% vs. 7.7%) and the proportion of patients who received combined intravenous and inhalational anaesthesia was lower (52.3% vs. 58.4%), as was the proportion receiving local anaesthesia alone (1.6% vs. 6.7%). There was a small increase in the number of incidents resulting in unplanned admission to a high dependency or intensive care unit (18.1% vs. 13.5%). It is not clear whether these differences represent trends or random observations. About 48% of incidents were considered preventable by the reporters (vs. 52% in the first 4000). These findings support continued emphasis on human and system factors to promote and improve patient safety in anaesthesia care.
Feenstra TM, van Felius LP, Vriens MR, et al. Does livestreaming surgical education have the future? Development and participant evaluation of a national COVID-19 livestreaming initiative [epub ahead of print, 2022 Jan 6]. Surg Endosc. 2022;1-9.
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Abstract
Backgrounds: COVID-19 related reduction of surgical procedures jeopardizes learning on the job of surgical residents. Many educators resorted to digital resources in the search for alternatives. However, these resources are often limited to the extent they offer resident-surgeon interaction like a joint surgical performance does. Here we present a roadmap of livestreaming surgical procedures, and evaluate how surgical livestreams on human cadavers address the unmet educational needs of surgical residents in our Dutch nationwide initiative.

Methods: Technical and organizational feasibility, and definition of outcome deliverables for the livestream series and per livestream were essential in livestream development. Faculty selected interventions, lecture contents, and participant preparations. Appropriate location, technical setup, and support were imperative for a stable, high-quality stream with integrated interaction, while maintaining digital privacy. A survey was sent to livestream participants to evaluate each livestream, and allow for constant improvement during the broadcasting of the series. Only surveys which were completed by surgical residents were included in the analysis of this study.

Results: Each livestream attracted 139-347 unique viewers and a total of 307 surveys were completed by participants (response rate of 23-38% per livestream). Sixty percent of surveys (n = 185) were completed by surgical residents. Livestreams were highly valued (appreciation 7.7 ± 1.1 and recommendation 8.6 ± 1.1), especially the live procedures combined with interaction and theoretical backgrounds. Criticized were technical difficulties and timing of the livestreams between 5 and 7 pm, which interfered with clinical duties.

Conclusion: Livestreaming surgical procedures on human cadavers is a valid and valued solution to augment resident education. Digital privacy and a stable, high-quality interactive stream are essential, as are appropriate moderation and relevant lectures. While livestreaming cannot replace hands-on training in the operating room, it enables surgeon-resident interaction which is key in education-and missed in pre-recorded surgical procedures which are currently available online.

Latest titles:

A new e-book offering a critical examination of evidence-based in medicine, and the latest edition of Talley & O'Connor's Clinical Examination now available e-book and print formats.

The Philosophy of Evidence-Based Medicine by Jeremy H. Howick
ISBN: 9781405196673
Publication Date: 2011-04-25
Evidence-based medicine (EBM) has become a required element of clinical practice, but it is critical for the healthcare community to understand the ongoing controversy surrounding EBM. Seeking to address questions raised by critics, The Philosophy of Evidence-based Medicine challenges the over dependency of EBM on randomized controlled trials.
Talley & O'Connor's Clinical Examination: A Systematic Guide to Physical Diagnosis (Vols. 1 & 2), 9e by Nicholas J. Talley; Simon O'Connor
Call Number: 616.0754 TAL
>> REQUEST PRINT LOAN <<
ISBN: 9780729544245
Publication Date: 2022-01-07
Talley and O'Connor's Clinical Examination addresses the core principles and clinical skills that underpin diagnosis for safe, effective medical practice. The text takes an evidence-based, patient-centric approach to conducting a clinical examination.

See the complete new titles listing

Te Hā – te reo (For the breath)/NZ News (10 Feb 2022)

Recent articles of interest:

Reilly JR, Deng C, Brown WA, et al. Towards a national perioperative outcomes registry: A survey of perioperative electronic medical record utilisation to support quality assurance and research at Australian and New Zealand College of Anaesthetists Clinic
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Abstract
In Australia, 2.7 million surgical procedures are performed annually. Historically, a lack of perioperative data standardisation and infrastructure has limited pooling of routinely collected data across institutions. We surveyed Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network hospitals to investigate current and potential uses of perioperative electronic medical record data for research and quality assurance.A targeted survey was sent to 131 ANZCA Clinical Trials Network-affiliated hospitals in Australia. The primary aim was to map current electronic data collection methods and data utilisation in six domains of the perioperative pathway.The survey response rate was 32%. Electronic data recording in the six domains ranged from 19% to 85%. Where electronic data exist, the ability of anaesthesiology departments to export them for analysis ranged from 27% to 100%. The proportion of departments with access to data exports that are regularly exporting the data for quality assurance or research ranged from 13% to 58%.The existence of a perioperative electronic medical record does not automatically lead to the data being used to measure and improve clinical outcomes. The first barrier is clinician access to data exports. Even when this barrier is overcome, a large gap remains between the proportion of departments able to access data exports and those using the data regularly to inform and improve clinical practice. We believe this gap can be addressed by establishing a national perioperative outcomes registry to lead high-quality multicentre registry research and quality assurance in Australia.
Webster CS, Taylor S, Thomas C, Weller JM. Social bias, discrimination and inequity in healthcare: mechanisms, implications and recommendations. BJA education. 2022;(202202).

NZ Print collection update

Due to the impact of ongoing COVID restrictions in New Zealand, it is not currently possible to lend out NZ-based books at this time. However, should any trainee or fellow require access to any materials only available in print, they can submit a chapter request via the ANZCA library's Request a chapter form.

BJA change of access (4 November 2021)

Due to a significant and unsustainable price increase, the ANZCA Library will discontinue its online subscription to the British Journal of Anaesthesia (BJA) from 1 January 2022.

See the complete college news item for more information

With this change, college members will continue to receive the following free online access to the BJA:

Issues published pre-2022
Issues published from 2022 onward that are older than 12 months

This content will be available through the library’s discovery service, journals list, apps and other linking tools and platforms. It will also be possible to request any newer articles not online through the library free-of-cost.

Any current college fellow, trainee, or SIMG, can also take out a personal subscription to the BJA at a heavily discounted rate.

See the college BJA personal subscriptions page for more information

Article access issues: Some users are experiencing ongoing privacy errors when trying to access articles via the library discovery service.

This is due to HSTS redirection issues on external servers preventing the user from properly authenticating.

Try emptying your browser cache and deleting your cookies, closing and reopening your browser, and trying again.
Try an alternative browser
Access the article using the journal title link on the Journals page
Try using BrowZine: there is both an app and web version
Try installing LibKey and accessing the article via PubMed

Users with persistent issues should contact the library for further assistance.

McGraw Hill e-Book access issues: There is an ongoing issue with McGraw-Hill e-books, whereby some users are improperly authenticated when accessing content within the IP range of another institution that also subscribes to MGH e-books. This results in the user being being unable to access some titles.

Access to the above collections should be unaffected when authenticated outside the IP range of the affected institutions. This includes access from home and access from a mobile device using 4/5G (and not the institutions' Wi-Fi). Users with a pre-existing MyAccess login, can sign out of the affected collections, and sign in using their MyAccess credentials.

Creating a MyAccess account:

Log into AccessMedicine
Check to make sure that it says Access Provided by: ANZCA in the top-right corner
Select the Sign in > Sign in or Create a Free MyAccess Profile from the dropdown [top-right corner]
Click the Create a Free MyAccess Account button
Complete the form and click the Create Profile button

ANZCA users requiring urgent access can submit chapter request/s via the Request an article service.

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We rely on your feedback to further develop and support the ANZCA library. Use the link below to provide content suggestions, as well as to make recommendations, report issues, and to give general feedback.

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