Anaesthesia Coffee Break

The immunology, anaesthesia and how Covid19 takes advantage of your immune system!

March 26, 2021 06:00 - 34 minutes - 23.7 MB

In this episode we dive into the basics of the immune system and how it is affected by anaesthesia. Additionally we discuss Covid19 as a way pf explaining some of the crucial elements of immunity to make it relevant to the most life changing event of our generation. *Correction: Angiotensin 2 receptor is not the ACE-1 receptor. ACE-1 receptor converts angiotensin 1 to angiotensin 2. ACE-2 receptor converts angiotensin 2 back to angiotensin 1. Please rate, post a review and subscribe! Ch...

Categorisation exercises to drill for the viva exam!

March 16, 2021 03:00 - 35 minutes - 24.3 MB

Thanks for listening to Anaesthesia Coffee Break! In this episode we categorise the key respiratory physiology topics control of breathing cause of A-a gradient hypoxaemia hypercapnoea CO2 carriage in blood 2,3 DPG venous admixture airways resistance compliance work of breathing FRC dead space and pulmonary vascular resistance Please rate, post a review and subscribe! Check out https://anaesthesiacollective.com/education/first-part-exam/ for general information and a collection of mod...

The cardiovascular changes in morbid obesity and how would YOU manage this patient perioperatively?

March 09, 2021 01:00 - 46 minutes - 32 MB

Hi everyone! In this episode we go through a trainee's practice SAQ about the cardiovascular changes in morbid obesity. We also have a detailed chat about the important aspects of obese patients perioperatively, intubation, extubation and some of the dilemmas we all face. Stan's model answer is ~ 27mins Stan's rule of 5s for SAQ answers is 5 teaching points and 5 reasons for each point to gain maximum marks for your answer! Please rate, post a review and subscribe! Check out https://a...

The placental transfer of oxygen explained in 4 easy steps!

March 04, 2021 05:00 - 23 minutes - 16 MB

In this episode we talk about the main steps that facilitate gas exchange at the placenta. This is great applied respiratory physiology and a common question in the viva and SAQs! Double Bohr effect Check out power and Kam chapter 3 - resp physiology or this great summary http://www.anaesthesia.uct.ac.za/sites/default/files/image_tool/images/93/10-The%20Bohr%20and%20Haldane%20Effects%20%28K%20Bergh%29.pdf check out some model answers at https://anaesthesiacollective.com/education/first-...

Miller's Anesthesia proven WRONG by Dr Stan! What REALLY happens to volatile washout with changes in cardiac output

February 19, 2021 06:00 - 37 minutes - 26 MB

Here is our deep dive into what exactly occurs to volatile washout in an anaesthetised person if cardiac output changes. Out of the textbooks we reviewed, only MILLER'S ANESTHESIA (thought by many to be the bible of anaesthesia) comments on exactly what occurs! In this episode we reveal what Dr Stan discovered by running his very own transparent simulations using Gasman. https://www.gasmanweb.com The cardiac output/washout analysis begins at approx 9mins 30seconds. Our parameters for wa...

How does morbid obesity affect washout of volatile anaesthetic?

February 01, 2021 07:00 - 46 minutes - 32.1 MB

This is one of the more complex questions in anaesthesia! Here's the actual WHO definition that doesn't use the term morbid obesity but rather obesity class 1, 2 and 3. Obesity is frequently subdivided into categories: Class 1: BMI of 30 to < 35 Class 2: BMI of 35 to < 40 Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity. NB LISTEN TO NEXT EPISODE FOR DEEP DIVE INTO THE EFFECT OF CARDIAC OUTPUT ON WASHOUT!!! Millers Chapter 20 I...

How do you PREVENT HYPOXAEMIA when performing a rapid sequence induction (RSI)?

January 24, 2021 01:00 - 38 minutes - 26.3 MB

You've probably performed a few RSIs in your anaesthesia practice. But have you though about all the techniques you do to make this inherently risky technique safer? In this episode we chat about the approach to the question from the April 2014 and September 2013 SAQ paper Describe the physiological basis of methods used to prevent hypoxaemia prior to intubation in a rapid sequence induction. Include any adverse effects of these methods. The exam paper https://networks.anzca.edu.au/d2l/...

What is the lowest oxygen saturation YOU would tolerate?

January 18, 2021 00:00 - 28 minutes - 19.4 MB

This is one of the most common dilemmas that will arise during your anaesthesia practice! In this episode we will step through the ANZCA part 1 SAQ, Q9 from 2014 September https://networks.anzca.edu.au/d2l/le/content/7669/Home?itemIdentifier=D2L.LE.Content.ContentObject.ModuleCO-86745 What lower limit of SpO2 would you accept in an ASA1 young male under general anaesthesia? Explain your reasons for choosing this value. We step through a framework for the answer involving a) the O2Hb d...

Lung compliance and the simple steps to optimise it for your patient

January 10, 2021 01:00 - 24 minutes - 17 MB

In this episode we delve into lung compliance! We chat about the 2020 aug/sep SAQ Q3: Discuss respiratory system compliance and outline factors that affect it. We also go into how to use this theoretical knowledge to improve ventilation of patients with poor static or dynamic compliance and high ventilating pressures in pneumoperitoneum. Some basic resources: https://en.wikipedia.org/wiki/Hysteresis https://www.physio-pedia.com/Lung_Compliance Please rate, post a review and subscribe!...

The 5 critical effects of pregnancy on respiratory physiology

January 07, 2021 11:00 - 21 minutes - 15.1 MB

In this Episode we discuss the effects of pregnancy on a patient's respiratory physiology. We step through the SAQ #3 from the 2019 feb/march ANZCA exam paper: Discuss the effects of pregnancy on the respiratory system that are relevant to the practice of anaesthesia. Include in your answer how these effects influence the conduct of anaesthesia. Respiratory changes during pregnancy affects: 1. Airway management 2. Pre-oxygenation 3. Ventilation 4. Lung mechanics 5. Uptake ...

Functional Residual Capacity (FRC) and how anaesthesia makes a mess of it!

December 20, 2020 01:00 - 15 minutes - 10.7 MB

In this episode we tackle the SAQ, explain the changes on FRC that take place with the administration of anaesthesia. July SAQ paper 2005 question 16. https://networks.anzca.edu.au/d2l/le/content/7669/viewContent/86778/View This is an important core topic that requires a broad understanding of the 1) A definition and normal values 2) How to measure FRC 3) and how it changes with anaesthesia 4) functions of FRC I use a categorised answer of anaesthetic, surgical and patient factors to ge...

Control of breathing made a bit more practical

December 15, 2020 06:00 - 19 minutes - 13.5 MB

Control of breathing is one of the most practically useful subjects you will learn in respiratory physiology! In this video we go through the most interesting aspects, exam tips, structures and how it relates to our own practice. The particular SAQ we address is from the ANZCA 2006 February exam paper, question 10: List the physiological factors which increase respiratory rate and include a brief explanation of the mechanism by which each achieves this increase. https://networks.anzca.e...

Lahiru's part 1 viva exam relived!

December 05, 2020 05:00 - 25 minutes - 17.9 MB

This is Lahiru's actual viva that we talk through and analyse! Again, try to gain as much from our technique and style of answering, and our mistakes rather than the facts themselves. Links to some of the subject matter is below: http://www.partone.lifeinthefastlane.com/pressure-volume_relationships.html https://www.amazon.com.au/Cardiovascular-Physiology-Robert-M-Berne/dp/0323011276 https://www.amazon.com.au/Vanders-Renal-Physiology-Douglas-Eaton/dp/1260019373/ref=sr_1_1?crid=3FXF014M...

Stan's gold medal viva exam

December 05, 2020 03:00 - 47 minutes - 32.5 MB

By popular demand, here is the actual physiology and pharmacology viva that Stan was examined on for the part 1 ANZCA exam! Please rate, post a review and subscribe! Check out www.anaesthesiacollective.com and sign up to the ABCs of Anaesthesia facebook group and check you the ABCs of Anaesthesia YouTube channel for more content Any questions please email [email protected] Some links and formulas! How does it measure cardiac output? Using thermodilution and utilisation of St...

Dr Stan's Study Plan

November 17, 2020 05:00 - 12 minutes - 8.73 MB

Hi everyone! We go through all the essential basics of a study plan for the part 1 exam. Check out this link for a sample study plan to cover all the topics https://anaesthesiacollective.com/the-anzca-first-part-exam-study-plan/ Please rate, post a review and subscribe! Check out https://anaesthesiacollective.com/education/first-part-exam/ for general information and a collection of model answers and sign up to the ABCs of Anaesthesia facebook group https://www.facebook.com/groups/2...

Short Answer Question Tips!

November 04, 2020 04:00 - 11 minutes - 8.28 MB

In this episode we go through all the tips and tricks we wish we had known before starting this exam. The SAQ section is seriously daunting, but the right frameworks, approach and mindset is crucial! Please rate, post a review and subscribe! Check out https://anaesthesiacollective.com/education/first-part-exam/ for general information and a collection of model answers and sign up to the ABCs of Anaesthesia facebook group https://www.facebook.com/groups/2082807131964430 and check out t...

MCQ tips!

November 04, 2020 04:00 - 4 minutes - 3.42 MB

In this short episode we go through all the things we wish our trainees knew about studying for the MCQ section of the exam. And remember to always keep it exam focussed! Please rate, post a review and subscribe! Check out https://anaesthesiacollective.com/education/first-part-exam/ for general information and a collection of model answers and sign up to the ABCs of Anaesthesia facebook group https://www.facebook.com/groups/2082807131964430 and check out the ABCs of Anaesthesia YouTub...

Welcome to Anaesthesia Coffee Break!

November 04, 2020 03:00 - 5 minutes - 4.12 MB

Hi everyone! Welcome to Anaesthesia Coffee Break, a podcast with tips, tricks and advice for the ANZCA (Australian and New Zealand College of Anaesthetists) First Part Exam. We hope to cover lots of useful information and present knowledge about pharmacology and physiology in a easy to understand structured way to help you through this potentially gruelling exam! Please rate, post a review and subscribe! Check out https://anaesthesiacollective.com/education/first-part-exam/ for general i...

How to get started with the First Part Exam

November 04, 2020 03:00 - 16 minutes - 11.3 MB

In this episode we go through the basics of how to approach this exam broadly. The why, how, when and what of this rather big quiz. Useful website links: ANZCA training program curriculum https://www.anzca.edu.au/resources/all-handbooks-and-curriculums/anzca-anaesthesia-training-program-curriculum MAK95 by Dr Frank Sun www.mak95.com A Primer for the Primary FANZCA examination by Dr Mark Reeeves https://primarydailylo.files.wordpress.com/2018/03/a-primer-for-the-primary-fanzca-examinatio...