Obsgynaecritcare

Hi Guys, Number 4 in the patient blood management in obstetrics and gynaecology mini tute series. Intravenous iron - a relatively safe and effective treatment that can rapidly correct iron deficiency and anaemia, increasingly used in many of our patients. But how much do you really know on this topic? What are all these different preparations available? What are the risks / cautions / contraindications? What about anaphylaxis, skin staining and what the hell is the "Fishbane reaction!" Give us only 11min of your time and you will be surprised how much more knowledge you'll have on this topic! Time to hone your knowledge! If you want to be a real expert do the online package at www.bloodsafelearning.org And to maximise your learning we recommend you have a good understanding of iron physiology and the principles of PBM first ....so if you haven't already make sure you check out all the previous episodes: Patient blood management what is it? Iron physiology Oral iron   Screencast: https://yout

Hi Guys, Number 3 in the patient blood management in obstetrics and gynaecology mini tute series. Nice and short this time! Oral iron the treatment of choice for the vast majority of our patients - seems relatively simple yeah? Maybe but there's more than to it meets the eye! -  do it wrong and you'll fail miserably - if they take the wrong tablets, don't take them for long enough or if they were never going to take them in the first place! Time to hone your knowledge! If you want to be a real expert do the online package at www.bloodsafelearning.org Screencast (recommended): https://youtu.be/7LPCsng7tb8 Thanks for watching - comments and feedback please!    

Hi again! This is episode two in my mini tutorial series on patient blood management (PBM) in obstetrics and gynaecology. This one is on the basics of iron physiology - I can hear you all yawning already! However if you really want to know how to effectively treat anaemia with iron (oral, intravenous) and understand how to recognise and diagnose iron deficiency and iron deficiency anaemia (IDA) this is core knowledge....Give me 12-15min of your life and have a listen below - all of the mini tutorials which follow will make so much more sense you'll be thankful you made this small investment! Go to these sites they are great: 1 The National Blood Authority (NBA): https://www.blood.gov.au/patient-blood-management-pbm 2 Bloodsafelearning: https://bloodsafelearning.org.au/ Comments and feedback please! Thanks for listening and see you soon with the next one! Screencast version (recommended): https://youtu.be/6tfokBtpikc  

Gidday, Bonjour, Hi! This is the first episode in my mini series on patient blood management in O&G. Menorrhagia, haemorrhage, PV bleeding, iron deficiency, anaemia - any of this seem familiar? It should do! These issues affect a huge number of obstetric and gyaecologic patients, and as such this is an issue we should all be interested in learning more about - so I hope you find these interesting! I have been teaching around this topic to my colleagues and our registrars for a number of years now but thought maybe I should share some of this with you & a wider audience. The plan is to break this large topic up into smaller (aka palatable) sized mini topics of 10-15min. Let me know what you think! I am definitely not the authority in this area but I hope to inspire you to become interested and I thoroughly recommend you go to (in my humble opinion) the two following websites to get the real low down. These are definitely the go to authoritative resources for PBM in Australasia and a big thank you to the t

(*This is a fictional case) Your patient has just had a very difficult instrumental delivery in theatre after a prolonged obstructed labour. Unfortunately now her uterus won't contract despite oxytocin and ergometrine and she is bleeding pretty briskly. You clean her deltoid with an alco-chlorhex wipe, inject 250mcg (1 ampoule) of carboprost i.m. and cross your fingers that this will do the job. You lean over the drapes, talk to the obstetric team and start rubbing her uterus while they repair the episiotomy. Suddenly you hear a raspy wheezing sound from the head of the bed - you immediately jerk your head around and glance at your patients face - she looks terrified. Bronchospasm! She has pursed lips and is struggling to breathe, her sats probe says 75% and you suddenly wish you had signed up to do dermatology back in your intern year..... Your assistant runs around trying to find a nebuliser and salbutamol and over the next 4 minutes she becomes unresponsive, her breathing becomes progressively worse and

      Can the type of anaesthetic you get when you have your cancer surgery effect how long you live afterwards? Well the answer is.................. maybe. Listen to my 6min discussion here: https://www.obsgynaecritcare.org/wp-content/uploads/2017/09/Doestheanaestheticeffectcanceroutcomes.m4a I wouldn't be surprised that if you aren't an anaesthetist you may have never heard this topic discussed before. For those of us working in the anaesthesia field though this is a topic which has quietly been building momentum over the last decade or more and has really been getting a lot more press in the leading anaesthesia journals in the last couple of years. I was unable to attend the recent ANZCA ASM held in Brisbane but luckily they now provide us access to listen to recordings of many of the presentations online and one of the sessions on "onco-anaesthesia" caught my eye. I especially impressed with one speaker who discussed the following recently published paper. They analysed the outcomes of a large n

"You are called urgently into one of the birth suite rooms. A woman has just given birth, there is blood everywhere, she is moaning & breathing (barely). She is a ghastly pale / mottled colour and you can't feel a peripheral pulse..... it is a sunday afternoon, you work in a smaller hospital and the theatre team aren't on site......." Being faced with a shocked / peri-arrest obstetric patient who is literally exsanguinating in front of you is one of those nightmare situations that  those of us who work in obstetrics dread being faced with. The sudden uterine rupture, the unexpected placenta accreta, or an amniotic fluid embolism with ensuing severe coagulopathy all spring to mind. This is also not an uncommon event in theatre in women having surgery for placenta accreta/percreta or ruptured ectopics - where we are usually prepared for massive haemorrhage but despite this where we can suddenly find ourselves in a situation where the rate of blood loss is so catastrophic that we have lost control of the patien

  https://www.obsgynaecritcare.org/wp-content/uploads/2017/08/Oxytocin-in-labour-increases-PPH.m4a   The use of oxytocin to induce or augment labour is an established, commonly used practice that underpins a lot of modern obstetric practice. This technique is a undoubtedly a useful tool which has allowed us to improve maternal and fetal outcomes. For example to induce a timely delivery when maternal illness such as PET occurs or to avoid an operative delivery for a mother when their spontaneous progress in labour is slow. However, like most things in medicine (and life in general) there is no such thing as a "free lunch" and it is perhaps a less well recognised fact that the use of oxytocin in labour - especially at higher doses and for prolonged periods - is associated with an increased risk of postpartum haemorrhage due to uterine atony. Uterine atony is becoming more common in developed countries: The incidence of uterine atony causing postpartum haemorrhage in developed countries has increased markedl