Small group discussions (SGDs) Small group discussions (SGDs) will be held daily from Saturday through to Tuesday throughout the day. SGDs will take place within the Adelaide Convention Centre and will be open to all registered delegates. Lunchtime sessions will be held after the commencement of the lunch break to allow time for delegates to have lunch prior to the commencement of the SGD. Facilitators may contact participants in the lead up to the meeting to provide background or preparatory material. A ticket is required for entry to all SGD sessions. Delegates are able to register for ONE SGD prior to the close of early bird registration on Friday March 20, 2015. After this time delegates are welcome to register for any remaining SGD places. Cost per SGD: $25 Maximum number of participants for all SGD: 12 Anaesthesia for the adventurous bronchoscopist Facilitator: Date/time: Dr Kate Drummond Sunday May 3, 2015 SGD04 10.30-11.30am Case discussions will cover techniques for sedation and anaesthesia for a variety of airway procedures performed in the bronchoscopy suite. Procedures include EBUS, tracheal stent management and manipulation and dilation of tracheal stenosis whilst sharing an airway with thoracic medicine physicians. Dr Kate Drummond is a staff specialist anaesthetist at the Royal Adelaide Hospital with a special interest in cardiothoracic anaesthesia, transoesophgeal echocardiography and perioperative medicine. SGD STREAM: Cardiac/thoracic SGD STREAM: PERIOPERATIVE MEDICINE Cath lab crisis There are bariatric patients, and then there are bariatric patients- decision making at the end of the line Facilitator: Dr Kelly Bratkovic Date/time: Saturday May 2, 2015 SGD01 12.15-1.15pm In this session we will discuss the challenges unique to all procedures performed in cardiac catheterisation and angiography suits. Cases will be made available to discuss, and participants are encourage to bring along any of their own cases to brain storm. Dr Kelly Bratkovic is a staff specialist at Flinders Medical Centre, South Australia. Her case mix includes cardiac surgery, cathlab procedures including transcathater aortic and mitral valve surgery. Tavi in non-hybrid theatre Facilitator: Dr William Cheng Date/time: Saturday May 2, 2015 SGD02 3.30-4.30pm This session will cover some management issues of transcutaneous aortic valve implantation (TAVI) in a smaller theatre. This session will highlight the importance of multidisciplinary approach for TAVI program. Dr William Cheng is a cardiothoracic anaesthetist at Flinders Medical Centre, Adelaide. He has been involved with TAVI program since it was established in 2008. Thoracotomy- analgesic options and dilemmas Facilitator: Dr Helen Vlachtsis Date/time: Monday May 4, 2015 SGD03 12.15-1.15pm The discussion will address some of the options for analgesia for patients having thoracic surgery and potential dilemmas relating to relative risks and benefits of the various techniques. Dr Helen Vlachtsis is a consultant anaesthetist at Flinders Medical Centre and The Repatriation General Hospital, South Australia, with an interest in anaesthesia for cardiothoracic, vascular and orthopaedic surgery, echocardiography and regional anaesthesia. Facilitator: Dr Simon Macklin Date/time: Monday May 4, 2015 SGD05 12.15-1.15pm This SGD will discuss assessment, management, peri-operative interventions for the end stage bariatric patient. This SGD will discuss assessment, management, perioperative interventions for the end stage bariatric patient. Case presentation: 56 year-old indigenous Australian from Alice Springs. BMI 56, diabetes requiring insulin, OSA on CPAP, hypertensive and on maximal dose frusemide plus ACE inhibitor. Your surgeon says “what do you think? I want to do a Roux-en-Y gastric bypass. I plan to do this laparoscopically, but I haven’t seen him yet and I may need to perform an open operation”. How will you optimise the patient? What investigations are relevant? How will you conduct the anaesthetic? What will you do for post-op analgesia? Where will you manage the patient post-operatively? Dr Simon Macklin is a senior specialist anaesthetist at the Royal Adelaide Hospital (RAH). He migrated from the UK in 1995, FRCA, to be appointed to a staff specialist position at RAH. He has a special interest in anaesthesia for upper GI surgery and airway management. He has been lead anaesthetist at RAH for patients undergoing bariatric surgery for nearly 20 years. The patient with pulmonary hypertension for non-cardiac surgery Facilitator: Dr Sam Tong Date/time: Saturday May 2, 2015 SGD06 10.30-11.30am Pulmonary hypertension is a challenging clinical condition that increases perioperative risk. The aim of this SGD is to provide a framework for managing patients with pulmonary hypertension for non-cardiac surgery with a focus on preoperative evaluation and management of acute right ventricular failure. Dr Sam Tong is a staff specialist anaesthetist at Royal Adelaide Hospital and has diverse experience in cardiothoracic anaesthesia. 23 Small group discussions (SGDs) (CONTINUED) Is transthoracic echocardiography for you? Facilitator: Dr Tony Pearce Date/time: Monday May 4, 2015 SGD07 1.30-2.30pm Cardiology has declined to perform an echocardiogram on your demented 94 year old patient with a #NOF. You become fired up with missionary zeal and begin agitating for the purchase of a TTE probe for your department’s ultrasound machine. What happens when it actually arrives? We will look at the indications for perioperative focused TTE and the thorny issues of appropriate use, training and audit. Dr Tony Pearce is a senior staff specialist anaesthetist at the Royal Adelaide Hospital. When not at work covered in ultrasound gel, he can be found at home covered in flour trying to bake the perfect sourdough loaf. Decision making in perioperative resuscitation Facilitator: Dr Cameron Main Date/time: Monday May 4, 2015 SGD08 1.30-2.30pm Cases will be presented to explore issues such as boundaries of intervention where advance directives are in place, duration of active resuscitation efforts when potentially reversible causes are present, and the role of emerging therapies such as ECMO. Dr Cameron Main is a staff specialist anaesthetist at the Royal Adelaide Hospital. He is regularly involved with the emergency and orthopaedic trauma services. Current areas of interest are anaesthesia for major hepato-biliary, spinal and ENT surgery. Non-pharmacological anxiolysis -vegas style Facilitator: Dr Michael Goldblatt Date/time: Sunday May 3, 2015 SGD09 3.30-5pm How many times have you heard …”I’m needle phobic?” or had patients demand general anaesthesia to cope with MRI. Even more dramatic are the patients who are so scared they abscond from the hospital before their surgery! Whilst we are all experts in the pharmacological management of these extreme behavior there are times when patients can be managed quickly and effectively using non pharmacological techniques such as hypnosis. This SGD will provide a brief introduction to hypnosis and how it can be used during our daily work to relieve anxiety and stress, remove phobias and make lifestyle modifications that make anaesthesia and surgery safer e.g. stop smoking. Dr Michael Goldblatt completed his primary medical degree at the Flinders University of South Australia. He completed his anaesthetic fellowship in 1999 after training in South Australia and Queensland. His experience included being the anaesthetist for a flying obstetric service in rural Queensland as well as subspecialty training in aeromedical medicine, paediatrics and cardiothoracic anaesthesia. As a result of seeing the successful use of hypnosis to resolve his daughter’s fear of flying (in one 45 minute drug free session), he trained in hypnosis and was awarded a Diploma of Clinical Hypnosis. He currently holds a half time position as a staff specialist at Flinders Medical Centre in the department of anaesthesia as well as working half time in private practice with State Anaesthetic Services. Iron shield: patient blood management in action Facilitator: Dr Bernd Froessler Date/time: Tuesday May 5, 2015 SGD10 1.30-2.30pm Patient blood management (PBM) is a patient-focused approach to improving patient outcomes by minimising or avoiding unnecessary exposure to blood components. Optimisation and maintaining the patient’s own red cell mass is crucial. Preoperative screening of iron status, with timely and adequate treatment modalities is a valuable part of the concept. Utilising appropriate alternatives to blood transfusion is cost-effective, complies with clinical governance requirements, and falls within the scope of the National Safety and Quality Health Service Standard 7 Blood and Blood Products. Dr Bernd Froessler is a staff specialist in anaesthesia at the Lyell McEwin Hospital in Adelaide and a clinical senior lecturer at the University of Adelaide. Bernd was born in Germany and completed undergraduate training in 1988 at the University of Cologne in Germany. He trained in anaesthesia and intensive care in Germany and worked as a specialist in Germany, Holland and Australia. He has been involved in patient blood management initiatives since 2006 which has also become his main research focus. Getting to the heart of perioperative myocardial injury in non cardiac surgery Facilitator: Dr Oliver David Date/time: Monday May 4, 2015 SGD11 3.30-4.30pm Using case based discussion we will examine the various aspects of perioperative myocardial injury. Who is at risk, how can we avoid it and what to do when it happens. Dr Oliver David’s interest in perioperative medicine began after completing the Perioperative Medicine Short Course through Monash University and went on to do a formal project looking at preoperative anaemia in cardiac surgical patients at the Royal Adelaide Hospital. Oliver began his anaesthesia training in South Australia and the Northern Territory and went on to spend his provisional fellowship year at Changi General Hospital in Singapore. His special interests are in regional anaesthesia, pain medicine, perioperative cardiology and transfusion medicine. Where neurologist and anaesthetist may clash: anaesthesia for acute stroke Facilitator: Dr Shona Osborn Date/time: Sunday May 3, 2015 SGD12 3.30-4.30pm Increasing numbers of patients suffering an acute ischaemic stroke who fail thrombolysis are taken to the angiography suite for endovascular therapy. The impact of general anaesthesia versus minimal sedation on patient outcomes after such endovascular therapy has been greatly debated among neurologists, but the riskbenefit balance may be less familiar to anaesthetists, particularly those who rarely undertake such cases. Using a case-based format, this SGD will examine the issues involved. Participants will be encouraged to discuss their own experiences. The SGD will also cover the anaesthetic management for non-cardiac surgery of patients who are at particularly high risk of stroke, and review cases where perioperative stroke has occurred. Dr Shona Osborn is a staff specialist and a current supervisor of ANZCA’s Specialised Study Unit in neurosurgery and neuroradiology, at the Royal Adelaide Hospital. 24 Eye lists made easier Facilitator: Dr Jon Clarke Date/time: Saturday May 2, 2015 SGD13 10.30-11.30am A small group discussion of common pitfalls in ophthalmic lists, how to avoid them and offer advice and group discussion on any issues experienced in your lists. This SGD is aimed at the occasional or improving ophthalmic anaesthetist. Dr Jon Clarke has a longstanding interest in all aspects of ophthalmic anaesthesia. This includes teaching and research as well as a large ophthalmic workload in both the public and private sectors. Utilising lumbar drains for spinal cord protection during TEVAR (thoracic endovascular aortic repair) or major aortic surgery Facilitator: Dr Dave Cardone Date/time: Sunday May 3, 2015 SGD14 12.15-1.15pm This SGD will cover lumbar CSF drain indications, kit, insertion technique, anticoagulation issues, monitoring CSF pressures, draining CSF, trouble shooting, clinical utility, and clinical evidence. Dr Dave Cardone works as a consultant cardiothoracic anaesthetist at Royal Adelaide Hospital, having competed a cardiothoracic fellowship at Papworth Hospital, Cambridge UK (2008/2009) and recently returned from 12 months work as an ‘attending’ at the University of Michigan Cardiovascular Centre, USA. Anaesthesia for cancer surgery Facilitator: Dr Jason Chou Date/time: Sunday May 3, 2015 SGD15 12.15-1.15pm What is the anaesthetists’ modus operandi in cancer surgery, with its major nociceptive input and a high risk of nerve damage? We want something that is effective, opioid sparing and have little effects on major organ systems. We also want our patients to leave the hospital as soon as possible. On a bigger picture, we want to reduce our patients’ risk of developing persistent post-surgical pain and even have improved cancer recurrence-free survival. Is it all too much to ask? What is the evidence? Dr Jason Chou is an anaesthetist and adult and paediatric pain medicine specialist. He heads the Acute Pain Service at the Peter MacCallum Cancer Centre and is also a clinical senior lecturer at the University of Melbourne. His other public appointments include the Alfred and the Austin Hospitals. His main clinical interests include the role of perioperative interventions in improving both short and long term outcomes, especially in cancer surgery. This interactive SGD will explore the concept of “effective” TP and provide participants with an evidence based guideline to assist in the assessment of thromboembolic risk and the provision of standardised recommendations based on these risk profiles. At the conclusion of the SGD, participants will be equipped with the quality improvement tools required to implement a surgical thromboembolism prevention protocol at their own institutions, thus expanding the role of anaesthetists as perioperative physicians. Dr Rani Chahal trained in anaesthesia at the Royal Melbourne Hospital and currently works as a specialist anaesthetist at Peter MacCallum Cancer Centre and Western Health in Melbourne, Australia. His interests include anaesthesia for surgical oncology, ENT surgery, quality improvement and perioperative medicine, specifically surgical thromboembolism prevention. To cement or not to cement…… Facilitator: Dr Jo Melick Date/time: Sunday May 3, 2015 SGD17 12.15-1.15pm The aetiology and risks of cement implantation syndrome, looking at risk stratification in regard to anaesthetic and surgical considerations in the management of fractured neck of femur. Dr Jo Melick is a staff anaesthetist at Flinders Medical Centre and Repatriation Hospital, with interests in orthopaedics and regional anaesthesia. Anaesthesia for electroconvulsive therapy - is there more to it than Propofol and Sux? Facilitator: Dr Ivan Ward Date/time: Tuesday May 5, 2015 SGD18 9-10am This small group discussion will review of current evidence related to the anaesthetic management of patients undergoing ECT, and a discussion of some interesting cases. Dr Ivan Ward is a senior anaesthetic consultant at Flinders Medical Centre and private anaesthetist with Pulse Anaesthetics. Dr Ward was an anaesthetic representative on the ECT advisory committee in the formation of the South Australian Guidelines for Electroconvulsive Therapy (2014) ECT manual. He has a broad range of experience in anaesthesia for ECT, working in both private and public ECT centres. As a supervisor of training at Flinders Medical Centre Dr Ward is heavily involved in teaching, and has previously given presentations on anaesthesia for ECT at both national and state psychiatric meetings. Perioperative thromboprophylaxis: expanding the role of anaesthetists in risk reduction and quality improvement Facilitator: Dr Rani Chahal Date/time: Sunday May 3, 2015 SGD16 1.30-3.30pm Preventative thromboprophylaxis (TP) is one of the most important interventions to improve patient safety in surgical patients. Evidence, however, points to significant underutilisation of and heterogeneity in perioperative TP, placing patients at significant risk of hospital-acquired venous thromboembolism (VTE). 25 Small group discussions (SGDs) (CONTINUED) YOU THINK THAT IS A COMPLEX CASE...CHECK THIS OUT! Facilitator: Dr Jeremy Fernando Date/time: Sunday May 3, 2015 SGD19 12.15-1.15pm This is a small group, interactive case discussion about an elderly patient who required urgent, life and limb saving orthopaedic surgery, managed in a regional center. Dr Jeremy Fernando is an anaesthetist and intensive care specialist at Rockhampton Hospital. He is a senior lecturer at the Rural Clinical School, University of Queensland. His interests include perioperative medicine, teaching and education, high fidelity simulation training, recognition and management of the deteriorating patient and collaborative health care. Practical aspects of IV iron prescribing, dosing and administration for the anaesthetist Facilitator: Dr Kathryn Robinson Date/time: Sunday May 3, 2015 SGD20 1.30-2.30pm This SGD will cover the nuts and bolts of how to get IV iron prescribing from an idea to a reality. Dr Kathryn Robinson is a haematologist and transfusion medicine specialist at the Australian Red Cross Blood Service and the Queen Elizabeth Hospital in Adelaide, South Australia. She holds a joint fellowship with the Royal Australian College of Physicians and Pathologists, training in Adelaide, Melbourne and Oxford. Kathryn is the clinical lead of “BloodSafe”, a state-wide collaborative program to improve the safety and appropriateness of clinical transfusion practice. She has a particular interest in iron deficiency and has been involved in a number of improvement programs, including the development of resources and academic detailing programs for GPs. SGD STREAM: UNUSUAL ENVIRONMENTS Beam me up Scotty! transporting the morbidly obese Facilitator: Dr Kylie Stanton Date/time: Saturday May 2, 2015 SGD21 1.30-3pm With the nation’s obesity levels on the rise, transfer of the morbidly obese critically ill patient is an increasing challenge in anaesthesia and retrieval medicine. This session will use case based discussion to examine the issues faced and how to solve them. BMI 90+ with severe sepsis...let’s make it look easy. Dr Kylie Stanton combines retrieval medicine and private practice anaesthesia in Adelaide. Anaesthetists and Aircrafts: preparing for the fall Facilitator: Dr Alex Zanker Date/time: Saturday May 2, 2015 SGD22 12.15-1.15pm A case based discussion on anaesthesia in the aeromedical setting with an emphasis on the different safety aspects to be considered, and preparedness for the worst case scenario. Dr Alex Zanker is a staff specialist at the Queen Elizabeth Hospital, South Australia. SGD STREAM: RESEARCH Getting started in research Facilitator: Professor Kate Leslie and Ms Karen Goulding Date/time: Saturday May 2, 2015 SGD23 1.30-3pm Would you like to conduct research? This workshop is aimed at people new to multi-centre research who are unsure of where to start. The session will cover: developing your research idea; protocol development; pilot and feasibility studies; funding opportunities; funding your own research coordinator - the business case; setting up your site; ethics and research governance; where to get help and Trials Group support. Professor Kate Leslie is the current chair of the ANZCA Trials Group Executive and is a member of the ANZCA Research Committee and Foundation Board of Governors. Kate’s current research interest is in mentoring emerging researchers in order to establish large multicentre randomised trials in anaesthesia and perioperative medicine. Ms Karen Goulding is an ANZCA Trials Group Coordinator at ANZCA and Monash University. She has a background in basic research and public health. Getting your research published Facilitator: Associate Professor Andrew Davidson and Professor David Story Date/time: Sunday May 3, 2015 SGD24 1.30-3.30pm This workshop is aimed to teach participants how to design, execute, analyse and write up research in such a way as to ensure publication in the best possible journal. Associate Professor Andrew Davidson is editor-in-chief of Paediatric Anaesthesia and on the editorial boards of several other leading journals. He is the Director of Clinical Research, Royal Children’s Hospital, and head of anaesthesia and pain management research at the Murdoch Children’s Research Institute. Andrew is a member of the ANZCA Trials Group Executive. Professor David Story is the coordinator of the Clinical Sciences and Health Practice Research Domain at the University of Melbourne. He holds the foundation Chair of Anaesthesia at the University of Melbourne and is Head of the Anaesthesia, Perioperative and Pain Medicine Unit within the Melbourne Medical School. David is a member of the ANZCA Trials Group Executive. 26 Navigating the ethics committee Facilitator: Dr Tim Porter Date/time: Saturday May 2, 2015 SGD25 3.30-4.30pm This SGD will address the issues of why we have ethics committees, what they do, and most importantly, how to ensure that research proposals get through the relevant committee as quickly and happily as possible. In particular, it will focus on common holdups in ethics reviews. Dr Tim Porter is a staff specialist anaesthetist at Flinders Medical Centre, has a Masters degree in Bioethics and is a deputy chair of the Southern Area Local Health Network’s Human Research Ethics Committee. Ethical legal consent Facilitator: Dr Bernadette Richards Date/time: Tuesday May 5, 2015 SGD26 1.30-3pm Consent to medical treatment is the subject of much debate, discussion and disagreement. At its base is the foundational right to determine what is or is not done to our own body, but it is not always straightforward to put into practice. Patients are by definition unwell, their cognitive processes impaired by pain or their illness. They have come to the hospital for a cure but this may not be possible. Often it is said that a patient will be ‘consented’ as though it is a process, something that is either done to or extracted from the patient. There are many layers to the consent conversation and this session will present scenarios in which the process of consent is opaque, it will involve a practical consideration of the legal and ethical foundations of consent and provide the opportunity to talk through the concerns that arise when the consent process is not straightforward. Dr Bernadette Richards comes from the Law School at the University of Adelaide and is an active researcher in the areas of Tort Law, Medical Law, and Bioethics. She has written a text book on Tort Law (Tort Law Principles,) has contributed to a collaborative text, Health Law in Australia and has recently completed a new text, Medical Law and Ethics: A Problem Based Approach. Bernadette is Deputy Chair of a major clinical research ethics committee, Associate Editor (Law) of the Journal of Bioethical Inquiry and provided advice to the Minister of Health as a member of the South Australian Council of Reproductive Technology. Her current research projects include a major grant project considering innovative surgery, the misapplication of the Australian Human Tissue Acts to posthumous donation of reproductive material and the role of ethical dialogue in popular entertainment. SGD STREAM: EDUCATION AND WELFARE Asleep at the wheel Facilitator: Dr Simon Jenkins and Dr Matthew Thomas Date/time: Tuesday May 5, 2015 SGD27 9-10am An investigation has been initiated into a sentinel event in a hospital in your area where a patient died after a cardiac arrest during a cholecystectomy. You have been given the task of investigating the circumstances around the event. Initial reports suggest the anaesthetist failed to detect subtle deterioration of the patient during the procedure. In this interactive session, we will lead you through the investigation as more detailed information comes to light. We will explore the relationship between fatigue and error, the implications for those involved at all levels of the health service with respect to roles and responsibility. The session will provide participants with an overview of best practice in terms of fatigue risk management. Dr Simon Jenkins is a consultant anaesthetist and Department Director at Lyell McEwin Hospital in the northern reaches of Adelaide. He previously ran the simulation unit at the Royal Adelaide Hospital where he had interests in human factors and performance in clinical anaesthesia. He is an Aquarius and would like to sail across an ocean before he dies. Dr Matthew Thomas is a leading human factors scientist in Australia. He has contributed to projects enhancing safety for airlines, health services, rail operators, mining organisations, utilities, and others across the Asia-Pacific region. Monsters in the mind Facilitator: Dr Michael Goldblatt Date/time: Monday May 4, 2015 SGD28 3.30-5pm Remember as a child when you were frightened of monsters hiding under your bed or in your bedroom cupboard? As an adult many of us experience the same fear and anxiety when faced with examinations, assessments of our performance in the work place or when having to give presentations to our colleagues. Whilst some degree of stress is required to achieve, there are situations where the increased stress and anxiety will detract from your performance. Hypnosis and Neurolinguistic programming (NLP) are well documented as techniques to help change how you feel in these situations. This SGD will demonstrate how you can simply use hypnotic techniques to reduce anxiety and stress and improve your performance where it counts-exams, vivas, and presentations-regaining control of these monsters which lurk in your mind! Dr Michael Goldblatt completed his primary medical degree at the Flinders University of South Australia. He completed his anaesthetic fellowship in 1999 after training in South Australia and Queensland. His experience included being the anaesthetist for a flying obstetric service in rural Queensland as well as subspecialty training in aeromedical medicine, paediatrics and cardiothoracic anaesthesia. As a result of seeing the successful use of hypnosis to resolve his daughter’s fear of flying (in one 45 minute drug free session), he trained in hypnosis and was awarded a Diploma of Clinical Hypnosis. He currently holds a half time position as a staff specialist at Flinders Medical Centre in the department of anaesthesia as well as working half time in private practice with State Anaesthetic Services. Moving from clinical practice to academic teaching Facilitator: Dr Robin Limb Date/time: Sunday May 3, 2015 SGD29 10.30-11.30am Are you interested in developing your career outside the operating theatre? Dr Robin Limb is a staff anaesthetist, now working also in Clinical Education for the University of Adelaide. She has explored options in detail, including medical education, academic medicine and perioperative medicine. 27 Small group discussions (SGDs) (CONTINUED) Performance issues Facilitator: Dr Di Khursandi Date/time: Saturday May 2, 2015 SGD30 1.30-2.30pm Have you wondered about performance issues in one of your colleagues? Do you know what you can do? This SGD will explore some common issues and the actions you might take. Dr Di Khursandi is the Director of Clinical Training, Caboolture Hospital, Queensland. Di is the founder and past chair of the Rural and Welfare of Anaesthetist Special Interest Groups. Di was a member of ANZCA Council and a number of other committees from 1998-2007. Building a happy department Facilitator: Dr Di Khursandi Date/time: Monday May 4, 2015 SGD31 1.30-2.30pm Do you look forward to coming to work? Are you supported in your department? Do you as a leader, or does your leader, have the right qualities to run a department or group? Let’s discuss what strategies might build great morale and an enviable reputation for your team. Dr Di Khursandi is the Director of Clinical Training, Caboolture Hospital, Queensland, Australia. Di is the founder and ex-chair of the Rural and Welfare of Anaesthetist Special Interest Groups. Di was a member of ANZCA Council and a number of other committees from 1998-2007. How green is my anaesthetic? Facilitator: Dr Kristen Llewelyn Date/time: Monday May 4, 2015 SGD32 1.30-2.30pm Interested in the environmental impact of anaesthesia? Concerned about sustainability issues? Come, learn and share ideas to move towards a more sustainable practice. Dr Kristen Llewelyn is a senior staff anaesthetist at Flinders Medical Centre. She enjoys providing anaesthesia for a wide variety of surgical disciplines. She is also a closet greenie. The expert trap Facilitator: Dr Dave Sainsbury Date/time: Monday May 4, 2015 SGD33 10.30-11.30am “The expert trap” centers on issues of unconscious bias in recognition-primed decision making. This is generally a valuable cognitive shortcut to free up the scarce but unique resources of working memory. It is important to recognise this shortcut as a potential source of error, exemplified by task fixation, myside bias, confirmation bias, accessibility bias etc. There are many implications for quality and safety in health care delivery, from premature closure in the diagnostic process to the impact of ageing in clinical practice. 28 Dr Dave Sainsbury graduated from the University of Adelaide in 1978, completing postgraduate training in anaesthesia in 1985. After one year in the Netherlands, he settled into a staff position at the Women’s and Children’s Hospital where he has remained, including five years as director. His interest in training in non technical skills started with a pilot project for TeamSTEPPS in South Australia in 2008. He is now a master trainer in that program, instructor in the national Teaching on the Run course, graduate of the original AusSETT program, facilitator/instructor in two programs with the Royal Australasian College of Surgeons; Non Technical Skills for Surgeons and Training in Professional Skills. Understanding the emotional patient Facilitator: Dr Dave Sainsbury Date/time: Saturday May 2, 2015 SGD34 3.30-4.30pm A simple model is described that traces difficult emotional states to loss and consequent grief. Scripts are suggested for avoiding our habitual response to patients demonstrating denial, anger, anxiety and depression. Some approaches to conflict resolution will also be covered. Dr Dave Sainsbury graduated from the University of Adelaide in 1978, completing postgraduate training in anaesthesia in 1985. After one year in the Netherlands, he settled into a staff position at the Women’s and Children’s Hospital where he has remained, including five years as Director. His interest in training in non technical skills started with a pilot project for TeamSTEPPS in South Australia in 2008. He is now a master trainer in that program, instructor in the national Teaching on the Run course, graduate of the original AusSETT program, facilitator/instructor in two programs with the Royal Australasian College of Surgeons; Non Technical Skills for Surgeons and Training in Professional Skills. SGD STREAM: ANAESTHETIC REGISTRARS Difficult airways: a PFY experience Facilitator: Dr Adam Badenoch Date/time: Monday May 4, 2015 SGD35 10.30-11.30am Twelve months at a busy tertiary referral hospital in Adelaide, a city with its fair share of oral and airway cancers courtesy of an excess of cigarette smoke and V8 engine exhaust, delivered many difficult airway scenarios. How would you handle them? Dr Adam Badenoch has recently completed an airway provisional fellowship at the Royal Adelaide Hospital, and is currently working as the medical education and simulation Fellow at Flinders Medical Centre. Teaching anaesthetic skills... the blind leading the blind Facilitator: Dr Faith Crichton Date/time: Monday May 4, 2015 SGD36 3.30-4.30pm The SGD is aimed at registrar’s where discussion will focus on teaching anaesthetic skills to junior trainees and/or other members of staff. Dr Faith Crichton has recently completed her medical education and simulation Fellowships at Flinders Medical Centre. The uncooperative paediatric patient versus the trainee Facilitator: Dr Rachelle Augustes Date/time: Monday May 4, 2015 SGD37 12.15-1.15pm What premedication do you give the screaming child in holding bay? What about the autistic child on tomorrows dental list? How can you prevent emergence delirium? This SGD is for trainees or the occasional paediatric anaesthetist facing common paediatric behavioural issues. Dr Rachelle Augustes is a provisional Fellow at the Woman’s and Children’s Hospital Adelaide. Anaesthesia for the high risk vascular patient - more than just vasopressor and an arterial line? Facilitator: Dr Jim London Date/time: Tuesday May 5, 2015 SGD38 9-10am Patients presenting for vascular surgical procedures represent a high risk patient group. There are many factors to consider in order to improve patient outcomes. The preoperative assessment and optimisation of these patients is essential. The literature on the intra-operative management can be conflicting. By the end of this session you will have a frame work for the optimal perioperative care of this high risk patient group. Dr Jim London is an anaesthetic fellow at the Royal Adelaide Hospital with an interest in perioperative medicine and high risk anaesthesia. James has completed a Bachelor of Medical Science, Bachelor of Science (Honours), Bachelor of Medicine and Bachelor of Surgery. Obstetrics and obesity for beginners Facilitator: Dr Sam Lumb Date/time: Monday May 4, 2015 SGD39 10.30-11.30am This SGD will cover approaches to the high BMI obstetric patient: from when you’re seeing a BMI 45 patient in high-risk anaesthetic clinic in the obstetric hospital at 20 weeks, to the 160kg patient who’s presented to the labour ward at 4am with a sketchy trace. Dr Sam Lumb is a provisional fellow at the Women’s and Children’s Hospital/LMH. Approaches and considerations for the acute and chronic liver failure patient and liver resection Facilitator: Dr Rick Champion Date/time: Sunday May 3, 2015 SGD40 10.30-11.30am This small group discussion is aimed at the trainee approaching patients with liver disease and patients for liver resection surgery. This group of patients have a complex pathophysiology which changes with the progression of disease. The anaesthetic management of these patients can be challenging but ultimately extremely rewarding. Dr Rick Champion is a provisional fellow at Flinders Medical Centre (upper GI). The troubleshooting epidural Management of the opioid addicted patient in acute pain for beginners Facilitator: Dr Irina Hollington Date/time: Saturday May 2, 2015 SGD42 1.30-2.30pm Patients with addiction disorders are often complex in their perioperative management. With case based scenarios we will give you a step-wise approach to review preoperative risk factors, the various pharmacological options available, the role of expectation setting and education of patients about their part in managing pain, the importance of discharge planning and how to manage weaning successfully. Dr Irina Hollington is an anaesthetist with a fellowship in acute pain and incoming chronic pain fellow at the Royal Adelaide Hospital. SGD STREAM: PAEDIATRICS Paediatric dilemmas Facilitator: Dr Dave Barker Date/time: Saturday May 2, 2015 SGD43 12.15-1.15pm Practical paediatric dilemmas for the occasional paediatric anaesthetist bring your favourites to the table. Cases will be available to discuss. Participants are encouraged to bring along any of their own cases to brainstorm. Dr Dave Barker is a paediatric anaesthetist (occasional adult anaesthesia) and staff specialist Women’s and Children’s Hospital Adelaide. Beads, peanuts, coins and batteries- the challenges of inhaled or swallowed foreign bodies in paediatric anaesthesia Facilitator: Dr Yasmin Endlich Date/time: Saturday May 2, 2015 SGD44 3.30-4.30pm This SGD will cover the different management in various inhaled or swallowed foreign bodies in paediatric anaesthesia. Discussion will be around the urgency and the necessity of various procedures. This SGD will focus on tips and tricks about induction, maintenance of anaesthesia and post operative care, and will touch base on surgical techniques. This session is ideal for trainees and the occasional paediatric anaesthetist. Dr Yasmin Endlich commenced anaestetic training in Vienna in 2007 and is now a staff specialist at the Women’s and Children’s Hospital and Lyell McEwin Hospital in Adelaide. Facilitator: Dr Irina Hollington Date/time: Monday May 4, 2015 SGD41 3.30-4.30pm Well working epidurals are a blessing, however troublesome epidurals are often considered hardly worth the effort. In this interactive SGD we will review the indications and complications, anatomy, insertion site and technique, how to secure and run the epidural effectively in the perioperative setting and how to swiftly troubleshoot and assess if and how it can be salvaged. The SGD aims to give pre-part 2 registrars the skills and confidence to manage a call for help in the middle of the night! Dr Irina Hollington is an anaesthetist with a fellowship in acute pain and incoming chronic pain fellow at the Royal Adelaide Hospital. 29 Small group discussions (SGDs) (CONTINUED) SGD STREAM: PAIN MEDICINE TIPS AND TRICKS: THE OPIOID-TOLERANT PATIENT WITH ACUTE PAIN Facilitator: Dr Lindy Roberts Date/time: Monday May 4, 2015 SGD45 10.30-11.30am The 4th edition of Acute Pain Management: Scientific Evidence will be released at the Adelaide ASM. The focus of this session is on how the new guidelines on opioid-tolerant patients, including those with opioid addiction, can be applied to your practice. Participants are encouraged to bring along their curly questions, tricky cases and tips for how they manage these patients. The approach will be case-based and practical. Dr Lindy Roberts is an anaesthetist and specialist pain medicine physician at Sir Charles Gairdner Hospital, Western Australia, with a particular interest in complex acute pain management. She has contributed chapters on opioid tolerance and addiction to Acute Pain Management: Scientific Evidence (ANZCA and FPM) and been an FPM examiner. Beyond morphine in paediatric pain management Facilitator: Dr Matthew Crawford Date/time: Tuesday May 5, 2015 SGD46 1.30-2.30pm This discussion will centre around acute pain management in children and the possible transition to chronic pain. How common is chronic pain in children? Are the chronic pain risk factors for children the same as adults? What are the most effective acute pain management strategies in this group? Dr Matthew Crawford is an anaesthetist, intensivist and pain medicine fellow at Prince of Wales/Sydney Children’s Hospital. He is Director of Pain and Palliative Care, and the Clinical Director of Surgery and Anaesthesia Program at Sydney Children’s Hospital. Acute neuropathic pain Facilitator: Associate Professor David Scott Date/time: Sunday May 3, 2015 SGD47 1.30-2.30pm Acute neuropathic pain is increasingly recognised as a component of early acute pain following surgery. Acute neuropathic pain needs to be recognised and treated as a specific entity to ensure optimal patient outcomes.The conventional treatment of acute postoperative pain often fails to address this, resulting in suffering and distress which may in fact be preventable and lead to longer term pain. During this small group discussion we will explore some of these issues from a practical point of view. Associate Professor David Scott is the Director of the Department of Anaesthesia and Acute Pain Medicine at St. Vincent’s Hospital in Melbourne. He was head of the Acute Pain Service for almost 20 years. He has a PhD in neuropharmacology and is interested in neuropathic pain. Over the last decade, his research has focussed on outcomes - including the cognitive effects of anaesthesia and surgery, also outcomes related to Acute Pain management and cardiac surgery. He has researched, published and presented extensively in these areas. New opioids and the anaesthetist Facilitator: Dr Tim Semple Date/time: Sunday May 3, 2015 SGD48 10.30-11.30am 30 With an ever increasing range of patches and formulations of opiates working out a perioperative management plan can start to seem daunting. In this session we will explore the ins and outs of these new chronic pain options and their impact on anaesthesia. Dr Tim Semple works at the Royal Adelaide hospital specialising in chronic pain and cardiac anaesthesia. SGD STREAM: OBSTETRIC ANAESTHESIA Fun with pregnant fontans Facilitator: Dr Jason Koerber Date/time: Saturday May 2, 2015 SGD49 10.30-11.30am A small case series of pregnant women with Fontan circulations who received a variety of anaesthetic types is presented. This series is used as a basis for discussion about the problems involved, the evidence in the literature, and possible management for this intimidating and increasingly less rare challenge. Dr Jason Koerber is a staff specialist Flinders Medical Centre. His interests include obstetric anaesthesia and regional anaesthesia. The ABC of pregnancy: adiposity, breathlessness and coagulopathy Facilitator: Dr Susmita Bhattacharya and Dr Helena Choi Date/time: Sunday May 3, 2015 SGD50 3.30-4.30pm This SGD will discuss a complex obstetric case, involving morbid obesity in pregnancy, dilemmas in the diagnosis and management of breathlessness and the impact of coagulopathy on obstetric management. During the session, the role of transthoracic echocardiography in pregnancy will be discussed and images relevant to the case will be presented. Participants will be encouraged to explore options in diagnosis and management of this challenging case, focussing particularly on the practical issues. Dr Susmita Bhattacharya and Dr Helena Choi are anaesthetists working at Westmead Hospital, who hold a special interest in high risk obstetrics. Both have completed an obstetric anaesthetic fellowship, and have been involved in the management of multiple high risk obstetric patients. Dr Helena Choi holds a special interest in the use of transthoracic echocardiography in pregnancy, while Dr Susmita Bhattacharya holds a special interest in peripartum cardiomyopathy. SGD STREAM: REGIONAL ANAESTHESIA Finessing your spinal anaesthesia Facilitator: Dr Dave McLeod Date/time: Monday May 4, 2015 SGD51 12.15-1.15pm Instead of using 3mls of 0.5% in your spinal why not tailor your dose and technique to suit your patient and the surgical procedure. We will look at spinal techniques for day surgery, prone position, anorectal and perineal procedures, patients with severe aortic stenosis, urological procedures in the decrepit, unilateral blocks, and hypobaric spinals for fractured NOF. Dr Dave McLeod is an anaesthetist at Flinders Medical Centre and in private practice. He has an interest spanning 20 years in low dose, unilateral, hypobaric and day surgery spinals, and has researched and published in the area. He is a foundation member of the executive of the Regional Anaesthesia Special Interest Group.
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