I recently submitted a “Letter to the Editor” of the BJA in response to the clever study by Zhong and colleagues demonstrating that the use of high fresh gas flows (FGF) during TIVA produces a cost-saving with, importantly, no adverse environmental consequences. My letter was responding to their conclusion regarding the impact of high FGFs on humidification of inhaled gases, and specifically the issue of heat and moisture exchangers (HMEs).
The letter was edited and shortened significantly during the review process, so much so that I felt some important discussion around a commonly misunderstood device was missing. The published letter is now available here, but I felt it might be helpful to make the full text of the original letter (with some minor corrections) publicly available, so I have presented it below.
Continue reading “Fresh Gas Flows, Filters, HMEs and Humidification”
In recent years, I’ve developed an interest in design, and in particular how both good and bad design impact humans. One outcome of that newfound interest was a Twitter account, @DunnyDesign. You can read a bit about it here, but it essentially documents and considers various aspects of toilet and bathroom design that I come across in daily life.
Probably the first aspect relating to toilets design that made me sit up and take notice, and was likely the impetus behind @DunnyDesign, was when I noticed that public toilets, especially those on large commercial premises such as shopping centres and cinema complexes, had slowly but surely transitioned from a “double door” entry to, what I refer to as, a “maze” entry. Continue reading “Dirty Doors and A-maze-ing Entryways”
I was recently clearing out my “Downloads” folder (which had got way out of hand!), and while doing so I found a document I’d downloaded in July 2019 when I was looking into the light-sensitivity of sugammadex. It was part of an FDA review into the drug when it was being considered for approval in the United States. It just so happened this discovery came in the middle of a Twitter discussion on the potential for sugammadex to cause, amongst other things, anaphylaxis. Continue reading “Sugammadex FDA Review Documents”
Juno recently released a TGA-approved pre-filled syringe containing metaraminol. However, not long after release, multiple issues were identified by anaesthetists who were using them. There was a fair bit of discussion and sharing of information and experiences on Twitter, and many anaesthetists have stopped using them, and some hospitals have now withdrawn them. Several people have contacted me regarding the syringes, and I thought I would aggregate some of the information I’ve collected in one place to make it easy for people to access it if they want to.
Continue reading “Juno Pre-filled Syringes”
The fact that my emerging interest in Human Factors/Ergonomics and design (see here) coincided to a large degree with me having to spend a lot of time in toilets due to colitis (see here), has meant I’ve developed a, some would say “unhealthy”,
obsession fascination interest in the way toilets and bathrooms are designed. It basically means that every time I go into a toilet or a bathroom, I’m paying more attention to what’s around me than I used to. This will include observing things such as taps, sinks, doors, locks, signage, layout (pretty much everything really!), and thinking about the potential impacts, both positive and negative, that these “99% invisible” features have on aspects of life such as personal hygiene, public health, privacy, accessibility, usability, aesthetics and so on.
Continue reading “Dunny Design”
This post outlines my medical history organised by system, since being diagnosed with advanced melanoma in October 2013. To see my medical history organised chronologically, see this post here. It remains a work in progress as new issues arise, and as I go back through my records and find things I’d overlooked.
Continue reading “Progress Notes-By System”
This is where I’ll be picking my way through all the dirty #DudScrubs laundry. Tighten those side-ties, because there’s a lot to get through!
For an explanation of what #DudScrubs is all about, read my more detailed post on it here.
Below I’ve started organising the various tweets into different categories to make them easier to find, and because different aspects may be of more interest or importance to different people. But I think it is the overall picture that makes the case for change so compelling, and that hospitals need to sit up, take notice, and start asking their staff what they can do to make their scrub provisioning system more fit-for-purpose. Continue reading “Sorting the #DudScrubs Laundry”
Back in 2018, my church ran one of their Big Ideas Nights on the topic of euthanasia and assisted suicide. I gave a presentation at that meeting discussing my background and some thoughts I had on the idea of suffering and euthanasia drawing from my own experience. Below is the transcript, and slides, from that presentation.
Continue reading “HBC Big Ideas Night: Euthanasia”
An unavoidable part of working in operating theatres is the requirement to wear what is formally known as “Perioperative Attire”, but casually known as “scrubs”. While the term “scrubs” is now used to refer to similar clothing worn anywhere in the hospital, the primary purpose of theatre scrubs is to reduce the introduction of environmental pathogens into the theatre environment, thereby reducing the incidence of surgical site infections. Most hospitals require staff to wear scrubs supplied and laundered by the hospital. So essentially, scrubs are a mandatory workplace uniform, supplied by the hospital, to be worn by staff to improve patient outcomes.
Continue reading “It’s Time to #ScrubOut #DudScrubs”
I spent three months at the end of 2012 working in Suva, Fiji as the ASA Pacific Fellow, which was a position they created and funded in order to help prepare anaesthetic trainees for their exams. At the end of the stay I wrote a short piece describing some of the practical aspects of living there with my young family, in case it proved helpful to other Fellows that came after me. I thought I’d re-post here for similar reasons, but also as an historical snapshot as a significant part of my medical career that has had a lasting impact on me and my family. Fiji is a strategic hub for training doctors working all around the South Pacific, so if you get the chance to contribute in some way, I highly recommend you do.
Continue reading “Day-to-Day Living in Suva c.2012”