David Pappin

[David Pappin @David_Pappin]

@goldstone_tony Thanks, I'll just sit tight then. Where would we be without you - legend!!

[David Pappin @David_Pappin]

@DrBruceWMYoung1 @BJAJournals how about the swapping of the psoas and erector spinae muscles in the QLB ( f)...eek!!

[David Pappin @David_Pappin]

@DrRobbieErskine Congratulations!!! ...about time. It's been in the "Torbay Hospital Anaesthesia Pocketbook" for years😀 Thanks Robbie

[David Pappin @David_Pappin]

@jeffgadsden @amit_pawa @EMARIANOMD @ASRA_Society @Nadia_Hdz_MD @anesthesiadocmd @Jerryblocksthat @zedunow @dr_melissabyrne @ajrmacfarlane @docmorne @claralexlobo @DrJeniMD Anybody else find injecting inside this fascial plane really hard? Always high injection pressure with only a low volume injected. Is it because I'm in the wrong place, or is it because we are always operating on older fractures than those in the videos??

[David Pappin @David_Pappin]

@mjoldman @anesthesiadocmd @jeffgadsden @VeenaGraffMD @Nadia_Hdz_MD @HoltzMaggie @EngySaid_MD I do love a Blocktober controversy. This discussion just highlights physician's different attitudes to risk and benefit. Normal distribution curve I suspect. We're all correct!!

[David Pappin @David_Pappin]

@mjoldman @anesthesiadocmd @jeffgadsden @VeenaGraffMD @Nadia_Hdz_MD @HoltzMaggie @EngySaid_MD Well that risk of Hep C is about as close to zero as you can get. I advocate being responsible for cleaning your own probe and cable, use a chlorhex and sterile gel on skin, tegaderm to probe - and don't lick the needle!😀

[David Pappin @David_Pappin]

@Nadia_Hdz_MD @anesthesiadocmd @sunny_tumber @jeffgadsden @VeenaGraffMD @HoltzMaggie @EngySaid_MD I kind of agree, I suspect risk is phenomenally low with SS blocks. If properly worried we should all wear masks when needling! I'm a fan of Tegaderms when I can find them (cheap and cheerful), also wear a mask if doing a PENG (don't want to be blamed). Full HGGM for catheters!

[David Pappin @David_Pappin]

@jeffgadsden @Nadia_Hdz_MD @garyschwartzmd @Steve_Coppens @Ropivacaine @MKwesiKwofie @BridgetPulos @anesthesiadocmd @bobfunn @NarouzeMD @amit_pawa @EMARIANOMD @fuzzymittens @AmyPearsonMD @ASRA_Society @dr_rajgupta @galusweegie @ruthi_landau @ajrmacfarlane @claralexlobo @nelkassabany @athmathottungal @docmorne @ChrisPrabhakar @VeenaGraffMD @James_Kim_MD @KohanLynn @lipidguy @GongGasGirl @mokaeleni @lianazucco @rljohnsonmd @jon_bailey_anes @KalagaraHari @blockergirlMD @hjas18anes @_anapatriciaper @BarbaraVersyck @AminaBenyoucef5 @mswami001 @megs1970 @zedunow @MariaaYasminee @Duke_Anesthesia @dr_melissabyrne @PeterMerjavy @SreeHPraveenKO1 @mjoldman @BlockIt_Hot_Pod Since 2008 I've scanned >95% of my patients backs. Started in obstetrics (midline), now mostly elderly trauma (paraspinous). Remember to use common sense, set depth to double expected distance to spinal canal (stops you missing things). Be super accurate with marks AND needling.

[David Pappin @David_Pappin]

@jeffgadsden Thanks for a fantastic Blocktober 2022. A triumph again! I applaud the phenomenal amount of work & dedication that you & your team put into it. Incredibly professional, educational and entertaining. Your videos are a big part of our hospital's Blocktober (and Nervember)! Thankyou

[David Pappin @David_Pappin]

@mjoldman @jeffgadsden @docmorne @DrRobbieErskine @Nadia_Hdz_MD @rosie_hogg @HoltzMaggie @Steve_Coppens @claralexlobo @_anapatriciaper @pritanand @Ropivacaine @anesthesiadocmd @EMARIANOMD Same reason I do it first Matt, and just like @DrRobbieErskine ... you can reach its fascial plane with the infiltration needle. Reassuring when you hear other people positively reinforcing your methods 😄Lets hope that continues!

[David Pappin @David_Pappin]

@jeffgadsden @ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @Duke_Anesthesia @AFSRA10 @PediAnesthesia @PedsPainMed @PedsAnesthesia @amit_pawa @EMARIANOMD @nelkassabany @Nadia_Hdz_MD @anesthesiadocmd @morefluids @ebmalinzakMD @imswimming3 @zedunow @KalagaraHari @BurgartBioethix @Ritaagarwal6 @JinaSinskeyMD @J_LauMD @concettalupa @cjwilde @JohnHagenMD @SKAnesthesia @DeepaKattail @RogueDadMD @theRodrigoDaly @AmberBoruckiMD @kfinmccarthy @innov8doc @jonmcck @DabeChatter @AmerAcadPeds @sassyanesdoc @FutureAnesRes @DrSeanBarnes @GongGasGirl @baby_blocks @NarouzeMD @garyschwartzmd @DrJeniMD @colinjmccartney @ajrmacfarlane @rjvanstone @rosshofmeyr Don’t do much Paeds anymore, but have found they’re really useful for post-op analgesia in A-P resections (20-30ml of 0.25% levobupivacaine with a little bit of clonidine like you said). Always use the ultrasound!!

[David Pappin @David_Pappin]

@DrRobbieErskine Thanks Robbie, good advice. Just got more patient info - 15yds exercise tolerance - pulmonary fibrosis 😬. Ever done it without interscalene?

[David Pappin @David_Pappin]

Anyone done a reverse polarity shoulder replacement under RA? Possible I guess with some sedation. Any issues or tips and tricks? Or should I avoid at all costs?

[David Pappin @David_Pappin]

@jeffgadsden @ASRA_Society @ESRA_Society @amit_pawa @EMARIANOMD @KalagaraHari @claralexlobo @dr_tgro @ASALifeline @ajrmacfarlane @rosie_hogg @docmorne @morne @RegionalAnaesUK @Assoc_Anaes @ASA_Australia @elboghdadly @zedunow @galusweegie @pritanand @nelkassabany @BarbaraVersyck @VeenaGraffMD @AndresR00916584 @rjvanstone @canibagthat @JensBorglum @DrJeniMD @jonlwilton @jgdavids @dr_rajgupta @mokaeleni @Eman60425195 @ram03kul @AoraIndia @kaohesham @dr_tinadoshi @MKwesiKwofie @Ropivacaine @garyschwartzmd @Steve_Coppens @SreeHPraveenKO1 @DrRobbieErskine @PeterMerjavy @Dr_Priester @hari @DukeAnesRes @DrPattyCake @James_Kim_MD @NarouzeMD Thanks Jeff and the DukeRAP team for another phenomenal Blocktober.
Inspired by you, across the pond at my hospital we are heading straight into Nervember, with a small break "going beyond the block" with hocusPOCUS week around Halloween - yeahah!!
Thanks again!

[David Pappin @David_Pappin]

@amit_pawa @AminaBenyoucef5 @esra @Asra @jeffgadsden @ajrmacfarlane @alaindelbos @EMARIANOMD @SerkanTulgarMD @PeterMerjavy @DrRobbieErskine Agree with above. Used to do infraclav with infiltration over 2nd rib, but reverted back to axillary a few years back. See adapted diagram from the excellent RA-UK Plan A blocks poster. No problems since, but subcutaneous infiltration just proximal to incision would solve it too

[David Pappin @David_Pappin]

@jeffgadsden Regarding your awesome instructional videos. Would you be happy for me to download them to our hospital’s anaesthesia intranet webpage? To remind occasional blockers how to do the simple plan A blocks at the weekend. They loved the videos during Blocktober!! Really helpful,thanks

[David Pappin @David_Pappin]

Thinking about coming to Torbay to work? Even in the Winter it’s beautiful! A view from my balcony on New Years Day! #astonesthrowfromthebeach #livingthedream

[David Pappin @David_Pappin]

@TorbayAnaesthe1 Full version coming to a Twitter account near you soon!!!

[Torbay Anaesthesia and Critical Care @TorbayAnaesthe1]

🥁🤫😅Anaesthetic, ICU and chronic pain team jobs coming out soon.....

#anaesthesia #ICU #painmedicine #CCT #NHSJobs #MedTwitter #LoveWhereYouWork