Baskar Manickam

NHS critic & fan, health care leadership, passionate about pain relief & patient safety

[Baskar Manickam @docbaskar]

#PlanAblocks - Trainee query : is it the preferred first option? NO. It is just a list of essential blocks to learn. Interesting confusion with @dasairway intubation guidelines- default strategy for intubation. @RegionalAnaesUK @ASRA_Society @Assoc_Anaes

[Baskar Manickam @docbaskar]

CHEWING GUM is a Foreign body in Airway. Why will a patient keep a chewing gum in their mouth before going to sleep? 🤔-bcos they forget to spit it out when stressed. ?NBM policies and checklist need tweaking.@dasairway @RCoANews @Assoc_Anaes

[Elizabeth Malinzak, MD, FASA @ebmalinzakMD]

Chewing gum is another controversy. Each society fasting guidelines treats it differently. The risk of chewing gum is not swallowing or aspiration--it's as an airway foreign body!!#AnesGR @MCW_Anesth @Duke_Anesthesia @DukeAnesRes @dukeanesfellows @ASALifeline @PediAnesthesia

[Baskar Manickam @docbaskar]

@DrRobbieErskine Interesting. Chloroprocaine claims maximum spinal height T10. Had high spinal with 5ml especially in obese/head down/lithotomy a few times. Now use 4-4.5ml in this scenario.

[Baskar Manickam @docbaskar]

@RishiSunak Your tagline IPAC is inspiring. Integrity (Philosophy), Professionalism(Politics), Accountability(Economics) - in a Compassionate way. The world needs more leaders like you in power at all levels. Best wishes. 🙏

[Baskar Manickam @docbaskar]

@FeliciaJCox introducing Pain Mgt Plan after surgery : colour coding strong opioids, PRN & fading colours for weaning. Is it possible to apply this on electronic prescriptions?. https://t.co/d4QP0QbaD5 @NAPS_UK @BritishPainSoc

[Baskar Manickam @docbaskar]

Opioid thermometer - Check your doses. Recommended by @loulouscorpio @NAPS_UK @EMARIANOMD

[Baskar Manickam @docbaskar]

@jane_quinlan guidance on opioid de prescribing. An important learning topic for all doctors/nurses who prescribe opioids. https://t.co/Lb2MqDTbft @OUHospitals @EMARIANOMD @NAPS_UK

[Baskar Manickam @docbaskar]

@DrRobbieErskine @jeffgadsden @amit_pawa @galusweegie @LloydTurbitt @RegionalAnaesUK Are you talking about the different Quadratus Lumborum blocks out there? 😇

[Baskar Manickam @docbaskar]

@DrRobbieErskine @jon_bailey_anes @jeffgadsden @Ropivacaine @ksbdoc @Steve_Coppens @bobfunn @ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @ASA_Australia @amit_pawa @EMARIANOMD @KalagaraHari @KartikBSonawane @HoltzMaggie @James_Kim_MD @garyschwartzmd @pritanand @colinjmccartney @MoosaFarhaan @claralexlobo @fuzzymittens @CarpenterAdam9 @L_D_White @mick_kerr @NarouzeMD @ashwani_doc @dr_tgro @rosie_hogg @LloydTurbitt @Nadia_Hdz_MD @rljohnsonmd @MKwesiKwofie @Jerryblocksthat @ajrmacfarlane @VeenaGraffMD @nelkassabany @PeterMerjavy @athmathottungal @TomJelic @mokaeleni @AminaBenyoucef5 @SreeHPraveenKO1 @anesthesiadocmd @OuahidRahil @BelgianBara I don’t understand it. It is a mix of heavy and plain bupivacaine to prolong duration. I think we should leave the mixing to experts. Most users would like to keep it simple nowadays.

[Baskar Manickam @docbaskar]

@DrRobbieErskine @jon_bailey_anes @jeffgadsden @Ropivacaine @ksbdoc @Steve_Coppens @bobfunn @ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @ASA_Australia @amit_pawa @EMARIANOMD @KalagaraHari @KartikBSonawane @HoltzMaggie @James_Kim_MD @garyschwartzmd @pritanand @colinjmccartney @MoosaFarhaan @claralexlobo @fuzzymittens @CarpenterAdam9 @L_D_White @mick_kerr @NarouzeMD @ashwani_doc @dr_tgro @rosie_hogg @LloydTurbitt @Nadia_Hdz_MD @rljohnsonmd @MKwesiKwofie @Jerryblocksthat @ajrmacfarlane @VeenaGraffMD @nelkassabany @PeterMerjavy @athmathottungal @TomJelic @mokaeleni @AminaBenyoucef5 @SreeHPraveenKO1 @anesthesiadocmd @OuahidRahil @BelgianBara Some drugs have stronger affinity to block receptors. It is multi factorial based on pH, etc. Difference of 1-2 min is not clinically relevant. Choice of LA should be based on duration alone. Have u heard of Dundee mix for spinal anaesthesia?🤔

[Baskar Manickam @docbaskar]

@jon_bailey_anes @jeffgadsden @Ropivacaine @ksbdoc @DrRobbieErskine @Steve_Coppens @bobfunn @ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @ASA_Australia @amit_pawa @EMARIANOMD @KalagaraHari @KartikBSonawane @HoltzMaggie @James_Kim_MD @garyschwartzmd @pritanand @colinjmccartney @MoosaFarhaan @claralexlobo @fuzzymittens @CarpenterAdam9 @L_D_White @mick_kerr @NarouzeMD @ashwani_doc @dr_tgro @rosie_hogg @LloydTurbitt @Nadia_Hdz_MD @rljohnsonmd @MKwesiKwofie @Jerryblocksthat @ajrmacfarlane @VeenaGraffMD @nelkassabany @PeterMerjavy @athmathottungal @TomJelic @mokaeleni @AminaBenyoucef5 @SreeHPraveenKO1 @anesthesiadocmd @OuahidRahil @BelgianBara What determines the onset time ? The drug, dose or concentration. The same question applies for spinal anaesthesia too.

[Baskar Manickam @docbaskar]

@mancunianmedic To be honest he was just explaining basic economics. Most people who know something about investing understand this.

[Baskar Manickam @docbaskar]

@DrRobbieErskine @docmorne @beckimarshRA @glauncel @ESRA_Society I totally agree. Paramedian should be Plan A (without a doubt) for spinals.

[Baskar Manickam @docbaskar]

Frustrating. Finding the Yankauer suction tip on the floor just when u most need it (Extubation). There must be a simple solution to this? than sticking under the pillow. 🤔@Anaes_News @RCoANews @Assoc_Anaes

[Baskar Manickam @docbaskar]

I see and hear this all the time in #nhs Another pyramid to think about It all begins with trust….

[Baskar Manickam @docbaskar]

@doctimcook Hi Tim. Nice pondering. Joining the queue….

[Baskar Manickam @docbaskar]

@BucksUSGRA @BucksHealthcare Nice Idea. Brilliant. Do you accept DM request in your settings?

[Baskar Manickam @docbaskar]

@goldstone_tony Thanks Tony. Good to see the difference between legacy and reform adjustment. My assumptions were wrong. Look forward to the updated version🙏 to input the new TRS figures. Kindly appreciated.

[Baskar Manickam @docbaskar]

Current NHS pension taxation rules are unfairly hitting senior doctors hard with many forced to retire early/reduce hours. No provision for alternative pension rewards .@Gibbo4Darlo as my MP, please will you attend @TheBMA pensions event on Weds 6 July