Top Tweets for #Nap7
How often are arterial lines really used during anaesthesia? 🩸🩺
New #NAP7 data show that only 10% of non-obstetric anaesthetics in the UK used invasive arterial BP monitoring.
📊 Usage rises with ASA grade:
•ASA 1: 2%
•ASA 2: 6%
•ASA 3: 19%
•ASA ≥ 4: 45%
🔍 But among ASA ≥ 4:
•62% of patients aged 36–45 had art lines
•Only 25% of those aged >85 did
🧠 Why the age disparity in the sickest patients? Is there implicit bias against the frailest?
🛠️ Orthopaedic trauma patients had the lowest art line use (5%) despite high periop risk of hypotension and cardiac arrest.
⚠️ Underuse of arterial lines in frail and elderly patients may delay detection of deterioration.
Read the full analysis 👉
https://t.co/3R1tCev4Ub
#anaesthesia #MedTwitter #NAP7 #arterialline #periopcare #geriatricanesthesia
@Anaes_Journal
@JCVAonline
@BJAJournals
@JournalofClinAn
@IAU_KFHU
@Mansoura_un
@ITACTAtwits
@American_Heart
@anesthesiology
@ESAIC_org
@scahq
@scahq_tas
@actacc
@EACTAIC
Great to see this Science letter from #NAP7 published
The graphic shows frequency of IABP use by specialty and patient risk category
You decide, is current use of arterial lines is logical.....& equitable?
@Anaes_Journal @adk300 @jas_soar @drrichstrong @emirakur @RCoANews @RCoA_CRI @AgeAnaesthesia
https://t.co/BbbA7RnuVd
@Anaes_Journal is nothing if not topical
@BBCNews
https://t.co/PCjvArCzbb
Skilled clinical support by anaesthetists in complex cardiological interventions is important for practical reasons….. and beyond
Also highlighted in #NAP7 in which cardiac catheter suites were an area where the need to optimise communication & address human factor deficits was emphasised
https://t.co/B47ErQ7VfW
Police investigate heart deaths at NHS hospital https://t.co/Ln82cnGjwy
@mariapsebastian explains the need for GPAS - Guidelines for Provision of Anaesthetics Services
#NAP7 demonstrated we are caring for more patients with obesity and at risk of airway complications - #regionalanaesthesia has a crucial role to play
#RAUK25
Fittingly starting with the informative #NAP7 analysis of cardiac arrest in #OBAnes from @OAAinfo’s own @noolslucas @doctimcook et al. Haemorrhage is a leading cause; cardiac arrest a recognized complication of spinal; high spinal may develop with spinal after failed epidural
@OAAinfo @NAPs_RCoA High neuraxial block can lead to cardiac arrest in #ObAnaes Dr Owais Shah & Dr Rakesh Basrur are taking us through the mechanism, identification, differential diagnosis and case studies. #NAP7 recommends test dose should not exceed the equivalent of 10mg bupivacaine #YSOA2025
I believe the @RCoANews is to be congratulated in navigating the treacherous path of defining scope of practice for Anaesthesia Associates
This involved
-huge surveys of opinion
-supporting #Nap7 in analysing practice in real life
-a Cochrane review
-extensive professional liaison & listening
All openly disseminated
It includes a pragmatic approach to future patient safety & protection of existing AAs
This response by the @GMC is bordering on bizarre
https://t.co/GbwyaIXxVZ
Stating
They state this should be based on ‘evidence’ …..the College has done a good job in trying to gain, assimilate & disseminate what evidence there is. There is not much!
What has the GMC done?
@Anaes_Journal Nice letter
#NAP7 cardiology
Improving multidisciplinary care of the critically ill patient in the cath lab
Looks like they’re doing a great job in Dublin
Completely agree with the letter
https://t.co/S6imO8zKC3
Responding to #NAP7 paper
https://t.co/q1lxreFFCv
Quite a lot to unpack in this interesting letter
#NAP7 elective ortho surgery is a little over 10% of all anaesthetic activity
The challenges of
-preoperative information provision
-shared decision making
-on the day consent
all discussed previously here
https://t.co/D0ngpitTAB
It might also be a bit of a leap from more patients having cognitive decline among those who have ortho surgery than that don’t …. to the cause being surgery or anaesthesia. The likelihood of covariate risk factors must be rather high.
@Anaes_Journal They’re certainly a rather small proportion of current obstetric blocks
@noolslucas @jas_soar @adk300 @drrichstrong @emirakur @FiOglesby
#NAP7
@OAAinfo @NAPs_RCoA @doctimcook @noolslucas Looking closer at #NAP7: 7 arrests related to #PPH (viscoelsatogram guided fibrinogen may have had effect?); 6 arrests related to neuraxial; 6 related to bradycardia (phenylephrine may have had an impact); and 5 related to GA after spinal. #OAA3dc24 #3DC24 #OBAnes.
@OAAinfo Maternal Morbidity and Mortality wouldn’t be covered without a mention of #NAP7 @NAPs_RCoA @doctimcook @noolslucas #OAA3dc24 #3DC24 #OBAnes
ANAESTHESIA ASSOCIATES - what does NAP7 tell us?
A thread based on this paper
https://t.co/Oe90iVUtmG
-clinical activity
-case mix
-supervision
-involvement in perioperative cardiac arrest
-experiences of perioperative cardiac arrest
....of note it is surprising that no one has asked for this topic to be presented anywhere. So here are some slides from a prepared.... but unused.... talk.
@Anaes_Journal @RCoANews @NAPs_RCoA
1/n
Hi all, back after a bit of break with the next- GAMT for NAP 7. When I started it I thought I can do it in a couple of days but boy I was wrong! It took close to 3 wks to get this ready
#nap7 @Anaes_Journal @doctimcook @jas_soar
Here comes part 1
https://t.co/cozrTvRalW
It's great to see evidence of the value of #NAP7 to our community. A huge THANK YOU once more to the project leads, authors, fellows, local coordinators, steering panel, patient contributors and the thousands of members who participated 👏👏@NAPs_RCoA @RCoA_CRI
Introducing the Number 1 paper of the 'Top 10 Papers of 2023'!
Peri-operative cardiac arrest: epidemiology and clinical features of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists
@drrichstrong @jas_soar @adk300 @emirakur @JerryPNolan @IainMoppett @SeemaMosca @Simon_Finney @noolslucas @RonelleMouton @kalapappaj @BarneyUoB @LeeVarney2000 @ecewain @doctimcook @NAPs_RCoA
https://t.co/VJ3orJfQA0
Dr. Jasmeet Soar with a detailed review of NAP-7. Key lessons to take forward in improving anaesthetic practice. #BAIOA2024 #NAP7 #PatientSafety
The @Anaes_Journal team were a pleasure to work with throughout #NAP7
Andy Klein, Matt Wiles, Mike Charlesworth, Rona Gloag (of course!) & many others
-Early discussions of options & strategy
-Rapid attentive review of the many papers we sent, sensitive to the co-publication in the report but also adamant that academic quality had to be maintained
-Brilliant turnaround
-Exemplary communication
-Fantastic support for dissemination in terms of social media posts, podcasts and infographics
-Prompt management of letters of response
-Open access for ever!!
This made a huge difference to getting messages out in the current challenging environment which is the point of these projects.
Thank you
@Anaes_Journal @jas_soar @IainMoppett @RCoA_CRI @RCoANews
Delighted #NAP7 work is the top article for @Anaes_Journal this year. We are very grateful to the journal for their work to help promote the project. https://t.co/BQSFT3uWAY @RCoANews @jas_soar @doctimcook @drrichstrong @emirakur @RCoA_CRI @IainMoppett #AC2024
Congratulations to the #NAP7 team for being awarded the Top Article of the Year prize by @Anaes_Journal. It's great to see this important work received so well by the anaesthetic community.
https://t.co/m2XQ8lMhFh
@RCoANews @jas_soar @doctimcook @drrichstrong @adk300 @emirakur
Delighted #NAP7 work is the top article for @Anaes_Journal this year. We are very grateful to the journal for their work to help promote the project. https://t.co/BQSFT3uWAY @RCoANews @jas_soar @doctimcook @drrichstrong @emirakur @RCoA_CRI @IainMoppett #AC2024
Lovely to see our fantastic #NAP7 fellows being awarded the Humphrey Davey Award. Very well deserved! @drrichstrong @FiOglesby @emirakur @adk300
4 fellows
1 report
4.5 yrs work
39 chapters
450+ pages
881 cardiac arrests
&
1 pandemic
1 emigration
2 retirements
3 consultant jobs
1 new president
4 PMs
6 secretary’s of state for education
290 local coordinators
11000 anaesthetists
300+ sites
30+ panel members
4.5 ACCCtracks
3 babies
2000 zoom hours
1 emergency fridge freezer
23 colour palettes
2 monarchs
1 marriage (of fellows)
3 Jesuans
1 Humphrey Davy award. Congratulations
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