@Oesophagusuk@strachanjamie@amateursuman Not possible anymore. I CCTโd at 33 (18yr old +ICSM6 +FY2 +ST7) having gone straight through +1yr for intercalated BSc, so you could do it at 32.
โI only have one coronary stent docโ
1) you have the risk factors to need one
2) you have coronary endothelial damage
3) you are having surgery, which is pro-thrombotic
4) you are on anticoagulants
#ANES18
Physiological reserve = biggest physiological insult the patient can survive minus baseline function
Frailty = loss of physiological reserve across multiple body systems (cannot be quantified by one test)
Elderly trauma patients have low reserve and high frailty
#ANES18
"Words have power"
- Terry Pratchett
Perimortem section = sounds like you are killing the mother to save the baby, people think twice
Resuscitative hysterectomy = procedure necessary to save the mother and baby, people perform it
Same thing though
#ANES18
Performing a blood patch on someone who turns out not to have a PDPH can precipitate seizures and delirium - something to think about if youโd asked to do one at 03:00 on the postnatal ward #ANES18
There is no such thing as the "straightforward post-op surgical in-patient". If there were simple, they would be been a day case. The entire hospital population has been pre-selected as high risk #ANES18
We all remember "that case" when the surgeon quietly cuts through the IVC without mentioning it, but in reality in 33% of cases the lowest sustained BP occurs before KTS - cycle NIBP frequently after induction #ANES18
Risk prediction for cardiac events:
Scoring systems: everyone ends up as "intermediate risk"
Ex tolerance: patients lie
Stress echo: no evidence
CT coronaries: only useful if itโs clear, which rarely happens
BNP: probably the best
#ANES18