subash s

Consultant Anaesthetist, Sandwell & West Birmingham Hospitals

[subash s @subashken]

Great presentation & discussion on Why we need to operate early @doc_hnaqvi @SujitAgarwal -thanks. Post CCT view is a more accurate one!

[subash s @subashken]

@KTheivendran @doc_hnaqvi The fact 1600 patients were randomised means they all received standardised care - and hence everyone is likely to have a good outcome - and soit is always going to contradict observational studies (which would include the sicker exclusion criteria patients in this trial)

[subash s @subashken]

@KTheivendran @doc_hnaqvi Technically correct but a 15 min intervention is unlikely to produce any difference in 60 day outcome due to the huge temporal disconnect, multiple confounders and mortality as an outcome difference for anaesthetic techniques is a very low bar in my estimation.

[subash s @subashken]

@IainMoppett @Sandwell and City Hospitals Birmingham (last 3 yrs), all elective patients are given a bottle of water - encouraged to take sips throughout... Similarly, hip fracture & Emergency patients have a jar of water bedside and allowed sips. THINK DRINK...

[subash s @subashken]

@doc_hnaqvi @AtulAtulmalik @sitenroy @DonnaJa98889626 NOT WAITING list - PREPARATION list

[subash s @subashken]

@doc_hnaqvi @chrisvthompson @mrdgwatt @ChaseSurgical @sitenroy Periop care 2021 @SWBHnhs is
#Block it Fast
#Fix it Fast
#Get up Fast
Simples..

[subash s @subashken]

@SpOrthopod @MrGella @KTheivendran @doc_hnaqvi @SaadElAshry @SWBHnhs @AtulAtulmalik I was hoping the provocative message will start a conversation, bottom line is More delays due to any reason = More delirium = Poor outcomes. PS. I've also urged my colleagues to BLOCK it FAST, so that FIX it Fast can happen.

[subash s @subashken]

@MrGella @KTheivendran @doc_hnaqvi @SaadElAshry Kind Reminder to T&O colleagues & Anaesthetists. FIX IT FAST @SWBHnhs

[subash s @subashken]

@doc_hnaqvi @KTheivendran @MrGella
Early nutritional supplementation was associated with a significantly shorter hospital stay without an increase in costs.
https://t.co/pd6M7oSB4i

[subash s @subashken]

@doc_hnaqvi @sitenroy @doc_AMajeed @natashajh86 @DonnaJa98889626 @Nataliecutmore1 @KTheivendran @drnickmakwana @AtulAtulmalik @SWBHnhs @SWBHnhs Desperately need an additional geriatrician to form part of the MDT team that enables this transformation

[subash s @subashken]

"Despite experience in self-management, many people with diabetes, particularly those on insulin, are often DISEMPOWERED to self-manage in hospital." @CPOC_News @SWBHnhs

[subash s @subashken]

Do you practice SDM? Often doctors think so…..but patients do not…@CPOC_News @doc_hnaqvi @chrisvthompson

[subash s @subashken]

@SWBHnhs Need to raise awareness regarding the misconception amongst many-BPT for hip fracture is not merely a financial tool for income-its aim is to provide additional income which is reflective of the quality of practice. Evidence = Delay means higher mortality/morbidity

[subash s @subashken]

@KTheivendran @manojsikand @natashajh86 @sitenroy @doc_hnaqvi "Central to this concept is the physical separation of resources or ‘ring-fencing' & Ring-fencing is of proven financial benefit in orthopaedic surgery and is
also associated with improved outcomes" -some work to do to convince Managment Team @swbh

[subash s @subashken]

@doc_hnaqvi @chrisvthompson Yes - Needs CROSS SKILLING to facilitate TRANS - disciplinary working

[subash s @subashken]

@KTheivendran @Ash75044681 @natashajh86 @doc_hnaqvi @sitenroy V True - that's what we are supposed to do:
Doctors must try to FIND OUT WHAT MATTERS TO PATIENTS so they can share relevant information about the benefits and harms of proposed options and reasonable alternatives, including the option to take no action.

[subash s @subashken]

Matt Morgan: A letter from ICU - https://t.co/zJH9jSnQnN

[Claire Lehmann @clairlemon]

Why has the so-called 'developing world' responded with more urgency & efficiency to coronavirus than Europe?

@MacaesBruno argues that cultures with a recent experience of poverty & disease are less likely to take human life & healthcare for granted

https://t.co/E5rq3GE0VK

[subash s @subashken]

https://t.co/WJ4d4qLQ4n

[subash s @subashken]

Anaesthesia Updates: @RCoANews: All anaesthetists should be trained and competent in the delivery of TIVA. Schools of Anaesthesia and training bodies should provide teaching, training and practical experience of TIVA to all anaesthetic and intensive care medicine trainees.