Anaesthetist/Anesthesiologist MBBS FANZCA MMed(Periop) MBA(Innov) https://xitter.cf/t.co/C5lNvBK1iN https://xitter.cf/t.co/WGnzKTeKNI @djoll@mstdn.social
Australia
Joined March 2009
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Anaesthetics have a certain rhythm.
At the beginning, the anaesthetist sets that rhythm. 🎶 But as the anaesthetic evolves, particularly late in a case, you risk the rhythm being defined by things outside your control…
#Anesthesiology
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Real-time propofol monitoring is scientifically possible, though currently neither clinically practical or commercially available. #Review
→ The quest for real time propofol monitoring: a review. Anaesth Intensive Care. 2026 Jul; 54 (4): 307-313
metajournal[.]com/42290030
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"Everyday courage has few witnesses. But yours is no less noble because no drum beats for you and no crowds shout your name."
– Robert Louis Stevenson
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After 18 months of coding, the new metajournal is now live. Faster and with better article suggestions than before, come and check it out → metajournal.com
One of anaesthesia's superpowers is being an aggressively introspective specialty (occasionally too much so, leading to neurotic, double-guessing & nervous anaesthetists).
Reading legendary tech-VC Marc Andreeson's "I try to be as minimally introspective as possible"… 1/2
The Unseen Anaesthetist: Trust is the foundation of anaesthetic care
➡️ metajournal.com/blog/114/the…
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A significant proportion of patients experience recallable #dreams during #anaesthesia, apparently higher with #propofol induction & maintenance, and when pre-induction psychological suggestion is used.
metajournal.com/articles/356…
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V interesting study out of Brisbane, revising previous estimates that suggested sugammadex hypersensitivity could be as high as 1 in 2,500. Crimmins et al. found in their data the incidence was 5-20 times less common (95% CI). → metajournal.com/articles/176…
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"Anaesthesia and Compounding Marginal Gains" – the path from mediocrity to excellence in anaesthesia isn't paved with breakthroughs – it's built on tiny improvements that compound geometrically.
metajournal.com/blog/112/ana…
"Kindness is the oxygen that sustains [anaesthesia] practice." 🙏
"The Power of Kindness in Anaesthesia" - Kindness is the foundation of quality anaesthesia, framing not just the goals of care but the paths we tread to reach them...
metajournal.com/blog/111/the…
It's incredibly disappointing that it took 14 years after Florvaag & Johansson's landmark 2009 paper describing a connection between #pholcodine and NMBD #anaphylaxis, for the TGA to finally ban it.
How many patients were exposed to avoidable harm?
metajournal.com/collections/…
TGA Australia … FINALLY …banned pholcodine 7 hours ago.
After more than a decade of anaesthetists pushing to have this unnecessary & dangerous drug removed from Aust pharmacies, they’ve done the right thing. #anaphylaxis
→ tga.gov.au/news/safety-alert…
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Let's not keep doing this: a Groundhog Day 🧵 about how to get past the COVID-19 pandemic.
"COVID is never going away, so we should just learn to live with it". No, we can do better!
There may still be much that can be done, e.g with vaccines (1/):
medrxiv.org/content/10.1101/…
@DavidSacks, @Jason, @friedberg, @Chamath a logical error when discussing mRNA vaccines: Vaccine side effects should be compared with COVID complication risks - which in EVERY age group are orders of magnitude greater than vaccine side effects. (must think probabilistically) /1
It's true that there has been too much focus on vaccines alone, this is part of the reductive trap of modern medicine. But vaccines are hugely important part of a N95 😷/ clean air 💨 / vax 💉bundle-of-care. /11
[FYI / who am I? Medical specialist, several Master degrees, and run medical critical care research site/data miner, with 40k COVID-related articles indexed already: metajournal.com/covid
Agree we need to keep open mind, but not so open our brains fall out.! 😝] /end