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The Presidential Address of the Section of Anaesthesia of the Manchester Medical Society was held on Thursday 9th October 2003 at 8.15 pm in the Manchester Dental Education Centre (MANDEC), University of Manchester. Prior to the Presidential Address, the Annual General Meeting took place. Dr McCluskey read the nominations and the office bearers and members of the Council for 2003/2004 were unanimously accepted. Dr Earlam proceeded to give her lecture entitled:- "It never turns out quite as you expect" This was a fascinating account of how times have changed over the course of Dr Earlam’s career with respect to the training and education of junior anaesthetists. Their changing working practices over the years, due amongst other factors to the impact of the Calman reforms and reduced hours worked "at the coal face", was the theme, presented in a clear, informative but thoroughly entertaining manner. In accordance with tradition, Dr Earlam was not asked any questions at the end of her lecture although informal discussion amongst Members continued after the vote of thanks and a well deserved prolonged round of applause. Prior to the meeting, a dinner was held in honour of the newly elected president, Dr Earlam, in the University Refectory.
A meeting of the Section of
Anaesthesia, of the Manchester Medical Society, was held on Thursday 13th
November 2003 in the Manchester Dental Education Centre (MANDEC),
University of Manchester at 8.15 p.m. "Obesity anaesthesia" The address began with a slide of a patient with a BMI of over 100 which certainly caught the audience’s attention. Dr Bellamy went on to discuss the scale of the problem in the UK and the rest of the western world and the problems that such a degree of obesity causes for the anaesthetist. He works in a team treating obesity with a stomach stapling technique, the aim being to reduce calorie consumption and so bring about weight loss. A video sequence was shown illustrating the operation performed. It was interesting to learn that he had become involved in the surgical treatment of obesity because the surgeon felt they both needed something easier than their liver work! The results and complications of this surgery were discussed and at the end of his address Dr Bellamy agreed to take questions. The interest generated by the talk was such that the president had to call a halt just after 9.50 pm and Dr Whittaker having given the vote of thanks the audience showed its appreciation in the traditional manner. An informal dinner was held before the meeting, in honour of Dr Bellamy, in the University Refectory and was attended by members of the section and their guests.
A meeting of the section was held on Thursday 11th December 2003 at 8.15 pm in the Manchester Dental Education Centre (MANDEC), University of Manchester. Dr J R Goodall was introduced to the audience by the President, Dr C M Earlam. A graduate of Guy’s, Dr Goodall had moved north to begin his career in anaesthesia and soon developed his interest in Intensive Care Medicine. Once appointed as a Consultant at Hope Hospital in Salford, he added to that a keen interest in education. He is a PBL tutor for the undergraduates, involved in the day-to-day teaching of trainees on the intensive care. More formally he taught on the CRISP courses and is the organiser of the ANWICU meetings in the North West. She then invited Dr Goodall to give his address entitled :- "Different ventilatory modes in ICU" He began with an overview of ventilatory modalities including definitions of the different modes of ventilation available, both in intensive care and theatre. The advantages and disadvantages of each were discussed. He developed this theme to look at the evidence to support the differing views held as to which method produced greater benefits for the sick patient. The evidence for each position was examined in detail and recent evidence shown to the audience. Present controversies were also discussed. As could be expected this talk produced a large number of questions from the audience not all of whom were intensivists. Questions had to be stopped at 9.50 pm. The President then chose to give the vote of thanks to Dr Goodall who had certainly delivered a talk that lived up to all expectations. Prior to the presentation a meal was held in honour of the speaker in the University Refectory to which members and guests were invited.
The fourth meeting for the session 2003/2004, of the Section of Anaesthesia, of the Manchester Medical Society, was held on Thursday 8th January 2004 at 8.15 pm in the Manchester Dental Education Centre (MANDEC), University of Manchester. Dr C M Earlam, President of the Section, introduced the evening’s speaker and his lecture title as follows :- Dr B F Matta (Consultant in Anaesthesia and
Clinical Director, Perioperative "Taking the trauma out of head injury" Although hypoxia and hypotension are the strongest indicators of poor outcome after severe head injury, there are many other factors that can influence outcome. Dr Matta’s lecture gave an insightful overview of the initial management of head injury and how new drugs, techniques and monitors may further improve outcome. A lively discussion took place and then Dr Protheroe gave a vote of thanks, which was followed by prolonged applause. The evening was preceded by a dinner, held in honour of the speaker, in the University Refectory.
The Trainees’ Prize evening for the Section of Anaesthesia, of the Manchester Medical Society, was held on Thursday 12th February 2004 at 8.15 pm in the Manchester Dental Education Centre (MANDEC), University of Manchester. It was encouraging to note that a large number of entries had been submitted this year and the four short listed entries were again of a high calibre. The President of the Section, Dr C M Earlam welcomed the audience and then proceeded to introduce the competitors, along with the titles of their lectures as follows:- V Kasipandian A Krige I Galvin G Thomas After intensive deliberation the judges agreed to award the first prize of £250 to Dr Thomas and the first runner-up prize of £100 to Dr Galvin. All four speakers will receive a certificate marking the occasion of their presentation. Dr Earlam thanked all the competitors for their excellent presentations, which were all of a very high standard. She then thanked Abbott Laboratories Limited for their continuous support of the occasion over the years. Prior to the meeting an informal dinner was held in the University Refectory in honour of all four competitors. They were joined by members and guests of the Section and also a representative from Abbott Laboratories Limited.
A Joint Meeting with the Section of Anaesthesia of the Manchester Medical Society and the Liverpool Society of Anaesthetists was held on Thursday 11th March 2004 at 8.15 pm in the Manchester Dental Education Centre (MANDEC). A dinner was held in honour of the speakers and the Liverpool guests in a private function room of the University Refectory before the meeting at 6.15 for 6.45 pm. The President of the Manchester Medical Society, Dr C M Earlam, opened the meeting and welcomed the familiar face of Dr J J Chambers, Honorary Secretary of the Liverpool Society of Anaesthetists. He has liaised and kept the channels of communication with the Section of Anaesthesia of the Manchester Medical Society prevalent over the years. She also offered a welcome to all the members of the Liverpool Society. Before introducing the first meeting she publicized 2 other meetings; one to be held in Liverpool on Intensive Care, the other a meeting of the History of Anaesthesia Society to be held in Grange-over sands. She also made sure everyone was aware of the next meeting at Lancaster on 29th April. The Liverpool speaker Dr J Harrison (Consultant in Anaesthesia & Intensive Care, Aintree Hospitals NHS Trust) spoke on "Hyperbaric oxygen". He is an anaesthetist with a special interest in Intensive Care. His area of work includes the hyperbaric chamber in Liverpool and his talk was based on his experience of 7 years attached to that unit. He briefly described the types of chamber available in the U.K and where they were situated. He then gave a comprehensive list of all the conditions for which Hyperbaric therapy could be used indicating those areas of proven effectiveness. He then gave more detail of the use of chambers in areas of specific anaesthetic interest including the use of hyperbaric oxygen to aid wound healing. The talk attracted considerable interest and questions from the floor. The Manchester speaker Dr M Columb (Consultant in Anaesthesia & Intensive Care Medicine and Honorary Clinical Lecturer, University of Manchester) spoke on "Regional anaesthesia for open and arthroscopic shoulder surgery: Definitely for the faint hearted!" His talk again was based on his own experience. He gave an account of the technique used and reasons for performing major surgery under local anaesthesia. He also gave a frank account of the problems and side effects of the technique. Again there were many questions and comments from the audience and the meeting had to be stopped by the president just after 10.00 pm. Both lectures were well received by the audience and a vote of thanks was given by Dr M Fryer. The audience showed its appreciation in the usual way.
The ‘Out of Town Meeting’ of the Section of Anaesthesia of the Manchester Medical Society was held on Thursday 29th April 2004 at Ashton Memorial, Williamson Park, Lancaster. After parking, members and guests were treated to an energetic walk through a lovely park to be rewarded at the top with superb views of Morecombe Bay and an excellent buffet thanks to the efforts of the hosts and the generous sponsorship from Aspect Medical Systems and Lidco Ltd. The meeting began with a welcome to all those attending from the president, Dr C M Earlam. She then introduced the first speaker Dr A P Vickers, who is well known for his interest in pain management, speaking on "Developing national standards for epidural analgesia". Dr Vickers began with a slide showing a catalogue of errors culled from the press over the recent years showing evidence of a need for guidelines and standards of care for epidural anaesthesia. The underlying cause for most errors was system failure and so guidelines should create a safe system for the use of epidurals particularly when an anaesthetist was not immediately available and this should be based on the best available evidence. In this case the guidelines were drawn up as a consensus by those invited to give an opinion. Dr Vickers began by defining the core characteristics of a safe epidural service. He explained his methods of doing this drawing on advice and opinions of acute pain specialists both nursing and medical who were involved in teaching and district general hospitals. The group was e-mailed and asked to rank the features as ideal, essential etc and then the group met again to arrive at a consensus for each listed feature. The first draft was "unveiled" at the ASM meeting in 2003 at Glasgow and has been submitted to the Royal College of Anaesthetists, the Pain Society and the Association of Anaesthetists. After a final meting at the College the guidelines were approved. His take-home message was "these things are more difficult than you imagine but e-mail is essential to move things forward as it is impossible to get the group together every time a decision needs to be made." After questions the president then introduced the second speaker Dr L J Williams from Furness General Hospital who spoke on "The Legionnaires' disease outbreak in Barrow, Summer 2002". His address on the outbreak of Legionnaires disease in Barrow; the largest so far in the U.K, began with an overview of Barrow and its new hospital. After a brief description of legionnaire’s disease itself he went on to the outbreak in Barrow. There were a total of 170 confirmed cases of which only 7 died. The infection originated in the air-conditioning unit of a council office, feeding the infection into a small alley linking the bus station with the main shopping mall and coincidentally onto the elderly who were more at risk but also more likely to use the buses. As a result of the outbreak two council employees are facing charges of manslaughter-it is not just doctors. The statistics were fascinating; for example the Trust used one year’s supply of erythromycin in one month alone. It was clear that the whole hospital had responded to the crisis in an incredible way. Elective surgery was cancelled and theatre staff redeployed to the wards. The trust management were particularly supportive; dealing with the press and leaning on other trusts when they would not co-operate by taking patients. The A+E came under siege when the outbreak was announced as every-one with any illness came to the hospital worried that they may be infected. The outbreak occurred in the school holidays when many staff was on holiday and as a final problem it was change-over time for the trainee staff. However it was obvious that the whole hospital pulled together and responded incredibly to this emergency, which many felt was because of the sense of community in a small local hospital which can be lacking from the larger Trusts. Again this talk generated many questions from the audience. The final speaker Dr A F Smith spoke on the topic of "Non-physician anaesthetists in the UK; evidence, promise and perils". He began by discussing the role of the Modernisation Agency with its brief to modernise the NHS and looking at the redesigning of roles in the service. He explained his role in this and the reactions of his colleagues when he suggested that Morecombe Bay Trust should be one of the pilot sites in the UK for this project. Morecombe Bay had chosen to recruit trained non-physician anaesthetists from Europe (specifically Switzerland) unlike Salford Royal Hospitals Trust who had chosen to train 2 individuals from scratch. In his Trust, once recruitment had taken place then there was a period of adaptation and assessment before advancing on to autonomy. He went through the benefits of the new role as well as the worries and concerns expressed to him by colleagues. He felt that the main worry based on experience from America where nurse anaesthetists practised independently of physicians was driven by factors that did not apply in Britain and believed that the individuals could have a valuable role in the health service. The only problem was that the Government was expanding the number of sites before the pilots had been able to complete the project. This talk generated much interest and questions but finally the President had to call the meeting to a close. She thanked the organisers warmly for the generosity of their hospitality, the magnificence of the venue and above all the quality of the speakers. After reminding the audience that the next meeting was the joint meeting with the RSM on Friday 17th September 2004 she called the meeting to a close at 10.00 pm, wishing everyone a safe journey home.
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MANCHESTER
MEDICAL SOCIETY
