This meeting is being held FACE TO FACE. All attendees MUST register in advance.
This event is accredited by the Royal College of Anaesthetists for 5 CPD credits.
9.30 am Coffee & Registration
Morning Session
10.00 am
Pain management in rib fractures
Dr Mahindra Chincholkar, Clinical Director of the Manchester and Salford Pain Centre, Salford Royal Hospital
Lecture synopsis:
Rib fractures are common in chest trauma. The aetiology of trauma has changed and the vast majority of trauma is due to low falls. In older patients aged>65 years, low falls accounts for 80% of all trauma.
Pain from rib fractures can result in inadequate respiratory efforts, atelectasis, and increased work of breathing with decrease in ability to clear secretions. Early and adequate pain relief is essential to help prevent chest infection from splinting and atelectasis. Good pain relief will allow early mobilisation and reduce the risk of chest infection by helping to deep breathe and cough- an innate defensive mechanism that prevents aspiration and clears airway debris. Pulmonary contusions can result in worsened ventilation and perfusion mismatch. This is often not apparent immediately and respiratory failure can develop in the ensuing 24-48 hours. It is therefore important that patients with thoracic injuries especially fractured ribs be monitored closely; any deterioration requires rapid escalation of treatment.
Early identification of rib fractures can be difficult due to the low sensitivity of X-ray imaging. Early use of CT imaging can prevent missed fractures. The Greater Manchester Chest Injury pathway stratifies patients based on the features at presentation and the presence of risk factors. It makes recommendations for imaging modalities and care pathways based on these features. Risk prediction models are available but relying on these models alone will not prevent missed fractures.
Pain can be managed well with oral analgesia and PCA in 80% of patients. Fascial plane blocks and epidural/paravertebral blocks are only required in about 20% of patients with rib fractures. Regular monitoring with MDT involvement, early identification of clinical deterioration, and rapid escalation of care are essential for optimal outcomes.
10.35 am
Community Opioids - The Role of the Anaesthetist
Dr David McCarthy, Consultant in Anaesthesia and Pain Medicine, Manchester University NHS FT (Wythenshawe)
Lecture synopsis:
This talk aims to explore the role of anaesthetists in addressing the multiple challenges associated with opioid use in the community. As opioids continue to be a prevalent and complex issue, it is important to consider the potential community and public health role for a specialty that is normally associated almost entirely with the secondary care setting . The discussion will cover various aspects, including the current local impact of opioids in Greater Manchester, the role of anaesthesia in contributing to opioid prescriptions, and the anaesthetist's role in potentially minimising harm.
11.10 am
Coffee
11.40 am
Chronic Pain in Children
Dr Zsuzsanna Kulcár, Consultant in Paediatric Anaesthesia and Chronic Pain Management, Royal Manchester Children's Hospital
Lecture synopsis:
The main feature of the children’s nervous system is plasticity and it changes as they develop. For this reason, management of chronic pain condition has better prognosis compared to adults.
The early diagnosis and prompt treatment is essential, otherwise the chronic pain will continue into their adult life.
Children and young people may experience chronic and recurrent pain that can have a significant impact on function. Unlike acute pain, it is an improvement in function than often precedes any reduction in pain intensity.
12.15 pm
Perioperative Pain Pathways
Dr Emma Baird, Consultant in Anaesthesia and Inpatient Pain Lead, Lancashire Teaching Hospitals NHS FT
1.00-2.00 pm
LUNCH
Afternoon Session:
2.00 pm
Trainee’s Prize Presentations supported by the North West School of Anaesthesia
- Dr Chris Fine - Outcomes following Major Lower Limb Amputation, an Anaesthetic prospective at a Regional Vascular Unit
- Dr Camilla Lees - Improving staff identification and team-work on the intensive care unit
- Dr Katherine Turner - Anaesthetic management of pregnant women with body-mass index > 40kg.m-2 undergoing Caesarean birth. A retrospective cross-sectional analysis of nine hospitals across the north-west of England
- Dr Mark Tan - Improving lung point-of-care ultrasound (POCUS) training and accreditation - a multipronged, stepwise approach to development and delivery by utilising Quality Improvement methodology
- Dr Marlon Walters - A comparison between volatile and total intravenous anaesthetic and intraoperative bleeding in surgical termination of pregnancies
- Dr Pei Shan Lim - How well does research reflect critical illness journeys? A systematic scoping review
- Dr April Lu - ‘Desbusters’: a regional project in sustainable healthcare with the aim capture desflurane in a timely and environmentally responsible manner
3.30 pm
Coffee
4.00 pm
Making Sense of “Getting it Right First Time”
Invitational Lecture given by Dr Chris Snowden, National Clinical Lead (Joint) for Get it Right First Time (GIRFT): Anaesthesia and Perioperative Medicine
Lecture synopsis:
The underpinning concept of eradicating unwarranted variation form medicine dates back to the 1930’s, before the beginnings of the NHS. The GIRFT program aims to reinvigorate this concept, by promoting a clinically-led focus, on data driven improvement, and the sharing of excellent practice – converting healthy competition into mutual collaboration and support.
The Perioperative component of the GIRFT program has a wide, cross cutting themed approach to surgical pathways. It recognises the important role played by the largest consultant hospital speciality and the unique skills therein. The future of Anaesthesia and Perioperative Medicine as a speciality, relies on initiatives that put clinical staff at the forefront of improvement opportunities. GIRFT provides an important gateway for these future initiatives and innovations.
Learning objectives:
- Understanding the relevance of tackling unwarranted variation and use of data sources to shape surgical pathways
- How the GIRFT program relates to Perioperative Medicine and Anaesthesia
- Future GIRFT involvement and initiatives for Perioperative medicine
5.00 pm
Close