Author Archives: Majic Sites

The ENIGMA-II trial by Dr. Matthew Vella @mjv.igee #Anaesthesia #anaesthetics #anesthesiology #anesthesia #anesthetic #abcsofanaesthesia #medicine #anesthesiologist #anaesthetist #anesthetist #anaesthesiology #nurse #medical #meded #FOAMed #medicalstudent #ENIGMAtrial # ENIGMA2trial #safety #generalanaesthesia #GA #Nitrousoxide #N2O #Gas #MajorSurgery #cardiacriskfactors Title: The safety of addition of nitrous oxide to general anaesthesia in at-risk patients having major non-cardiac surgery (ENIGMA-II): a […]

Definition Hyperkalaemia refers to a state of high serum potassium (K+), typically > 5.5 mmol/L. Potassium is split between intracellular (98%, ~150 mmol/L K+ concentration) and extracellular (2%, ~4-5 mmol/L concentration) compartments. Potassium ions are the main intracellular cation and carry an electrical charge. They establish an electrochemical gradient across the cell membrane known as […]

Imagine you arrive at your morning urology list with 7 cystoscopy cases. Your 1st patient is a 60yo male for a rigid cystoscopy. He has a drug eluting stent from an AMI 5 years ago and has functionally declined since. He is 120kg with the usual collection of diabetes, hypertension and hypercholesterolaemia with no previous […]

I remember one stressful case of a patient who was septic, and suffering a post partum haemorrhage. After induction of anesthesia, the patient’s blood pressure dropped precipitously requiring large doses of inotropes. She developed a rash and bronchospasm signifying likely anaphylaxis. How could this unlucky patient have so many complications? We stepped into crisis mode […]

You induce a 60yo male for an aorto-bifemoral bypass with severe leg claudication. He has the expected past history of ischaemic heart disease (STEMI 5 years ago – stents + medical management), diabetes, hypertension, and was a 20-pack year ex-smoker. After a reasonably stable induction, his blood pressure continues to need vasopressor. You administer escalating […]

Definition Hypokalaemia simply means low blood potassium (K+). Mild hypokalaemia refers to a serum potassium concentration of under 3.5mmol/L Severe hypokalaemia indicates less than 2.5mmol/L of potassium in the blood. Potassium is split between intracellular (98%, ~150mmol/L K+ concentration) and extracellular (2%, ~4-5mmol/L concentration) compartments. Potassium ions are the main intracellular cation and carry an […]