Hans Huitink
@airwaymxacademy.bsky.social
Anesthesiologist🇳🇱Founder Airway Management Academy non-profit airway teaching #AAF25 | Mobile Critical Care Support😷🚑🩺 | AirAmbulance🛩 @AirwayTriageApp
Reposted by Hans Huitink
Cross sensitivity between neuromuscular blocking agents
If a patient has had a POHR to:
• rocuronium, suxamethonium or vecuronium, then atracurium is the lowest risk alternative
• atracurium, then rocuronium and suxamethonium are low risk alternatives
#AnSky
doi.org/10.1111/anae...
If a patient has had a POHR to:
• rocuronium, suxamethonium or vecuronium, then atracurium is the lowest risk alternative
• atracurium, then rocuronium and suxamethonium are low risk alternatives
#AnSky
doi.org/10.1111/anae...
November 13, 2025 at 7:49 PM
Cross sensitivity between neuromuscular blocking agents
If a patient has had a POHR to:
• rocuronium, suxamethonium or vecuronium, then atracurium is the lowest risk alternative
• atracurium, then rocuronium and suxamethonium are low risk alternatives
#AnSky
doi.org/10.1111/anae...
If a patient has had a POHR to:
• rocuronium, suxamethonium or vecuronium, then atracurium is the lowest risk alternative
• atracurium, then rocuronium and suxamethonium are low risk alternatives
#AnSky
doi.org/10.1111/anae...
Reposted by Hans Huitink
Here is the first consensus-based core outcome set for airway management research, with agreed definitions and measurement instruments.
This will harmonise evidence synthesis and improve the translatability of findings to improve clinical care.
#AnSky #AirwaySky
doi.org/10.1111/anae...
This will harmonise evidence synthesis and improve the translatability of findings to improve clinical care.
#AnSky #AirwaySky
doi.org/10.1111/anae...
November 14, 2025 at 7:03 AM
Here is the first consensus-based core outcome set for airway management research, with agreed definitions and measurement instruments.
This will harmonise evidence synthesis and improve the translatability of findings to improve clinical care.
#AnSky #AirwaySky
doi.org/10.1111/anae...
This will harmonise evidence synthesis and improve the translatability of findings to improve clinical care.
#AnSky #AirwaySky
doi.org/10.1111/anae...
Reposted by Hans Huitink
2025 DAS guidelines for the management of unanticipated difficult airway published today in the British Journal of Anaesthesia. #airway #difficultairway #intubation #anaesthesia #anesthesia
https://www.bjanaesthesia.org/article/S0007-0912(25)00693-2/fulltext
https://www.bjanaesthesia.org/article/S0007-0912(25)00693-2/fulltext
November 7, 2025 at 2:15 PM
2025 DAS guidelines for the management of unanticipated difficult airway published today in the British Journal of Anaesthesia. #airway #difficultairway #intubation #anaesthesia #anesthesia
https://www.bjanaesthesia.org/article/S0007-0912(25)00693-2/fulltext
https://www.bjanaesthesia.org/article/S0007-0912(25)00693-2/fulltext
Reposted by Hans Huitink
Every time I write "explained anaesthetic" in the notes as part of a pre-assessment, I'm reminded of the fact that even the most expert professor of anaesthesia wouldn't *really* be capable of making that true.
a man wearing a white shirt and a mask says magnets how do they work
Alt: a man wearing a white shirt and a mask says magnets how do they work
media.tenor.com
November 3, 2025 at 9:58 AM
Every time I write "explained anaesthetic" in the notes as part of a pre-assessment, I'm reminded of the fact that even the most expert professor of anaesthesia wouldn't *really* be capable of making that true.
Reposted by Hans Huitink
Postoperative sore throat has an incidence of up to 62%.
The current literature lacks high-quality randomised controlled trials on treatments that prevent a complication that is of importance to patients and their recovery.
#AnSky #MedSky
doi.org/10.1111/anae...
The current literature lacks high-quality randomised controlled trials on treatments that prevent a complication that is of importance to patients and their recovery.
#AnSky #MedSky
doi.org/10.1111/anae...
October 29, 2025 at 9:06 AM
Postoperative sore throat has an incidence of up to 62%.
The current literature lacks high-quality randomised controlled trials on treatments that prevent a complication that is of importance to patients and their recovery.
#AnSky #MedSky
doi.org/10.1111/anae...
The current literature lacks high-quality randomised controlled trials on treatments that prevent a complication that is of importance to patients and their recovery.
#AnSky #MedSky
doi.org/10.1111/anae...
Airway Triage App
October 29, 2025 at 3:57 PM
Airway Triage App
October 26, 2025 at 8:16 PM
October 25, 2025 at 12:48 PM
Reposted by Hans Huitink
Sustained, exhaled carbon dioxide by waveform capnography is an essential component of tracheal intubation.
But what if there is bronchospasm?
Tracheal intubation can be confirmed using flexible bronchoscopy.
#AnSky
doi.org/10.1002/anr3...
But what if there is bronchospasm?
Tracheal intubation can be confirmed using flexible bronchoscopy.
#AnSky
doi.org/10.1002/anr3...
October 24, 2025 at 10:02 AM
Sustained, exhaled carbon dioxide by waveform capnography is an essential component of tracheal intubation.
But what if there is bronchospasm?
Tracheal intubation can be confirmed using flexible bronchoscopy.
#AnSky
doi.org/10.1002/anr3...
But what if there is bronchospasm?
Tracheal intubation can be confirmed using flexible bronchoscopy.
#AnSky
doi.org/10.1002/anr3...
Reposted by Hans Huitink
Having said that in that first case of hyperacute onset, neurological symptoms started almost immediately post op and peaked after two days. That would be quite the coincidence.
October 21, 2025 at 8:35 PM
Having said that in that first case of hyperacute onset, neurological symptoms started almost immediately post op and peaked after two days. That would be quite the coincidence.
Reposted by Hans Huitink
A more plausible mechanism would be the inflammatory effects of surgery, rather than toxicity/triggering from a spinal. I feel like the spinal is an innocent bystander.
In this SR of case reports, the majority of surgeries are spine and cardiac.
pmc.ncbi.nlm.nih.gov/articles/PMC...
In this SR of case reports, the majority of surgeries are spine and cardiac.
pmc.ncbi.nlm.nih.gov/articles/PMC...
Guillain-Barré syndrome after surgery: a literature review
Guillain-Barré syndrome (GBS) is a rare postoperative complication that is sometimes characterized by serious motor weakness and prolonged weaning from mechanical ventilation. Although the exact natur...
pmc.ncbi.nlm.nih.gov
October 21, 2025 at 10:59 PM
A more plausible mechanism would be the inflammatory effects of surgery, rather than toxicity/triggering from a spinal. I feel like the spinal is an innocent bystander.
In this SR of case reports, the majority of surgeries are spine and cardiac.
pmc.ncbi.nlm.nih.gov/articles/PMC...
In this SR of case reports, the majority of surgeries are spine and cardiac.
pmc.ncbi.nlm.nih.gov/articles/PMC...
Reposted by Hans Huitink
I think it is a coincidence. GBS can occur within 4 weeks of campylobacter infection. Preop diarrhoea can be common in some populations (eg bariatrics ~ nearly 10%), and it isn’t usually asked about.
October 21, 2025 at 10:59 PM
I think it is a coincidence. GBS can occur within 4 weeks of campylobacter infection. Preop diarrhoea can be common in some populations (eg bariatrics ~ nearly 10%), and it isn’t usually asked about.
Reposted by Hans Huitink
Have any authors proposed a mechanism whereby a central drug exposure creates a peripheral neuropathy?
October 21, 2025 at 9:31 PM
Have any authors proposed a mechanism whereby a central drug exposure creates a peripheral neuropathy?
Reposted by Hans Huitink
One could probably calculate the odds of it arising by chance using the prevalence of GBS in the general population and the odds of needing a spinal/epidural
October 21, 2025 at 3:57 AM
One could probably calculate the odds of it arising by chance using the prevalence of GBS in the general population and the odds of needing a spinal/epidural
Reposted by Hans Huitink
Yes I wondered that too. Association is not causation
October 21, 2025 at 3:44 AM
Yes I wondered that too. Association is not causation
Reposted by Hans Huitink
Onset apparently almost immediate, peaking day two post spinal
jmedicalcasereports.biomedcentral.com/articles/10....
jmedicalcasereports.biomedcentral.com/articles/10....
October 19, 2025 at 8:33 AM
Onset apparently almost immediate, peaking day two post spinal
jmedicalcasereports.biomedcentral.com/articles/10....
jmedicalcasereports.biomedcentral.com/articles/10....
Reposted by Hans Huitink
This article reported acute onset GBS in 4 patients within 1-2 weeks of epidural anaesthesia
www.neurology.org/doi/10.1212/...
www.neurology.org/doi/10.1212/...
October 19, 2025 at 8:38 AM
This article reported acute onset GBS in 4 patients within 1-2 weeks of epidural anaesthesia
www.neurology.org/doi/10.1212/...
www.neurology.org/doi/10.1212/...
Reposted by Hans Huitink
This case report of a pt developing GBS 4-5 days post spinal for renal calculi. It's rare, but it happens. www.jcpsp.pk/archive/2013...
October 19, 2025 at 8:41 AM
This case report of a pt developing GBS 4-5 days post spinal for renal calculi. It's rare, but it happens. www.jcpsp.pk/archive/2013...
Reposted by Hans Huitink
Although quite rare, I think there are enough independent case reports of spinals triggering acute GBS (temporally linked) to support the claim that there is some association that we don't yet understand.
That's not the same as saying it's unsafe to do a spinal on a post-GBS pt. I don't think it is.
That's not the same as saying it's unsafe to do a spinal on a post-GBS pt. I don't think it is.
October 18, 2025 at 8:51 PM
Although quite rare, I think there are enough independent case reports of spinals triggering acute GBS (temporally linked) to support the claim that there is some association that we don't yet understand.
That's not the same as saying it's unsafe to do a spinal on a post-GBS pt. I don't think it is.
That's not the same as saying it's unsafe to do a spinal on a post-GBS pt. I don't think it is.
Reposted by Hans Huitink
Carbon footprint of total intravenous anaesthesia vs. inhalational sevoflurane anaesthesia in adults: a modelling study
#AnSky #climate #MedSky
doi.org/10.1111/anae...
#AnSky #climate #MedSky
doi.org/10.1111/anae...
doi.org
October 15, 2025 at 6:03 AM
Carbon footprint of total intravenous anaesthesia vs. inhalational sevoflurane anaesthesia in adults: a modelling study
#AnSky #climate #MedSky
doi.org/10.1111/anae...
#AnSky #climate #MedSky
doi.org/10.1111/anae...
Reposted by Hans Huitink
Save the date 📆
The SALG Patient Safety Conference is coming up!
This year’s themes are👇
➡️Local Anaesthetic Systemic Toxicity (LAST)
➡️Rapid Sequence Induction (RSI)
➡️Plus poster competition for anaesthetists in training
Book👉 ow.ly/YAvo50WXl9v
#Ansky #Medsky
The SALG Patient Safety Conference is coming up!
This year’s themes are👇
➡️Local Anaesthetic Systemic Toxicity (LAST)
➡️Rapid Sequence Induction (RSI)
➡️Plus poster competition for anaesthetists in training
Book👉 ow.ly/YAvo50WXl9v
#Ansky #Medsky
October 14, 2025 at 9:41 AM
Save the date 📆
The SALG Patient Safety Conference is coming up!
This year’s themes are👇
➡️Local Anaesthetic Systemic Toxicity (LAST)
➡️Rapid Sequence Induction (RSI)
➡️Plus poster competition for anaesthetists in training
Book👉 ow.ly/YAvo50WXl9v
#Ansky #Medsky
The SALG Patient Safety Conference is coming up!
This year’s themes are👇
➡️Local Anaesthetic Systemic Toxicity (LAST)
➡️Rapid Sequence Induction (RSI)
➡️Plus poster competition for anaesthetists in training
Book👉 ow.ly/YAvo50WXl9v
#Ansky #Medsky
Reposted by Hans Huitink
I feel I deserve the Nobel Peace Prize for the judicious use of a small syringe of saline with a red sticker, rather than a full on rant when the surgeon asks for muscle relaxation just before the end of the case.
I find it unfair that I was yet again not awarded the Nobel Peace Prize this year.
Nearly 12 years in the NHS and I have not sworn at any of the people who really needed it over that time.
Nearly 12 years in the NHS and I have not sworn at any of the people who really needed it over that time.
October 10, 2025 at 2:40 PM
I feel I deserve the Nobel Peace Prize for the judicious use of a small syringe of saline with a red sticker, rather than a full on rant when the surgeon asks for muscle relaxation just before the end of the case.
Reposted by Hans Huitink
4/9 The child's head was quite heavy and asymmetrical due to the tumour, and awkward to hold in a good position to maintain the airway. Eventually we got the child deep enough to attempt bronchoscopy.
October 3, 2025 at 9:13 AM
4/9 The child's head was quite heavy and asymmetrical due to the tumour, and awkward to hold in a good position to maintain the airway. Eventually we got the child deep enough to attempt bronchoscopy.
Reposted by Hans Huitink
3/9 We decided to breathe the child down with halothane and try an asleep oral fibreoptic intubation. The child was cooperative and we soon got him under, but keeping his airway patent was a challenge, which meant getting him deep was also a struggle.
October 3, 2025 at 9:13 AM
3/9 We decided to breathe the child down with halothane and try an asleep oral fibreoptic intubation. The child was cooperative and we soon got him under, but keeping his airway patent was a challenge, which meant getting him deep was also a struggle.
Reposted by Hans Huitink
2/9 Anil and I were both on one day, and we were presented with a 3yo with a massive craniopharyngioma. I don't recall what the procedure was but the child needed to be intubated, and we thought it would be good to do it together.
(I hope he remembers this the way I do.)
(I hope he remembers this the way I do.)
October 3, 2025 at 9:13 AM
2/9 Anil and I were both on one day, and we were presented with a 3yo with a massive craniopharyngioma. I don't recall what the procedure was but the child needed to be intubated, and we thought it would be good to do it together.
(I hope he remembers this the way I do.)
(I hope he remembers this the way I do.)