Dr Helgi Jóhannsson
@doctorhelgi.bsky.social
Doctor, #medsky, Anaesthesiologist at Imperial, RCOA council member, but also a human who likes nature, music, fitness and getting to know people. 🇪🇺🇮🇸🇫🇴🇬🇧🏳️🌈
If your patient has delirium post op, they usually have some other complication too. Check for infection, thrombosis etc, but also think “is this patient bleeding?”
September 11, 2025 at 9:55 AM
If your patient has delirium post op, they usually have some other complication too. Check for infection, thrombosis etc, but also think “is this patient bleeding?”
Tricky one… I mean the floral shirt still looks great so maybe just that again?
July 2, 2025 at 8:56 PM
Tricky one… I mean the floral shirt still looks great so maybe just that again?
Keep the blood pressure higher in the situation of abdominal compartment syndrome. (This includes surgically induced such as laparoscopic surgery, especially when head down and of higher BMI). #rcoaupdates.
June 11, 2025 at 1:55 PM
Keep the blood pressure higher in the situation of abdominal compartment syndrome. (This includes surgically induced such as laparoscopic surgery, especially when head down and of higher BMI). #rcoaupdates.
Turns out having an experienced physician individualising the treatment to that particular patient makes the biggest difference.
At risk patients though should generally have their intra-op blood pressure above 60 (mean arterial pressure that is). #rcoaupdates
At risk patients though should generally have their intra-op blood pressure above 60 (mean arterial pressure that is). #rcoaupdates
June 11, 2025 at 1:55 PM
Turns out having an experienced physician individualising the treatment to that particular patient makes the biggest difference.
At risk patients though should generally have their intra-op blood pressure above 60 (mean arterial pressure that is). #rcoaupdates
At risk patients though should generally have their intra-op blood pressure above 60 (mean arterial pressure that is). #rcoaupdates
Exercise and training reduces the surgical stress response and prevents complications.
Why are we not doing this for every patient having a major operation?
#ea25
Why are we not doing this for every patient having a major operation?
#ea25
May 26, 2025 at 11:03 AM
Exercise and training reduces the surgical stress response and prevents complications.
Why are we not doing this for every patient having a major operation?
#ea25
Why are we not doing this for every patient having a major operation?
#ea25
Pre-op screening for frailty and cognitive impairment is only done in a minority of UK hospitals.
Should we be screening more? Should we discuss it pre-op?
Discussing delirium in pre-assessment reduces patient and relative distress if it does happen. #Anaesthesia2025
Should we be screening more? Should we discuss it pre-op?
Discussing delirium in pre-assessment reduces patient and relative distress if it does happen. #Anaesthesia2025
May 22, 2025 at 10:51 AM
Pre-op screening for frailty and cognitive impairment is only done in a minority of UK hospitals.
Should we be screening more? Should we discuss it pre-op?
Discussing delirium in pre-assessment reduces patient and relative distress if it does happen. #Anaesthesia2025
Should we be screening more? Should we discuss it pre-op?
Discussing delirium in pre-assessment reduces patient and relative distress if it does happen. #Anaesthesia2025
If you have emergency surgery you’re much more likely to develop delirium.
Delirium has an enormous effect on your length of stay in hospital. It increases by 5 to 10 days!
Post-op delirium increases your longer term mortality threefold. #Anaesthesia2025
#Anaesthesia2025
Delirium has an enormous effect on your length of stay in hospital. It increases by 5 to 10 days!
Post-op delirium increases your longer term mortality threefold. #Anaesthesia2025
#Anaesthesia2025
May 22, 2025 at 10:48 AM
If you have emergency surgery you’re much more likely to develop delirium.
Delirium has an enormous effect on your length of stay in hospital. It increases by 5 to 10 days!
Post-op delirium increases your longer term mortality threefold. #Anaesthesia2025
#Anaesthesia2025
Delirium has an enormous effect on your length of stay in hospital. It increases by 5 to 10 days!
Post-op delirium increases your longer term mortality threefold. #Anaesthesia2025
#Anaesthesia2025
Frailty is a massive risk factor for post op delirium. Much more than having other significant medical conditions, which didn’t make that much difference.
We under-detect delirium but around 10% of our patients develop it.
#anaesthesia2025
We under-detect delirium but around 10% of our patients develop it.
#anaesthesia2025
May 22, 2025 at 10:44 AM
Frailty is a massive risk factor for post op delirium. Much more than having other significant medical conditions, which didn’t make that much difference.
We under-detect delirium but around 10% of our patients develop it.
#anaesthesia2025
We under-detect delirium but around 10% of our patients develop it.
#anaesthesia2025
Observe
Listen
Learn
Adjust
Your patient will probably have a hospital passport - please make sure you have a look at it and adjust your standard approach to accommodate their needs.
#Anaesthesia2025
Listen
Learn
Adjust
Your patient will probably have a hospital passport - please make sure you have a look at it and adjust your standard approach to accommodate their needs.
#Anaesthesia2025
May 22, 2025 at 9:12 AM
Observe
Listen
Learn
Adjust
Your patient will probably have a hospital passport - please make sure you have a look at it and adjust your standard approach to accommodate their needs.
#Anaesthesia2025
Listen
Learn
Adjust
Your patient will probably have a hospital passport - please make sure you have a look at it and adjust your standard approach to accommodate their needs.
#Anaesthesia2025
Top tips continued:
- Don’t say “I’ll be back in ten minutes” (unless you really will be). Be less specific.
- Communicate clearly, use simple positive body language.
- Your standard approach may not work - your patient may not be able to count backwards.
#Anaesthesia2025
- Don’t say “I’ll be back in ten minutes” (unless you really will be). Be less specific.
- Communicate clearly, use simple positive body language.
- Your standard approach may not work - your patient may not be able to count backwards.
#Anaesthesia2025
May 22, 2025 at 9:09 AM
Top tips continued:
- Don’t say “I’ll be back in ten minutes” (unless you really will be). Be less specific.
- Communicate clearly, use simple positive body language.
- Your standard approach may not work - your patient may not be able to count backwards.
#Anaesthesia2025
- Don’t say “I’ll be back in ten minutes” (unless you really will be). Be less specific.
- Communicate clearly, use simple positive body language.
- Your standard approach may not work - your patient may not be able to count backwards.
#Anaesthesia2025