Tis me right now. I feel your pain! My solution was to keep applying. 🤷‍♂️🥴

Very apt topic given what we were discussing last week 😆

Hawn! Trust you to chime in and nice to catch you on BSky (your med student from POW days + CCAM last year 🤣). Nice to see you speaking at the Code Blue Conference at UNSW this year; the conference has grown heaps!

I don’t disagree which is why we should appreciate the patient’s context/fn before recommending treatment (or not). But ultimately it’s also up to the patient themselves to decide what issues are important *to them*. Hence *shared* decision making! Don’t think it’s an abdication of responsibility!

The textbook answer would be shared decision making, but it’s really a shot in the dark with no/minimal statistics with no clear answer. Reminds me of this little comic strip from the patient perspective courtesy of Woke Salaryman. I feel for the patients - seems like rock and a hard place really.

I think this is what gets me - risk of spinal may be small, but those risks are highly consequential - had a patient say they’d rather be dead than be paralysed vs the benefits of reduced analgesia use.

I… somewhat empathise?!

Would you do it with Clopidogrel on board though? Genuinely curious - been drilled into me *not* to so curious what the thoughts are!

The rookie in me would ask what the upside of a spinal is apart from decreased analgesia requirements POD0-1.

Can’t imagine trying to position the patient for a spinal + the bleeding risk. GA+FIB might be better for the patient? Happy to be educated and will peruse the articles!

Definitely. These things tend to stick with you. But also important to be led by the evidence when things evolve!

Crickets on BSky but booked in with an interview coach - fingers crossed! Strange b/c feedback last year for the most part was that I interviewed okay but needed (epidural) experience 😂 Hitting a moving target really, but alas!

Ah thought your discussion at the NZ ASM was eye opening and might (hopefully) interest folks at the college… 👍

Happy birthday! Was nice putting a face to the name the other day in ICU 👍

SALG (Safe Anaesthesia Liaison Group; @rcoanews.bsky.social @assocanaes.bsky.social ) have been looking at the place for pre-filled syringes. www.salg.ac.uk/salg-publica... #AnSky

That side eye 👀 😂