TomH
@thomhall.bsky.social
Still says “dude” and “sick” in his 40s. Can surf though.
Occasionally gives an anaesthetic. Mainly to small people
Occasionally gives an anaesthetic. Mainly to small people
Either do the three way tap trick, or just hit the Ce at 6 and augment with an extra 10mls in the cannula port.
TIVA purists will flap with the latter but you titrate to effect anyway so it makes no difference.
TIVA purists will flap with the latter but you titrate to effect anyway so it makes no difference.
October 5, 2025 at 7:24 AM
Either do the three way tap trick, or just hit the Ce at 6 and augment with an extra 10mls in the cannula port.
TIVA purists will flap with the latter but you titrate to effect anyway so it makes no difference.
TIVA purists will flap with the latter but you titrate to effect anyway so it makes no difference.
All else being equal, GA (volatile + BIS) and block. Spinal if resp/airway badness.
FWIW I don’t like slugging patients with Alf/Midaz and flipping them over for a spinal when a GA is perfectly safe. Just my practice, if spinal works for you then go for it
FWIW I don’t like slugging patients with Alf/Midaz and flipping them over for a spinal when a GA is perfectly safe. Just my practice, if spinal works for you then go for it
September 15, 2025 at 8:26 AM
All else being equal, GA (volatile + BIS) and block. Spinal if resp/airway badness.
FWIW I don’t like slugging patients with Alf/Midaz and flipping them over for a spinal when a GA is perfectly safe. Just my practice, if spinal works for you then go for it
FWIW I don’t like slugging patients with Alf/Midaz and flipping them over for a spinal when a GA is perfectly safe. Just my practice, if spinal works for you then go for it
Interesting, I always consent/warn parents about it but I guess I don’t need to anymore
September 13, 2025 at 9:36 AM
Interesting, I always consent/warn parents about it but I guess I don’t need to anymore
Mandatory antenatal consent for neuraxial anaesthesia in advance. If they say no (eg they are footballer/dancer and can’t risk nerve damage) then we see in clinic to talk about it and plan GA if appropriate.
On arrival on LW everyone gets it reiterated while lucid. Then when they ask we crack on
On arrival on LW everyone gets it reiterated while lucid. Then when they ask we crack on
July 26, 2025 at 5:21 PM
Mandatory antenatal consent for neuraxial anaesthesia in advance. If they say no (eg they are footballer/dancer and can’t risk nerve damage) then we see in clinic to talk about it and plan GA if appropriate.
On arrival on LW everyone gets it reiterated while lucid. Then when they ask we crack on
On arrival on LW everyone gets it reiterated while lucid. Then when they ask we crack on
Easy. GA. suprainguinal Fib. Go
+\- art line based on valve badness and vibes
+\- art line based on valve badness and vibes
July 10, 2025 at 11:00 AM
Easy. GA. suprainguinal Fib. Go
+\- art line based on valve badness and vibes
+\- art line based on valve badness and vibes
Fun fact there’s plenty of cases of this happening in the literature. Usual drug errors/wrong packet etc.
Despite this I’ve worked in precisely one hospital with pre-diluted metaraminol and phenyl
Despite this I’ve worked in precisely one hospital with pre-diluted metaraminol and phenyl
July 7, 2025 at 9:24 AM
Fun fact there’s plenty of cases of this happening in the literature. Usual drug errors/wrong packet etc.
Despite this I’ve worked in precisely one hospital with pre-diluted metaraminol and phenyl
Despite this I’ve worked in precisely one hospital with pre-diluted metaraminol and phenyl
Is this cause for 20mg ketamine or S-ketamine ampules to be more widely available? Because I see the “well I’ve opened 200mg so might as well use a proper dose” rationale quite a bit..
July 7, 2025 at 8:41 AM
Is this cause for 20mg ketamine or S-ketamine ampules to be more widely available? Because I see the “well I’ve opened 200mg so might as well use a proper dose” rationale quite a bit..
Both ideas are pretty unworkable.
Better question is; should be AFOI all mallampati 4/ predicted difficult like the Swiss apparently do. Increases safety and obviously improves the skill set
Better question is; should be AFOI all mallampati 4/ predicted difficult like the Swiss apparently do. Increases safety and obviously improves the skill set
July 2, 2025 at 6:23 PM
Both ideas are pretty unworkable.
Better question is; should be AFOI all mallampati 4/ predicted difficult like the Swiss apparently do. Increases safety and obviously improves the skill set
Better question is; should be AFOI all mallampati 4/ predicted difficult like the Swiss apparently do. Increases safety and obviously improves the skill set
The correct phrase is “send send send” otherwise it doesn’t work
June 23, 2025 at 8:57 PM
The correct phrase is “send send send” otherwise it doesn’t work
No. While the environmental impact is wildly overblown (see Slingo and Slingo in Anaesthesia), it was just rubbish. Everyone coughs, it’s horribly expensive, and even in the obese barely made a difference, especially if you pay attention.
June 20, 2025 at 1:56 PM
No. While the environmental impact is wildly overblown (see Slingo and Slingo in Anaesthesia), it was just rubbish. Everyone coughs, it’s horribly expensive, and even in the obese barely made a difference, especially if you pay attention.
Yep, glycopeptide like Vanc but you just bang it in like other Abx.
…. Then notice the anaphylaxis and give adrenaline
…. Then notice the anaphylaxis and give adrenaline
June 14, 2025 at 7:44 AM
Yep, glycopeptide like Vanc but you just bang it in like other Abx.
…. Then notice the anaphylaxis and give adrenaline
…. Then notice the anaphylaxis and give adrenaline
Orthopaedics like it here. It’s also often the go-to in cases of penicillin “allergy”
It was the UK NAP 6 audit that found Teic was a troublemaker. Probably because we hand it out like smarties
It was the UK NAP 6 audit that found Teic was a troublemaker. Probably because we hand it out like smarties
June 14, 2025 at 6:47 AM
Orthopaedics like it here. It’s also often the go-to in cases of penicillin “allergy”
It was the UK NAP 6 audit that found Teic was a troublemaker. Probably because we hand it out like smarties
It was the UK NAP 6 audit that found Teic was a troublemaker. Probably because we hand it out like smarties
Fabulous improvement. Thank you
June 14, 2025 at 6:42 AM
Fabulous improvement. Thank you
Doing an axillary block? Open the patient’s Lancaster sling early, take the back strap, wrap it round the head of the bed somewhere then they have something to hang on to and keep their arm abducted appropriately
June 13, 2025 at 8:45 AM
Doing an axillary block? Open the patient’s Lancaster sling early, take the back strap, wrap it round the head of the bed somewhere then they have something to hang on to and keep their arm abducted appropriately
Drawing up Teicoplanin in a hurry?. Slam in the water, shake all you want.
Then get a non filter needle, aspirate as much air as you can to generate negative pressure, then disconnect syringe from needle and boom. No bubbles. Draw up as normal
Then get a non filter needle, aspirate as much air as you can to generate negative pressure, then disconnect syringe from needle and boom. No bubbles. Draw up as normal
June 13, 2025 at 8:41 AM
Drawing up Teicoplanin in a hurry?. Slam in the water, shake all you want.
Then get a non filter needle, aspirate as much air as you can to generate negative pressure, then disconnect syringe from needle and boom. No bubbles. Draw up as normal
Then get a non filter needle, aspirate as much air as you can to generate negative pressure, then disconnect syringe from needle and boom. No bubbles. Draw up as normal
Whoever is doing the GA SEES THE CHILD THEMSELVES. Trust is fleeting and so useful.
Give the child a job as soon as they enter the room. They love a helper job. “Hold your sticker (tegaderm) for me, help me move your bed”. Now you’re a team.
Be quick, be fun, be calm. True for adults too
Give the child a job as soon as they enter the room. They love a helper job. “Hold your sticker (tegaderm) for me, help me move your bed”. Now you’re a team.
Be quick, be fun, be calm. True for adults too
June 13, 2025 at 8:33 AM
Whoever is doing the GA SEES THE CHILD THEMSELVES. Trust is fleeting and so useful.
Give the child a job as soon as they enter the room. They love a helper job. “Hold your sticker (tegaderm) for me, help me move your bed”. Now you’re a team.
Be quick, be fun, be calm. True for adults too
Give the child a job as soon as they enter the room. They love a helper job. “Hold your sticker (tegaderm) for me, help me move your bed”. Now you’re a team.
Be quick, be fun, be calm. True for adults too
Can I get in early and say I hate the vortex? Too much lingo, too abstract.
If you say out loud “I’m in the vortex here” to people who don’t know it they’ll assume you’ve been getting at the ketamine
If you say out loud “I’m in the vortex here” to people who don’t know it they’ll assume you’ve been getting at the ketamine
June 1, 2025 at 1:38 PM
Can I get in early and say I hate the vortex? Too much lingo, too abstract.
If you say out loud “I’m in the vortex here” to people who don’t know it they’ll assume you’ve been getting at the ketamine
If you say out loud “I’m in the vortex here” to people who don’t know it they’ll assume you’ve been getting at the ketamine
I don’t but have no issue with those that do. I do reach for it early
June 1, 2025 at 8:03 AM
I don’t but have no issue with those that do. I do reach for it early
Hard no. Useful for addictor canal to avoid wanging nerve to vastus, also useful in Axillary if musculocutaneous is playing hide and seek
May 31, 2025 at 6:15 PM
Hard no. Useful for addictor canal to avoid wanging nerve to vastus, also useful in Axillary if musculocutaneous is playing hide and seek
Completely agree. Why the hell did they need people to know how a fire extinguisher empties?
May 15, 2025 at 11:02 AM
Completely agree. Why the hell did they need people to know how a fire extinguisher empties?