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1 AUSTRAL ASIAN ANAESTHESIA 2017 AUSTRALASIAN ANAESTHESIA 2017 Invited papers and selected continuing education lecturesEditor: Richard RileyDepartment of ANAESTHESIA and Pain MedicineRoyal Perth HospitalPharmacology and Anaesthesiology Unit School of Medicine and PharmacologyUniversity of Western AustraliaPublished in 2017 by:Australian and New Zealand College of Anaesthetists630 St Kilda RoadMelbourne, Victoria 3004 AustraliaISBN 978-0-9945075-5-6 Copyright 2017 by the Australian and New Zealand College of Anaesthetists, all rights reserved. None of the contents of this publication may be reproduced, stored in a retrieval system or transmitted in any form, by any means without the prior written permission of the note that any views or opinions expressed in this publication are solely those of the author and do not necessarily represent those of by: Ellikon 384 George Street Fitzroy, Victoria 3065 AustraliaContentsAirwayAwake videolaryngoscopy 3 Vazira Moosajee, Scott Douglas, Iljaz HodzovicAirway management after cervical spine surgery.

2 A review of the literature 13 Jonathan Nicholson, William Bradley, Tish Stefanutto, Glen Downey, Lauren Berkow Tracheostomy crisis management 21 James Anderson, Travis Leahy Breathing / VentilationPerioperative lung protective ventilation 31 Simon Wong, Ajay Kadaliparambil, Hergen BuscherTransnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) technique in paediatric 43 ANAESTHESIA practice Susan Humphreys, Derek Rosen, Andreas SchiblerCirculationHeart failure with preserved ejection fraction: Diastole is important too! 53 Kate DrummondExtra corporeal membrane oxygenation.

3 Anaesthetic perspectives 63 Elizabeth Winson, Matthew BrainCoagulationIntroducing viscoelastic haemostatic assay-guided blood product transfusion into your hospital 77 Megha Jain, Erin Chamberlen, Kathryn Santifort, Surbhi Malhotra, Catherine DownsRotational thromboelastometry (ROTEM ) in obstetrics 95 Julie Lee, Kerstin Wyssusek, Jeremy Cohen, Andre Van ZundertFibrinogen concentrate for acquired hypofibrinogenaemia 105 Hamish Mace, Mansi KhannaEvidence, new methods and current practice of point-of-care coagulation testing in major haemorrhage 117 Michael C Reade, James WinearlsIntraoperative cell salvage 135 Laura Willington, Michelle RoetsRegionalWhat is the role of thoracic epidural analgesia in contemporary ANAESTHESIA practice?

4 147 Andrew Deacon, Jennifer Hartley Dissecting epidural failure in the obese parturient: Time to carefully consider the lumbar 159 interspinous ligament Sue Lawrence, Adrian Langley, David SturgessAbdominal wall blocks steps to quality assurance and managing risk 169 James GriffithsPainRecent insights into the mechanism of opioid tolerance and withdrawal: Implications for the use 179 of remifentanil David A JarvisLidocaine infusions: The golden ticket in postoperative recovery? 185 Martin Bailey, Andrew Toner, Tomas CorcoranCaution with ketamine 197 David A JarvisBrain / NeuroAcute management of stroke 209 Candice Delcourt, Pierre JaninDecompressive craniectomy in the management of neurological emergencies: An inconvenient truth?

5 221 Stephen Honeybul, Kwok Ho, Grant GillettAdenosine for transient cardiac standstill in neurovascular surgery: A heart-stopping moment 229 Shona OsbornLiver / MetabolicAnaesthesia for patients with liver disease 241 Tom Fernandez, Chris NixonPerioperative hyperglycaemia epiphenomenon or therapeutic target 253 Alexandra Skubala, Tomas CorcoranMalignant hyperthermia Keeping things cool 263 Sin ad O Keeffe, Philip Nelson, Mark DavisPaediatricsHypnosis and communication in paediatric peri-operative care 273 Rob Laing, Allan CynaPostoperative behaviour change in children 281 Paul Lee-Archer, Michael Reade, Britta Regli-von Ungern-Sterberg.

6 Deborah LongAssessmentEpigenetics and ANAESTHESIA 291 Christopher Bain, Kiymet BozaogluEducationPreparing candidates for the ANZCA primary examination vivas 301 Andrew Gardner, Ross MacphersonTrainee mentoring Tips to setting up a program and issues encountered along the way 309 Ian BalsonFree open access online education in ANAESTHESIA 317 Ryan JuniperIt s more complicated than that: Complexity and ANAESTHESIA 325 Dave Gillespie, Rod Peadon, John NealManagementInformed consent in the age of peri-operative medicine: Is it possible? 335 Scott Simmons, Allan M CynaThe anaesthetist as a leader and manager.

7 Priorities, dilemmas and solutions 343 Debra SA ColemanA guide to the electronic roster 355 Peter MulrooneyFaculty and Regional Sub-EditorsProfessor Thomas BruesselAustralian Capital TerritoryDr Brenda CassidyFaculty of Pain MedicineAssociate Professor Alicia DennisVictoriaDr Thomas FernandezNew ZealandDr Adrian LangleyQueenslandDr Priya NairCollege of Intensive Care MedicineAssociate Professor Richard RileyWestern AustraliaDr Sharon TiveyNew South WalesDr Gerald TohSouth AustraliaDr Maurice VialleTasmaniaAUSTRALASIAN ANAESTHESIA 2017 PrefaceWelcome to the 2017 edition of

8 AUSTRALASIAN ANAESTHESIA . I continue to be surprised at the depth and breadth of talent in our fields. Although there is some emphasis in several topics, it is always gratifying that we are able to produce a wide range of areas that reflects the diversity of practice in ANAESTHESIA and pain medicine. Airway management , regional ANAESTHESIA , coagulation and cardiac function will always be topical. Articles on education and management also feature to make this edition well-rounded and deserving of your this edition we also welcome the inclusion of several chapters focusing on intensive care medicine.

9 I hope that you will be similarly impressed to read about some of these developments that our ICU colleagues are leading. Further, a chapter on outcomes following decompressive craniectomy for severe traumatic brain injury is timely and thought-provoking. Having a family member undergo such an operation years ago made it especially poignant. Several years back a keynote speaker at an international simulation in healthcare meeting described the reluctance of many senior clinicians to ask for feedback on their own clinical and teaching practices.

10 As a practicing surgeon, and clinical educator, he decided to embrace the principles of adult education and began to seek feedback from his surgical trainees. Thus, at the completion of each day s operating, he now asks the trainee, How d I do today? It was a little confronting at first but it became part of his embedded practice and he now welcomes it. The speaker exhorted us to follow his example and seek feedback from our juniors; irrespective of their level of training. He suggested that we might be surprised at the feedback. To follow on this theme, I can let you know that I typically receive one complaint and one to two compliments for each edition of AUSTRALASIAN ANAESTHESIA , but this is hardly enough.