Case based discussions

During this session I invite you to take a walk with me through some burns cases we have treated at the National Burns Centre. Together we can explore how referring centres can be a powerful influence in the outcomes of patients. The session will dip into the EMSB core teachings and is also an opportunity to refer to clinical scenarios that you may have encountered. Together we can problem solve difficulties that might range from how to secure the airway of a rapidly swelling facial burn to initial discussions with the next of kin and managing expectations.

The queue for volunteers to manage a chronic pain patient on an acute pain round is often a short one. This session will aim to suggest some strategies and with these in mind, to discuss participants cases. Chronic pain patients are individual in their backgrounds and needs, but common themes of central sensitisation (as a consequence of pain) and mental health issues, often with a background of adverse childhood events, can influence both the way acute pain is expressed and the response to standard management techniques. Previously perceived poor experiences with health professionals can add to the patients burden of pain and distress. We can consider both flares of pre-existing chronic pain and unrelated acute pain in chronic pain patients. Medication is often not helpful for patients with primary chronic pain, but other strategies are available. The importance of distinguishing between nociplastic, neuropathic and nociceptive pain will be discussed.

Join us for a small group case based discussion of Malignant Hyperthermia(MH) clinical presentations and current management guidelines. Are you the local equipment rep for your local DHB or private hospital? Do you know how much Dantrolene should be stocked at each anaesthetising location? When do you stop giving a patient with a suspected MH reaction Dantrolene- what are your treatment endpoints? What is the relationship between exertional rhabdomyolysis and MH- should you use TIVA for these patients? An MH patient contacts you for advice- they want to join the army- what are the occupational implications of MH susceptibility?

Bring along your curly cases with an MH theme for a 90 minute Case Conference led by Dr Terasa Bulger, who heads the New Zealand Malignant Hyperthermia Investigation Unit in Palmerston North.
This session is eligible for Practice Evaluation CPD points.

In this session we will look at the typical profile of the patient presenting for bariatric surgery. We will think about clinical dilemmas in the pre-operative setting and possible approaches to these. We will touch on the varied surgical procedures offered and their implications for the patient. We will tick off what requirements exist for an institution or team to tackle this surgery safely. We will look at the intra-operative care with particular attention to drug choice and other strategies to keep our stress to a minimum. Finally we’ll think about the postoperative management of the bariatric patient and some approaches to this.

Please bring along any bariatric cases you’ve been involved with that challenged or interested you to add to the discussion.

Join us for an interactive session aimed to demystify the use of TIVA, Dexmedetomidine and Regional anaesthesia in common paediatric procedures. A selection of cases will be discussed highlighting the advantages of these approaches when used in isolation and or in combination. Participants will be encouraged to share common cases they are exposed to at their hospitals as well as any interesting cases where they may have liked to use one or more of the above techniques but lacked the confidence to do so.

How prepared is your department in the event of a local earthquake, tsunami, terrorist attack or train crash? This SGD will explore preparedness and response to an unexpected event with the use of case examples, scenarios and experience across the group. We will examine how we can learn from defence and civil defence to enrich our planning and resilience touching on leadership structures, a shared language and how to do our best for the most. This case based discussion is aimed at smaller / non-trauma centre / rural hospitals where resources and plans are likely to be lacking. Participants will be expected to get involved in the chaos that will ensue!

This case based discussion session will be aimed at sharing knowledge and recapping current best practice and guidelines for management of common obstetric challenges such as: post partum haemorrhage, the morbidly adherent placenta, the obese parturient, pre-eclampsia and it’s variety of presentations, disorders of coagulation in pregnancy, and management of the post dural puncture headache. Participants in the discussion will be expected to attend armed with a case to share and the goal will be an interactive and informative session to refresh knowledge of management of these frequent but nevertheless stressful obstetric challenges.

All Anaesthetists are experts in airway management. So why do some cases still feel so challenging? In this session we will discuss potential and actual difficult airway cases. We will identify how your routine approach can be modified including using tips and tricks to help you achieve the best outcome. Participants are encouraged to bring actual cases they have encountered for discussion at the session.

Most surgery is low risk and beneficial, but how do we approach those cases that seem like they might not turn out well?

This session will discuss clinical issues that make surgery a bad idea and how we can use different tools to help patients make choices that are in their best interests.

We will discuss some of the tools and approaches that we have found helpful in our Complex High Risk Surgical Patient Pathway.

This will be an interactive session and participants are encouraged to bring interesting and challenging cases for discussion.