Case based discussions

Held at the InterContinental Hotel

During the early bird registration period, each delegate may only choose one case based discussion. After early bird closes, all delegates will be notified of available sessions.

All case based discussions are eligible for ANZCA CPD practise evaluation credits.

Case based discussions programme

Click on the case based discussion titles below to view the corresponding session information

Friday 21 October 2022

CBD 1 | "Initial Burns Management - Following the All Black Model of doing the basics very well"

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.

Date/TimeFriday 21 October
1:30pm - 3:00pm
LocationThorndon
Cost$35.00
FacilitatorAdam Harper
Max per CBD15 pax

CBD 2 | Tactics for managing chronic pain patients on acute pain rounds

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.

Date/TimeFriday 21 October
1:30pm - 3:00pm FULL
LocationAurora
Cost$35.00
FacilitatorLouise Lynch
Max per CBD11 pax

CBD 3 | Novel aspects in MH treatment

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.

Date/TimeFriday 21 October
3:30pm - 5:00pm
LocationThorndon
Cost$35.00
FacilitatorTheresa Bulgar
Max per CBD15 pax

CBD 4 | Awake surgery under peripheral regional anaesthesia – does my patient really need to be unconscious?

This will be an interactive case based discussion with the aim of facilitating successful awake surgery under peripheral regional anaesthesia in your personal and/or departmental practice. Topics to be covered include: benefits and drawbacks, patient selection, consent discussion, managing patient anxiety, block set-up, selecting the right block for the case, intra-operative management and tips to overcoming obstacles. The discussion is not designed to cover the technical aspects of actually performing regional anaesthesia. Participants are strongly encouraged to bring actual or theoretical cases or scenarios to the discussion

Date/TimeFriday 21 October
3:30pm - 5:00pm
LocationAurora
Cost$35.00
FacilitatorDavid Prior
Max per CBD11 pax

Saturday 22 October 2022

CBD 5 | Anaesthetic preoperative decision making

Our patients are getting older, sicker and we are moving towards shared decision making for their care.
In this session we will use clinical case examples to discuss our commonly used models and introduce other tools which can help the decision making process function more efficiently.

Date/TimeSaturday 22 October
10:45am - 12:15pm FULL
LocationThorndon
Cost$35.00
FacilitatorAruntha Moorthy
Max per CBD15 pax

CBD 6 | Minimal Opiate Cardiac Anaesthesia

High dose opiates, have been the foundation of cardiac anaesthesia for decades, but is this approach still needed? In this case based session, we will explore minimal / opiate free cardiac anaesthesia. What techniques can employed to make it a reality? Why bother? What are the risks and possible benefits? This discussion will be of interest to those who are prepared to challenge anaesthetic dogma!

Date/TimeSaturday 22 October
10:45am - 12:15pm
LocationAurora
Cost$35.00
FacilitatorChris Horrocks
Max per CBD11 pax

CBD 7 | “Bariatric anaesthesia, what are you afraid of?”

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.

Date/TimeSaturday 22 October
1:30pm - 3:00pm FULL
LocationThorndon
Cost$35.00
FacilitatorCathy Caldwell
Max per CBD15 pax

CBD 8 | Changing the game of NoF

This session aims to reframe your approach to managing neck of femur fractures. A lot has changing in the last decade. There is an abundance of new guidelines, research, drugs and MDT stakeholders to consider. This is a patient group that needs your skill and advocacy. You can make a difference. We will base this discussion around real cases. We will also use this as an opportunity for information sharing of local anaesthetic and/or hospital guidelines and pathways.

Date/TimeSaturday 22 October
1:30pm - 3:00pm FULL
LocationAurora
Cost$35.00
FacilitatorJustin Holborow
Max per CBD11 pax

CBD 9 | Anaesthetic management for emergency gastroscopy in an elderly patient with multiple comorbidities

The aim of this session is to discuss preoperative assessment and planning, monitoring, sedation/anaesthesia drugs, airway management and resuscitation.
The discussion will be based around a real patient who presented for gastroscopy for investigation of melaena in the setting of multiple myeloma, acute on chronic renal failure and recent initiation of dialysis.

Date/TimeSaturday 22 October
3:30pm - 5:00pm
LocationThorndon
Cost$35.00
FacilitatorKate Leslie
Max per CBD15 pax

CBD 10 | Myocardial injury after non-cardiac surgery

Myocardial injury after non-cardiac surgery (MINS) is due to myocardial ischemia (i.e., supply-demand mismatch or thrombus) and is associated with an increased risk of mortality and major vascular complications at 30-days and up to 2 years after non-cardiac surgery. The diagnostic criteria for MINS includes an elevated postoperative troponin measurement judged as resulting from myocardial ischemia (i.e., no evidence of a non-ischemic etiology), during or within 30 days after non-cardiac surgery, and without the requirement of an ischemic feature (e.g., ischemic symptom, ischemic electrocardiography finding. Patients ≥65 years of age or with known atherosclerotic disease should have troponin measurements for the first few days after surgery to avoid missing >90% of MINS and the opportunity to initiate secondary prophylactic measures and follow-up. In this small group discussion participants will evaluate cases of patients with an elevated troponin after surgery and gain insights into the pathophysiology, prognosis, and management of MINS.

Date/TimeSaturday 22 October
3:30pm - 5:00pm FULL
LocationAurora
Cost$35.00
FacilitatorPJ Devereaux
Max per CBD11 pax

Sunday 23 October 2022

CBD 11 | TIVA, dexmedetomidine and regional anaesthesia in children: recipes and tips

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.

Date/TimeSunday 23 October
10.45am - 12:15pm FULL
LocationThorndon
Cost$35.00
FacilitatorChris Badenhorst
Max per CBD15 pax

CBD 12 | Planning for a major incident. What can we learn from the defence force, civil defence and a design learning perspective?

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!

Date/TimeSunday 23 October
10:45am - 12:15pm
LocationAurora
Cost$35.00
FacilitatorNicola McCarthy
Max per CBD11 pax

CBD 13 | Obstetric challenges for the occasional obstetric anaesthetist

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.

Date/TimeSunday 23 October
1:30pm - 3:00pm FULL
LocationThorndon
Cost$35.00
FacilitatorKatie Percival
Max per CBD15 pax

CBD 14 | Airway challenges. “This could be difficult.”

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.

Date/TimeSunday 23 October
1.30pm - 3.00pm  FULL
LocationAurora
Cost$35.00
FacilitatorPatrick Wong
Max per CBD11 pax

CBD 15 | Futile Surgery. “I’ve got a bad feeling about this case”

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.

Date/TimeSunday 23 October
3.30pm - 5.00pm FULL
LocationAurora
Cost$35.00
FacilitatorPaul Daley
Max per CBD11 pax

CBD 16 | Impairment, Clinical Governance and Mandatory Reporting: a conundrum

Managing a colleague with suspected impairment can be challenging. Impairment can be categorised as neurocognitive, sensorimotor, and psychosocial. It can be due to intrinsic and/or extrinsic factors such as drug and alcohol.

It is likely that we may experience some degree of impairment at some stage of our career. The importance is if the impairment causes incapacitation and risks patient harm. Mandatory reporting can be distressing, and the GMC of UK and AHPRA have recognised the increased risk of self-harm in clinicians undergoing investigation.

This case based discussion will look at and discuss clinical scenarios that may be encountered as clinicians, clinical leaders or those who may be members of a Medical Advisory Committee.

Date/TimeSunday 23 October
3.30pm - 5.00pm
LocationThorndon
Cost$35.00
FacilitatorBernard Kelly
Max per CBD15 pax