Mahmoud Nassar, Specialty Trainee 3
Laurin Allen, Consultant Anaesthetist

The use of ultrasound for regional anaesthesia is well described in the literature, but not routinely used in our department. Given its advantages, especially with anticipated difficult neuraxial procedures, we developed a local protocol and promoted it with ‘tea trolley’ teaching to encourage its use on a routine basis.

Ross Thomson, Consultant Anaesthetist
Colin Patterson, Consultant Anaesthetist

Rib fractures remain a difficult to manage complication following thoracic wall trauma, associated with increased mortality and morbidity, especially in the elderly. Initial 2018 evaluation at Aberdeen Royal Infirmary (ARI) found variability in analgesic management, and clinical need to identify at-risk group early in admission.

Aberdeen: North of Scotland Trauma Network meeting

Laura McCance, Specialty Trainee 6
Andrew Ying, Core Trainee 2
Nicola Walker, Core Trainee 2
David Nesvadba, Consultant Anaesthetist

NAP 4 highlighted inadequate communication as a contributory factor for adverse events during airway management. Further, “failure to plan for failure” was specifically discussed. Verbalisation has been shown to reduce errors in safety critical industries, but this is not standardised in anaesthesia. Key recommendations for airway management have recently been published and reinforce the aims set out for this project. This project focuses on two areas of communication relevant to airway management; forming and discussing an airway strategy and verbalisation during induction of anaesthesia.

Newcastle: Difficult Airway Society Annual Scientific Meeting

Anna Celnik, Specialty Trainee 7

To assess the use of locally 3D printed part-task trainers for Emergency Front of Neck Access (eFONA) training

Aberdeen: Association for the Study of Medical Education Annual Scientific Meeting

Anna Celnik, Specialty Trainee 7
Timothy Jagelman, Consultant Anaesthetist

Paediatric anaesthesia forms an important part of UK
training. Anaesthetists at the end of their training are
expected to be able to provide anaesthesia for children over the age of one in non-complex circumstances. Needs assessment is integral to meaningful education, as
adult learners come with different prior experiences and
skills. Our trainees reported difficulty in identifying their own training needs when rotating to paediatrics, and therefore had difficulty in targeting their learning during their blocks. Self-assessment is an established method for assessing felt needs – those needs identified by the learner - and we wished to examine its use in improving trainees’ experiences.

Lisbon: European Society of Paediatric Anaesthesia meeting

William Smy, Specialty Trainee 3
Douglas Coventry, Consultant Intensivist & Anaesthetist
Shay Nanthakumaran, Consultant Surgeon

Aberdeen Royal Infirmary is a low volume centre carrying out approximately 13 oesophagectomies per annum. Due to minimal exposure to post-operative oesophagectomy patients, staff had low perceived confidence in their management within the Intensive Care Unit (ICU). After an initial pause due to the COVID-19 pandemic, oesophagectomy service provision restarted in June 2020. Prior to this project, no
standardised care pathway existed for post-operative oesophagectomy patients. A protocol driven management pathway was implemented within the ICU setting in October 2020.

Belfast: Intensive Care Sociey State of the Art meeting

Li Yen Liew, Specialty Trainee 6
Piotr Orzylowski, Specialty Trainee 7
Graham Wilson, Consultant Anaesthetist

Chloraprep (2% chlorhexidine gluconate in 70% alcohol) remains unlicensed for use in children less than 2 months of age. This is due to issues with skin irritation and systemic absorption. For this reason many centres advocate abandoning its use in this age group altogether. Our aim was to review skin antisepsis in theatre for surgery and line insertion in children less than 2 months of age at the Royal Aberdeen Children's Hospital.

Peebles: Scottish Society of Anaesthetists Spring Meeting (Third Place)

Li Yen Liew, Specialty Trainee 6
Emmanuel Feldano, Specialty Trainee 3
Donald Irvine, Consultant Anaesthetist

Paediatric anaesthesia is a foundation of the training curriculum of the Royal College of Anaesthetists, usually delivered and assessed using various workplace based assessments. Anecdotal reports from trainee colleagues in our centre indicated these competencies were achieved at varying rates, directly related to clinical exposure and out of hours opportunities. We intend to improve the delivery of training in paediatric anaesthesia linked directly to the RCOA curriculum outcomes in our hospital.

Edinburgh: Scottish Paediatric Anaesthetic Network Spring Meeting 2022 (Selected for Oral Presentation)

Emmanuel Feldano, Specialty Trainee 3
Li Yen Liew, Specialty Trainee 6
Donald Irvine, Consultant Anaesthetist

Simulation teaching is a well validated method of delivering clinical learning outcomes successfully in medical education. It is particularly useful in enabling ‘hands on’ experience in a safe and controlled space.

Edinburgh: Scottish Paediatric Anaesthetic Network Spring Meeting 2022

Dinushi Jayasuriya, 5th Year Medical Student
Li Yen Liew, Specialty Trainee 6
Ross Thomson, Consultant Anaesthetist

The use of iron supplementation in patients with iron deficiency anaemia that underwent elective colorectal surgery was assessed. 87% of patients were managed as per recommendations indicating that there is still room for improvement to ensure that iron supplementation prior to elective surgery is provided to all patients that are iron deficient. This could be achieved by implementing more robust pathways to refer such patients.

Peebles: Scottish Society of Anaesthetists Spring Meeting 2022 (Medical Student Prize)

Ross Thomson, Specialty Registrar 6

Colin Patterson, Consultant Anaesthetist

A Major Trauma Centre was commissioned in October 2018. There was no agreed local clinical pathway for managing rib fractures despite high morbidity and mortality. This project aimed to evaluate the management of patients presenting with rib fractures assessing analgesia, use of regional techniques and respiratory deterioration requiring ventilatory support.

Manchester: National Acute Pain Symposium 2019

Piotr Orzylowski, Specialty Trainee 5

Kay Davies, Consultant Anaesthetist

Swapnil Aswar, Consultant Anaesthetist

Post-operative nausea and vomiting (PONV) continues to be an issue in the paediatric population. The incidence is almost twice as high as in adults and varies between and 42%. It is associated with morbidity, delayed discharge and parental and patient dissatisfaction. Our department at the Royal Aberdeen Children’s Hospital (RACH) in Aberdeen continues to support regular re-auditing of the incidence of PONV in children.

Virtual: APAGBI Annual Scientific Meeting 2021

Sarah-Anne Milne, Core Trainee 2

Jill Austin, Consultant Anaesthetist

We employed the flipped classroom in our online Anaesthesia tutorials to improve engagement and collaborative learning during the Covid 19 pandemic.

Virtual: Keck School of Medicine of USC 18th Annual Innovation in Medical Education Conference

Seong Hoon Lee, Foundation Year 1

Andrea Harvey, Consultant Anaesthetist

National and international consensus statements have recently published guidelines evidencing increased postoperative risks associated with modified-release opioids (MRO), especially when used within 48 hours of surgery. We aimed to ascertain the rate of MRO prescription by anaesthetists for post-operative day 0 use in surgical patients at ARI.

Virtual: Scottish Society of Anaesthetists Annual Spring Meeting 2021

Second Place Poster Prize

Michael Kirkham, Specialty Trainee 6

David Seath, Consultant Anaesthetist

A patient presented to her GP with odynophagia, dysphagia and reduced oral intake over several weeks. She was referred to gastroenterology and upper GI endoscopy revealed a foreign body in the pharynx. This was thought to be a screw related to a nterior cervical discectomy and fusion (ACDF) surgery 6 years previously.

Virtual: Scottish Society of Anaesthetists Annual Spring Meeting 2021

Shortlsted for Poster Prize

Charles Moore, Specialty Trainee 6

Jill Austin, Consultant Anaesthetist

The advent of the Covid-19 pandemic necessitated a rapid expansion into the realm of online learning, with a resultant need to review the curriculum and develop modalities that were suitable for an online, distanced model of learning. Simply recording teaching that works effectively in a face to face format does not lead to the same results when delivered online, and prolonged exposure to narrated powerpoint presentations does not produce an effective and engaging learning experience.

Virtual: Keck School of Medicine of USC 18th Annual Innovation in Medical Education Conference

Ben Tanner, Foundation Year 2

Eanna Mulvihill, Foundation Year 2

Karen Cranfield, Consultant Anaesthetist

NICE guidance recommends that oral paracetamol should be offered perioperatively and that the intravenous route should only be offered if an oral route is not available.

Virtual: Scottish Society of Anaesthetists Annual Spring Meeting 2021

Philip Jackson, Specialty Trainee 5

Due to the construction of a new women's hospital in Aberdeen, a review of historic and current ICU provision to obstetric cases was undertaken.

Newcastle-Gateshead: Obstetric Anaesthetists' Association Annual Scientific Meeting 2019

Linzi Moir, Specialty Trainee 3

Andrew Bayliss, Consultant Anaesthetist

Leanne Duffy, Senior Charge Nurse

Critical incidents involving tracheostomies have a 60-70% risk of harm, with a relative risk of seven in the ward environment. While this increased risk is multifactorial, lack of training plays a part. Junior doctors on hospital wards may face managing an acutely unwell patient who has had a tracheostomy or laryngectomy until expert help arrives. In NHS Grampian, we initiated a quality improvement project focusing on educating junior doctors in airway management for these patients.

Glasgow: Association of Anaesthetists Annual Congress 2019

Sarah Rae, Specialty Trainee 6

Hal Robinson, Specialty Trainee 7

There is increasing evidence to suggest that tranexamic acid (TXA) can significantly lower blood loss by up to 30% in patients undergoing lower limb arthroplasty with seemingly no significant increase in risk. However, there remains a wide discrepancy on the agreed dose and timing.

London: Association of Anaesthetists Winter Scientific Meeting 2019

Second Place Poster Prize