/ Dr. Roisin Nee
Dr Aoife Quinn is a SAT 6 currently doing a neurocritical care fellowship in the Neuro and Trauma critical care unit in Addenbrookes Cambridge. Addenbrookes is the major trauma centre for the East of England. This fellowship year is supported by a Richard Steevens bursary. In July she commences a neuroanaesthesia and neuro critical care fellowship in St Michaels Hospital Toronto.
Her other areas of interest are trainee support and doctors wellbeing. During her three years on the Committee of Anaesthetists in training she helped organize the CAT wellbeing day, started the CAT mentoring scheme and the SAT buddy system. She was conferred the JFICMI diploma yesterday, which is absolutely the last exam she is every doing, and it rounds off her post graduate training which includes an MD “Ets transcription factor regulation of COX 2 in Colorectal Cancer”, MRCSI, MCEM, FRCA and FCAI.
Management of major intra operative haemorrhage
Observational data from military medicine has shaped current management of major intraoperative haemorrhage. This approach is not necessarily applicable to our patient population. Furthermore RCTs have indicated a role for a more conservative approach to blood transfusion management. The aim of this talk is to give an overview on how we might balance all available data to our best advantage when we consider the scenarios we are most likely to deal with: the patient coming to theatre for haemorrhage control, the patient in whom major bleeding is inevitable, and the initially low risk patient who is now in extremis.
Topics for consideration include major transfusion protocol, recent blood management guidelines, how best to optimize physiology and maintain anaesthesia, use of point of care tests (both blood work and ECHO) for targeted resuscitation, the expanding role of interventional radiology, post op complications, and impact of comorbidities including medications and a nod to human factors in team work and complex decision making in a fraught environment.
This talk draws together some of the key points from the literature for pre, peri and post op care of our patients, so that we can best anticipate and manage haemorrhage and the potential complications that ensure as a consequence of the therapy.
- Kozek-Langenecker et al. Management of severe perioperative bleeding : guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2017; 34:332-395
- Ghadimi et al Perioperative management of the bleeding patient. British Journal of anaesthesia 2016; 117 ( S3): iii18-iii30