In this episode I chat with Dr Yasmin Endlich, Medical Director at webAIRS, web based Anaesthesia Incident Reporting System. We currently have over 13,000 reports in webAIRS, making it one of the world's largest incident reporting systems.

We chat about the various analyses (currently over 30 underway!), what's happening behind the scenes and how we will be discussing de-identified incident reports at the up and coming Australian Society of Anaesthetists M&M meeting. I also couldn't help discussing safety-II principles - examining what went right to prevent harm rather than only analysing failures.

Three action items to consider:

1. Come to the next ASA M&M meeting! 29th June 2026. Complimentary registration for ASA members. Register or find the next event here
2. Join webAIRS user, if you haven't already. Any anaesthetist or trainee member of the ASA is eligible.
3. Report your incidents. Including the near misses. Help us better develop a safety-II approach

Three more podcasts on webAIRS:

Ep54. webAIRS with Prof Martin Culwick

Ep57. webAIRS: Lingual Nerve Injury

Ep79. webAIRS: Jaw Dislocation

Some AI generated notes:

Key Takeaways

webAIRS is the world's largest anesthetic incident reporting system with over 13,000 reports, enabling rare event analysis and evidence-based safety improvements across Australia and New Zealand.

Safety-II methodology—analysing what went right in near misses and no-harm events—offers a complementary approach to traditional incident analysis and may drive more effective safety interventions

Implementation science remains underdeveloped in anaesthesia. Most institutions adapt to safety recommendations but rarely publish their implementation processes, limiting knowledge sharing and replication

webAIRS supports institutional M&M programs through anonymous, de-identified case access with categorization tools. ASA is launching exclusive member M&M events using webAIRS data

Registration with webAIRS offers dual benefits: self-reflection and learning for individual reporters, plus contribution to community-wide safety analysis. Reporting is legally privileged, anonymous, and eligible for CPD credit

Quotable Moments

"We understand that the health system is a complex beast, which we as humans are constantly adapting and adjusting or creating workarounds to keep things safe for our patients and usually efficient as well."

"We report a lot. So the numbers of our reports are there. Then they get assessed. But the reporting back and then looking at systems and then looking how to improve things and going up the pyramid to reduce adverse events, that's basically where it stops in most healthcare areas."

"It's not only important for oneself when you report as it's a part of self-reflection. It is a part of working through an incident yourself as well. But it also benefits the wider community."

"We don't want is anybody who has reported an incident feel like, oh, we are not treating the data safely. We 100% are. And it will stay anonymous and it will stay completely de-identifiable as well."

In this episode, I'm reviewing an article that was published in the April 2026 Anaesthesia and Intensive Care journal (AIC). It's all about sharps waste management! A snapshot (literally) on what we are placing in our sharps bins and whether there is any room for improvement (spoiler alert - yes, there is plenty!). I also share some insights from my Sabbatical in Switzerland.

This podcast accompanies the poster designed by Dr Nathan Chin in the June 2026 Australian Anaesthetist magazine. Download your free copy here.

To read the scientific paper from AICm click here. You may need your ASA login to access it.

Three more episodes you might want to listen to:

Ep69. Talking TRA2SH - trainee led research into sustainability in healthcare with Dr Jess Davies

Ep96. Introducing Prof Philip Peyton, new editor in chief at Anaesthesia and Intensive Care

Ep114. Laughing Gas, Serious Waste: Measuring Nitrous Wastage with Dr Ethan Fitzclarence

Some AI generated notes:

Episode Highlights

00:00:30: Introduction to the sharps bin contamination study from April 2026 Anesthesia and Intensive Care journal, featuring artwork by anaesthesia trainee Dr. Nathan Chin

00:02:15: Sharps waste disposal costs 30 times more than general waste, with incineration producing 10 times the carbon footprint of regular waste disposal

00:04:45: UK data shows sharps disposal produces 50 times more carbon dioxide emissions compared to recycling

00:06:30: Zurich, Switzerland example demonstrating the "polluter pays principle" through mandatory tax-added garbage bags and strict recycling enforcement

00:10:20: Study methodology involved photographing sharps bins and counting non-sharps contamination across multiple hospital sites

00:12:45: Key finding: 79.5% of non-sharps items could theoretically be recycled, but only 18% could realistically be recycled with current hospital infrastructure

00:15:30: Most common sharps bin contaminants include glass vials (propofol bottles), plastic syringes without needles, IV lines, endotracheal tubes, and single-use stainless steel instruments

00:18:15: Only 19% of surveyed hospitals can recycle plastic syringes and one-third can recycle plastic ampoules, with glove recycling available at only one surveyed site

Key Takeaways

Healthcare waste management practices significantly lag behind residential recycling standards; implementing systematic segregation at point of use could dramatically reduce environmental impact and costs

Policy presence alone does not ensure compliance—hospitals must invest in infrastructure, education, and accountability systems to translate waste management guidelines into operational reality

Individual clinician behaviour change is achievable and impactful; simple actions like detaching needles from syringes before disposal can redirect substantial waste from expensive sharps streams

Hospitals should audit their recycling capabilities and partner with waste management providers to expand options for plastic syringes, glass vials, and metal instruments currently defaulting to sharps bins

Quotable Moments

"Sharps bin waste is the most expensive waste to get rid of, both from an economic perspective and also in terms of the impact on our environment."

"Getting rid of sharps waste could be 30 times more expensive than getting rid of general waste. 30 times!"

"Sharpe's disposal, the autoclaving crushing landfill type of disposal, produces 50 times the amount of carbon dioxide emission compared to recycling. 50 times. Whoa."

"We buy stuff, we open endless amounts of packaging and we don't think about how or how much it's going to cost to dispose of it."

"Nearly 80% or four in five items could have been recycled for perhaps one 50th of the carbon footprint. That is astounding."

In this episode, I explore trauma informed care with expert clinical psychologist Brigette Berry who specialises in acute and chronic pain. We examine five core principles of Fallot and Harris (2009): safety, trustworthiness, choice, collaboration and empowerment.

Trauma informed care benefits all patients, not just those who have disclosed trauma. For example, many women may have undisclosed trauma, children and neurodivergent people could all benefit from the application of these principles.

Brigette recommends the Blue Knot Foundation for support and further training.

Three other episodes of the Australian Anaesthesia podcast you might enjoy listening to are:

Ep55. Hypnotising children! with Drs Annette Webb and James Auld

Ep60. Communicate like a Boss with Dr Andrea Wojnicki

Ep83. The Women's Empowerment and Leadership Initiative (WELI) with Prof Nina Deutsch & A/Prof Larry Schwartz

Let me know if you're interested in the Blue Knot training or any other feedback: [email protected]

Some AI generated notes:

Episode Highlights

00:02:15: Suzi introduces the concept of non-technical skills as essential core competencies for good doctoring, noting that anaesthetists can inadvertently contribute to patient trauma through insensitive communication.

00:05:30: Bridgette defines trauma using DSM-5 criteria as experiencing a literal or perceived threat to life, and notes that general anaesthesia itself may constitute a perceived threat to self.

00:08:45: Discussion of statistics showing one in three women have experienced interpersonal violence, emphasising the prevalence of trauma in patient populations without requiring explicit disclosure.

00:12:20: Explanation of the five trauma-informed care principles from Fallot and Harris (2009): safety, trustworthiness, choice, collaboration, and empowerment.

00:15:00: Practical safety applications including physical environment modifications (lighting, noise reduction), narrating procedures, and obtaining consent for physical contact.

00:22:30: Bridgette highlights unconscious behaviours in healthcare settings, such as lifting blankets without introduction or consent, demonstrating how small actions affect emotional safety.

00:28:15: Discussion of preoperative communication using positive language and imagery to support post-operative recovery and self-efficacy, referencing hypnosis-based communication techniques.

00:35:40: Bridgette introduces the COPE AHEAD skill from dialectical behaviour therapy as an evidence-based framework for imagined rehearsal and coping strategy preparation.

00:42:00: Emphasis on maintaining professional boundaries and respectful containment as essential components of trustworthiness, alongside being curious about fostering safety.

00:45:15: Bridgette recommends Blue Knot Foundation training and resources as practical tools for implementing trauma-informed care in healthcare settings.

Key Takeaways

Trauma-informed care is universal best practice applicable to all patients, not only those with disclosed trauma histories, and benefits neurodivergent individuals and children equally.

Simple acts of narration, consent-seeking, and signposting (e.g., "I'm about to put the drip in") significantly reduce threat perception and build emotional safety without requiring additional time.

Anaesthetists have a powerful preoperative role in setting positive post-operative outcomes through clear expectations, anxiety reduction, and empowering communication that improves both physical recovery and patient trust in healthcare systems.

Individualisation within a trauma-informed framework is essential; clinicians should remain flexible and responsive to patient cues, recognising that some patients may find excessive choice overwhelming while others require it.

Professional development training through organisations like Blue Knot Foundation provides practical, evidence-based tools for implementation, and adopting these principles requires ongoing humility and willingness to unlearn and relearn practices.

Quotable Moments

"There is always something more to learn, something more I can improve upon."

"One in three women have experienced some type of interpersonal violence, as an example. So if we think about one in three patients that we see for anaesthetic procedures, you know, there's a high proportion of those who experience traumatic events."

"Re-traumatisation is a very real thing. And I guess when we go through the principles, I can dive in slightly further. But we know, especially for those who have been through the more kind of chronic, prolonged, inescapable traumas, that are cumulative, we're less likely to feel safe within our own bodies."

"Even if we're asking the question of, is there anything else we can do in this space within reason that could make you more comfortable? That's really therapeutic than just not asking and making the person feel like they can't advocate for anything."

"It's the spirit of cooperation. So that may have to involve negotiation for the specific person in front of me."

"Being curious about how can I foster more safety. I think training, professional development training within your setting is really, really helpful."

"It's very humbling though, I will say, working in a trauma-informed way. So there's always stuff to learn unlearn, relearn, you know, and it's about humbling ourselves enough to be okay with that process because it makes us better clinicians and then it gives our patients a better experience."

In this episode I chat with Dr Mark Priestley, Chair of the Leadership and Management Special Interest Group (LAMSIG), Australian Salaried Medical Officers Federation (ASMOF) NSW and ANZCA Councillor.We are chatting about one of my favourite topics – leadership!

We go through my 4 part leadership curriculum, the importance of identifying core personal values, his work based on the book “Crucial Conversations” and navigating media when speaking out.

Want to continue discussing leadership?

Listen to Episode 83 where I chat with Professor Nina Deutsch and Assoc Prof Larry Schwarz about the Women’s Empowerment and Leadership Initiative

Dr Priestley hosts a leadership and management discussion at the ASA’s 2025 National Scientific Congress (NSC). The videos from the 2025 NSC are due out in August. ASA members can access them here.

The leadership collection of the Australian Anaesthesia podcast can be found on the LAMSIG webpage.

Find out more about AUS-NZ WELI and apply to join here.

Some AI generated notes:

Episode Highlights

00:02:15: Assoc Prof Suzi Nou introduces WELI (Women's Empowerment and Leadership Initiative), a mentorship program matching emerging leaders with advisors, designed to address the underrepresentation of women in senior anaesthesia roles.

00:05:30: Mark Priestley discusses how leadership became his passion after joining the tripartite ASA/ANZCA/NZSA Leadership Special Interest Group five years ago, discovering that leadership development is largely absent from medical training.

00:12:45: Priestley describes the AFRACMA (Affiliated Royal College of Medical Administrators) course as valuable for understanding healthcare management, finance, and difficult conversations, delivered as half-day fortnightly sessions over six months.

00:18:20: Mark explains his transition to Head of Department at Westmead Hospital after six months’ sabbatical, emphasizing that effective leadership combines both strategic vision and day-to-day management.

00:28:40: Discussion of ASMOF (Australian Salary and Medical Officers Federation) and Priestley's advocacy for improved working conditions in New South Wales, noting that unions thrive when organisational leadership fails.

00:35:15: Mark addresses concerns about speaking publicly on contentious issues, recommending transparency with stakeholders and clear communication about media appearances to avoid ambush situations.

00:42:00: Suzi presents a four-part leadership curriculum: self-knowledge, communication and negotiation, strategic thinking and political context, and mentoring the next generation.

00:48:30: Mark emphasizes the importance of identifying core personal values and "ratcheting down the moral compass" to guide decisions when facing conflicting priorities.

00:55:45: Priestley describes his workshop on difficult conversations, based on the book "Crucial Conversations," delivered specifically to anaesthetists with clinically relevant scenarios.

01:08:20: Mark discusses the inaugural Heads of Department networking day (H2H), designed as a forum for senior leaders to discuss challenging scenarios and share expertise.

01:15:30: Priestley announces his transition from Head of Department to ANZCA Council member and ASA PIAC (Professional Issues Advisory Committee) representative, continuing his leadership contribution at a broader level.

Key Takeaways

Leadership development should begin early and continue throughout your career; it's not a single destination but a continuous learning cycle involving reflection, feedback-seeking, and strategic growth.

Self-awareness is the foundational prerequisite for all other leadership skills—you cannot effectively manage others or navigate complex situations without first understanding your own values, strengths, and limitations.

Difficult conversations are a core leadership competency that can be learned and improved through deliberate practice; avoiding them creates long-term organizational dysfunction and erodes influence.

Strategic focus requires saying "no" to good opportunities to concentrate on two or three truly important priorities; attempting everything leads to failure and burnout.

Formal credentials and titles matter less than demonstrated competence, authentic communication, and the ability to build trust with stakeholders across hierarchical levels.

Quotable Moments

"Once you've finished your training, whether it be in anaesthesia or another area completely outside of medicine, then most of your career development will be made in the area of leadership."

"If you don't know yourself, you can't manage yourself, you can't manage yourself, you can't manage others."

"The big decisions are not what you're going to do, but what you're not going to do, like deliberately actively decide to put on a back burner because the common mistake is to try too much."

"If you think the good stuff means they're talking about you, then you have to accept that maybe the bad stuff means they're talking about you and sometimes you're better off ignoring the commentary, you know, full stop."

"Unions thrive when the corporation or the organisational leadership is failing. And I think that's what's happening in New South Wales."

I chat with Dr David Borshoff about the latest edition of the Anaesthetic Crisis Manual. This edition includes a new 'Prevention' section, collaboration with Médecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC) and comes out in 2 versions: International and North American.

As an ASA member, you are eligible for a FREE(!) or discounted Manual. Contact [email protected] for more details.

Not a member? Find out about more benefits of being a member here:

https://asa.org.au/types-of-membership

Key Takeaways

Cognitive aids like the Anesthetic Crisis Manual reduce cognitive load and anxiety during crises by providing systematic reassurance rather than replacing clinical judgment.

Simplicity in crisis management protocols requires substantial effort— Dr Borshoff spent nine months updating the fourth edition with fellowship-level study commitment to distill information to essential directives.

Team communication and psychological safety are critical; the anaesthetic technician's willingness to speak up during Dr Borshoff's front-of-neck access directly contributed to patient survival.

Passion projects and creative outlets in medicine maintain professional engagement and curiosity, preventing burnout while advancing patient safety and departmental culture.

Accessibility matters: offering manuals free to trainees and discounted to members embeds cognitive aid culture into the profession from early career stages.

Quotable Moments

"None of us are infallible 100% of the time."

"When you're cognitively loaded, you want to be making as few decisions as possible so that you can stick to the big stuff."

"The crisis manual is there to support the clinical acumen and the decision making of the doctor. It's not the other way around."

"If you've got something that you're passionate about, then you're prepared to do the work and you don't realise how many hours are ticking away while you're doing it."

"Why don't you just do it properly, doc?" — The anaesthetic technician's intervention that broke Borshoff's fixation error during emergency front-of-neck access.

Some other episodes you might enjoy:

Ep25. The Anaesthetic Crisis Manual with Dr David Borshoff

Ep78. AMAX4 - a cognitive aid for anaphylaxis with Dr Ben McKenzie

Find the Anaesthetic Crisis Manual and other Crisis Manuals here: https://leeuwinpress.com.au/

We welcome any feedback: [email protected]

We have a new wellbeing webpage!

In this episode I chat with Dr Lan-Hoa Le, Chair of the ASA's Wellbeing Advocates Committee. She has been busy curating a webpage with a tonne of useful resources from crisis helplines, peer support programs and mindfulness training. There is something there for everyone, whether you or a colleague would appreciate some confidential support, you are interested in supporting others or you already have a well established interest and role in developing wellbeing in the workplace.

We welcome all anaesthetists and those that support us to visit the webpage, regardless of your ASA membership status. You can find it here.

Everymind's guide to language and suicide

Ep33. Substance use disorder: A personal perspective with Dr Colin Baird

Ep84. Ahpra with AMA Policy Manager Nick Elmitt

Donate to or seek assistance from the ASA Benevolent Fund.

Who likes the idea of excessive waste in healthcare? Especially when it is something that can impact our colleagues and has negative climate effects?

In this episode I chat with Dr Ethan Fitzclarence, from Perth, Western Australia about an audit he conducted as part of his anaesthetic training. He discovered an astounding amount of nitrous oxide was being leaked to the atmosphere.

We discuss his methodology, the health impacts of nitrous oxide waste and the growing movement to toward decommissioning pipeline systems in favour of cylinder-based delivery.

Read our Joint Statement on decommissioning nitrous oxide medical gas pipeline systems.

For this work, Dr Fitzclarence won the Nerida Dilworth prize - congratulations! Find more information about this and other ASA research prizes here.

The accompanying poster to the podcast can be found in the March 2026 edition of Australian Anaesthetist. The September 2022 edition is all about environmental sustainability and where you can read more about this and other initiatives undertaken by anaesthetists. Both are available on the ASA website.

Learn more about other ways to get involved in an audit as a trainee:

Ep69. Talking TRA2SH - trainee led research into sustainability in healthcare with Dr Jess Davies

Welcome to 2026!

In this episode I chat with Dr Andrea Binks, an anaesthetist and accomplished yoga facilitator from Wollongong, NSW. Dr. Binks shares her unconventional journey into anaesthesia, transitioning from physician and cardiology training in the UK to intensive care and eventually anaesthesia. I learn how yoga has been a constant in her life since childhood, evolving from a personal practice to teaching qualification, and how it now informs her approach to patient care.

We explore the intersection of trauma-informed yoga practices and anaesthetic practice, the use of invitational language, and the importance of patient autonomy, and creating safe spaces for vulnerable patients.

Episodes you may want to enjoy after this one:

Ep98. Coaching for Doctors with Dr Anne Frankl

Ep83. The Women's Empowerment and Leadership Initiative (WELI) with Prof Nina Deutsch & A/Prof Larry Schwartz

Ep106. Anaesthesia Unlocked: Fast-tracking IMGs in Australia with Prof David Story

Find out more about the Australian and New Zealand chapter of WELI - Women's Empowerment and Leadership Initiative

We welcome new members and any feedback.

https://asa.org.au/types-of-membership/how-to-join/

[email protected]

I catch up with Professor Tim Cook, of the UK National Audit Projects live at the Australian Society of Anaesthetists' National Scientific Congress (NSC). We discuss his incredible work, his ideas of success and what risk in anaesthesia mean to him.

ASA branded scrubs are here! Only available to ASA members. Get your discounted scrubs with free embroidery here.

https://asa.org.au/your-asa-advantage-program#scrubs

Professor Cook's talk from the NSC is available to be viewed on demand. If you haven't already registered, you can do so here: https://asansc.com.au/registration/

3 other episodes to listen to:

Ep54: webAIRS with Prof Martin Culwick

Ep79: webAIRS: jaw dislocation

Ep111: The GLP-1 Revolution: What it Means for Anaesthesia with Dr Doug Hacking

Want to access more resources? Become an ASA member!

We welcome any feedback.

[email protected]

In this episode:

• The last of my thought bubble talks on how to introduce yourself with confidence and clarity
• Some tips on balancing an academic research career and clinical medicine
• Changing from one medical specialty (e.g. paediatrics) to another (e.g anaesthesia)

I'm chatting with Dr Doug Hacking, paediatrician, anaesthetist, researcher. We are discussing GLP-1 receptor agonists and what they mean for anaesthesia. This is based on his editorial in the September 2025 edition of the scientific journal, Anaesthesia and Intensive Care.

ASA Members! Are you interested in learning more about gastric POCUS? At the end of the podcast I share with you an exclusive offer that will save you hundreds of dollars.

Link to Prof Dariush Mozaffarian podcast on the health harms of unprocessed foods and ralated policies: https://www.youtube.com/watch?v=IaiGzkKIgbc

The exclusive ASA gastric POCUS offer: https://www.asahq.org/education-and-career/educational-and-cme-offerings/gastric-pocus

Become an ASA member to access these resources and more: https://asa.org.au/types-of-membership/how-to-join/

We welcome any feedback: [email protected]

In this episode I hand the mic over to Dr Tom Neal-Williams, an anaesthetic trainee and hard working member of the ASA Communications Committee to be a guest host on the podcast. He is talking with Professor Ed Mariano, regional anaesthesia guru, researcher, leader and educator and gaining tips on how he navigates his career.

I also share some thoughts on vocal fry.

This episode was recorded live at the ASA's National Scientific Congress in Canberra.

If you want to watch Professor Mariano's talks from the Congress (and I suggest you do), you can register for access here: https://asansc.com.au/registration/

Join the ASA to have access to more great educational content: https://asa.org.au/types-of-membership/how-to-join/

We welcome any feedback. Email us ! [email protected]