Eoin and Rosie are joined by Susanna Stanford, a patient advocate, to talk through how to the importance of the prevention and management of pain during C-section. We discuss how to avoid pitfalls when testing neuraxial anaesthesia and how to manage problems under regional anaesthesia, then go on to talk about the criticality of patient communication and human factors when facing problems with neuraxial blockade.

References
-        Prevention and management of intra-operative pain during caesarean section under neuraxial anaesthesia: a technical and interpersonal approach
-        What is ‘genuine’ failure of neuraxial anaesthesia?
-        You test because you cannot make assumptions

Episode 10 the Postpartum Visit! Eoin & Rosie dive into how to approach, structure the postpartum visit and why we as a speciality should do it! We will cover everything from postpartum headache to what red flags to look for with nerve injury. 

• BJA education - postpartum headache: diagnosis and treatment
• AoA guideline - Neurological monitoring associated with obstetric neuraxial block
• AoA guideline - Anaesthesia and sedation in breastfeeding women

Our good friend and anaesthetic registrar colleague Rahul returns to defend his undisputed title as 'NovPod champion'. This time Eoin and Rahul go head to head with their knowledge of anaesthetic drugs used on the labour ward, competing for the glory of winning the golden Tuohy needle. 

References 

• OAA obstetric quick reference handbook
• Oxford handbook - drugs in anaesthesia and intensive care
• Anaesthesia (e-LA) -> Core Training - Basic Sciences -> e-LA Module 07c - Pharmacology
• Guideline on anaesthesia and sedation in breastfeeding women 
• MAPGIE Trial
• Women Trial

We are joined by the fantastic Dr Damien Hughes - an anaesthetic consultant and OAA council member - to discuss how we manage pain on the labour ward. We discuss the physiology of pain in labour and the management options we are able to deliver as anaesthetists, as well as how we can positively impact maternal health outcomes and our patients' birth experience. 


References 

• Anaesthesia (e-LA) -> Core Training - Clinical -> e-LA Module 04a - Obstetrics -> 04 Regional analgesia & anaesthesia
• Anaesthesia (e-LA) -> Core Training - Clinical -> e-LA Module 04a - Obstetrics -> 03 Labour analgesia
• BJA education - Epidural analgesia in labour
• BJA education - Non-regional analgesia for labour
• Epidural troubleshooting – East Anglia guide
• Prevention and management of intra-operative pain during caesarean section
• OAA labour pains

In Episode 7, Eoin and Rosie sit down with our fantastic guest Dr Kirsty Maclennan - an anaesthetic consultant and OAA board member - to talk through the anaesthetic emergencies that we encounter on the labour ward. With expert advice from the lead editor of the recently released obstetric anaesthetic quick reference handbook - this is not an episode to miss!

References - 
-        OAA obstetric quick reference handbook
-        Anaesthesia (e-LA) -> Core Training - Clinical -> e-LA Module 04a - Obstetrics -> 07 Serious problems in obstetric anaesthesia
-        WOMAN trial
-        TEG interpretation - Life in the fast lane
-        Load n Bread for feedback
-        DAS and OAA Airway Guidance

For Episode 6 - a 2 part special! - we are joined by our friend and obstetric registrar colleague, Miss Chiara Petrosellini, to talk through common obstetric emergencies and how Anaesthetists are involved in their management. Chiara gives us some great advice about working in high pressure situations and dealing with emergencies as part of the wider obstetric team.

References
OAA obstetric quick reference handbook

• Anaesthesia (e-LA) -> Core Training - Clinical -> e-LA Module 04a - Obstetrics -> 07 Serious problems in obstetric anaesthesia
• WOMAN trial
• TEG interpretation - Life in the fast lane 

In this episode Rosie and Eoin are joined by Gail Roberts, a midwife coordinator, to talk through how the labour ward actually works. Gail gives us an insight into what makes a good anaesthetist on labour ward and how to work well within the labour ward MDT.

References - 

-        OAA obstetric quick reference handbook
-        Association of Anaesthetists guideline - Neurological monitoring associated with obstetric neuraxial block

For Episode 6 - a 2 part special! - we are joined by our friend and obstetric registrar colleague, Miss Chiara Petrosellini, to talk through common obstetric emergencies and how Anaesthetists are involved in their management. Chiara gives us some great advice about working in high pressure situations and dealing with emergencies as part of the wider obstetric team.

References
OAA obstetric quick reference handbook

• Anaesthesia (e-LA) -> Core Training - Clinical -> e-LA Module 04a - Obstetrics -> 07 Serious problems in obstetric anaesthesia
• WOMAN trial
• TEG interpretation - Life in the fast lane 

In episode 3 we are joined by Dr Serina Sidhu, an anaesthetic CT1 about to start her obstetric novice period. Rosie and Eoin are here to answer her questions about the role of the anaesthetist on the labour ward and what we actually do on a day to day basis. 

References -

-        OAA Obstetric QRH - https://www.oaa-anaes.ac.uk/oaa-quick-reference-handbook/qrh
-        Anaesthesia (e-LA) -> Core Training - Clinical -> e-LA Module 04a - Obstetrics -> 07 Serious problems in obstetric anaesthesia

In this episode, Eoin, Rosie and Serina discuss some of the pathophysiological conditions that anaesthetists encounter on the labour ward including gestational diabetes, pre-eclampsia and abnormal placental implantation. Eoin and Rosie give advice on how to approach these and how they might impact our management of patients presenting with these conditions. 

References -

-        OAA Obstetric QRH - https://www.oaa-anaes.ac.uk/oaa-quick-reference-handbook/qrh
-        MAGPIE trial - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)08778-0/abstract
-        BJA - Management of cardiac disease in pregnancy https://academic.oup.com/bjaed/article/9/2/44/299573
-        Society of Bariatric Anaesthesia - consent guidelines
-        AoA guideline - Regional anaesthesia and patients with abnormalities of coagulation
-        Anaesthesia (e-LA) -> Core Training - Clinical -> e-LA Module 04a - Obstetrics -> 07 Serious problems in obstetric anaesthesia

Dr Ramai Santhirapala welcomes Dr Claire Shannon as new President of the Royal College of Anaesthetists with an interview featuring questions from the RCoA Member Engagement Panel and covering everything from training programmes, careers, Anaesthetic Associates, sexism in medicine, Claire's own professional journey, and the advice she'd give her younger self. 

This audio interview accompanies a condensed print version in the October 2024 edition of the RCoA member Bulletin.