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bjaeducation.bsky.social
BJA Education
@bjaeducation.bsky.social
390 followers 170 following 130 posts
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bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 2h
🧠 From Fremantle to PeDiAC: VL-specific grading systems are emerging, but none yet hold the crown. Which will become the new standard? #BJAEd www.bjaed.org/article/S205...
Grading systems for tracheal intubation using videolaryngoscopy
The first videolaryngoscopes were marketed in 2001. In the two decades since, the number of models available, diversity in design and popularity have all significantly increased.1 Designs can be…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 1d
🔍 From tracheal aspirates to novel molecular diagnostics — what’s the best way to diagnose VAP? This article reviews evidence & controversies. #BJAEd www.bjaed.org/article/S205...
Ventilator-associated pneumonia
Ventilator-associated pneumonia (VAP) is a common complication of invasive ventilation that afflicts critically ill patients and is associated with increased morbidity and mortality. However, it is…
www.bjaed.org
2 1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 2d
Damage-control anaesthesia & surgery in the elderly is essential to understand. When do we push on, and when is palliation the most appropriate path? 💡 Explore the nuances in #BJAEd: www.bjaed.org/article/S205...
Major trauma in the elderly: unique challenges and considerations
In England there are around 60 cases of major trauma (Injury Severity Score (ISS) > 15) daily.1 Trauma continues to be the leading cause of death in children and adults aged <40 years and has…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 3d
From excitatory pathways to disinhibition and glial cell activity — central sensitisation reflects a plastic re-wiring of pain circuits. A must-read on the science behind chronic pain in #BJAEd: www.bjaed.org/article/S205...
Neurobiological mechanisms of central sensitisation underlying chronic pain states
Chronic pain, whether primary and recognised as a disease in its own right, or secondary to another disease, is associated with a persistent amplification of the painful experience, which explains…
www.bjaed.org
1 1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 4d
ACHD + non-cardiac surgery = high stakes 🚨 When should you contact, or transfer to, a specialist centre? When is local care appropriate? 🔍 This #BJAEd article offers a practical framework: www.bjaed.org/article/S205...
Anaesthesia for non-cardiac surgery in patients with adult congenital heart disease
Congenital heart disease (CHD) is the most common group of congenital anomalies, with a prevalence of approximately nine per 1000 live births. Advances in medical and surgical care have significantly…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 5d
💡 A “good view, cannot intubate” is a familiar challenge in videolaryngoscopy. New scoring systems aim to capture this reality more reliably – could they change your practice? #BJAEd
www.bjaed.org/article/S205...
Grading systems for tracheal intubation using videolaryngoscopy
The first videolaryngoscopes were marketed in 2001. In the two decades since, the number of models available, diversity in design and popularity have all significantly increased.1 Designs can be…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 6d
🧠 VAP prevention bundles, antimicrobial strategies & guideline differences… this review explores this challenging condition. #BJAEd www.bjaed.org/article/S205...
Ventilator-associated pneumonia
Ventilator-associated pneumonia (VAP) is a common complication of invasive ventilation that afflicts critically ill patients and is associated with increased morbidity and mortality. However, it is…
www.bjaed.org
1 1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 7d
Falls from standing height are now the commonest cause of major trauma in adults. But mechanism tells only part of the story — frailty & physiology are critical. More in #BJAEd 📘: www.bjaed.org/article/S205...
Major trauma in the elderly: unique challenges and considerations
In England there are around 60 cases of major trauma (Injury Severity Score (ISS) > 15) daily.1 Trauma continues to be the leading cause of death in children and adults aged <40 years and has…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 8d
🔍 Why does pain persist when the injury is gone? Central sensitisation offers an answer — neural circuits adapt, amplify, and reorganise, sustaining chronic pain. Read more in #BJAEd: www.bjaed.org/article/S205...
Neurobiological mechanisms of central sensitisation underlying chronic pain states
Chronic pain, whether primary and recognised as a disease in its own right, or secondary to another disease, is associated with a persistent amplification of the painful experience, which explains…
www.bjaed.org
1 1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 9d
Not all ACHD patients carry the same risk ⚖️ Classifying by anatomical complexity & physiological status is key for safe periop planning 🧠 Full breakdown in #BJAEd: www.bjaed.org/article/S205...
Anaesthesia for non-cardiac surgery in patients with adult congenital heart disease
Congenital heart disease (CHD) is the most common group of congenital anomalies, with a prevalence of approximately nine per 1000 live births. Advances in medical and surgical care have significantly…
www.bjaed.org
1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 10d
📘 Videolaryngoscopy is now central to safe airway management – but are we still documenting it with tools built for a different era? This article questions whether Cormack–Lehane should finally be retired for VL. #BJAEd www.bjaed.org/article/S205...
Grading systems for tracheal intubation using videolaryngoscopy
The first videolaryngoscopes were marketed in 2001. In the two decades since, the number of models available, diversity in design and popularity have all significantly increased.1 Designs can be…
www.bjaed.org
1 1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 11d
🌍 Ventilator-associated pneumonia (VAP) varies widely between regions — but why? Definitions, diagnosis & practice all play a role. A must-read review in BJA Education. #BJAEd www.bjaed.org/article/S205...
Ventilator-associated pneumonia
Ventilator-associated pneumonia (VAP) is a common complication of invasive ventilation that afflicts critically ill patients and is associated with increased morbidity and mortality. However, it is…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 12d
Major trauma is shifting. 🚑 The “typical” patient is now in their 60s, often with frailty & comorbidities. How should anaesthetists adapt to this new reality of silver trauma? Read more in #BJAEd: www.bjaed.org/article/S205...
Major trauma in the elderly: unique challenges and considerations
In England there are around 60 cases of major trauma (Injury Severity Score (ISS) > 15) daily.1 Trauma continues to be the leading cause of death in children and adults aged <40 years and has…
www.bjaed.org
2 1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 13d
Chronic pain isn’t always about structural damage. 🧠 Central sensitisation reshapes the nervous system, amplifying pain signals for a long time.
Explore the mechanisms behind this phenomenon in #BJAEd: www.bjaed.org/article/S205...
Neurobiological mechanisms of central sensitisation underlying chronic pain states
Chronic pain, whether primary and recognised as a disease in its own right, or secondary to another disease, is associated with a persistent amplification of the painful experience, which explains…
www.bjaed.org
1 1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 14d
Patients with adult congenital heart disease (ACHD) are living longer 🫀➡️ increasing presentations for non-cardiac surgery. What does this mean for perioperative risk, planning & anaesthesia? 📘 New #BJAEd review. www.bjaed.org/article/S205...
Anaesthesia for non-cardiac surgery in patients with adult congenital heart disease
The dates displayed for an article provide information on when various publication milestones were reached at the journal that has published the article. Where applicable, activities on preceding…
doi.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 20d
📈 CLIF-C ACLF score is more predictive of mortality than MELD or Child–Pugh.
It incorporates organ failure, age & WCC.
Key for prognosis & decision-making.
👉 Check out the table in this month’s BJA Education.
www.bjaed.org/article/S205...
Acute-on-chronic liver failure
Acute-on-chronic liver failure (ACLF) is a distinct clinical entity from both acute liver failure and simple decompensation in chronic liver disease. Acute-on-chronic liver failure involves chronic…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 21d
⚡Peripheral nociception → spinal cord → supraspinal centres

Feedback loops (neuroimmune, neuroendocrine)
= sensory + emotional + behavioural experience.
Pain is more than just a signal.

👉 www.bjaed.org/article/S205...
Neurophysiology of acute and chronic pain: from genes to pain symptoms
As the earliest writings of ancient civilisations attest, pain has been an unceasing challenge for humanity. This sensory and emotional experience is essential if we are to live in good health. It…
www.bjaed.org
1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 22d
🛠️ What would your ideal pre-hospital bag contain?
Equipment matters:
• Portable, robust, checked daily
• 2nd-gen supraglottic devices preferred
• Videolaryngoscopes = primary tool in most UK prehospital services
Kit reliability = patient safety.
Read more: www.bjaed.org/article/S205...
Prehospital management of the airway in trauma
Poor airway management is a significant cause of morbidity and mortality in patients suffering major trauma. In 2007 a National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 23d
🔍 Identify unique features of ICU airway management.
Critically ill patients have physiologically difficult airways due to hypoxaemia, shock, and poor reserve—very different from elective theatres.
Full article 👉 www.bjaed.org/article/S205...
#ICU #AirwayManagement
Airway management in critically ill patients
Airway management in the critically ill patient is a challenging task, with an estimated 45% risk of adverse events. Cardiovascular collapse (defined in most studies as a systolic pressure <65 mmHg…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 24d
🔑 In major trauma, the priority is a patent airway + adequate oxygenation.
Suspected unstable cervical spine injuries are rare, and airway takes precedence.
Read more: www.bjaed.org/article/S205...
#Prehospital #AirwayManagement
Prehospital management of the airway in trauma
Poor airway management is a significant cause of morbidity and mortality in patients suffering major trauma. In 2007 a National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report…
www.bjaed.org
2 3
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 25d
⚠️ Ataxia telangiectasia:
• Neurodegeneration & ataxia
• Immunodeficiency → recurrent infections
• Aspiration risk from dysphagia
• Radiosensitivity & ↑ cancer risk
Anaesthesia requires specialist centre care + careful aspiration & infection assessment.
👉 www.bjaed.org/article/S205...
Anaesthesia for children with DNA repair disorders
DNA repair disorders are caused by genes involved in DNA mutation detection and repair mechanisms. These disorders have diverse phenotypes which manifest at birth or early childhood. Although…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 26d
🧠 Pain is multidimensional: sensory, emotional, cognitive & behavioural.
It results from an imbalance between excitatory and inhibitory control in nociceptive circuits.
This month’s BJA Education explores pain from genes to symptoms.
👉 www.bjaed.org/article/S205...
Neurophysiology of acute and chronic pain: from genes to pain symptoms
As the earliest writings of ancient civilisations attest, pain has been an unceasing challenge for humanity. This sensory and emotional experience is essential if we are to live in good health. It…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 27d
🫀 Haemodynamic collapse after ICU intubation: remember all the key mechanisms.
• Hypovolaemia
• LV/RV dysfunction
• Drug-induced vasodilation
• Transition to positive pressure ventilation
Optimise fluids & vasopressors early.
#Airway #ICU
👉 www.bjaed.org/article/S205...
Airway management in critically ill patients
Airway management in the critically ill patient is a challenging task, with an estimated 45% risk of adverse events. Cardiovascular collapse (defined in most studies as a systolic pressure <65 mmHg…
www.bjaed.org
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 28d
⚖️ Rebalanced coagulation

Patients may bleed or clot in acute liver failure.
Routine correction of INR with products isn’t recommended unless bleeding.
Viscoelastic testing can help guide therapy.
Read more in BJA Education: www.bjaed.org/article/S205...
#CriticalCare #Haemostasis
Acute-on-chronic liver failure
Acute-on-chronic liver failure (ACLF) is a distinct clinical entity from both acute liver failure and simple decompensation in chronic liver disease. Acute-on-chronic liver failure involves chronic…
www.bjaed.org
1
bjaeducation.bsky.social
BJA Education @bjaeducation.bsky.social · 29d
🌦️ Environmental factors play a huge role in the pre-hospital arena:
• Weather, noise, lighting
• Distance to major trauma centres
• Scene safety & hazards
Each shapes airway management decisions in the field.

Read more: www.bjaed.org/article/S205...
Prehospital management of the airway in trauma
Poor airway management is a significant cause of morbidity and mortality in patients suffering major trauma. In 2007 a National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report…
www.bjaed.org
1 2