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Saturday 5th & Sunday 6th November 2016
Invited Guests Prof David Scott
Prof Rupert PearseA/Prof Bernhard Riedel
A/Prof Laurence WeinbergDr Wayne Kelly
Dr Keith GreenlandA/Prof Gerald Kaye
Venue: Russell Strong Auditorium
Princess Alexandra Hospital199 Ipswich Road, Woolloongabba
Brisbane, Queensland.
Princess AlexandraHospitalBRISBANE • AUSTRALIA
Princess Alexandra Anaesthesia Conference
PROGRAM
Princess Alexandra Anaesthesia Conference
PA
AC
2016
Dear Colleagues,
Welcome to the 2016 Brisbane PAAC (Princess Alexandra Anaesthesia Conference). On
behalf of The Princess Alexandra Hospital Anaesthetic Department, it gives me great
pleasure to invite you to join us at 2016 PAAC on the weekend of Nov 5th & 6th. In keeping
with this year’s theme “Perioperative Medicine’’ the conference program has been designed
to deliver the latest clinical content relevant to everyday anaesthetic practice. For a busy
anaesthetic practitioner, attending the PAAC provides the opportunity to take some much
needed time away from routine work and reflect on the nature of our work, to share ideas
and experiences with colleagues to learn and evolve as better practitioners.
In addition to covering a range of perioperative medicine topics such as sleep apnoea,
cognitive dysfunction, anaesthesia and cancer, Pacemaker & ICDs, coagulation and
perioperative fluid therapy, the conference will also deliver variety of hands on workshops
including all 4 ANZCA emergency responses CPD activities. A workshop on FANZCA final
exam by current college senior examiners is also included in this year program.
Demands for workshops are high and participant places are limited. Therefore I urge you to
register at your earliest possible opportunity in order to secure your place in the workshop
of your choice.
I look forward to welcoming you to the PAAC 2016.
Conference Convenor
Dr Pal Sivalingam
Deputy Director of Anaesthesia,
PA Hospital, Brisbane.
Perioperative Medicine
Preoperative
Postoperative
Intraoperative
Princess Alexandra Anaesthesia Conference
PA
AC
2016
PAAC5th - 6th November 2016
ORGANISING COMMITTEE
Dr Adrian HallDr Owen BourneDr Ben HowesDr Srinivas RachakondaDr Phil Lee
PAAC5th - 6th November 2016
CME PointsThis educational activity has been approved in the ANZCA CPD Program.
VENUE
Russell Strong AuditoriumPrincess Alexandra Hospital199 Ipswich Road, WoolloongabbaBrisbane / Queensland.
Princess Alexandra Anaesthesia Conference
PA
AC
2016
FOR FURTHER INFORMATION:Theresa Bott
Conference Coordinator0433514657
orTheresa.bott@health.qld.gov.au
http://paac-anaesthetic.eventbrite.com.au
Website for registration:
Princess Alexandra Anaesthesia Conference
PA
AC
2016
FRIDAY 10th July 2015 - Day 1 PAAC5th- 6th November 2016
Saturday 5th November 2016
8.00 8.20am Registration
8.20 - 8.30 Welcome Dr Pal Sivalingam
8.30 - 9.30 Sleep Apnoea and Anaesthesia
Anaesthetic perspective Dr Keith Greenland
Physician & ICU perspective Dr Wayne Kelly
9.30 - 10.00 The Challenge of perioperative cognitive Prof David Scott
dysfunction in elderly surgical patients
10.00 - 10.30 MORNING TEA
10.30 - 11.00 Onco-anaesthesia – Myth or Reality? A/Prof Bernhard Riedel
11.30 - 12.00 Patients with Pacemaker and ICD for A/Prof Gerald Kaye
non-cardiac surgery - What should you know
12.00 - 13.00 LUNCH
13.00 - 14.30 Workshops Workshop Numbers
1. Anaphylaxis
2. CICO
3. Advanced Haemodynamic monitoring
4. US guided peripheral nerve blocks
5. FANZCA final exam- examiners perspective
14.30 - 15.00 TEA
15.00 - 15.40 Rotem & TEG for diagnosing coagulopathy TEG - Dr Rae Duffy
- same test but different results? Rotem - Dr Fayavar Ajvadi
15.40 - 16.00 Acute Neuropathic pain - What is the evidence? Dr Paul Gray
16.00 - 16.45 Prof. Pearse view of evidence based Prof Rupert Pearse
perioperative medicine
(video conference from the UK)
18.30 - 22.00 Dinner at Burrito Bar - Modern Mexican- Skygate DFO
Shop 1A-17, The Corso, Ninth Avenue, Brisbane Airport QLD 4007
Phone (07) 3114 1185
Free carparking available
SATURDAY 11th July 2015 - Day 2
Sunday 6th November 2016
07.00 - 07.45 Isha Kriya by Teacher from Isha foundation (Isha Yoga centre)
(Kindly be seated in the auditorium by 6.55 am)
07.45 - 08.15 Breakfast (Russell Strong Auditorium Foyer)
08. 15 - 09.00 Surgery specific fluid optimisations- Simulation A/Prof Laurence Weinberg
09.00 - 09.30 Fluid management- type of fluid matters? Dr Adrian Hall
09.30 - 10.00 Intravenous induction - Is it safe in patients with Dr Robert Bond
a compromised airway?
10.00 - 10.15 MORNING TEA
10.15 - 10.45 Relevance of DBS in the treatment of Parkinson’s Dr Martin Wakefield
Disease
11.00 - 12.30 Workshops Workshop Numbers
6. Cardiac Arrest
7. Major Haemorrhage
8. CPEX
9. TTE
PAAC5th - 6th November 2016
Princess Alexandra Anaesthesia Conference
PA
AC
2016
Invited Speaker
Invited GuestsProf. David Scott
David Scott is a clinical professor and Director of Anaesthesia at St Vincent’s Hospital in Melbourne.
His clinical interests include regional anaesthesia, acute pain management, vascular and cardiac anaesthesia. He has researched and published extensively in these areas, especially with respect to acute pain management techniques, regional anaesthesia and cognitive outcomes and anaesthesia. David completed a PhD in the area of neuropathic pain in 2004. His current research interests are neuropathic pain in the acute postoperative patient, perioperative complications and cognitive outcomes following anaesthesia. He was elected to the ANZCA Council in 2008 and elected ANZCA president in 2016.
Rupert M Pearse MBBS FRCA FFICM MD
Rupert Pearse graduated in 1996 from St George’s Hospital Medical School, London, UK. His clinical duties are based on the busy intensive care unit at the Royal London Hospital where he oversees the care of patients suffering from critical illness of various causes. In 2006, Rupert was appointed Senior Lecturer in Intensive Care Medicine at Queen Mary University of London and was promoted to Professor in 2014. He is an active member of several national and international societies for anaesthesia and intensive care medicine. In June 2015 he was appointed Director of the UK Perioperative Medicine Clinical Trials Network.Rupert’s main research interests are in improving outcomes for patients following major surgery and the cardiovascular pathophysiology of critical illness. He has experience in a wide range of research methods includes translational laboratory and clinical research, multi-centre observational and randomised trials and large epidemiological studies.
A/Prof Bernhard Riedel MB.ChB, FCA, FAHA, FASE, M.Med., FANZCA, MBA, PhD
Bernhard is the Director of the Department of Anesthesia, Perioperative and Pain Medicine at the Peter MacCallum Cancer Centre, with an honorary academic appointment at the University of Melbourne. His academic interests lie in the field of onco-anaesthesia, with his collaborative efforts investigating the role of prehabilitation prior to major surgery and the impact of the perioperative adrenergic-inflammatory response and anaesthetic technique on tumor-progression signaling as methods of improving cancer outcomes. Bernhard’s academic interests focus on improving surgical outcomes, especially following cancer surgery. Bernhard’s collaborative research program to date has resulted in numerous research grants (~$3M), 61 peer-reviewed scientific publications, 50 invited articles, 3 edited books (including ‘Acute Care of the Cancer Patient’), and 13 awards presented to his team for research (including a health minister award for excellence in clinical quality improvement).
heAd & neCk CAdAver disseCtion Course15h - 16th July 2016
PAAC5th - 6th November 2016
Princess Alexandra Anaesthesia Conference
PA
AC
2016
PAAC5th - 6th November 2016
Princess Alexandra Anaesthesia Conference
PA
AC
2016
Laurence Weinberg BSc, MBBCh, MRCP, FANZCA, Dip Crit Care & Echo, MD
Laurence Weinberg is the Director of Anaesthetics at The Austin Hospital, Victoria and Associate Professor in the Departments of Surgery, and The Perioperative Pain Medicine Unit at the University of Melbourne. His clinical and research interests are in cardiac surgery, thoracics and hepatobiliary surgery including liver transplantation and fluid optimization.
Dr Wayne Kelly MBBS, FRACP
VMO Princess Alexandra Hospital Intensive Care Unit: 1990 - CurrentPrivate practice in Respiratory/Sleep & Intensive Care: Major clinical interests being sleep-disordered breathing and peri-operative medicine.
Dr. Keith Greenland FANZCA, MD
Keith Greenalnd is in Private Practice Anaesthesia, Brisbane, Queensland, Australia. He previously workedas a consultant anasethetist in Hong Kong (1997-2006) and Royal Brisbane and Womens Hospital, Brisbane (2004-2012).
He has published over 40 papers on difficult airway management as well as an M.D. thesis on difficult airway management.
His current academic workload includes providing medico-legal reports for coronial and judicial cases, airway management lecturing, reviewing submissions for several anaesthetic journals and writing editorials and review articles on request.
A/Prof Gerald (Gerry) Kaye MBChB MD FRCP(London) FRACP Associate Professor of Cardiology at the University of Queensland and Interventional Electrophysiologist at Princess Alexandra Hospital since 2005, he commenced private practice as a founding partner at Brisbane Heart in September 2014. He graduated from Manchester University in 1978 and undertook specialist cardiology and electrophysiology training at St Bartholomew’s and St George’s Hospitals London and Leeds University Teaching Hospital before being appointed as a Consultant Cardiologist at the Royal Hull and East Yorkshire Hospitals where he established a new cardiology unit and developed the complex electrophysiology and device implantation service. He completed his doctoral thesis at St. Bartholomew’s Hospital (1984-1986). He has presented at both national and international research meetings and continues to undertake clinical research and publish in peer-reviewed journals. He practises in general cardiology, management of coronary disease including coronary angiography and has a particular interest in pacemakers and defibrillators, arrhythmias, electrophysiology and device therapy for heart failure.
SPONSOR ADVERTISEMENTSPAAC
5th - 6th November 2016
WORKSHOP INFORMATION
Cardiac Arrest : ANZCA CPD Emergency Response Activity Facilitators: Dr Francesca Rawlins, Dr Adrian Hall, Dr Phil Lee, Dr Kellie Bird, Dr Clinton Patricks, Dr Jonathan
Samaan, Dr Peta Lorraway and Dr Monique Wells.
This hands-on workshop is aimed at refreshing the knowledge and application of the most recent
Advanced Life Support (ALS) guidelines. This workshop has been designed to enhance performance in a
crisis, and build confidence in the management of anaesthetic emergencies. Training will include the use
of defibrillators, crisis resource management, and ALS scenarios relevant to anaesthetists and anaesthetic
nurses.
ANAPHYLAXIS : ANZCA CPD Emergency Response Activity Facilitators: Dr Tim Sampson, Dr Christian Van Nieuwenhuysen and Dr Richard Scolaro
This workshop will utilise case scenarios and interactive group discussion to explore issues in
perioperative anaphylaxis. Areas covered will include presentation, triggers, acute crisis management,
follow up and investigation of intraoperative anaphylaxis. The workshop will use the Australian and New
Zealand Allergy Group (ANZAAG) anaphylaxis management guidelines as a basis for discussion of crisis
management.
CICO Can’t Intubate Can’t Oxygenate: ANZCA CPD Emergency Response ActivityFacilitators: Dr Owen Bourne, Dr Jenny Greenwood and Dr Phil Lee.
Anaesthetists are required to possess the knowledge, technical and non-technical skills to manage the
rare and life threatening CICO situation. This workshop provides an educational session, hands-on and
scenario based practice on infraglottic airway techniques to manage this crisis.
Major Haemorrhage: ANZCA CPD Emergency Response Activity Facilitators: Dr Anand Parameswaran, Dr Fayavar Ajvadi and Dr Kristin Hielscher
Using a combination of facilitated discussions and simulations, participants will develop and practise the
skills, knowledge and attitudes required to manage major haemorrhage and the complications that arise
including cardiovascular instability and coagulopathy. This course promotes a team-based approach and
anaesthesia. Anaesthetic assistants and nurses are encouraged to attend with their
medical colleagues.
Princess Alexandra Anaesthesia Conference
PA
AC
2016
SPONSOR ADVERTISEMENTSPAAC
5th - 16th November 2016
WORKSHOP INFORMATION
CPEx TESTING - Cardiopulmonary Exercise TestFacilitators: Dr Adrian Hall, Dr Rebekah Ferris.
CPEx testing is a study of the physiologic response to exercise by simultaneous
measurement of respiratory gas exchange and cardiovascular variables. CPEx evaluates
the transfer of atmospheric oxygen to metabolising tissue; the coupling between external
and cellular respiration. CPEx is non-invasive, integrative, dynamic and quantitative. It
gives information about exercise capacity and physiologic reserve. Exercise capacity
has a strong association with quality of life and health outcomes in general; physiologic
reserve has particular relevance to preoperative evaluation of patients scheduled for major
surgery. The workshop will provide an introduction to CPEx testing including indications for
testing, advantages of CPEx, practical aspects of testing, measurements made, display and
interpretation of data and use of CPEx in peri-operative risk stratification.
Point of care trans-thoracic echocardiography Facilitators: Dr Kurichi Marudhachalam and Dr Sarvesh Natani
The last decade has witnessed the emerging role of an anaesthetist as a “perioperative physician”.
Point of care transthoracic echocardiography (POC TTE) can be defined as a bedside investigation done
and interpreted by a physician. Transthoracic echocardiography (TTE) has established its role for diagnosis
and management in cardiology. Currently, the role of echocardiography has extended to other specialities
including anaesthesia, critical care and emergency medicine and paramedical staff in the hospital
and pre-hospital setting. However, TTE is not routinely practised by anaesthetists in the perioperative
period, including the pre admission clinic/outpatient clinic. POC TTE is a safe and cost effective tool for
non-invasive examination of the real time cardiac status, which can be repeated for its diagnostic and
therapeutic responses as and when required. It can precisely answer some of the important clinical
questions in the perioperative care of the patient.
In this workshop we will be presenting a brief introduction about knobology and basic trans-thoracic
windows. This is followed by a hands-on workshop to obtain the images using the windows and assess
the haemodynamic status of the patient.
Princess Alexandra Anaesthesia Conference
PA
AC
2016
SPONSOR ADVERTISEMENTSPAAC
5th - 6th November 2016
Princess Alexandra Anaesthesia Conference
PA
AC
2016
WORKSHOP INFORMATION
Advanced Haemodynamic Monitoring Workshop (AHD)Facilitators: Dr Pal Sivalingam, A/Prof Bernhard Riedel, and A/Prof Laurence Weinberg.
Haemodynamic monitoring and interventions to normalise haemodynamic parameters are one of the most
important aspects of managing critically ill patients. This workshop is designed to teach all aspects of
advanced haemodynamic monitoring and their relevance in clinical practice. Participants will learn about
principles and practice of cardiovascular and haemodynamic assessment and management.
1. Hands on session with non-invasive cardiac output monitoring-FloTrac.
2. How to float a pulmonary artery catheter and interpret the results.
3. Non-invasive, continuous cardiac output monitoring—Nexfin system
Ultrasound Guided Nerve Blocks (US)
Facilitators: Dr Bart McKenzie, Dr Ben Howes, Dr Owen Bourne and Dr Srinivas Rachakonda
Upper Limb Blocks: Ultrasound guided interscalene; supraclavicular; infraclavicular; axillary approaches
to the brachial plexus.
Lower Limb Blocks: Ultrasound guided fascia-iliacus; femoral; sub-sartorial; sciatic (popliteal) blocks.
There will be time to discuss current regional anaesthesia controversies such as catheter techniques,
choice of local anaesthetics/additives and block safety, practical tips to improve scanning and efficacy as
well as patient (and surgeon) satisfaction.
WORKSHOP INFORMATION
FANZCA Final exam- Current ANZCA Examiners perspective
Dr Rajesh Brijball, Dr Greg Moloney, Dr Mark Lai and Dr Anthony Coorey
This workshop is designed to guide the advanced anaesthetic trainees in the FAZCA final exam. All four
components of the exams: SAQ, MCQ, medical and anaesthetic viva are to be explored by the experienced
current ANZCA examiners.
There will be time allowed for the participants to ask questions to the examiners to
clear their doubts about content, format and curriculum covered in the final exam.
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