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Anaesthesia Points West Anaesthesia Points West Autumn 2OO7 rssN 0265-9212 THE SOCIETY OF ANAESTHETISTS OF THE SOUTH WESTERN REGION PRESIDENT: DR JOHN CARTER Frenchay VICE PRESIDENT: DRNEVILLE GOODMAN Southmead PRESIDENT-ELECT: SIRPETERSIMPSON Frenchay IIONORARY SECRETARY: DRE. MORRIS Southmead SECRETARY TO HON. SECRETARY: Ms K. PRYS-ROBERTS UBHT HONORARY TREASI]RER: DRA. BURGESS Plymouth LOCAL ORGAMSERS: DR S. SHINDE Frenchay (Jubilee meeting) DRA. BURGESS Plymouth/Guernsey TRAINEE REPRESENTATIVES: DR S. CARTY South West School DRI. THOMAS Bristol School EDITORIAL COMMITTEE: DRJ. PITTMAN Editor, Exeter DRF. DONALD Assistant Editor, Southmead Ms K. WILKINSON/ Secretaries to Editor, Ms G. HUSBAND Exeter WEBSITE: DRK. SPOONER Cardiff www.saswr.co.uk ANAESTHESIA POINTS WEST CONTENTS Vol.40 No.2 Autumn,2007 Page Committee Members I Contents 2 Editorial Dr.I Pittman J Future Meetings of the Society 4 News of the West 5 Examination Successes and Honours t7 Society Takes Budapest By Storm Dr E Morris l9 A Survey ofAnaesthetic Practice for Dr G Werrett 24 Carotid Endarterectomy in the Southwest Dr N Preston Region of the UK Dr Q Milner Epidural Analgesia in a New Zealand Dr G Werrett 28 Tertiary Hospital before and after Dr H Horton publication of the MASTER study - Dr R Craig Evidence Based Medicine in action? Dr R French Michael Turstall andthe Development of DrTDawes 32 Entonox MMC & MTAS - a Trainer's View Dr C Johnson 36 Clinical Systems Engineering DrN Williams 4t SASWR Members And Anaesthesia In Dr B McCormick The Developing World Dr I Wilson 47 Reflections on Thirry-Thee Years of Dr P Marshall 5l Anaesthesia in The South West Region Securing the Airway: DrD Snow 55 The Torbay Experience Dr M Stocker DrA Varvinskiy Dr S Medakkar More Thoughts on Anaesthesia - Dr H Blanshard 57 A Decade on and into the Future All of the following are true: DrN Goodman 60 MCQs in anaesthesia exams Three Days by the Sea GAT 2007 Dr M Thomas, Dr A Binks, 62 Dr C Dowse, Dr J Gatward, Dr A Mayell lst West of England Anaesthesia Update, DrA Johnson 64 St Anton, 2007 Wine Column Dr T Perris 66 Poem R Forward 67 Crossword B Perriss 68 Society Prizes 69 Notice to Contributors 1l @2001 The Society of Anaesthetists of the South Western Region Editorial The Society of Anaesthetists of the South West NHS and Hannah Blanshard provides us with some Region (SASWR) has reached its 60th Anniversary more of her thoughts on where anaesthesia is going and is still going strong. Regional Societies were in the future. For many years Torbay Consultants founded at the suggestion of the Minister of Health have been developing a nationally recognised in 1947 with the aim of spreading knowledge, expertise in managing the difficult airway. How this promoting friendship and encouraging co-operation came about is described by Dr Snow et al. Their between local colleagues in specialties across the department organise an excellent course for those United Kingdom. Enlightened thinking which helped wanting any further training. Supporting the establish good professional development of our advancement of anaesthesia in the developing world specialty and ourselves. We should be proud that has been a long-term concern of many south west SASWR continues to meet these goals and remains anaesthetists. Plenty of individuals have done their an excellent example of an effective regional society. bit and are mentioned in the article by Iain Wilson Congratulations to everyone who over the last sixty and Bruce McCormick. Both authors have dedicated years has given their time and energy to keep the huge amounts of time and energy to improving the organization so buoyant. desperate state of anaesthesia in many parts of the Anaesthesia Points West did not arrive through world. It remains a real on-going challenge and your post box for another twenty-one years but since plenty ofopporhrnities exist for those interested. The then has reliably reached the members of the Society excellent articles by Chris Johnson and Nicky twice yearly. It remains an integral part of the Williams show us that working in the NHS has its Society filled with a wide array of articles covering real challenges too, be they in training or the delivery all aspects of anaesthesia. The structure of the ofpatient care. journal has remained consistent with core articles With sixty years on the clock the Society is such as 'News of the West' being particularly probably the most vibrant regional anaesthetic popular. There are many Anaesthetists, particularly society in England. However the next 60 years may those trained in the south west, who learn more about prove a far greater challenge. The Society is its their friends in this article than they ever do from the members, and recruitment must continue yearly Christmas card! The Perris crossword has enthusiastically. Ten years ago it was proposed that been a regular feature almost since the first edition Linkmen be selected in all the hospitals of the south and the poetry of Robin Forward is a long west to represent the Society. Their responsibilities established and much loved item. Another author included encouraging existing (especially new) who has produced a continuous stream ofinteresting, consultants and trainees to join the Society and humorous and thought-provoking articles over the attend its meetings. This remains an imporlant role. last twenty years is (Vice-President), Dr Neville Large numbers of new Consultant Anaesthetists have Goodman. Opening each new communication from come to work in the south west from other regions Neville always generates a certain level of and have not been affrliated with the SASWR during excitement for the Editor. You can never predict the their training. We need to encourage these colleagues subject matter in advance and of course there will be to join up. Run Through training will mean trainees no need for any editorial input. As he has reached stay in the south west for long periods of time and retirement, he has decided to make this his last piece through Anaesthesia Points West and SASWR there of writing, so I must thank him for the many years of are excellent opportunities to win prizes, publish contributing. articles and make contacts. Linkmen spread the There are several articles in this Diamond Jubilee word. edition that I requested the authors write. Some history seemed appropriate; Paul Marshall gives us James Pittman an insightful account of 30 years working in the Exeter Future Meetings of the Society Spring 2008 Spring 2009 Plymouth/Guernsey, final dates to be arranged Cheltenham Autumn 2008 Autumn 2009 North Bristol, final dates to be arranged Exeter News of the 'West This is where you are kept uplo-date on all the news and gossip from each departrnent in the South Western Region. The name of the correspondent appears at the end of each contribution and he/she is also SASWR LINKPERSON for that department. Anyone wishing to find out more about SASWR or wishing to join should search out the local linkperson who will readily supply details and qn application form. In addition to other benefits, members receive the twice yearly editions of APW- FREE! Barnstaple Operating Theatre Orderlies (aka Porters). The No doubt every department in the region has a fund Orderlies were a great bunch of characters who not of horror stories about the MMC debacle so I'll only moved patients around but "lubricated" the spare you the grisly details. Suffice to say that most working of the operating theatres in a hundred and of our excellent trainees found a job somewhere, one unSung tways. Surprise, surprise this many after months of anxiefy and not always what masterstroke has strangled at birth the plan to they really wanted. With a bare two weeks to spare "improve theatre efficiency" which is one of the we acquired a mixed bag of trainees, just sufficient main planks of the Trust's strategy to meet the l8 to run a rota. Thanks to Kate Tipping for hanging on week target: - pure genius! in there and fighting our corner. Steve Forster We have also been forhrnate in acquiring two new Staff Grades; Nick Sheppard (well known in Truro) Bath & Katrina Scholer, who was an SHO with us about We very much hope our neighbours just north of us five years ago before leaving to expand her have recovered from the terrible summer flooding in anaesthetic horizons in Sheffield. Nick is away in Gloucester and Cheltenham. Having been one of the Spain as I write this (mid September) getting hitched last to inch through on the gravel of the M5 central to Maria in her home town of Jerez; best wishes to reservation with all six lanes under two feet of them. water, I can only imagine the havoc and misery it The new department accommodation has been a must have caused. great success, particularly for educational and The department here is a hive of feverish physical management activities. We now have almost an activity, presumably in preparation for 2012. Tom embarrassment of computers; this makes the Simpson has taken up triathlons, which is how favourite excuse for not having read an e-mail, "I Lance Armstrong started out. Talking of which, couldn't get on", redundant (pity). Malcolm Thornton completed the most gruelling leg The whole department are in awe of Rod of this year's Tour de France; we should all put our Lindenbaum who followed in the footsteps of Guy hands together and applaud how, even at work, our Rousseau and completed the Etape du Tour (a stage Chairman has broken with tradition and gone out on of the Tour de France). It was over 200km, five a limb to wrestle with his fitness levels whilst still Pyrrenean mountain passes and a very hot day.
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