Count to 10 - Anaesthetic Primary Podcast EP42 – Live Practice Viva with Derek and Special Guest Celia | CT10
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Sep 21, 2025 A live practice session unravels complex medical topics. Isomers are defined, with warfarin's potent enantiomers highlighted. Respiratory changes during pregnancy take center stage, detailing vital gas exchange factors. Mechanisms behind nausea and the role of the chemoreceptor trigger zone are explored, alongside effective antiemetics. The discussion on atelectasis emphasizes prevention techniques, the importance of PEEP, and recruitment maneuvers. Feedback offers insights into exam performance, ensuring candidates are well-prepared.
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Match Antiemetic To Patient Risks
- Use dopamine antagonists (e.g., metoclopramide) but avoid in Parkinson's due to extrapyramidal effects.
- Consider domperidone for peripheral action when central dopamine blockade is undesirable.
NNT Clarifies Antiemetic Value
- Number needed to treat (NNT) shows clinical impact and tradeoffs with side effects.
- Metoclopramide has a higher NNT than ondansetron, so combine antiemetics for better effect.
Prevent And Treat Atelectasis Proactively
- Prevent perioperative atelectasis with PEEP, head-up positioning and rapid airway control during induction.
- Use recruitment maneuvers if alveoli are already collapsed, as PEEP alone may not reopen them.