Your letters

Dear Editor

GlideScope Auto Power Off – a nasty surprise

We used a GlideScope (Verathon Inc., Bothell, WA, USA) for a difficult tracheal intubation in a patient with severe burns to the head, neck and chest. As a bougie was being inserted into the mouth, the screen went blank, leading to a delay while the instrument restarted; however the oxygen saturation remained > 96%.

Like many other instruments that have limited battery back up, the GlideScope has an adjustable Auto Power Off function to conserve screen and battery life, with a factory default of 30 min. In this case, the ODP had turned the machine on (and plugged it into the mains supply) considerably in advance while preparing the equipment for anaesthetic induction. However, we did not realise the Auto Off was set at 20 min (Figure 1), nor did we notice the imminent shut-down message on the instrument screen (Figure 2).

We all know the old adage “Know thine enemy”. It is also important to get to know your friends thoroughly.

Toby Ma
Anaesthetic Clinical Fellow
East Midlands Deanery

Figure 1. Screen showing Auto Power Off menu

Congratulations to Toby Ma for winning February's Letter of the Month prize.

Dear Editor

COVID-19 airway assessment: public masks = anaesthetists’ angst

I wish to highlight a hitherto unreported, but highly significant, consequence of COVID-19 on the wellbeing of anaesthetists. The recently mandated wearing of facemasks in enclosed public spaces, in particular on public transport, has robbed us of a favourite anaesthesia pastime - “How would I manage his/her airway?” (insert random passer-by/ fellow passenger).

I strongly recommend anaesthetists affected by these new government regulations seek immediate professional help from their local anaesthesia coffee room support group. It is crucial to acknowledge the effect this may be having on morale, and to share any negative emotions with others, who may be experiencing similar feelings of loss and emptiness!

Fortunately, there is still at least one pastime to keep us anaesthetists happy - “What size cannula could I insert into his/ her vein?”

Patrick Alexander Ward
Consultant Anaesthetist and Airway Lead
Chelsea & Westminster Hospital, London

Dear Editor

The COVID Novice

I have a confession; I am a senior anaesthetic trainee who has never cared for a COVID patient. By a peculiar twist of fate, I have ‘dodged’ working during the biggest healthcare crisis for 100 years. I do have a healthy (and rather large) baby boy to show for it, born two days into lockdown, while COVID guidelines pummelled my WhatsApp inbox.

Soon, however, I will return to work. The world has changed. When we leave the house, we check for our facemask as we do our keys or phone, and to ‘Zoom’ is a verb. Lost in a shop’s inexplicably complicated one-way system, I wonder how I will navigate the new hospital landscape.

Fortunately, I am part of a supportive School of Anaesthesia, with an excellent return-to-training programme. However, I cannot help but think that there will be subtleties and nuances that cannot be taught or simulated, and theatre etiquettes that have evolved organically and are now embedded in hospital culture. All of these will be alien to those who have watched the pandemic from the side lines.

Returning to work has a new dimension. Not only do we need to remember how to do the job we know, we need to learn to do a job that we never did. So, if you see a COVID-novice, staring at a cannula, wondering not only whether they can still put one in, but also what attire they should don to do so, offer some pointers and socially distanced reassurance. Also, if anyone can explain the oneway system in my local WH Smith, that too would be appreciated!

Emma Jenkins
ST7 Anaesthetics
Southmead Hospital, Bristol

Dear Editor

With reference to the letter by Kler et al. on Page 30 of the December issue of Anaesthesia News, ‘How many times can one prone a patient with COVID-19 pneumonia?’:

‘Prone’ is an adjective. Can I also be ‘supined’?

I am iPadding this thought. Or should I be iPading it?

With respect

Robin Weller
Retired amateur editor
Sent from my iPad

PS In no way, I would emphasise, is this a criticism of the authors of the letter in which this new verb appeared. I remain amazed how the ICUs have managed throughout this dreadful year. Makes me quite proud to be an Honorary Member of the Association to which so many anaesthetists belong.

Editor's reply

Like Dr Weller, I don't like the tendency to change nouns or adjectives into verbs, but I'm not going to get into an ipaddy about it.

Prone/ proning/ proned is much easier for communication purposes than 'turn/ turning / having turned the patient into the prone position'. In support of its current use, Google Scholar finds the terms 'proned' + 'covid' in > 17,000 places.

I am with King Canute on this one.

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