What's New


The 2023 Ottawa Anesthesia Primer is a major update of the previous 2013 version and is available as a QR Code enabled print book, an Apple iBook and as a Kindle book. Each chapter in the Print version is accompanied by a QR Code image. Simply scanning the QR image with any smart device camera allows the reader to have immediate and direct access to open-source reference articles and videos that are available in the electronic versions. For readers who prefer a traditional print book, the QR Code enabled print book offers the best of both the digital and analog worlds. 
 
The Anesthesia Primer provides an overview of our fascinating specialty for both medical students and residents who have a limited amount of elective time in anesthesia and who have chosen career paths in other specialties. We hope that practicing anesthesiologists and residents will also find it to be a valuable reference resource and an educational springboard for teaching. 
 
Over the last decade, major advances in our specialty have been made with point of care ultrasound (POCUS) as well as ultrasound for regional anesthesia. While the internet provides a vast resource of information, it can be a challenge for the busy clinician to find high quality relevant information while providing clinical care. Below are a few samples of relevant clinical situations that the Primer can help address: 
  1. I have a medical student with me and I’m planning to do an ankle block for my next patient.  Suggestion: have your student go to the anesthesiaprimer.com website to review the Primer’s ankle block video link so that they understand the procedure. If time permits, have them review the local anesthesia chapter and go over the principles of using local anesthesia.
  2. My next elective patient requires general anesthesia and took his last dose of Ozempic 5 days ago. I am concerned that they may have a full stomach and I’d like them to have a preoperative gastric ultrasound for risk stratification. Suggestion: Use the interactive POCUS pdf link to review the principles of performing and interpreting a gastric ultrasound.
  3. I have trouble keeping up to date with the recommendations for oral diabetic medications and whether they should be taken or stopped before surgery. Suggestion: Use the table 3.5 hyperlink to view common oral diabetic medications and their perioperative management.
  4. Our patient for tomorrow is requesting a block for their olecranon fracture. Where can I find an infraclavicular block video to share with my resident?Suggestion: Use the interactive Anterior Regional Blocks pdf to share the infraclavicular video link with your resident.
  5. I’d like to run a TIVA simulation program in real time while providing a TIVA anesthetic but can’t remember where to find this program. Suggestion: go to anesthesiaprimer.com to view the Video & links tab and the free interactive stanpumpr.io software.
  6. My medical student is on their first day of their anesthesia elective. I need to multitask and setup my room but would like to keep them busy while I do this. Where can I find a couple of videos on establishing IV access and video laryngoscopy that they can watch while I setup my room? Suggestion: have the student open the anesthesiaprimer.com website to view the Videos & links tab where they will find introductory videos for establishing IV access and performing video laryngoscopy.​

The Primer incorporates direct links to reference material as well as video links to both POCUS examinations and ultrasound guided regional blocks. The POCUS and regional block open-source videos were chosen as they were deemed to be concise high-quality resources that can be used as a starting point for teaching.

Teaching videos as well as the POCUS and regional block resources are free to use at anesthesiaprimer.com. 
 
Other updates in the 2023 Primer include:
  • A fascinating interview with Professor J Earl Wynands on the history of anesthesia (chapter 2; reference 5).
  • The assessment and importance of frailty in the perioperative period.
  • Euglycemic diabetic ketoacidosis (EKDA) in the perioperative period.
  • CJA Guidelines on perioperative cardiac risk assessment and management for patients undergoing non-cardiac surgery.
  • 2021 Canadian Airway Focus Group recommendations for the management of the difficult airway.
  • A checklist for management of the critically ill adult patient with an anticipated difficult airway.
  • Rapid sequence induction (RSI) pro-con debate.
  • Pulse pressure variation (PPV) and fluid responsiveness.
  • Cardiac output monitoring technology
  • Remimazolam
  • Sugammadex
  • Apprepitant 
  • Counseling women of childbearing age who have received apprepitant or sugammadex about the need to consider other contraceptive options.
  • Substance use and opioid use disorders.
  • Methadone, buprenorphine and naltrexone in the perioperative period.
  • Management of local anesthetic toxicity (LAST).
  • 2020 AHA Neonatal resuscitation algorithm.
  • 2022 Ontario costs of blood products, transfusion guidelines, complications of blood products and risks of transfusion.
  • 2020 Fourth consensus guidelines for the management of postoperative nausea and vomiting in adult patients.
  • Postoperative cognitive dysfunction.
  • 2020 AHA ACLS Algorithms.
  • ACLS in the perioperative period.
  • Malignant hyperthermia update.
  • 2019 Consensus recommendations for the diagnosis, management and testing of perioperative anaphylaxis.
  • 2020 Perioperative diagnosis and management of serotonin syndrome.
  • 2020 Fourth consensus guidelines for the management of postoperative vomiting in pediatric patients.
​