Workshops

16th February 2017

TTE FATE LUNG AND USG GUIDED CANNULATION

Co ordinator- Dr. NILESH JUVEKAR

ULTRASONOGRAPHY FOR ANESTHETHISTS

Anesthetists, during perioperative management of cardiac&sick non cardiac patients, face many clinically challenging situations primarily presented as unresponsive hypoxia and / or hypotension. In most of these situations, immediate action is required in the abscence of luxury of expert opinion and possibility of other advanced investigations. Meticulously performed transthoracic ultrasound of heart and lungs, most of the times open the suspense and can save patients´ lives.

Perioperative use of ultrasound, therfore, has become necessity and is no more a luxury. Focus assessed Transthoracic Echocardiography ( FATE ) protocol is one of the most used transthoracic echocardiography protocol, specially designed for non cardiologist users. It is robustly supported by globally accepted e-learning program and unique Hands on Training(HOT)based teaching model. To make the training more complete , we ( IACTA 2017 and Piceu foundation) have added additional lung and abdomen ultrasound module to the FATE training schedule.

After enrolling to the course , the participants get precourse reading material sent to their e-mails , which the participants are expected to read before coming to the hands on training (HOT) workshop to be held on 16 th Feb. During the workshop, there will be four HOT sessions where the participants will be encouraged to practice the performance of ultrasonography of heart and lungs as per the FATE protocol. Supervisors and chief instructor will help to fine tune participants skills.

The tentative programme is given below.

Course Director and ChiefInstructor

Dr. Rajesh Bhavsar

HOT Supervisors :

Dr Vaibhavi Upadhye
Dr Avinash Ratnaparkhi
Dr Muthuswami G
Dr Sanjeevani Inamdar

USforAnesthetists

Programme


0800-0830 - Introduction, Group distribution & breakfast
0830-0900 - Highlights to HOT 1 ( Dr.Nilesh Juvekar )
0900-1000 - HOT 1 - Knobology, FATE views, FATE card page 1 and IVC

PAUSE

1005-1030 - Highlights to HOT 2a ( Dr.Vaibhavi Upadhye)
1030-1115 - HOT 2 - Repetition of HOT 1, M-mode in pos. 2,

MAPSE/TAPSE

PAUSE


1120-1140 - Highlights to HOT 2b ( Dr.Sanjeevani Inamdar)
1140 1225 - M-mode in pos. 3, parasternal view.(FS,EF,MSS)

1225-1315 Lunch


1315-1340 - Highlights to HOT 3 (Lung and Abdomen)( Rajesh Bhavsar)
1340-1420 - HOT 3 – Lung and abdomen

PAUSE


1425-1545 - HOT 4 Interesting cases (Dr.Avinash & Dr.Muthuswami )
1545-1600 - Questions and evaluation( Dr. Rajesh And Dr.Muthuswami )


HOT = Hands-on training
Starting time and length of breaks are subject to change

BASIC TEE WORKSHOP

Co ordinator- Dr.BHAGYASHREE KAKADE

Objectives:

How to do Basic TEE examination with understanding of cardiac anatomy ,the Echo machine and image storing.
  1. Importance of understanding Physics of Ultrasound for image acquisition.
  2. Basic examination of cardiac valves with detailing - on Simulator based training.
  3. Examination of Cardiac chambers and understanding quantification methods on Simulator
  4. Understanding ofDoppler and Haemodynamic calculations.
Program : Based on few lectures and atleast 30 min time on Simulator .

THEME CHANGING HEART SPEAKER CHAIRPERSON
9:30 – 10:00 Relevant Physics for Echocardiography
Relevant Doppler – Understanding
DR SATYAJIT MISHRA
10:00- 10:30 Good Image Aquisition and Basic Views for TEE DR ANGELA MAHDI
Workshop 30 min each max group of 10 10:30 to 12:00 A. Standard TEE Views- Simulator 2 stations DR ANGELA, DR PATIL T A
B.Knobs to create best Image –Image storage On Machine DR MISHRA , DR PRABHU
C. Doppler on Simulator and more DR VENU KULKARNI, DR SHAH S
12:00 to 12:25 Anatomy and Echo images – Electronic dissection with 3 D simulator Dr Desurkar V
12:25 to 12:45 Reporting TEE Exam DR THOMAS KOSHY
LUNCH 12:45 to 13:15
13:20 to 14:15 Examination of MV DR PATIL T A
Examination of AV DR VENU KULKARNI
LV 2D and Dynamic DR ANGELA MAHDI
Workshop 2
30 min each includes doppler
14:20 to 16:00 A. Examination of MV on Simulator DR PATIL, DR MISHRA
B. Examination of AV on Simulator DR MAHDI , DR VENU
C. Examination of LV, RV,TV on simulator DR SHAH S, DR NALGIRKAR
16:00 to 16:20 Echo in post surgical cardiac critical care DR NICK FLETCHER
16:25 to 16:50 Examination of Aorta DR SHAH S.
16:55 to 17:30 Quiz – certification for the day

ADVANCED TEE WORKSHOP

Co ordinator- Dr SHARMILA DESHPANDE

SESSION 1 THEME IMPROVING OUTCOME SPEAKER CHAIRPERSON
09:45-10:10 How to use echo with relevance to Clinical Scenario Dr Justin Swanevelder
10:15-10:40 3D quantification -? Better for Aortic Valve perioperatively? Dr Mahesh Prabhu
10:45-11:10 3D Quantification of Mitral Valve lesions. Dr Chirojit Mukherjee
coffee 11:15-11:30
11:30-11:55 Quantitative 3D LV and RV Dr Gadhinglajkar Shreeniwas
12:00-12:25 25 Tissue Doppler and strain/Strain Rate for Quantifcation of LV Function- future in periop.setting? Dr ShastriNaman
Workshop 1
1/2 hr each
12:30-13:30 Station 1: LV 3d quantification Dr Shreeniwas, Chirojeet
Station 2: Tissue doppler,Strain/Strain Rate Dr Naman
Lunch 13:30-14:00
Workshop 2 14:00-15:00 3 D Mitral Valve Dr Sriniwas, Chirojit, Naman
15:00-15:25 DiastologyLV & RVany use periop?
15:30-15:55 TAVR Vs SAVR For whom and Why ? Dr Joerg Ender
COFFEE 16:00-16:15
16:15-16:40 40 Prosthetic Valve assessment and PPM Practical utility Dr Thomas Koshy
16:45-17:10 Echo in post surgical cardiac critical care Dr Nick Fletcher
17:15-17:40 Tricuspid Regurgitation with Left heart disease - ?Leave it alone
17:40-18:00 ECHO pre and Post VAD Dr Linda Shore Lesserson

ECMO WORKSHOP IACTA

Co ordinator- DR.SWAROOP MARGALE

Theme for ECMO workshop:

ECMO overview

ECMO workshop coordinator- Dr.Swaroop Margale
Time:
0830 to 0900 am --registration
0900 to 1600 pm –Workshop

Introduction and programme overview (5 mins)

Dr.Swaroop Margale

Lecture1: (25+5 mins)—Dr.Poonam Malhotra

Types of ECMO, evidence in clinical practice, Indications and contra indications, Ethical and Long term outcomes.

Lecture 2: (25+5 mins) ---Dr.Suresh Rao

Patho physiology, circuits, Anticoagulation, Pharmacokinetics and thermodynamics on ECMO, Complications

Tea break (15mins)



Lecture 3: (25+5 mins) --Dr.Govini Subramanian

Surgical aspect and complications of ECMO

Lecture 4: (25+5 mins)--- Dr.Maneesha Tol

Management of a patient on ECMO (VV), peripheral and central VA ECMO.

Lecture 5: (25+5 mins) -- Dr.Swaroop Margale

ECMO post surgery , ECMO in septic shock, ECPR,ECMO for organ retrieval

Lunch break 60 mins.



Hands on workshop. (Total 90 mins)

Questions and Feedback (30 mins )

THORACIC ANESTHESIA

Co ordinator- DR.JAIPRAKASH GALAPALLI

WORKSHOP OBJECTIVES

Thoracic Anesthesia Workshop, IACTA

Pune, Feb. 16, 2017

a)To improve the ability of anaesthetists to provide safe and reliable lung isolation for thoracic surgery.
b)To increase the understanding of attendees of the physiology of one-lung ventilation
c)To understand anaesthetic management options for airway surgery

Workshop Program (3.5 h)

5 lectures (20min. each)

1)One-lung ventilation – Indications and physiology. D. Thakar
2)Double Lumen tubes for lung isolation. J Singh
3)Bronchial blocker, how to use and advantages and limitations. P. Slinger
4)Mediastinal Masses and distal airway problems. P. Slinger
5)Postoperative Analgesia. P. Norman

6 stations for hands on workshop (15 min. each):

1) Double-Lumen Tube J. Singh
2) Bronchial Blocker P. Slinger
3) PEDIATRIC Lung Isolation.
4) DIFFICULT AIRWAY-lung Isolation.P. Norman
5) Airway surgery. D. Thakar
6) Fiberoptic bronchoscopy.S. Souche

Workshop Equipment:

Computer projector and screen

Station 1:

Olympus or Storz to provide pediatric video bronchoscopy with monitor. Laryngoscope, left and right double-lumen tubes and Mannequin with bronchi.Syringes , silicone spray, tissues. Ambu Bag

Station 2:

Olympus or Storz to provide pediatric video bronchoscopy with monitor. Laryngoscope, bronchial blockers Arndt, Coopdech, ( I will bring EZ blocker) and Mannequin with bronchi. Syringes , silicone spray, tissues. Endotracheal tubes sizes 6-8, Ambu Bag

Station 3:

Olympus or Storz to provide pediatric video bronchoscopy with monitor. Laryngoscope, bronchial blockers Arndt, Coopdech, ( I will bring EZ blocker) and Mannequin with bronchi. Syringes , silicone spray, tissues. Endotracheal tubes sizes 6-8, Ambu Bag

Station 4:

Olympus or Storz to provide pediatric video bronchoscopy with monitor.Difficult Airway Mannequins.video laryngoscopes: Storz, Glidesope, McGrath, etc. Double-lumen tube exchange catheters (Cook). Endotracheal tubes sizes 6-8. Bronchial blockers.Syringes , silicone spray, tissues

Station 5:

Rigid bronchoscope, jet ventilator.Olympus or Storz to provide pediatric video bronchoscopy with monitor. Laryngoscope, Endotracheal tubes sizes 6-8. Syringes , silicone spray, tissues

Station 6:

An internet connection. 3 laptop computers connected to internet. Olympus or Storz to provide pediatric video bronchoscopy with monitor.Laryngoscopy equipment and Mannequins with detailed bronchial anatomy. Endotracheal tubes sizes 6-8. Syringes , silicone spray, tissues

ADVANCED AIRWAY MANAGEMENT

Co ordinator- DR.SAMEER GHATAVADEKAR

WORKSHOP OBJECTIVES

Venue - JW Marriott hotel, Pune
Date - Thursday, 16th February 2017
Workshop Timing - 9 am to 4 pm

1.AIDAA 2016 guidelines for difficult airway management -

To be well versed with the recent national guidelines for the management of unanticipated difficult intubation in adults and children including the management of difficult extubation.

2.Practical use airway tools and techniques

Use of second generations supraglottic airway devices (SGAs), intubation through SGAs, use of channeled and non channeled videolaryngoscopes, optimising fiberoptic intubation, performing emergency cricothyroidotomy–using needle, scalpel bougieand other techniques including proper use of trans tracheal jet ventilation.

3.Practical approach to an unanticipated difficult airway

Using a case based approach.

REGISTRATION AND BREAKFAST

9 am to 10 am

LECTURES

Session 1 - Unanticipated Difficult Airway- (AIDAA 2016 Guidelines)

10 am -11 am

Management of Unanticipated Tracheal Intubation in Adults (15 mins) - Sheila Myatra Management of Unanticipated Tracheal Intubation in Paediatrics(15 mins)-Jeson Doctor

Management of Anticipated Difficult Extubation(15 mins) - Amit Shah

Discussion (15 mins)

Session 2 - Airway Tools and Techniques

Second Generation Supraglottic Airway Devices (SGAs) (15 mins) - AnandRajbhoj

Airway preparation, tip and traps for successful fiberoptic intubation (15 mins) - Raj Sahajanadan

Emergency cricothyroidotomy (15 mins) - Linda D’Souza

Discussion (15 mins)

WORKSTATIONS

(4 workstation rotations, 40 mins each – 2 pre and 2 post lunch )

• Videolaryngosocpy -

Use of channeled and unchanneled video laryngoscope and the BonfilsTM(videostilet) - Jason Doctor + Faculty Dr.Vaibhav Mahajan



• Supraglottic Airway Devices -

Use of second generation devices like LMA ProsealTM, LMA SupremeTM, IgelTM , BaskamaskTM, AmbuAuraGainTM Intubation through ILMA and intubation through second generation SGAs using AintreeTM exchange catheter AnandRajbhoj, Sameer Ghotavadekar



• Fiberoptic Intubation -

Oral and nasal fiberopticintubation skills and use of ORSIMTM simulator Sheila Myatra, Raj Sahajanadan



• Surgical Airway -

Performing emergency cricothyroidotomy using scalpel bougie technique , commercial cricothyroidotomy sets and using RavussinTM needle with trans tracheal jet ventilation (Manujet IIITM ) Linda D’Souza, Amit Shah



INTERACTIVE CASE DISCUSSION -

3.15 pm – 4.00 pm Putting it all together - We give you the case scenario, you give us your airway plan



Moderator -

Sheila Myatra

Panelists -

AnandRajbhoj, Linda D’Souza , Amit Shah, Raj Sahajanandan, Jeson Doctor, Sameer Ghotavadekar

WRAPUP, FEEDBACK AND CERTIFICATION

4.00 pm -4.15 pm

TEA BREAK

4.15 pm

WORKSHOP OBJECTIVES

IACTA2017

Objective: Goal Directed haemostatic Protocol for bleeding in Cardiac surgery
Date - 18th Feb 2017
Workshop Timing - 16:00 hr to 18:00 hrs

Cardiac surgery and bleeding was accepted norm in the past. However over a period of time world over things have changed and transfusion during cardiac surgery has gone down to a great extent. Still few situations are unavoidable and for that we should have guideline for working in these patient in order to avoid excessive bleeding as well as unnecessary transfusions as transfusion is not without hazard. Some of the conditions are uncommon so we should be more prepared for them rather than casual approach. Let us consider few situations elective and emergency that need specific mention in this regard.

Elective :

CPB Surgery on Aorta , Surgery in patient with liver malfunction ( CCF with MV disease) , Patient with ITP or platelet disorders , Patient on Antiplatelet agents. Redo surgery.

Emergency :

Aortic Dissections, Patients on antiplalteagents coming fprOffcab /on pump surgery The objective is trainees should understand that this issue can be kept under control with good patient outcome and not that bleeding Is always unavoidable part . Surgical Planning, Anaesthetic technique, Coagulation management all should work in synchronous way for predictable outcomes. So there has to be Goal Directed haemostatic Protocol for bleeding in Cardiac surgery

Talks:

Dr Poonam Malhotra : Pathophysiology
Dr Ravi Gill : Monitoring Coagulation
Dr Linda Shore-Lessorson: Risk factors and Treatment.

Faculty :

Dr Poonam Malhotra India
Dr Ravi Gill UK
Dr Linda Shore-Lessorson USA
Dr Raghu Nalgirkar UK
Dr Kunal Waghmare UK