@iainmoppett
Human, doctor, anaesthetist, academic - in that order. Director Centre for Research & Improvement at RCoA. Editor Anaesthesia. #HipFracture #AnSky #PatientSafety Views own. Work for University of Nottingham and Nottingham University Hospitals.
"It wasn't until a geriatrician reviewed my mother's medications that we found the cause of her sudden confusion. A new sleeping pill... Within two days of stopping it, she was back to her old self."
#delirium
The story of the Paper Boat. A British Geriatric Society blog from 2018. Let me know if you’d like the full text & I’ll send it to you.
The story of the Paper Boat was a blog I wrote back in 2018 for @gerisoc.bsky.social.
It was an analogy that I found useful to explain to patients and families how difficult it can be to predict the future accurately.
Now as I and my friends get older, I find myself sharing it once again.
🧵1/n
"My dad has dementia but was doing ok. Suddenly he became aggressive and was seeing spiders on the wall. We were terrified. It turned out he had a raging UTI with no other symptoms."
#delirium
Congratulations to Professor Iain Moppett for his Webb Johnson Oration award
We're delighted to announce that Professor Iain Moppett has received the Webb Johnson Oration, jointly awarded by The Royal College of Surgeons of England and us.
Congratulations on this distinguished honour!
Read more 👉 https://ow.ly/TYLQ50Yp43m
#Ansky #Medsky
Join CPOC as Board Chair
Could you be our Centre for Perioperative Care (CPOC) next Board Chair?
If you’re passionate about improving patient care and leading change, we want to hear from you!
Learn more and apply by April 12👉 https://ow.ly/q7PW50Yp1AM
#Ansky #Medsky
Join us as the Strategic Oversight Board Chair of the National Clinical Audit of Perioperative Care (NCAPC)
⏰ New opportunity!
We’re seeking a leader to Chair the Strategic Oversight Board for the new National Clinical Audit of Perioperative Care (NCAPC).
Help shape the future of perioperative care.
Learn more and apply👉 https://ow.ly/slC250YpB5M
#Ansky #Medsky
Explain delirium in accessible terms: "The brain isn't processing information normally right now."
This helps families understand why repeating basics about what is going on, as well as being reassuring over and over again, can help the person experiencing #delirium.
Giving a small dose of dexmedetomidine (between 0.25 and 0.35 micrograms per kilogram of body weight) during surgery may help reduce confusion afterwards but giving more than this does not seem to help.
#AnSky #MedSky #PharmSky
doi.org/10.1111/anae...
THESE ISLES: Sophia Jex-Blake (1840-1912), physician, teacher and feminist, led the pioneering ‘Edinburgh Seven’, the first women admitted to study medicine in the UK. 1/9
Interested in leading your own clinical research project? Seeking training and mentoring from senior investigators?
We're recruiting new members to join the @rcoa-cri.bsky.social Research Leaders Scheme!
More information on how to apply here: www.rcoa.ac.uk/research-lea...
Some studies show that in some undergraduate degrees nurses get no formal #delirium training.
For an emergency that affects 1 in 6 hospital patients.
Help me understand why this is.
Black cat on cushion.
Today feels like a big day!
I had my final Oncology appointment this morning, and that's me now signed off with just annual review from now on.
A six month journey with breast cancer, which has gone at times very quickly and at other times very slowly.
Short (grateful) thread.
1/n
Heraeus Bone Cement Supply Issue
Today we have issued joint guidance with BASK, BHS and OTS. Please read the full statement below
https://ow.ly/T14q50YhLhZ
Generating evidence regarding peri-operative outcomes and the role of regional anaesthesia is important to the ongoing process of improving patient participation in clinical decision-making.
@emarianomd.bsky.social @yintubate.bsky.social @ajrmacfarlane.bsky.social
#AnSky
doi.org/10.1111/anae...
Our new editorial on peri-operative nerve injury in @anaesjournal.bsky.social is published and free to read!
Great international collaboration with @yintubate.bsky.social @ajrmacfarlane.bsky.social and Dr Kelly Foster
associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10....
Just in case anyone is wondering… the cement is being prioritised for cemented hemiarthroplasty for hip fracture. #OrthoSky #AnSky
Another #NAP8 milestone: we have received over 8500 individual baseline surveys and 250 departmental surveys. Encourage all your colleagues to take part and contribute to #NAP8!
Much as I agree with you that a 4AT should be done, at the moment it’s not always. And folk may not realise that the words they are writing in the notes are indicative of delirium. So maybe we need both? #GeriSky #Delirium
Why are we building complex AI systems to detect delirium from casenotes when we could just... do a 2-minute bedside test?
The 4AT exists.
It's well-validated (33 studies).
It's free.
Sometimes clinical medicine doesn't need machine learning.
#delirium
Unable to sleep in hospital? It's not just a horrible zombie feeling- it increases postop complication rates. 😱
'...each 10-minute reduction in change in total sleep duration was associated with higher odds of Clavien-Dindo grades I and II complications.'
#MedSky
jamanetwork.com/journals/jam...
On your way to a pharma meeting about #LookAlikeDrugs in #anesthesia, you find a magic lamp. 🧞
Genie grants you three wishes.
Non-technological solutions only.
What would you wish for to improve medication safety? 👇
#ansky #medsky #patientsafety #medicationsafety
Peri-operative peripheral nerve injury
The 8th National Audit Project (NAP8) of the Royal College of Anaesthetists in the UK is due to launch in early 2026 and aims to study both major complications of regional anaesthesia and general PPNI.
#AnSky #RASky
doi.org/10.1111/anae...
Shocking reality: 1 in 4 older hospital patients develop #delirium, yet most families have never heard the word.
We need to do much better in improving public awareness of delirium.
Made the 4AT #delirium assessment tool with 2 colleagues in 2011 to help improve the rates of detection in my hospital at the time. Also made a website - www.the4AT.com - to help with dissemination.
Pleased to say it has now been widely adopted & has a large evidence base.
Keynote address from Prof @emmavardy2.bsky.social on her amazing work within the NHS focused on turning dementia audit data into improved practice and better outcomes for patients.
Particular focus on the symptom of delirium and the importance of catching this as soon as posssible.
#NOCA2026
Let's look at delirium and dementia:
Episodes of delirium: more rapid progression of dementia.
Delirium survivors: x3-fold higher risk of future dementia.
➡️ We really need the support of dementia charities in helping improve delirium care.
#delirium #dementia #medtwitter
Woman standing in front of a board of donor names in gold writing with black background holding a large bound document
V happy to have passed my PhD viva today with no corrections!
Spending the last five years examining how gender shoes the experience of training and working in ICM has been so rewarding
Qualitative research is challenging, fascinating and actual lots and lots of fun! 1/
A delirium tool that also finds dementia?
New study: n=75,221 older adult admissions
↳ 4AT score ≥1: • 87% sensitive for clinical dementia diagnosis
↳ The 4AT isn't just for delirium anymore.
#Delirium #Dementia #4Ms
Penfold et al, Age Ageing 2025
Over 7500 anaesthetists and physician assistants in anaesthesia have filled out their #NAP8 baseline surveys. If you provide anaesthetic service cover, even if you don't do any regional anaesthesia, we still want to hear from you!
The word "delirium" comes from Latin: *de-lira* — "out of the furrow."
Like a plough going off track.
Delirium is an abrupt departure from the person's normal path.
To recognise it, you need to know what their path was before.
#delirium