SPANZA endorses one hour clear fluid fasting consensus statement
The Society for Paediatric Anaesthesia of New Zealand and Australia (SPANZA) has examined the APA-ESPA-ADARPEF joint consensus statement on clear fluid fasting in children, and associated special interest article: Thomas M, Morrison C, Newton R, Schindler E. Consensus statement on clear fluids fasting for elective pediatric general anesthesia. Pediatr Anesth. 2018;28:411–414.

SPANZA adds its endorsement to this joint consensus statement agreeing that “based on the current convincing evidence, unless there is a clear contra-indication, it is safe and recommended for all children able to take clear fluids, to be allowed and encouraged to have these fluids up to one hour before elective general anaesthesia.”

Dr David Linscott, SPANZA executive

Fight Fatigue Campaign
Fatigue is a key contributor to both poor mental and physical health, as well as poor clinical performance. A campaign to ‘Fight Fatigue’ has been launched by the Association of Anaesthetists of Great Britain to raise awareness of fatigue and the problems that it can cause for doctors and patients, and to offer practical solutions to help address fatigue. The NZSA is endorsing this campaign. Find out more here

AAGBI encourages positive attitudes towards rest across the medical workforce and to reduce the stigma of talking about fatigue. We encourage you to look at these resources, which you may be interested in promoting and using in your department. These resources are useful in learning about the risk factors associated with fatigue and how individuals can best manage their own fatigue. Resources include: a checklist adapted for clinicians to assess fatigue and fitness to work, tips for clinicians working night shifts, and tips to aid restful sleep. Theses can be accessed here

WFSA represents global anaesthesia at 71^st World Health Assembly
With five billion of the world’s 7 billion people unable to access safe and affordable anaesthesia and surgical care when needed, scale-up is essential to achieving universal health coverage, one of WHO’s key targets. The World Federation of Societies of Anaesthesiologists (WFSA) strongly conveyed this message to the 71st World Health Assembly (WHA) held in May 2018 in Geneva. Read full article here about the WFSA’s outstanding contribution at the WHA, which included co-hosting an event entitled “How Can We Scale-up Surgery and Anesthesia to Achieve Universal Health Coverage,” together with Lifebox and Nesta.

Ora Taiao – Environmental sustainability and health
Ora Taiao (the NZ Climate and Health Council), which comprises of health professionals, is focused on addressing the negative impacts of climate change on health, and the health gains that are possible through strong, health-centred climate action. Ora Taiao has written an open letter which calls on the Ministry of Health to set greenhouse gas emission (GHG) targets for DHBs, in line with commitments under the Paris Agreement. NZSA member and Ora Taiao member Dr Matt Jenks says that they hope to present the open letter to the Ministers of Climate Change and Health by the middle of the year. You can read and sign the letter here. Find out more about Ora Taiao’s work on their website.

Bullying of senior doctors rife in public health system, report finds
A survey of senior doctors and dentists working in New Zealand’s public health system found more than a third had been bullied at work, and two-thirds had witnessed others being bullied. The Association of Salaried Medical Specialists (ASMS) report, Bullying in the New Zealand senior medical workforce: prevalence, correlates and consequences, is available on the ASMS website at https://www.asms.org.nz/wp-content/uploads/2017/11/ASMS-Health-Dialogue-Bullying-WEB.pdf.

Decision to delist tramadol hydrochloride oral drops 100 mg per ml
The NZSA welcomes PHARMAC’s decision to progress the proposal to delist tramadol hydrochloride oral drops 100 mg per ml from Part II of Section H of the Pharmaceutical Schedule, and instead list a 10 mg per ml strength of tramadol hydrochloride oral solution for use in DHB hospitals. This was the subject of a consultation letter dated 4 October 2016. In summary, the effect of the decision is that:
– tramadol hydrochloride oral solution 10 mg per ml was listed for use in DHB
hospitals from 1 January 2017.
– tramadol hydrochloride oral drops 100 mg per ml were delisted from 30 June 2017.

Sole supply of propofol
Sole Supply Contracts (Hospital Supply Status) have been awarded to two suppliers for propofol:
• AFT Pharmaceuticals’  Provive brand MCT-LCT 1% inj 10 mg per ml, 20 ml vial;
• Fresenius Kabi (NZ)’s Fresofol brand 1% MCT/LCT inj 10 mg per ml, 50 ml vial and inj 10 mg per ml, 100 ml vial.

These products will be the only brands of propofol that can be used in DHB hospitals from 1 June 2016 until 30 June 2019. The 50ml and 100ml vials of Fresofol were introduced on 1 April. All other presentations of propofol currently listed were delisted from 1 June 2016. The NZSA wrote a submission to Pharmac earlier in the year expressing strong support for continued availability of Provive and Fresofol and said consistency of supply for NZ’s leading anaesthetic drug is essential.