Saving Lives Academy

BIG NEWS from Saving Lives Academy (SLA)!

We’re proud to announce that our course is now officially CPD Accredited 🎓

✅ 39 CPD Credits Awarded
📌 Accredited by The CPD Group
🔎 Activity Number: #1020329

This recognition reflects our commitment to delivering high-quality, practical, and clinically relevant education for clinicians working in Anaesthesia, ICU, and Emergency Medicine.

Our Next Course is At KAUH, Jeddah, Saudi Arabia...

At SLA, we don’t just teach theory — we focus on:
✔ Real-world decision making
✔ Case-based learning
✔ Skills that translate directly to patient care

This is another step forward in our mission to elevate critical care education globally

If you haven’t joined yet — this is the time.

Critical Care Ultrasound Masterclass – Jeddah 11-13th of JUNE 2026

Join our comprehensive, hands-on ultrasound course designed for clinicians who want to master POCUS and Echocardiography, and haemodynamic assessment in real-world critical care settings.

✔ Structured learning from basics to advanced Trans-thoracic and TEE
✔ Expert faculty & case-based teaching
✔ Intensive hands-on training (9.00 am to 6.00 pm everyday)
✔ Ideal for ICU, Anaesthesia, Cardiology and Emergency clinicians

📅 Limited places available

👉 Book now:
https://savinglivesacademy.com/ultrasound-masterclass-main-page

Why Critical Care Ultrasound Masterclass is not just an ultrasound course!

Critical care Ultrasound Masterclass by Saving Lives Academy Link to registration:https://savinglivesacademy.com/ultrasound-masterclass-main-page/

It was far more than a standard ultrasound course, it brought together an exceptional faculty with outstanding expertise, seamless organisation, and highly motivated participants, creating a truly remarkable learning experience.

See you in Bahrain soon..

Registration is open for the Patient–Ventilator Interaction (PVI) Masterclass, an educational pathway developed through a collaborative work between Saving Lives Academy, the PVI Network and endorsed by the Society of Mechanical Ventilation.

The 12-week educational series focused on recognizing and managing patient–ventilator asynchrony through waveform analysis and case-based learning.

The program combines interactive webinars with dedicated simulation sessions, bringing physiology and waveform interpretation to the bedside through structured PVI assessment and case-based learning to improve recognition and management of patient–ventilator asynchrony.

Starts: 1 March 2026
Certificate: Attendance certificate

If you are an intensivist, anesthesiologist, pulmonologist, fellow/resident, RT, ICU nurse, or ventilation educator, I’d be glad to have you join this global learning cohort.

Register here:

https://savinglivesacademy.com/patient-ventilator-interaction-pvi-masterclass/

A new marvelous collaboration with WICCEM, for sake of more education and saving lives..

NOT EVERY LUNG POINT = Pneumothorax

Patient Presentation
68-year-old male presented to ED with severe hypoxemic respiratory failure
- Oxygen saturation: 65% on non-rebreather mask
- Sinus tachycardia: 145 bpm
- Hypotension: 75/40 mmHg
- Tachypnea: 36 breaths/min
- Immediately intubated due to severe hypoxemia, Rt side no movement, ETT is at 21 cm at teeth!
- High airway pressures despite low tidal volume (ARDS-net protocol)

Initial Assessment and Misdiagnosis
- ED consultant performed a quick Rt sided lung ultrasound using linear probe on anterior chest
- Identified lung point and diminished air entry on right side
- Initial diagnosis: right-sided pneumothorax
- Plan was to insert intercostal drain
- I arrived to ED given the critical illness with hypoxia and Hypotension.

Diagnostic Challenge and Re-evaluation

- I performed a thorough clinical examination
- Key findings that didn't correlate with pneumothorax:
-* Right side showed **dullness on percussion** rather than hyper-resonance
- These findings inconsistent with tension pneumothorax
- Decision to insert chest drain was challenged pending completion of ultrasound examination using curved abdominal probe on PLAPS point

Correct Diagnosis
- Complete lung ultrasound performed using curvilinear probe at PLAPS point
- Findings revealed complete hepatization of right lung
- Only aerated portion showing lung sliding was at bottom of right lung which explains why there is a lung point!
- CT scan confirmed diagnosis

Final diagnosis: patient was known HLH (Hemophagocytic Lymphohistiocytosis) and on steroids, had URTI treated with simple Abx for 5 days resulted in this Rt. sided massive pneumonia

Key Teaching Points
Examination First

- Always complete full clinical examination before point-of-care ultrasound
- History, examination, and investigations should tell a harmonious story
- If findings don't correlate (e.g., pneumothorax with dullness on percussion), review assessment from beginning

Complete Ultrasound Examination
- Don't rely on linear probe on anterior chest alone
- Must perform complete exam including PLAPS point before making clinical decisions
- Particularly important before invasive procedures
- Different probe types and positions may reveal different findings

Clinical Integration:
- All pieces of the diagnostic puzzle must fit together harmoniously
- Point-of-care ultrasound is a tool that complements, not replaces, clinical examination
- When findings are discordant, reassess rather than proceed with potentially harmful interventions

NB:
with retrospective more careful assessment of the lung point the sliding pleura was actually showing shredded pleura and sub-pleural consolidation, which correlates with severe pneumonia.

Thanks for reading

Dr Walid Alhabashy
Anaesthesia and ICU consultant

Case Title: The "? Acute MI" in PACU Mystery!!

The Context and Patient Mrs. X, a 45-year-old female, had just arrived in the Post Anaesthesia Care Unit (PACU) following a two-hour Functional Endoscopic Sinus Surgery (FESS) and Septoplasty performed under general anaesthesia. The surgical course had been uneventful. His past medical history included mild asthma and gastro-oesophageal reflux disease (GORD), controlled on omeprazole.

The Trigger Event Approximately 15 minutes after arriving in PACU, Mrs. X was fully roused. She was sitting up to 45 degrees and complaining of a dry throat. The recovery nurse offered her a small sip of water to check his swallow reflexes post-extubation.

She took one swallow, and then his eyes widened in sheer terror.

She immediately clasped both hands to his mid-sternum, groaning loudly. She became instantly diaphoretic and tachypnoeic. When asked to rate the pain, she couldn't even speak, only holding up ten fingers desperately. She indicated the pain was crushing and tearing through to his back.

Initial Management: The PACU monitors alarmed instantly: Heart Rate 145 bpm (sinus tachycardia), Blood Pressure 190/110 mmHg. Oxygen saturation remained 98% on 4L via Hudson mask.

The immediate concern in the recovery room setting is always perioperative myocardial infarction (MI) or pulmonary embolism (PE). A 12-lead ECG was ordered stat.

Meanwhile, aggressive pain management was initiated according to PACU protocol for severe breakthrough pain:

IV Fentanyl: Immediate bolus of 25-50mcg upto 200 mcg. Result at 5 minutes: Patient still writhing, pain 10/10.

IV Morphine: Given the lack of response to Fentanyl, 10mg of Morphine was titrated over the next 10 minutes. Result: Patient became more drowsy but remained in obvious agony, clutching his chest.

IV Magnesium Sulfate (MgSO4): The attending anaesthetist, considering the possibility of severe perioperative coronary artery vasospasm, administered a 2g slow IV bolus of MgSO4. Result: No discernible impact on the pain.

We had a patient with crushing, opioid-refractory chest pain immediately post-extubation. The 12-lead ECG showed rate-related changes but no distinct ST-elevation. We were preparing to call the cardiology consultant for urgent cath lab activation.

The Clinical Clue The anaesthetist who had performed the case (Myself) came to the bedside. Reviewing the sequence of events, one detail stood out: the exact timing. The pain began immediately after his first voluntary swallow upon waking.

I noted on the chart that during the FESS procedure, haemostasis and decongestion had been achieved using neurosurgical pledgets (patties) soaked in Moffett's solution (which contains co***ne, adrenaline, and bicarbonate) placed deep in the nasal cavity near the nasopharynx.

A theory emerged: As the patient woke up and his pharyngeal reflexes returned, he swallowed secretions that had pooled in the posterior nasopharynx, rich with residual runoff from the co***ne-soaked pledgets used during surgery.

The Diagnostic Pivot: The Recovery Room Echocardiography Before sending the patient for a CTPA or angiography, I grabbed the portable ultrasound machine from the ICU. The goal was a quick "Point of Care" cardiac assessment to Role in/out RWMA, or Signs of RV syndromes.

Standard Views: In conclusion: No regional wall motion abnormalities suggesting a massive MI, and no RV dilation suggesting a massive PE. Ascending, Arch and Descending Aorta showed no signs of Aortic dissection!

Diagnosis and Resolution The diagnosis was Acute, Severe Oesophageal Spasm triggered by the ingestion of residual topical co***ne/adrenaline runoff upon emergence from anaesthesia. The sympathomimetic "kick" to an oesophagus already primed by a history of GORD caused a spasm so intense it mimicked an MI.

We administered sublingual Glyceryl Trinitrate (GTN) spray (400mcg) immediately.

Within 3 minutes, the patient’s facial expression changed from agony to relief. The pain score dropped from 10/10 to a dull ache (3/10).

The heart rate dropped from 145 to 100 bpm, and BP normalised.

She was observed for another 16 hours overnight in HDU bed and was discharged to the ward with instructions for soft diet and oral antispasmodics if needed.

Conclusion This case highlights that in the Recovery Room, "chest pain" is not always cardiac, even when it looks terrifyingly like it. The failure of high-dose IV opioids (Fentanyl, Morphine) and MgSO4 was the primary indicator that the pain pathway was not standard ischaemia. The bedside POC Echocardiography was the definitive tool that allowed us to R/O other pathologies. THe Serial ECGs and Troponin were supportive that the severe chest pain is of non-cardiac origin ..

هل وجودي ع السوشيال ميديا ممكن يكون سبب تحويلي لل GMC .. طبعاً وبدون ادني شك..وهناك امثلة كثيرة ومعلنه علي صفحات الاطباء علي ال GMC ودرجات ال Sanctions المختلفة ..

أمثلة من قضايا سابقة تعاملت معها الـ GMC .. مع الدروس المستفادة:

١- نشر معلومات أو تفاصيل قد تكشف هوية مريض

الوقائع تضمنت:
• مشاركة قصة حالة يمكن التعرّف على صاحبها
•نشر صور أو نتائج طبية دون إخفاء كامل للهوية

حكم الـ GMC
تم اعتبارها خرقًا للسرية المهنية

وتم إصدار:
•تحذيرات رسمية
•أو قيود على الممارسة

الدروس العملية
• لا تنشر أي حالة حدثت مؤخرًا
• لا تذكر تفاصيل زمنية او مكانية او شخصية
• حتى بدون اسم (مهم جدااااااااا)… قد يصبح المريض قابلًا للتعريف..

٢- نشر تعليقات غير مهنية أو مسيئة على الإنترنت
أمثلة:
• سخرية من مرضى أو مجموعات معينة
• لهجة عدائية أو ازدرائية
• محتوى تمييزي

حكم الـ GMC
تم تصنيفه: سلوكًا يقلل ثقة المجتمع بالمهنة (خللي بالك هنا قوي من الجملة دي!)

الدروس العملية
• اكتب دايما باحترام واوعي حد يستفزك ..
• تجنب السخرية و التهكم و الشتائم
• لا تنشر وأنت غاضب (هتسمع دايما كلمة Sleep on it) يعني اكتب النهاردة وبكرة راجع وبعدين انشر او ابعت ..

٣- تواصل غير مناسب مع المرضى عبر الرسائل الخاصة
مثل:
• محادثات شخصية مطولة
• خروج عن الحدود المهنية (ودي لي شخصيا قصة معاها هبقي احكيها في فيديو منفرد لوحدها لان فيها دروس مستفادة كتيييييير)

حكم الـ GMC
تمت معاملتها كخرق للحدود المهنية

وقد تصل إلى:
• إيقاف مؤقت
• أو ممارسة تحت شروط إشرافية

الدروس العملية
• لا تقدّم دعمًا شخصيًا خارج القنوات الرسمية
• لا تبني علاقات عبر المنصات
•حوّل أي استشارة إلى مسار سريري رسمي..

٤- تقديم نصيحة طبية فردية عبر المنصات
مثل:
• تشخيص حالة عبر الرسائل
• وصف علاج محدد لشخص مجهول السجل الطبي

حكم الـ GMC
اعتُبر: ممارسة طبية غير آمنة وخارج إطار مسؤولية مهنية

الدروس العملية
• قدّم توعية عامة فقط
• لا تفسّر نتائج طبية لشخص محدد
• اجعل الردّ: برجاء مراجعة الطبيب المعالج (اتعلم من ال AI كدة)

٥- نشر محتوى يسيء لسمعة المهنة أو جهة العمل
مثل:
• الهجوم العلني على زملاء أو مؤسسة
• مشاركة معلومات داخلية (يعني اي معلومات حساسة عن زميل بعينه (بعينها)
• منشورات انفعالية بعد خلاف مهني

حكم الـ GMC
تم اعتباره: سلوكًا يضعف ثقة المجتمع بالمهنة

الدروس العملية
• ناقش الخلافات عبر القنوات الرسمية
• لا تنشر مشاعر الغضب أو العمل الداخلي
• احفظ المهنية حتى خارج الدوام

أهم قاعدة في جميع القضايا

القيم المهنية والأخلاقية تنطبق على الإنترنت
مثلما تنطبق داخل مكان العمل
حتى لو كان:
• حساب شخصي
• إعدادات خاصة
• جروب مغلق

أعرف شخصيات عامة في مجتمعنا الطبي ممكن يكتبوا مجلدات في البوست ده .. بس عارف كمان انهم ممكن ما يحبون يكتبوا الان بسبب تجربتهم القاسية ..

فبما ان المحتوى قد يُستخدم كدليل مهني أو قانوني فدي قائمة نصايح سريعة للأطباء على السوشيال ميديا:

- لا تنشر أي شيء قد يعرّف مريضًا
- لا تعطِ نصائح طبية فردية
- لا تكتب ابدااااااا وانت غضبان او مستعجل
- احرص على لغة محترمة وغير هجومية
- افترض أن أي محتوى قد يصبح عامًا
- التزم بسياسات صاحب العمل والجهات التنظيمية
- اطلب استشارة طبية-قانونية عند الشك

وأخيرا يا ريت اللي عنده اضافة او نصيحة لا يتردد يضيفها في تعلق او يرسلهالي خاص وانا اضيفها .. لتعظيم الاستفادة..

We’ve had an incredible year of "firsts" and "new additions" at SLA, all designed to better support the healthcare community. Here’s a look at what we accomplished together in 2025:

1- A Fresh Online Presence: We launched our sleek, user-friendly new website.

2- SLA in Your Pocket: Our mobile app is now LIVE! Download it for free on the App Store or Google Play.

3- Advanced Learning: We expanded our catalog with the ECMO & MCS course and the cutting-edge AI for Healthcare Professionals program.

4- Masterclass Launch: The Patient-Ventilator Interaction (PVI) Masterclass.

5- Critical Care Ultrasound Masterclass in Madina, KSA for the first time.

6- Global Collaboration: Partnering with WICCEM, we brought expert POCUS training to acute care settings.

What’s next for 2026? We are going global! We are thrilled to bring our Masterclasses to new horizons, including Ireland, Bahrain, Egypt, and Riyadh. Stay tuned for dates!

You can register your email to our email list, and get notified with our new events from here: https://savinglivesacademy.com