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Dr Pieter Peach

@pieterpeach.com

Anaesthesiologist, paediatric and adult | MPH | Royal Children’s Hospital, Melbourne rch.org.au Also mastodon.social/@pieterpeach #AnSky #MedSky

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Latest posts by Dr Pieter Peach @pieterpeach.com

Organ failure type in fatal and near-fatal anaphylaxis: a systematic review Objectives Anaphylaxis is a sudden onset multiorgan allergic reaction that infrequently but regularly causes fatalities which may be preventable with appropriate organ support. There is limited data a...

In his 1st PhD paper Ben shows respiratory failure (bronchospasm) is the main cause of death in fatal anaphylaxis.
Food allergy deaths nearly if not all due to bronchospasm

Important-most resuscitation guidelines don’t prioritise intubation & ventilation

#Medsky

bmjopen.bmj.com/content/16/3...

12.03.2026 08:34 👍 6 🔁 2 💬 1 📌 1
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How are asymptomatic COVID-19 cases tracking? In the first year of the SARS-CoV-2 pandemic, data were assembled that defined how the virus spread among us, who, at the time, had never been infected. But the world's population is very different now - billions of infections, many waves triggered by evolved variants, vaccination, and that has impacted incubation periods, serial interval, generation times, and, according to this modelling, increased the proportion of cases (=infections) that are asymptomatic. A study published last year applied a modelling system. It started by acknowledging that these estimates are challenged by many variables.

As a fully immunised (=successfully vaccinated and boosted) individual, this study is good news. If you get infected, you're a bit more likely to come away with an unnoticed infection.

02.03.2026 02:48 👍 53 🔁 18 💬 6 📌 1
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Vaccines save lives and have protected millions of people. Choosing to vaccinate is a simple step to safeguard your health and that of your loved ones. Check out today’s daily dose by @drtedros.who.int

24.02.2026 09:13 👍 236 🔁 65 💬 5 📌 2

Fun fact - Febreze is also a cyclodextrin, and traps odour molecules to 'neutralise' smells.

23.02.2026 17:24 👍 4 🔁 1 💬 1 📌 0
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The political effects of X’s feed algorithm - Nature Among users initially on a chronological feed, 7 weeks of exposure to X’s algorithmic feed in 2023 shifted political attitudes and account-following behaviour in a more conservative direction compared...

Brainwashing, 2026 edition. This paper shows how X's algorithmic feed shifts people's views rightwards. It's a sophisticated, highly effective form of reorientation. And it is utterly chilling.
If you're still on that platform, unhook yourself now.
www.nature.com/articles/s41...

23.02.2026 07:42 👍 2607 🔁 1572 💬 82 📌 136
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To help you understand how bad people are at the concept of estimating relative risk, about 1 person dies every two years from a shark attack in the US, whereas cows kill about 20 people per year.

18.02.2026 19:42 👍 19 🔁 5 💬 2 📌 0
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Record spike in whooping cough cases due to 'potentially catastrophic' trend A "potentially catastrophic" decline in Australia's childhood vaccination rates has contributed to the sharpest increase in cases of whooping cough in 35 years, infectious diseases experts say.

Whooping cough cases hit record high after vaccine rate drop in Australia.

-we need a government Comms campaign about the benefits of vaccination. Yesterday.

www.abc.net.au/news/2026-02...

15.02.2026 20:24 👍 64 🔁 23 💬 2 📌 2
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After just nine months Sussan Ley was sent on eternity leave The issue for the Liberal Party is not simply the toppling of a female leader. It's also about what happened to that leader while she was in the job.

What frikkin epic writing!

www.abc.net.au/news/2026-02...

13.02.2026 20:37 👍 21 🔁 6 💬 4 📌 0

"If I had an ego, I'd be dead."

13.02.2026 23:34 👍 1 🔁 0 💬 0 📌 0

Horrible news. Each of these are future cases of horrible, painful, devastaing cervical cancer in the making.
This is a safe and hugely effective vaccine.

13.02.2026 22:52 👍 55 🔁 19 💬 6 📌 1
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The Inventor Of The Little Arrow That Tells You What Side The Fuel Filler Is On Has Finally Been Found - Jalopnik I bet most of our regular readers have, at some point, blown the mind of one of their non-gearhead friends by pointing out the little arrow in almost every modern fuel gauge that shows what side the f...

Jim Moylan 1986

www.jalopnik.com/the-inventor...

09.02.2026 07:58 👍 0 🔁 0 💬 0 📌 0
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Statement of Ethics | Infectious Dose Statement of ethics for Infectious Dose, explaining why silence is not neutral and why science, public health, and human rights are inseparable.

A brief statement clarifying the ethical boundaries of #InfectiousDose is now live.
www.infectiousdose.com/statement-of...

06.02.2026 00:42 👍 2 🔁 1 💬 0 📌 0
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On Silence, Science, and Complicity: A Statement From Infectious Dose Podcast Episode · Infectious Dose · 06/02/2026 · Bonus · 3m

“This episode is not a scientific explainer & not an invitation to debate. It exists to make clear where this podcast stands, why silence is not an option, why evidence, accountability & human rights are inseparable from public health” @infectdosepodcast.bsky.social

06.02.2026 07:18 👍 1 🔁 1 💬 0 📌 0

Well that’s an experience! Awake surgery. Anaesthetist was 😊 one of my old regs but been a boss for a while. But I know is high cognitive load when you have awake colleague! A thread…

03.02.2026 03:45 👍 14 🔁 2 💬 5 📌 1

Reasonable!

02.02.2026 23:01 👍 1 🔁 0 💬 0 📌 0

A recommendation like this with few/no published case reports is a little unusual given how long sevoflurane has been in use.

02.02.2026 19:50 👍 2 🔁 0 💬 0 📌 0

I spend my days defending against “Did you have cars when you were growing up?”

01.02.2026 01:47 👍 1 🔁 0 💬 0 📌 0

Instalabelled as you walk into ED

01.02.2026 00:58 👍 2 🔁 0 💬 0 📌 0
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31.01.2026 22:07 👍 2 🔁 2 💬 0 📌 0

So in homage to the fine traditions of anaesthetic anecdotes, what descriptions have your patients given of the ‘flavour’ of anaesthetic agents? #AnSky @maffygirl.medsky.social

31.01.2026 12:39 👍 9 🔁 3 💬 11 📌 1

A young patient of mine reported, surprisingly accurately, that it tasted like they were eating a rubber glove

31.01.2026 12:36 👍 4 🔁 0 💬 1 📌 1

Painless IV cannulation 👌

31.01.2026 11:01 👍 2 🔁 0 💬 2 📌 0

I prefer classics in elderly patients. Seem to get a better seal when there is an airway that is less forgiving

30.01.2026 22:13 👍 2 🔁 0 💬 1 📌 0

The reference for this is from the ASRA guidelines & is based on the catheter tip culture in 214 parturients with labour epidural. Rates of colonisation were 9.2 vs 7.6% (ungowned vs gowned). The background paper states that there’s no good evidence for their use.

Not sure that translates well.

30.01.2026 08:08 👍 1 🔁 1 💬 0 📌 0

Thank you.

30.01.2026 06:48 👍 1 🔁 0 💬 0 📌 0

Which guideline in Europe?

29.01.2026 19:16 👍 0 🔁 0 💬 1 📌 0

Interesting!

I wonder if/when the UK will do the same.

29.01.2026 05:53 👍 3 🔁 1 💬 1 📌 0
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The @anzca.bsky.social “PG28 Guideline on infection prevention
and control in anaesthesia 2025” now states that sterile gowns are not required for all single shot spinals.
This could reduce a significant amount of waste.

#Ansky

www.anzca.edu.au/getContentAs...

29.01.2026 04:24 👍 9 🔁 5 💬 3 📌 1
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a man with glasses and a beard says what do you do ALT: a man with glasses and a beard says what do you do

This is the first of 2026 #MedSkyDebate.
Managing obstructive sleep apnoea -OSAS, as a day patient does not require any changes to your techniques.
Discharge if ok post op should occur normally.
How do you manage patients with known or high risk of OSAS?

28.01.2026 08:33 👍 8 🔁 2 💬 8 📌 2
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AI bot swarms threaten to undermine democracy When AI Can Fake Majorities, Democracy Slips Away

AI bot swarms threaten to undermine democracy
- When AI Can Fake Majorities, Democracy Slips Away

garymarcus.substack.com/p/ai-bot-swa...

28.01.2026 05:05 👍 0 🔁 0 💬 0 📌 0