https://crikeystreety.com/home daily 1.0 2020-09-26 https://crikeystreety.com/share-your-words daily 0.75 2020-09-28 https://crikeystreety.com/camperdown daily 0.75 2020-09-27 https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f416402200104f66381e5/1601126775898/Neil+Street+and+fellows+Party+Day.JPG Camperdown https://crikeystreety.com/westmead daily 0.75 2020-09-27 https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f478cb66cd43eed4d1e27/1601128251393/Victor%27s+farewell.JPG Westmead - New Things A new joint came with a series of firsts. Neil was an integral member of the team who commenced paediatric liver transplantation inside the walls of the children’s hospital in 1998. He was part of the group refining approaches for managing children having spinal surgery. He was a vital member of the paediatric cardiac anaesthesia team, there as new possibilities for neonatal heart surgery became the norm. Across the hospital he was known as a clinician with peerless technical skills and a deeply compassionate approach to caring for kids and their families. https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f478cb66cd43eed4d1e2a/1601128327682/IMG_3597.jpeg Westmead - Colleague, friend. For colleagues he was universally admired for his keen intellect, unwavering dedication to children and generous encouragement and support of all those he worked with. Any doctor, nurse, engineer, perfusionist, or porter could count on Neil as a friend ready for a chat, a moment of inspiration and, always, a laugh. From his arrival at Westmead in 1995 to a semi-retirement in 2019, Neil was the heart and soul of the department of anaesthesia at The Children’s Hospital at Westmead. https://crikeystreety.com/malignant-hyperthermia daily 0.75 2020-09-28 https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f34ae36b37d25b6d67cbc/1601123554248/4O6A6570.jpg Malignant Hyperthermia - What is Malignant Hyperthermia? Malignant Hyperthermia (MH) is a rare clinical condition seen when patients with a genetic predisposition are exposed to certain anaesthetic agents, resulting in uncontrolled release of calcium into muscle cells. This creates sustained muscle contraction, metabolic changes and, if not recognised and treated, death. It is also preventable. All that it takes to prevent MH is to use different anaesthetic agents. But to know to do that in a patient, you need to know a diagnosis in advance. Neil knew this all too well having looked after a patient during his anaesthetic training who died after an episode of MH. As a specialist, he realised that patients in New South Wales needed a service devoted to this rare condition - this is what he created. https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f3ad46994936d8fb0a3d0/1601125186883/IMG_3699.jpeg Malignant Hyperthermia - What do you need for an MH service? Well you need people to do the work, obviously. But the testing itself relies on a very specific test – the In Vitro Contracture Test (IVCT). This is not a test you do by sending it to your standard lab. You need a whole machine dedicated just to this test. For Neil and others to set up the MH service they needed that machine. A machine that can take a small bit of muscle, bathe it in fixed concentrations of both caffeine and halothane and measure the tension that develops. This is no simple machine and it has to be extremely accurate. So if you do not have a machine and you are Neil Street you build one. Like so many things Neil did this was a collaboration. The biomedical engineering and biochemistry departments were all part of the mission to source and manufacture components. All to produce a machine that could sit in his office. The IVCT is supplemented by an MH genetic service provided by Dr Margaret Perry. The MH service includes establishing family trees and counselling families about what a test result means and also provide support and assistance to anaesthetists. They are also ready at any time to support and provide advice to anaesthetists, wherever they call from. https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6ff140f414a7531ec37638/1601171801720/IMG_8040.jpg Malignant Hyperthermia Finally, someone needs to get a sample of muscle. And, to hear Neil tell it, surgeons just didn’t give him the samples he wanted. So he did that too. All of those elements came together to produce the MH service. First planned in 2000. First operational in 2002. And then the first centre in the world outside of Europe to be accredited by the European Malignant Hyperthermia Group in 2006. And they have provided their service to more than 520 families not just in NSW but across multiple states. https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/5f6fef129497f96ef900b7e6/5f6fef58fb587d114600be6d/1601171308846/IMG_9641.jpg Malignant Hyperthermia https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/5f6fef129497f96ef900b7e6/5f6fef59485a946f489282ba/1601171310156/IMG_9642.jpg Malignant Hyperthermia https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/5f6fef129497f96ef900b7e6/5f6fef598d2cb23bb11a4d1b/1601171308515/IMG_9643.jpg Malignant Hyperthermia https://crikeystreety.com/read-the-wall daily 0.75 2020-10-28 https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f707a4e6994936d8fcc4fde/1601206961974/IMG_7917.jpg Read the Wall “Why did you put that in”? 18 gauge in the long saph. 2 yo burn Flabbergasted I looked at him Hands on hips “What will we do now when he comes for his cardiac surgery”? And for a moment, just a moment, I believed him. That was how I met Streety 20 years ago Larrikin Joker Someone who cared about the patients, the staff, everyone. He would make you laugh He would make everybody laugh Up there with the best Someone I wanted to be just like Took over as director and the place became fun again I miss his smile and his funny expressions I miss the honesty And the stories He was so understated and easy going There was no unnecessary pomp Or unreasonableness He cared. If you asked him for something... a day off. Chance to go and see your kids at school or whatever, he’d move things around and work something out. Not because he had to but because he genuinely cared about the staff. - Dr Donald Innes, Specialist Anaesthetist, The Children’s Hospital at Westmead and Canterbury Hospital, Sydney. https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f8e57395818874f718ac93c/1603163989452/IMG_7923.JPG Read the Wall https://crikeystreety.com/overseas daily 0.75 2020-09-27 https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f4a7a1d058032c88a328e/1601129106852/IMG_6453.jpg Overseas https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f4a4f641b936671e6b629/1601129055021/IMG_4774.JPG Overseas https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f4cf9080c5d3cdc87b318/1601129735286/IMG_6489.jpg Overseas https://static1.squarespace.com/static/5f6ea80b8cd6b20cc01b5674/t/5f6f4bc33a2a3d3970286259/1601129434728/IMG_8751.jpg Overseas