SlideShare a Scribd company logo
1 of 52
Download to read offline
Mile High Anaesthesia 
Geoff Healy
DISCLAIMER / DISCLOSURE 
2
3 
1% 
11% 
13% 
35% 
40% 
XXX 
Funny pictures/videos of Cats 
People taking pictures of their food 
Gangnam Style Videos 
FOAMeD 
Healy, G (unpublished) 2013
“Don’t believe 
everything you 
read on the 
internet” 
-ABRAHAM LINCOLN
5
5
ANAESTHESIA 
6
“Gentleman, 
this is no 
humbug” 
7 
- Dr John Collins Warren 
(October 17, 1846)
8
9
10
RSI 
11
ANAESTHESIA 
12
13
13
14
16
17
You gotta listen to 
your 
gut feeling
20
21
22
23
24
25
26
Delays getting the patient to 
hospital care 
27
Delays getting the patient to 
hospital care 
27
Airway audits 
• KPI is 15mins 
28
29
29
30
31
31
32
33
34
Safety of Prehospital RSI 
35
36
37
PTSD 
• Anaesthetic 
awareness vs 
major trauma 
38
39 
Rehab 
begins 
at the 
roadside
40
41
42
43 
Thank you 
@drgeoffhealy
43 
Thank you 
@drgeoffhealy
44
45
46

More Related Content

Viewers also liked

How to Think Straight- Cognitive Debiasing Pat Croskerry
How to Think Straight- Cognitive Debiasing Pat CroskerryHow to Think Straight- Cognitive Debiasing Pat Croskerry
How to Think Straight- Cognitive Debiasing Pat CroskerrySMACC Conference
 
Anaesthesia outside operating room
Anaesthesia outside operating roomAnaesthesia outside operating room
Anaesthesia outside operating roomnarasimha reddy
 
Critical Care in Humanitarian Emergencies: Nikki Blackwell
Critical Care in Humanitarian Emergencies: Nikki BlackwellCritical Care in Humanitarian Emergencies: Nikki Blackwell
Critical Care in Humanitarian Emergencies: Nikki BlackwellSMACC Conference
 
Anesthesia outside the operating room
Anesthesia outside the operating roomAnesthesia outside the operating room
Anesthesia outside the operating roomSumit Prajapati
 
Surviving in the Wild - Justin Hensley
Surviving in the Wild - Justin HensleySurviving in the Wild - Justin Hensley
Surviving in the Wild - Justin HensleySMACC Conference
 
Forgotten Cardiovascular Physiology by Myburgh
Forgotten Cardiovascular Physiology by MyburghForgotten Cardiovascular Physiology by Myburgh
Forgotten Cardiovascular Physiology by MyburghSMACC Conference
 
The Wrong Stuff: Prehospital Dogma - Cliff Reid
The Wrong Stuff: Prehospital Dogma - Cliff Reid The Wrong Stuff: Prehospital Dogma - Cliff Reid
The Wrong Stuff: Prehospital Dogma - Cliff Reid SMACC Conference
 
The Right Stuff: Training in PHARM - Bill Hinckley
The Right Stuff: Training in PHARM - Bill HinckleyThe Right Stuff: Training in PHARM - Bill Hinckley
The Right Stuff: Training in PHARM - Bill HinckleySMACC Conference
 
Rich Levitan - Extreme Airways
Rich Levitan - Extreme AirwaysRich Levitan - Extreme Airways
Rich Levitan - Extreme AirwaysSMACC Conference
 
Post-Intubation Sedation: Scott Weingart
Post-Intubation Sedation: Scott WeingartPost-Intubation Sedation: Scott Weingart
Post-Intubation Sedation: Scott WeingartSMACC Conference
 

Viewers also liked (12)

How to Think Straight- Cognitive Debiasing Pat Croskerry
How to Think Straight- Cognitive Debiasing Pat CroskerryHow to Think Straight- Cognitive Debiasing Pat Croskerry
How to Think Straight- Cognitive Debiasing Pat Croskerry
 
Anaesthesia Outside O.R.
Anaesthesia Outside O.R.Anaesthesia Outside O.R.
Anaesthesia Outside O.R.
 
Anaesthesia outside operating room
Anaesthesia outside operating roomAnaesthesia outside operating room
Anaesthesia outside operating room
 
Critical Care in Humanitarian Emergencies: Nikki Blackwell
Critical Care in Humanitarian Emergencies: Nikki BlackwellCritical Care in Humanitarian Emergencies: Nikki Blackwell
Critical Care in Humanitarian Emergencies: Nikki Blackwell
 
Anesthesia outside the operating room
Anesthesia outside the operating roomAnesthesia outside the operating room
Anesthesia outside the operating room
 
Surviving in the Wild - Justin Hensley
Surviving in the Wild - Justin HensleySurviving in the Wild - Justin Hensley
Surviving in the Wild - Justin Hensley
 
Forgotten Cardiovascular Physiology by Myburgh
Forgotten Cardiovascular Physiology by MyburghForgotten Cardiovascular Physiology by Myburgh
Forgotten Cardiovascular Physiology by Myburgh
 
The Wrong Stuff: Prehospital Dogma - Cliff Reid
The Wrong Stuff: Prehospital Dogma - Cliff Reid The Wrong Stuff: Prehospital Dogma - Cliff Reid
The Wrong Stuff: Prehospital Dogma - Cliff Reid
 
The Right Stuff: Training in PHARM - Bill Hinckley
The Right Stuff: Training in PHARM - Bill HinckleyThe Right Stuff: Training in PHARM - Bill Hinckley
The Right Stuff: Training in PHARM - Bill Hinckley
 
Rich Levitan - Extreme Airways
Rich Levitan - Extreme AirwaysRich Levitan - Extreme Airways
Rich Levitan - Extreme Airways
 
NON OPERATING ROOM ANAESTHESIA
NON OPERATING ROOM ANAESTHESIANON OPERATING ROOM ANAESTHESIA
NON OPERATING ROOM ANAESTHESIA
 
Post-Intubation Sedation: Scott Weingart
Post-Intubation Sedation: Scott WeingartPost-Intubation Sedation: Scott Weingart
Post-Intubation Sedation: Scott Weingart
 

More from SMACC Conference

Precision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain InjuryPrecision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain InjurySMACC Conference
 
CSD by Jeffcote Coda 22.pdf
CSD by Jeffcote Coda 22.pdfCSD by Jeffcote Coda 22.pdf
CSD by Jeffcote Coda 22.pdfSMACC Conference
 
Subdural Haemorrhage and MMA embolisation
Subdural Haemorrhage and MMA embolisationSubdural Haemorrhage and MMA embolisation
Subdural Haemorrhage and MMA embolisationSMACC Conference
 
Andy Neill - More neuroanatomy pearls for neurocritical care
Andy Neill - More neuroanatomy pearls for neurocritical careAndy Neill - More neuroanatomy pearls for neurocritical care
Andy Neill - More neuroanatomy pearls for neurocritical careSMACC Conference
 
The BONANZA Trial and PbTO2 Monitoring
The BONANZA Trial and PbTO2 MonitoringThe BONANZA Trial and PbTO2 Monitoring
The BONANZA Trial and PbTO2 MonitoringSMACC Conference
 
Dilating the Dogma of Vasospasm
Dilating the Dogma of VasospasmDilating the Dogma of Vasospasm
Dilating the Dogma of VasospasmSMACC Conference
 
There is no such thing as mild, moderate and severe TBI - by Andrew Udy
There is no such thing as mild, moderate and severe TBI - by Andrew UdyThere is no such thing as mild, moderate and severe TBI - by Andrew Udy
There is no such thing as mild, moderate and severe TBI - by Andrew UdySMACC Conference
 
TBI Debate - Mild, moderate and severe categories work
TBI Debate - Mild, moderate and severe categories workTBI Debate - Mild, moderate and severe categories work
TBI Debate - Mild, moderate and severe categories workSMACC Conference
 
TBI: when to stop and when to give time
TBI: when to stop and when to give timeTBI: when to stop and when to give time
TBI: when to stop and when to give timeSMACC Conference
 
Ketamine in Brain Injury by Toby Jeffcote
Ketamine in Brain Injury by Toby JeffcoteKetamine in Brain Injury by Toby Jeffcote
Ketamine in Brain Injury by Toby JeffcoteSMACC Conference
 
Managing Complications of Chronic SCI by Bonne Lee
Managing Complications of Chronic SCI by Bonne LeeManaging Complications of Chronic SCI by Bonne Lee
Managing Complications of Chronic SCI by Bonne LeeSMACC Conference
 
EEG and Status Eplilepticus by Tania Farrar
EEG and Status Eplilepticus by Tania FarrarEEG and Status Eplilepticus by Tania Farrar
EEG and Status Eplilepticus by Tania FarrarSMACC Conference
 
Browne Neuro symposium.pptx
Browne Neuro symposium.pptxBrowne Neuro symposium.pptx
Browne Neuro symposium.pptxSMACC Conference
 
Paediatric Stroke by Shree Basu
Paediatric Stroke by Shree BasuPaediatric Stroke by Shree Basu
Paediatric Stroke by Shree BasuSMACC Conference
 
Hypertensing Spinal Cord Injury - gold standard or wacky?
Hypertensing Spinal Cord Injury - gold standard or wacky?Hypertensing Spinal Cord Injury - gold standard or wacky?
Hypertensing Spinal Cord Injury - gold standard or wacky?SMACC Conference
 
Optimal Cerebral Perfusion Pressure
Optimal Cerebral Perfusion PressureOptimal Cerebral Perfusion Pressure
Optimal Cerebral Perfusion PressureSMACC Conference
 
The Power of Words - Death and Language.ppt
The Power of Words - Death and Language.pptThe Power of Words - Death and Language.ppt
The Power of Words - Death and Language.pptSMACC Conference
 
Sepsis and Antimicrobial Stewardship - Two Sides of the Same Coin
Sepsis and Antimicrobial Stewardship - Two Sides of the Same CoinSepsis and Antimicrobial Stewardship - Two Sides of the Same Coin
Sepsis and Antimicrobial Stewardship - Two Sides of the Same CoinSMACC Conference
 
Brain injury outcomes and predictors
Brain injury outcomes and predictorsBrain injury outcomes and predictors
Brain injury outcomes and predictorsSMACC Conference
 

More from SMACC Conference (20)

Precision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain InjuryPrecision Medicine in Acute Brain Injury
Precision Medicine in Acute Brain Injury
 
CSD by Jeffcote Coda 22.pdf
CSD by Jeffcote Coda 22.pdfCSD by Jeffcote Coda 22.pdf
CSD by Jeffcote Coda 22.pdf
 
Subdural Haemorrhage and MMA embolisation
Subdural Haemorrhage and MMA embolisationSubdural Haemorrhage and MMA embolisation
Subdural Haemorrhage and MMA embolisation
 
Andy Neill - More neuroanatomy pearls for neurocritical care
Andy Neill - More neuroanatomy pearls for neurocritical careAndy Neill - More neuroanatomy pearls for neurocritical care
Andy Neill - More neuroanatomy pearls for neurocritical care
 
The BONANZA Trial and PbTO2 Monitoring
The BONANZA Trial and PbTO2 MonitoringThe BONANZA Trial and PbTO2 Monitoring
The BONANZA Trial and PbTO2 Monitoring
 
Dilating the Dogma of Vasospasm
Dilating the Dogma of VasospasmDilating the Dogma of Vasospasm
Dilating the Dogma of Vasospasm
 
EVD Tips and Tricks
EVD Tips and TricksEVD Tips and Tricks
EVD Tips and Tricks
 
There is no such thing as mild, moderate and severe TBI - by Andrew Udy
There is no such thing as mild, moderate and severe TBI - by Andrew UdyThere is no such thing as mild, moderate and severe TBI - by Andrew Udy
There is no such thing as mild, moderate and severe TBI - by Andrew Udy
 
TBI Debate - Mild, moderate and severe categories work
TBI Debate - Mild, moderate and severe categories workTBI Debate - Mild, moderate and severe categories work
TBI Debate - Mild, moderate and severe categories work
 
TBI: when to stop and when to give time
TBI: when to stop and when to give timeTBI: when to stop and when to give time
TBI: when to stop and when to give time
 
Ketamine in Brain Injury by Toby Jeffcote
Ketamine in Brain Injury by Toby JeffcoteKetamine in Brain Injury by Toby Jeffcote
Ketamine in Brain Injury by Toby Jeffcote
 
Managing Complications of Chronic SCI by Bonne Lee
Managing Complications of Chronic SCI by Bonne LeeManaging Complications of Chronic SCI by Bonne Lee
Managing Complications of Chronic SCI by Bonne Lee
 
EEG and Status Eplilepticus by Tania Farrar
EEG and Status Eplilepticus by Tania FarrarEEG and Status Eplilepticus by Tania Farrar
EEG and Status Eplilepticus by Tania Farrar
 
Browne Neuro symposium.pptx
Browne Neuro symposium.pptxBrowne Neuro symposium.pptx
Browne Neuro symposium.pptx
 
Paediatric Stroke by Shree Basu
Paediatric Stroke by Shree BasuPaediatric Stroke by Shree Basu
Paediatric Stroke by Shree Basu
 
Hypertensing Spinal Cord Injury - gold standard or wacky?
Hypertensing Spinal Cord Injury - gold standard or wacky?Hypertensing Spinal Cord Injury - gold standard or wacky?
Hypertensing Spinal Cord Injury - gold standard or wacky?
 
Optimal Cerebral Perfusion Pressure
Optimal Cerebral Perfusion PressureOptimal Cerebral Perfusion Pressure
Optimal Cerebral Perfusion Pressure
 
The Power of Words - Death and Language.ppt
The Power of Words - Death and Language.pptThe Power of Words - Death and Language.ppt
The Power of Words - Death and Language.ppt
 
Sepsis and Antimicrobial Stewardship - Two Sides of the Same Coin
Sepsis and Antimicrobial Stewardship - Two Sides of the Same CoinSepsis and Antimicrobial Stewardship - Two Sides of the Same Coin
Sepsis and Antimicrobial Stewardship - Two Sides of the Same Coin
 
Brain injury outcomes and predictors
Brain injury outcomes and predictorsBrain injury outcomes and predictors
Brain injury outcomes and predictors
 

Recently uploaded

Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptxDr.Nusrat Tariq
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️saminamagar
 
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Servicesonalikaur4
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliRewAs ALI
 
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original PhotosBook Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalorenarwatsonia7
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000aliya bhat
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Miss joya
 
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort ServiceCall Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Serviceparulsinha
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiNehru place Escorts
 
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfHemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfMedicoseAcademics
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknownarwatsonia7
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Modelssonalikaur4
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbaisonalikaur4
 
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceCollege Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceNehru place Escorts
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowRiya Pathan
 

Recently uploaded (20)

Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptx
 
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in green park  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in green park DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
 
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Servicesauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
 
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas Ali
 
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original PhotosBook Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804  Short 1500  💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
 
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hebbal Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort ServiceCall Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
 
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfHemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
 
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceCollege Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 

Mile High Anaesthesia by Healy