v1.108 is rolling out today 🚚 Now live, at long last: Bookmarks, aka Saved Posts. For all those posts you'll definitely plan to come back to! Update the app and give it a try. The button is right down there 👇

x.com/ACCESS_Londo... For those near London interested in #resus, #emimcc Maternal critical care transfers is the theme of this Clinical Development Day (in person only). Sorry it's a link to the other place....

Very pleased to share short report just published in #EMAJournal @emajournal.bsky.social Case Series of Resuscitative Hysterotomy in Pregnant Trauma Patients Performed in the Emergency Department of a Level One Major Trauma Service onlinelibrary.wiley.com/share/author...

minor updates to the antiemetic chapter 🤢 inhaled isopropyl alcohol pads are safe, fast, and underutilized 🤢 ondansetron is often a front-line drug due to favorable safety profile 🤢 olanzapine is a highly effective, broad-spectrum agent that is underutilized (emcrit.org/ibcc/antieme...) #EMIMCC

My take on sepsis, circulation management in septic shock, peripheral noradrenaline #EmergencyMedicine #EM #Sepsis #MedSky #EMedSky #MedEd #EMSky

Sad news: Another giant in Critical Care, Professor Rinaldo Bellomo, passed away this morning. He was born in Reggio Emilia, Italy & emigrated to Australia in the 1980s receiving his medical degree from Monash Medical School in Melbourne He completed fellowships in nephrology,

I work with the best team! Love this battle of the inotrope education: milrinone vs dobutamine. Blue 🔵 or 🔴?

I’m obviously a bit biased, but I believe there is greater danger in misclassification of non-septic shock (especially cardiogenic) as septic shock than from delayed recognition of septic shock. #emimcc #cccsky

🚨 New: Best Practice Guidelines with the National Poisons Information Service (NPIS) - Management of Patients with Suspected but Unidentified Poisoning in the Emergency Department. ⬇️ Download it 🔄 share it ▶️ practice it. 🔗 Link: rcem.ac.uk/clinical-...

Relationship between ⌚ spent in A&E & odds of 30-day, post-discharge, all-cause mortality: Compared with patients who spent 2h in A&E, the odds of post-discharge death were: 🕒 1.1 x ☝️ if spent 3h 🕕 1.6 x ☝️ if spent 6h 🕘 1.9 x ☝️ if spent 9h & 🕛 2.1 x ☝️ if spent 12h #EMedsky 🔗 shorturl.at/Tvw9e

The Barts/London prehospital experience has just been published www.resuscitationjournal.com/article/S030... Excellent work by my friends and colleagues.

1/ I love love LOVE scanning the heart 😍, but when it comes to bang for your buck for ultrasound novices, lung ultrasound is such a winner 🏆 It's time for another #POCUS basics #skeetorial 🧵 Let's talk about common pitfalls in #LungUltrasound and how to correct these ✔️ #emimcc

Beautifully articulated as always It's not just about rate of patients seen. *Emergency* Medicine needs time and space to train, reflect, innovate, discuss and enjoy the unique challenges it faces. These aspects are still work and service. They've been devalued but they're more important than ever

Since we’re entering the last month of 2024, here is a non-systematic review of #pulmcrit trials published this year that I found particularly noteworthy. Not comprehensive, so please include any that I may have missed! (🧵1/11) #emimcc #critcare #pulmsky #medsky

I built and lead a HIU programme and if your unit hasn’t got one, you need one - benefits the patient, benefits the unit, benefits the finances, and can be extremely interesting work

Interesting article. A lot of what we label as refractory VF isn’t refractory at all. It’s actually recurrent. Is there a way in which we could change defibrillation strategies or antiarrhythmic drug administration to better address this? academic.oup.com/eurheartj/ad...

Face mask ventilation vs high-flow nasal oxygenation Comparison of end-tidal oxygen concentration and the lowest SpO2 after tracheal intubation between parturients. #AnSky #MedSky https://buff.ly/4fMvK6u

Look forward to the East Anglian Air Ambulance RAID annual conference this Friday…the theme being ‘Innovations in Pre-Hospital Resuscitation’.

Skytorial: Five pearls on olanzapine 😁 Between agitation and nausea/vomiting, olanzapine has a wide range of use. Olanzapine is generally not a front-line agent (e.g., haloperidol or ondansetron often are). But sometimes, it really comes in clutch....

Nipped back to the other place briefly. 8 bot followers waiting for me, not much else since I came across. Not really missing it loads but will check in from time to time while the communities build here.

For those professionals interested in improving the standard of care provided to patients with learning disabilities: The Medical Practice in Adult Learning Disability postgraduate certificate (PGCert) www.edgehill.ac.uk/course/medic... www.rcp.ac.uk/events-and-e... #medsky #emimcc

Will happily take a work-provided smart phone with the same capabilities as my personal one which currently offsets a huge amount of inadequate IT... This is a systems issue that needs a solution. That solution needs to make it easy not to need to use a personal device (as well as appropriate IG)

They produced another very insightful report on inequalities and ED use a couple of years back www.redcross.org.uk/about-us/wha...

Critical fundamentals #emimcc #resussky

editorial from @bmj.com and paper: Poor staff retention is associated with higher patient mortality. Have said it before & I’ll say it again. If you don’t care for the carers, they cannot care for their patients. www.bmj.com/content/387/...

Want to improve your Basic Bag-Valve-Mask Ventilation skills? Here's a VERY short course I made that's free and will only take 5-10 minutes. tinyurl.com/BMVCourse

Why do people wear shoe covers in the operating room? 💥 The reason may surprise you! A 🧵 about the #HistoryOfMedicine and the dangers of blindly following traditions. onepagericu.com/blog/cx1l66q... 1/

"Your scientists were so preoccupied with whether or not they could, they didn't stop to think if they should"

Important skill for EM folks #emesky #resussky #emimcc For those in London (UK), the folks at Homerton do good #pocus teaching on this

Tell your friends! Prehospital Sky as a feed is up and running! If you see things relevant to EMS please tag them #EMSsky for them to be cataloged! Everyone is welcome, I hope this ends up high yield! bsky.app/profile/did:...

Have yall heard of “Wellen’s Syndrome”? It describes a characteristic ECG appearance (biphasic anterior ST segments)- associated with a critical LAD lesion. in cases of ongoing discomfort- it should be considered like an Anterior STEMI because it can progress to one should the LAD fully occlude

“Patients are suffering the consequences of a system that is in crisis, while staff continue to shoulder the burden of delivering effective and safe care in these conditions." RCEM's President responds to CQC's Urgent and Emergency Care survey. Read more here - tinyurl.com/3ypeesvh

“Learning CPR on manikins without breasts puts women’s lives at risk, study finds” Dr Rebecca Szabo et al @inquisitivegyn.bsky.social Research 🔗: academic.oup.com/heapro/artic... #ResusSky

It’s likely that experts gain less in terms of reduction of physical stress due to awkward body posture than novices as they have refined technique over time. Maybe though, training of DL & VL both need to emphasise body posture and physical ergonomics of intubation? #AnSky #MedSky #HFESky

New to Bluesky? Check out our #patientsafety starter pack go.bsky.app/Jhnn8Yb

The latest from @stemlyns.bsky.social - what dose of TXA in traumatic brain injury? #FOAMed #MedSky #EMedSky www.stemlynsblog.org/dose-txa-in-...

You're in luck! I just made the Prehospital Sky feed! bsky.app/profile/did:...

shortcomings of the STEMI NSTEMI paradigm, resulting patient harm, and why we need to add on the 'OMI paradigm' which i will post next #CardioSky #EmImCc #12lead #ekg #STEMI #pci #OMI heart.bmj.com/content/110/...

Pediatric #ECPR: where next?? EuroELSO webinar 🗓️ Nov 27, 17:00 CET 🎙 speakers: M Davidson, M O’Callaghan, A Desai, J Brandt 🎙 moderator: P Roeleveld 🎙 chairs: M Mendonca, U Pollak, T Thiruchelvam 🖋 www.euroelso.net/webinars/! 🎥 all previous webinars available at 🔓 bit.ly/EuroELSOyout... #PedsICU

Medicine focuses a lot on the question “will this help my patient” but not on the question “when will it help my patient.” The latter becomes important as we age. We’ve developed a “time-to-benefit” tool on eprognosis.ucsf.edu to help answer this question. Here is a snapshot #MedSky #FOAMed #meded

Also relates to: 🛑 ED crowding 🛑 Corridor care 🛑 Ambulance offload delays Among others... If it's enough of an issue to hammer front line staff, it's enough of an issue to need systemic solutions #emedsky #emimcc #resussky #EMSsky #paramedicinesky [😡 & monitor alarms which are not acted upon 🤯]

Physiologically challenging airway? Watch out for SHARK KILLERS 🦈 (H/T @cliffreid.bsky.social) #Resuscitology15 #FOAMed #MedSky #EMedSky

With multiple front doors into urgent and emergency care (UEC), why don't we measure performance at each? 🩼 & 🚑 = 👌🕓 / 💺 = 👎 #Medsky #EMedsky .../1

Hello all! On behalf of the editors, @maxhockstein.bsky.social and @zentensivist.bsky.social, we’d like to announce the launch of our living textbook for hemodynamics, shockwaves.icu! #emimcc

#ParamedicineSky - let’s regrow the community 💛 pls tag more to help us find each other 👇🏼 go.bsky.app/BZpAcQN

Still ordering daily labs? Let’s talk about phlebotomy and hospital-acquired anemia. Reports from 1970-2000s suggested that pts were losing 25-50 ml/day to phlebotomy; about a unit of blood each week. We must be better today, right? 1/x #anemia #medsky #ansky #emimcc

Critical care intubation hills I’m willing to die on (collating an occasional series from elsewhere). Each hill is based on experience and other people’s research (I claim no other expertise) #EMIMCC #PCCM #AnSky

Great great #patientsafety folk to follow here. go.bsky.app/Ly8qptZ

Very nice overview of the current state of affairs in cardiogenic shock (published this week in @TheLancet):

In those super sick patients on high doses of pressors, keep it in your back pocket! Nb: And no the transducer was not on the floor… @pulmcrit.bsky.social has a great blog post on the topic for anyone wanting to learn more 📖 emcrit.org/pulmcrit/a-l... 2/2