Absolutely. For as long as it takes I love Day 1 of service. It is the day to scrape the MAR, scrape the note and make things tidy.

The success rate of “idk try an inotrope” has to be sub 5%* *even for intermediate physiologic outcomes

🛠️ ICU clinicians ❤️ monitoring tools… but ever worry you’re interpreting them wrong? Just out in #journal_CHESTCritCare, M Siuba et al present a HIDI on interpreting invasive hemodynamics in clinical context: www.chestcc.org/article/S294... ➕ learn about esoph manometry! @accpchest.bsky.social

Our review on esophageal manometry for invasive hemodynamic monitoring is live at @accpchest.bsky.social Critical Care

new systematic review & meta-analysis on peripheral pressors: "the incidence of adverse events after short-term vasopressor administration through PIV catheters was low… with appropriate monitoring, PIV administration might reduce the need for CVC placement." in @jamanetworkopen.com

commentary by @zentensivist.bsky.social in @jamanetworkopen.com on the safety of peripheral pressors: "PIV administration of vasopressors likely can be accomplished safely, with perhaps less discomfort and harm, compared with conventional CVC-based approaches in some critically ill patients."

Cartoon by Tommy Siegel

Hey @zentensivist.bsky.social , that was a great discussion of the RV you had on Critical Care Time. Thanks!

Thrilled to join @nickmark.bsky.social and @askinforair.bsky.social to talk about managing the RV in the ICU YT link here youtu.be/Supq1q7J28w?... Also on your fav podcast platforms

Thrilled to join @nickmark.bsky.social and @askinforair.bsky.social to talk about managing the RV in the ICU YT link here youtu.be/Supq1q7J28w?... Also on your fav podcast platforms

"Jesse Jackson Made It Possible for Democrats to Speak About Palestine" Activist James Zogby pays tribute to his late friend, who was the first politician to welcome Arab Americans into the Democratic Party - and even met with Yasser Arafat when others wouldn't.

We looked at thermo vs Direct Fick during exercise and the results might surprise you! Still discordant for absolute values but possibly good enough to classify patients with eg exercise PH or exercise HFpEF based on slope calculations

Thanks to @zentensivist.bsky.social for the HT This is utterly, utterly, brilliant www.leezhaomd.org/post/the-wic...

We need health care for all, not militarized immigration enforcement that destabilizes communities across the country.

You have to read this. Firsthand affidavit from one of the women who was there and recording the video. She talks about how Alex Pretti was directing traffic when she arrived. She watched him be killed in front of her. She's afraid to go home, worried she'll be arrested.

ive seen more articles this week about how the phrase “abolish ice” could hurt dems in the midterms than ive seen articles about how paramilitary death squads terrorizing cities will hurt republicans in the midterms

Nice work by a stellar team of trainees journals.lww.com/ccmjournal/f...

I was just denied access to the ICE processing center at the Whipple Building. Members of Congress have a legal right and constitutional responsibility to conduct oversight where people are being detained. The public deserves to know what is taking place in ICE facilities.

The goal here is martial law. It’s martial law. Let’s be clear about that.

friendly reminder that urine drug screens are bad tests, they miss a lot of things and a lot of common/benign medications can trigger false positives it's basically an EM boards question to NOT make clinical decisions based on UDS

Asking for a visual abstract on first submission of a manuscript is an act of violence

Great summary of driving pressure and overview of DESIGNATION. Maybe check out some of my old physiology musings too 🤪 www.pulmccm.org/p/can-drivin... @zentensivist.bsky.social @drfreeze.bsky.social @www.pulmccm.org @pulmcrit.bsky.social @maxhockstein.bsky.social

NEW: Ohio has just restricted mail voting, banning the so-called 'grace period' that allows mail ballots to come in the day after Election Day as long as they've been postmarked in time. This is likely to lead to thousands of Dem-leaning ballots to be rejected. Ohio is following Trump's demands.

NEW: In this short piece (open access!) I describe how ecomodernist visions and "green growth" scenarios rely on fundamentally imperialist assumptions, and have no answer to this problem. brill.com/view/journal...

The US aggression against Venezuela is naked imperialism. All pretext has been exposed as farce. An invasion would cause tens of thousands of deaths. Every sane person must oppose this madness.

In case people need a refresher: The Trump administration is fighting contempt proceedings y in federal court over what happened “inside CECOT” to human beings unlawfully renditioned there. Bari Weiss’s CBS News is now part of the coverup.

suspect a big reason why many academics and others who work in areas where getting facts RIGHT is key are disinterested in using LLMs for research: they’ve tried it, they keep noticing major errors in output, and they conclude that having to verify all that doesn’t actually save them time.

Yeah I have a question can I have 20% of my screen back so I can RTFA

Traditionally a ketamine first guy, but I let my trainees choose their med most of the time and don’t see apparent hemodynamic differences I do push the MAP to ~75 with pressors regardless of agent And I do give fent with etomidate Overall agree with @pulmcrit.bsky.social’s take

Man, this is just the most fucked up blatantly racist shit, for the last forty years any national politician would have been afraid to say anything even remotely like this

Typeset version of our scoping review on RV reserve is now live in the latest issue of @jcfint.bsky.social www.onlinejcfi.org/article/S305...

One of my strong pet peeves: never start vasopressin based on a fixed cutoff for noradrenaline and never without an echo. I strongly oppose the algorithm proposed here #emimcc #cccsky

Two papers on high cardiac output states in the special hemodynamics issue of the Journal of Cardiac Failure thanks to hard work by stellar fellows and residents

When they tell me I have a bad bedside manner

your daily reminder: ☕️ coffee is great ☕️ caffeine-free diets for hospitalized patients are silly & cause misery due to caffeine withdrawal #EMIMCC

To recap, among young voters… Prop 50: +58 Sherril: +37 Spanberger: +40 Mamdani: +61 I better see the media start retracting some of those stories saying Gen Z is the most conservative generation.

Mamdani: "We can respond to oligarchy and authoritarianism with the strength it fears, not the appeasement it craves. After all, if anyone can show a nation betrayed by Donald Trump how to defeat him, it is the city that gave rise to him."

Nearly all of the #Gaza Strip’s residents have been displaced. Following the start of the ceasefire, many families tried to return to their homes, most to find only rubble. According to the United Nations Satellite Centre, around 81% of all structures in Gaza are damaged.

After 13 years, Mississippi Democrats have broken the Republican Party’s supermajority in the Mississippi Senate. Democrats flipped two GOP-held Senate seats and one House seat in the special elections. buff.ly/nTvLlFI

“The youngest New York mayor in more than a century. The city’s first Muslim mayor, first South Asian mayor, first mayor born in Africa.” In First Draft from Zeteo, ⁦‪Peter Rothpletz ‬⁩on a historic night for Mamdani, for Dems, for NYC, for America:

“Dick Cheney Has Died. The War Criminal in His Own Words” 10 quotes worth remembering, and that’ll be glossed over in MSM obits, from a former vice president who pushed for a murderous invasion of Iraq, lied about the WMD threat, and defended torture.

He should have died in The Hague.

If you have to remember one thing today, this is it: #foamed #foamcc #meded #Medsky #emimcc

Please use my tax dollars to help feed literally everyone. Age? I don’t care. Citizenship status? Don’t care. Race/gender/religion? Don’t care. Do they have a job? Statistically yeah but don’t care. Do they have nice nails? DON’T CARE.

“Trump’s administration arrested Sami Hamdi following a social media campaign from far-right, Islamophobic figures.” New reporting from Zeteo on the latest example of this administration cracking down on speech on behalf of Israel. Against a British Muslim journalist on a valid visa:

No one knows what is or isn't possible politically. Anyone who says they do is lying.

Shame on NEJM for keeping this under a paywall.

💯 The study doesn’t mean that all A-lines are worthless. It does mean that you can excercise your judgement and if you drag your feet a little to see how patients respond to initial resuscitation thats OK.

New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications They avoided A-lines despite patients requiring pretty substantial doses of vasopressors Very #zentensivist Don't need to rush to an A-line www.nejm.org/doi/full/10.... #EMIMCC

MASSIVE RCT from Kenya showing that steroids reduce mortality in CAP Mortality benefit easier to demonstrate w/ less resources available to salvage pts Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered) www.nejm.org/doi/pdf/10.1... #EMIMCC