Tickets for #lactic25 are selling fast! Check out the programme below. Including the legendary @dogicuma.bsky.social Register here👉 clockworkmedical.com/meeting/lact... #ICU #critcare #AIM #EM #emergencymedicine #CPD #FOAMed #medicalconference #leeds #LTHT #leedshospitals #yorkshire

What do people think about some sort of "POCUS on call" service? I'm thinking a practitioner with advanced multimodality skills who could respond to requests for POCUS from multiple hospital departments. Anyone know of anything like this that exists?

Here’s one for #Scanuary: wondered how beekeeping and #POCUS relate? Chap11 in #Scars&Stains explores pearls and pitfalls of POCUS in a seemingly dissimilar parallel. amzn.eu/d/aVEQTTW @manoj-w.bsky.social @casualtysrus.bsky.social

Today's Paper of the Day is organ crosstalk and dysfunction in sepsis criticalcarereviews.com/latest-evide... Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025

It’s a pleasure to be part of the upcoming Critical Care Symposium in Manchester on the 24-25 April Featuring an absolute smorgasbord of excellent critical care content I’ll be co-chairing the ECMO session and teaching POCUS Would love to see some of you there! www.critcaresymposium.co.uk

As Promised Season 3 - Episode 1 of #BILIH #BlockItLikeItsHot @bilih.bsky.social is out now! Featuring one of our favourite blocks, the #Paravertebral! Join @jeffgadsden.bsky.social and I on this fun episode #RAsky #AnSky #PainSky Spotify link: open.spotify.com/episode/0aUX...

The Association of Anaesthetists have published new guidelines on blood components & their alternatives! Tranexamic acid has been proven to ⬇️ bleeding in most surgical settings. But what dose of TXA should you use in different clinical contexts? #AnSky #MedSky #HaemSky https://buff.ly/4hbI4O6

And - if you get bored on your next commute, do check out our @bilih.bsky.social @jeffgadsden.bsky.social on Knee blocks here #WSM2025 @assocanaes.bsky.social open.spotify.com/episode/6LKW...

Was great to see and catch up with you at #WSM2025 too @sthjournalclub.bsky.social ! That video is fantastic from @jeffgadsden.bsky.social ! I also have one here youtu.be/bAxMvcTf0kU?...

The second trial result for #CCR25 in Titanic Belfast in June is GASTROSAM Gastroenteritis Rehydration of African Children with Severe Acute Malnutrition Join us in June for the best critical care trials in the world Register at criticalcarereviews.com/meetings/ccr25

#hr2025 will be an absolutely excellent event. I’m looking forward to joining in and talking about ventilation, ECMO, and POCUS. It would be great to see as many of you there as possible. Register here: ccusinstitute.wixsite.com/ccus/events/hr… @katiewiskar.bsky.social @thinkingcc.bsky.social

I mean, I'm pleased that clinicians "beat" #AI - but this kind of study totally misses the point of medical exams. We examine doctors by written exam as only one of many assessment types, on the (usually valid) assumption that it predicts real-world performance. 1/ bmjopen.bmj.com/content/14/1...

Sepsis-induced cardiogenic shock: controversies and evidence gaps in diagnosis and management CCR Journal Watch criticalcarereviews.com/latest-evide... CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...

It's Jan 1st, so we reset the Paper of the Day record Every day we'll review one topic & cover the entire spectrum of critical care across 2025 The papers are open access & available on the website or via email Interested? Join in! criticalcarereviews.com/latest-evide...

Echocardiography in the Ventilated Patient: What the Clinician Has to Know CCR Journal Watch criticalcarereviews.com/latest-evide... Get the latest critical care literature every weekend via CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...

🔥 FDA just *rejected* full approval for Adnexxa 🔥 likely due to increased thrombosis risk in ANEXA-I trial IMHO the best strategy is to keep this off your hospital's formulary (thereby avoiding endless circular debates about Adnexxa vs PCC) firstwordpharma.com/story/5921956 #EMIMCC

It’s becoming an increasingly relevant topic that were debating regularly in the CICU. Should we stop SGLT2i in critically ill decompensated heart failure? When should we start? #cccsky #emimcc #cardiosky

🦠We call a lot of things “sepsis” 🔎Our #AnnalsofIM study examined how broad this grab bag really is ⚠️Among ~75,000 patients with sepsis, we found remarkably wide spectrum of presentations & outcomes across infection source & organ dysfunction patterns Thread ⬇️ #medsky #emimcc #idsky #pharmsky

🔥🔥 Join us on @criticalcaretime.bsky.social to hear Drs. Paul Wischmeyer and Alin Gragossian share their experiences #BeneathTheDrape on this week’s episode. Links 👇 🌎 tinyurl.com/3d7p4e9f 🍎 tinyurl.com/3737eusu 🟢 tinyurl.com/mry33267 🎥 tinyurl.com/2nchzw5c

Management of pain and sedation in the intensive care unit CCR Journal Watch https://criticalcarereviews.com/latest-evidence/journal-watch Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://criticalcarereviews.com/newsletters/subscribe

We present another publication-quality chapter from ShockWaves, the 1st chapter in the RHC section. Sergio Caravita presents a masterclass on the invasive PA waveform. Section editors: Sophia Airhart and Zach I'lGiovine shockwaves.icu/app/page/1O3...

Fresh blog: the ADAPT and SCREEN trials are full of sound & fury, signifying little 🤷‍♂️ Sepsis screens & procal-based ABX duration are highly context-dependent interventions. Effects will vary depending on baseline usual care. 🤷‍♂️ They lack generalizability. emcrit.org/pulmcrit/ada... #EMIMCC

Interesting. The best study I can see looking at this is www.obstetanesthesia.com/article/S095... Increased dose dependant risk of Fetal bradycardia with intrathecal opioids. Postulates theories beyond maternal hypotension for Fetal bradycardia.

Are combined spinal-epidurals better than labour epidurals? Are anaesthetists who do not universally adopt CSEs disadvantaging patients? Universal use of CSE would likely: ⬆️ burden of PDPH morbidity ⬆️ risk of fetal bradycardia & maternal pruritus #ObGynSky #AnSky https://buff.ly/41rbYJs

I used to put all my arterial lines in like this, until I saw the “Out-of-Plane Dynamic needle tip tracing”-light (You can tell how old this is by the machine!) Don’t @me about landmark being easier! What is your preferred technique? #AnSky #MedSky #POCUSky

When I teach Axillary Brachial plexus blocks I often talk about the relatively common variation where the musculocutaneous nerve has “Late take off”. Here is a post-block example where you see median, ulnar, radial, MCN & MABCN #RAsky #AnSky #POCUSky

skytorial: my zentensivist urosepsis secrets this is a super common ICU admission & usually pretty gratifying because patients turn around fast. there are really just four main things you need to do... 🧵

#CardioSky #MedSky @bmj.com @mmamas1973.bsky.social heart.bmj.com/content/earl...

My approach when the team wants one of these

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

Interested in advancing and building on your echo skills. Come join us at LACE! Focus on hands on scanning and case based learning. #echofirst #POCUS

Places left for Leeds Advanced Critical Care Echo Course 8th -10th July 2025 Three days of excellent echo teaching Endorsed by ESICM & ICS #FUSICHD #EDEC #ACCE #fTOE #critcareecho @manoj-w.bsky.social @drfreeze.bsky.social @smallzalex.bsky.social @medicluke.bsky.social @lukeflower.bsky.social

If the LV of the patient with sepsis is «hyperdynamic» when on noradrenaline, then EF dropps and the LV looks poorly when vasopressin is added, but recovers to normal with dobutamine, you likely haven’t «uncovered hidden LV dysfunction» or septic cardiomyopathy. #emimcc #pocus #echofirst 1/

These are some really cool loops! 😍

There's not enough #POCUSky so let's get the ball rolling. What is the similarity between the following two thoracic ultrasounds? Clip 1: #emimcc #medsky

Great analogy

People often talk about the time critical nature of sepsis. But it may surprise you to hear that the evidence to support “early” antibiotics actually isn't a settled debate. Why is that? The key question is “early in relation to what”? 🧵 1/n

The best reason not to check phosphate levels in ICU pts, is to avoid endlessly being told about phosphate levels For a whole load of other good reasons check out @criticalcarereviews.com linked review (below) TL;DR - no good evidence it helps anything other than waste time/money #EMIMCC