First time using outlook for android (by necessity). Pretty awful user experience. How do people workflow tasks that require looking at email and calendar at the same time?

"One intangible advantage of capillary refill time is that performing it brings the clinician back to the bedside to reassess the patient. This act may be itself the holy grail of early sepsis management." great piece on #sepsis

Outcome 6 🍾💪 IYKYK.

Masking up on public transport for the approaching winter. Get some funny looks. I just enjoy being less sick. Weird.

Fascinating how so much food has its protein content promoted front and center. Even bread. Even though most of these sources lack the necessary amino acids for utilisation. Nutritional awareness in the UK is silly.

Doing shit statistics.

www.theguardian.com/politics/202... what a collosal and irresponsible waste of tax payer money this would be. I could think of thousands of better uses for this money.

I think it's incredible that AI is going to kill us all, not because it's a super intelligence that has deemed us an existential threat, but because it's just so overwhelmingly stupid

Please tell me this loophole is real... #OnlineSafetyAct

Digital literacy should really be a minimum requirement to run a country

This is actually a pretty good idea. It's become very trendy in recent years to install a wood burning stove. Which is idiotic. Massively increases indoor air pollution and contributes to local particulate emissions (amongst other things). We should look at this as we do smoking.

Its come to my attention that pokemon cards are valuable again? I have the entire original run, including all holographics in an original presentation folder. Pretty much all in mint condition. Does anyone know how I can go about getting them valued?

I occasionally get asked why I chose medicine as a career. Easy answer. 50% following my brother whom I adore. 50% @robertpicardo.bsky.social who was the best doctor in starfleet. Naturally I didn't say this in my interview, but on reflection, I wish I had!

Of all the bad medical takes, this is one of the worst. Well played bad medical takes... Well played.

As I come to the end of my training, and my 27th and final rotation, I have reflected on this rotational aspect. It has made me extremely adaptable and provided a rich background of experience. But equally, it has broken me, prevented me from creating the social connections that are so... human.

My latest, exploring with numbers how the millennial household budget is basically incomprehensible to retired boomers.

Who was it that described “Shrodinger’s resident doctor”? Too important to strike, yet as an “apprentice” not important enough to pay properly …

Every. Single. Story. about women not using AI as much as men portray it as bad for their future career prospects (without a shred of evidence) and a result of women being fearful little ladies rather than looking at AI's output and saying "this sucks, it's not going to help me."

Please stop using chatGPT in clinical contexts. If you don't know the answer, check a reputable source or ask a colleague. ChatGPT is absolute medical garbage and not safe to use in this context.

Last week, Em Dash had some things to say. Now, it's En Dash's turn. What's your move, Elipsis?

Chasing lactate with fluid boluses in a patient with [other stuff than true, absolute, hypovolemia] is probably useless, deleterious...and dumb

I really truly dislike latex. The sooner I can completely remove it from all workflows the better.

Fascinating. Microsoft emailed me to say it was raising the price of Microsoft 365, but when i went to cancel it offered me me the old price — without all the AI bullshit. It’s forcing AI on everyone and making them pay more for it, then only telling them they don’t have to if they try to cancel.

I am no longer chairing defenses or joining committees where students use generative AI for their writing statmodeling.stat.columbia.edu/2025/07/18/i...

Child #1 asked me today if all anaesthetists had to carry a copy of John Snow's broadstreet pump map with them and honestly I'm just delighted.

Just wait till you see what climate change does to top quality farmland……FFS

Excellent discussion

2.7ml 0.5% hyperbaric bupivacaine 15mcg (0.3ml) fentanyl 100mcg (0.2ml) morphine Total: 3.2ml Patients mostly feel nothing. No added hypotension Not significantly higher block (sometimes slightly higher block to ice but no motor effects). Just longer, denser block.

Yeah it's not about being hot it's about not dying, it's the same reason you run the heat when it's cold. And it's more energy intensive to heat a house. Stop publishing takes by morons.

New drawing: Hire bike Notes on this cartoon: open.substack.com/pub/diagramc...

Medicine is about developing a rich network of knowledge, and understanding how to connect those pieces. Its a complexity that after 20 years of study i am only just beginning to get a handle on. Breaking it down into the pieces without understanding the connections is a such a profound misstep.

🗣️| @drmk.link: “There's unease at the direction of travel towards a fragmented, task-based model which implies ‘anyone can do it’. "Medicine can't be reduced to checklists and delegated tasks. It's a complex, deeply responsible profession that demands a medical degree and years of further training."

Maternal Sepsis Review and Update CCR Journal Watch - tracking the critical care literature daily https://criticalcarereviews.com/latest-evidence/journal-watch

This was a relatively small sum of money from households that could mostly afford it – £200 a year vs up to £10,000 a year from the welfare reforms as first proposed. And we wonder why politicians won’t dare ask the UK electorate to face up to any difficult decisions.

#soa25 from @ics-updates.bsky.social kicks off 3 days of intensive care education and networking. @shond.bsky.social gives tributes to Rinaldo Bellomo, Luciano Gattinoni, and Tom Barker. They will be missed.

I use dilute NA on a (good) periferal i.v. *all the time! Very very few problems. *unless CVL is in.

We have written to the Presidents of the Medical Royal Colleges to draw their attention to the staggering revelations over GMC decision-making that came to light in our judicial review.

I'm in the midst of moving my entire workflow to typst. Would thoroughly recommend. It's honestly so much better than latex I don't even think the two are comparable.

"digital asbestos" is fantastic framing.

We're really pleased to announce that @chartertrust.bsky.social ‪has become the first Educational Trust to sign up all nine of their schools to our #CleanAir schools accreditation scheme. We celebrated at Lyndhurst Primary with bubbles, bugles and emission-free ice cream! 😍

"Let's use AI in key decision making areas in medicine" meanwhile I still have to reboot a computer to even login a minimum of once a day. @shaunlintern.bsky.social IYKYK 😂

What is common knowledge in your field but shocks outsiders? Intensive care doesn’t always “give people a chance”. Sometimes it is actively harmful and results in suffering.

Counterpoint: Women are ahead of the curve on knowing AI is bullshit. www.ft.com/content/7f0f...

If this isn't real, i will be so upset. youtu.be/eoAUHM7O6V8?...

I remember looking up lactate as infusion in F1 - no apparent detriment to cardiac function, which was my first intro to idea not the lactate itself causing problems in cardiogenic shock!! Lactate has loads of immunomodulatory roles / oxidative stress roles

Catching up on the #CCR25 livestream as couldn't make it in person this year in the end. Fantastic presentation from Dan Martin for UK-ROX. Lots to consider, but a marked reduction in cumulative O2 exposure, so I think they got the separation they were aiming for.