🧠 New on Currents: Quantitative pupillometry may help predict neurologic deterioration in large MCA stroke. Explore the latest insights: https://bit.ly/3PSBUd6

@stevemagness.bsky.social writes about performance through the lens of sport, but these lessons are highly relevant to clinicians (and medical educators). Worth a follow!

Applications for our APP CCM fellowship open next week! One year, starting in September. Core ICU rotations include MICU, CICU, CVICU, SICU, STICU, NSICU. #emimcc www.camcmedicine.edu/departments/...

Determination of Adult Critical Care Physician Core Knowledge and Skills: Results of a Multidisciplinary, Modified Delphi Process journals.lww.com/ccmjournal/f...

This is now a political account because I can’t treat your heavy menstrual bleeding and iron deficiency appropriately if ICE disappears or executes you.

As a rule, I do not post about politics, but we must abolish ICE, boycott anyone supporting them, and vote for political candidates who mean business about standing up to this madness.

Winner- most creative named sign www.neurology.org/doi/10.1212/...

ICU documentation pet peeve: is there any cirrhosis that is not "liver cirrhosis"? This must be the "ATM machine" equivalent of medicine. #Medsky

Catch up on the latest NCS podcast episodes wherever you listen to podcasts to hear the latest scientific findings, perspectives from experts in the field and conversations on hot topics in ncc: https://bit.ly/4gU1tCr

Important text to read re: #braindeath www.neurology.org/do...#braindeath

updated the acute liver failure chapter biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure) now rec'd for clinically overt encephalopathy (Grade 2-4) if admitting to ICU for ALF & encephalopathy, just dialyze emcrit.org/ibcc/alf/ #EMIMCC

First "clamp rounds" in NCC with my senior fellow was a huge success! But what is the NCC equivalent? Don't typically hook the EVD up to suction ☠️ Clamp, 20/open, 10/open? Not quite as slick. Either way, thanks for the idea/analogy @gbosslet.bsky.social!

Excited to share our newest work on free VPA: improving ability to predict levels with the Fraser equation. We reveal that the orig eq. is modestly accurate in an external cohort and make improvements to the eq, but confirm measurement remains ideal @cbthepharmd.bsky.social doi.org/10.1002/phar...

📊 Research Summary: Personalized resuscitation targeting capillary refill time modestly improved organ support–free days and composite outcomes in early septic shock, but showed no difference in mortality vs usual care. #LIVES2025 @esicm.bsky.social ja.ma/4huvHOa

Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀 Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc) If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC

Today, on World Trauma Day, empower your team and colleagues to improve patient outcomes during the critical first hours of a patient's neurological emergency. Designed for multidisciplinary practitioners, ENLS provides a consistent set of protocols, checklists and more: https://bit.ly/42HBcE3

Do you use vasopression for MAP augmentation in your SCI patients? In our newly published series, we describe significant hyponatremia frequently develops when used just to push up the MAP - quite literally induced SIADH pubmed.ncbi.nlm.nih.gov/41051384/

This would be an amazing advance in the care of patients with neurologic disease if true (and accessible to patients)!

A gene therapy buzz: Did AMT-130 really slow Huntington's disease by 75% at 36 months? A press release say YES. The data not yet been subjected to peer review and publication. uniqure.gcs-web.com/news-release...

Come train with us! The BU/BMC NCC fellowship has an opening for a 1 or 2 year fellow beginning July 2026. Visit sfmatch.org/vacancies or message for details!

During my own job search, I was struck by how wildly academic offers vary—from $0 startup 😬 to multi-million-dollar packages 💰. Inspired by online datasets (ex: www.reddit.com/r/AskAcademi...), we surveyed PCCM physicians about their offers 📊.

hi, medical toxicologist that knows a lot about Tylenol here👋 Claiming that tylenol use in pregnancy causes autism is fearmongering here's what you need to know 🧵

INCC Keynote speaker Dr. Altaf Saadi presenting her keynote this morning, "Bending the Arc: How Health Care Professionals Can Speak Up and Out for Change." #NCS2025

Dr. Brian Coffey, this year's DEI Abstract Award Winner, presented on his abstract, "Toward Equitable Care After Cardiac Arrest: The Impact of Race, Ethnicity and Insurance on Outcome at Two Safety Net Hospitals." #NCS2025

Switching from 1% to 2% propofol in ICU sedation cut greenhouse gas emissions, waste, and costs, with savings equal to over seven Paris–New York flights annually, showing concentration adjustment as a path to greener critical care. zurl.co/DHWbi

The COMA (certain of missing awesome) has begun 😭 Hoping for a productive meeting for all my friends and colleagues at #ncs2025 @caseyalbin.bsky.social @namorrismd.bsky.social @ajwpharm.bsky.social

Afternoon workshops on ENLS simulation and 2025 informatics/big data/AI have kicked off! Annual Meeting workshops provide attendees the opportunity to learn in small-group settings and gain expertise from neurocritical care professionals with hands-on engagement. #NCS2025

In academia, this fleeting moment of internally derived self-worth is quickly followed by reviewer 2's feedback:

Do you give 23.4% #hypertonicsaline at your center? If not, why not? Will this data help? link.springer.com/ar...#hypertonicsaline #neurocritcare

New preprint - A Modified Delphi Consensus-based Comprehensive Checklist and Angoff Standard for Assessment of Competency in Brain Death/Death by Neurologic Criteria Determination. Thanks to co-authors, especially @namorrismd.bsky.social! www.medrxiv.org/content/10.1... #neurology #critcare #MedEd

🆕💫PROTECT RCT Ceftriaxone to prevent early-onset pneumonia in comatose patients after out-of-hospital cardiac arrest: a pilot randomized controlled trial and resistome assessment (PROTECT) #IDsky #EMIMCC @pulmcrit.bsky.social journal.chestnet.org/article/S001...

I spent 2020 taking care of critically-ill COVID patients & was so grateful to receive the vaccine that felt like a miracle of science. The vaccine reduces the risk of transmission to vulnerable people & since then has saved millions of lives. What are we even doing now? apnews.com/article/vacc...

ICU Facts: In my experience, in any decent size ICU (~15 beds), at any point in time, there is at least 1 patient with unequal pupils (anisocoria). People are often freaking out & rush to get a CT brain to rule out intracranial bleeding... Just think hard before reflexively doing this

Do we drain? Operate? Observe? Where’s the line between doing things *for* someone and doing things *to* them? There are no perfect answers. Only imperfect humans making impossible choices with love. And in the middle of it all, hope persists.

P-values are fraught with hazard, but SO IS BAYESIAN STATISTICS the Achilles heel of Bayesian stats is that someone determines a pre-test probability distribution (usually arbitrarily) The pre-test probability is often too high This inflates the final posterior probability 🧵 #1/4 #EMIMCC

Congratulations to all the newly matched #NCC fellows! Wonderful to meet many of you during the application cycle. Welcome to our challenging and fantastic field!

This week on the show, Leeah Sloan gives us the straight scoop on the new CHEST critical care APP certification program. icuscenarios.com/lightning-ro... #medsky #emimcc

Not everything labeled alternative therapy for Parkinson's is snake oil. Should we be rethinking PD therapies in 'shades of grey.' Instead of labeling treatments as either evidence-based vs. alternative, how about a spectrum of credibility grounded in science, patient perception, real-world impact.

I decided August is Women in Neurology Month (August 31 is Women in Neurology Day, you should celebrate it, probably with cake) ...so listen to this @GreenJournal Minute on Tilly Edinger, paleoneurologist (it contains a funny paleoneurology poem!) www.aan.com/education/ne...

Also NCC/stroke staff re: gen neuro floor

Don't have a simulation course that meets your learning objectives? Borrow someone else's! "Shared" simulations have the potential to improve learner confidence and knowledge: www.neurology.org/doi/10.1212/...

in case you haven’t heard me rant about fentanyl gtts, see this blog: https://emcrit.org/pulmcrit/pulmcrit-fentanyl-infusions-sedation-opioid-pendulum-swings-astray/ dubious whether long-acting or continuous opioids help for acute pain we largely eliminated fentanyl gtts in MICU 👋 #EMIMCC

APPs—come do a CCM fellowship with me in WV! www.camcmedicine.edu/departments/...

Where are we at with post-grad APP training residencies/fellowships in critical care? We chat with Melissa Bridges for the inside scoop on what makes a good program, who should attend one, getting in, and more. icuscenarios.com/lightning-ro... #medsky #emimcc

A bit late in sharing, but proud of this piece published in @pedneurojournal.bsky.social. As DEI efforts face backlash, we argue why neurologists must stay committed to equity for the health of our profession and our patients. www.pedneur.com/article/S088... @dianacejasmd.bsky.social

1st line therapies for constipation: 💩 mobilization 💩 less opioids 💩 provide nutrition, enteral water, and fiber 💩 polyethylene glycol powder - probably best single agent (effective but gentle) if you remember one thing from this thread: remember that polyethylene glycol powder is GREAT #3/7

As a junior resident, I participated in a peer-led simulation course on neurologic emergencies. It was developed by @caseyalbin.bsky.social but she had moved on from the institution. We (with Galina Gheihman) explore what might lead peer-led courses to persist: www.neurology.org/media/blog-p... 1/🧵

Congratulations to all the soon to be newly minted neurologists and neurointensivists! What a privilege to celebrate our BU/BMC grads last night!