One interesting lesson I learned as a parent: don't constantly praise your kid. It not only cheapens the words, it conveys a message of judgment and emphasis on success—I am the arbiter of worth and I deem your efforts worthy.

Clint Leonard gives us the scoop on the odd, sweaty place that is the burn ICU. icuscenarios.com/lightning-ro... #medsky #emimcc

We dive into the subtle art of placing, understanding, and interpreting the PA (Swan Ganz) catheter, on a new lesson at icu101.com. #emimcc #medsky

No more PSV trials! RSBI is not a weaning parameter! Respiratory muscle fatigue is a myth! And more hot takes from the great Martin Tobin, this week on the show. icuscenarios.com/episode-95-s... #medsky #emimcc #intensivecare

Connecticut humans (also a remote option): I will be speaking at the Bridgeport Hospital CME conference on November 8 with a deep dive into shock. Check it out if interested! e.givesmart.com/events/KFO/ #emimcc #medsky

The great Tom Bleck shares his insights on treating seizures. Which benzo? When do you load an ASM, and which one? What drug to intubate, which drip? What's the ketamine deal? And more. icuscenarios.com/episode-94-m... #medsky #emimcc

New lesson on Pacemakers at the Intensive Care Academy - TCP, TVP, epicardial, PPMs, and more, including management in critical illness, the problem of false capture, and more. #medsky #emimcc

This week on the podcast, Jon-Emile Kenny on fluid resuscitation and his wireless doppler device for predicting responsiveness icuscenarios.com/episode-93-f... #medsky #emimcc

We explore the rare but scary phenomena of propofol infusion syndrome (PRIS) and propylene glycol toxicity, with our favorite toxicologist Jerry Snow. icuscenarios.com/episode-92-p... #emimcc #medsky

We demo a simulated goals of care conversation on this week's episode at icuscenarios.com/episode-91-a... #medsky #emimcc

How does a town get a cervical collar named after it

Had a great time chatting with you guys about residual NMB and reversal strategies in the ICU! Thanks so much for the conversation and for highlighting this topic. #emimcc #medsky #pharmsky

I joined the ACCRAC podcast to discuss one of my favorite topics: physiologic methods to determine the best PEEP. Check it out if you're into that! accrac.com/episode-314-... #emimcc #medsky

#medsky peoples: alpha agonists cause more venoconstriction than vasopressin. Agree/disagree? #emimcc

The great @sarajpharmd.bsky.social tells us how to use sugammadex in the ICU, why we should, and how many of our patients may have occult residual paralysis. #medsky #emimcc icuscenarios.com/episode-90-s...

epic case 🤯 man trying to eat a better diet asks ChatGPT how to eliminate chloride, it advises him to use *bromide* instead he buys NaBromide from the internet develops bromism (with psychosis) key diagnostic clue = negative anion gap! (more on low anion gap emcrit.org/ibcc/agma/#l...) #EMIMCC

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

I need one of those graphic T shirts Facebook keeps trying to sell me with an image of a grizzly doing curls. Caption: “Weight bear” #medsky

Looking to subscribe to the Academy? To celebrate our 1-year anniversary, we're running a sale for the month of August: use the code AUG25 for 20% off all new subscriptions. Check it out! #medsky #emimcc

From our new lesson in the SICU program: Abdominal emergencies and damage control surgery Available at icu101.com #medsky #emimcc

not common but it’s there. I’m thinking about patients on 4-6 liters O2 baseline, etc - doesnt take much to precipitate ICU admit

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

Want to spend a couple days learning All the Things? Come hang at the Vanderbilt APP Critical Care Bootcamp this September! I'll be speaking, but so will some rockstars, so you can grab lunch during my sessions. #emimcc #medsky www.eventbrite.com/e/2025-advan...

New lesson in our POCUS program: Vascular ultrasound! From DVTs to aortic pathology and everything in between. at icu101.com #medsky #emimcc #POCUS

We are dipping our toes into post-grad APP training and this was such a helpful and timely episode.

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

Holy cow

Andrew Schulman gives us the scoop on medical musicians, and how music can help our critically ill patients. icuscenarios.com/lightning-ro... #medsky #emimcc

when the first two pressors don’t work

Yeaaa buddy! If you’ve never tried to accredit a CME program, it’s… a process. Thanks to everyone for their patience. But if you need credits, now we’ve got ‘em. #emimcc #meded #medsky

You're doing your #POCUS echos wrong - here's how. icuscenarios.com/lightning-ro... #medsky #emimcc #echo

On a side note I agree completely. It depends on how departments “use” this space. Often juniors present. Cursory discussion and off you go. Rather than the in depth and if one can get institutional memory as these “fads” go in and out of fashion then it is a 👌

#EMIMCC

No more perfusion scans! Radial access for all! Lots of interesting thoughts on the cutting edge of thrombectomy from Justin Fraser. #medsky #emimcc icuscenarios.com/episode-89-t...

clinical humility arises from realizing that sometimes people say the dumbest shit and end up being right and sometimes I say the smartest shit and end up being wrong #medsky #emimcc

As far as I can interpret, SIR guidelines suggest that lumbar puncture ("low risk") can be performed right through almost any antiplatelet/anticoagulant medication including DOACs, DAPT, heparin ASRA guidelines are much more conservative What's everyone's practice? #medsky #emimcc

Pregnant patient in your (non obstetric) ICU? Don't be scared. icuscenarios.com/episode-87-m... #medsky #emimcc

Gotta use that deionized water #emimcc

Carolina Maciel on critical care EEG icuscenarios.com/episode-86-e... #medsky #emimcc

Should you be prepared to do a cric? We wrap up our airway management series with a deep dive into cricothyrotomy, over at icu101.com. #medsky #emimcc

sometimes I wonder how I landed a wife

When assessing a patient on ICU (or hospital) admission to determine if they have risk of alcohol withdrawal, either as their presenting problem or a potential later complication, it seems like many of us have independently come up with a one-question screen: do you drink alcohol every day?

If I ever say "if that's your thing" in reference to a clinical practice, you can rest assured that it is almost certainly my thing. #medsky #emimcc

So without a randomized clinical trial this is what we are left with. The highest quality epidemiology studies are unable to detect any increase in AKI, so those bumps in creatinine following contrast are almost certainly run of the mill AKI and not contrast induced AKI.

Question for the respiratory therapists: Is it something taught in RT education that 1. pCO2 should always be normal, or 2. lowering pCO2 too much can be harmful? #emimcc #medsky

PAC use in medical ICUs is a dying art form. Don’t always need them, but you still should be able to work with them in select situations. Even if you’re experienced, get all you can out of the data! It’s not about any 1 #. And context is everything.

Our old friend @zentensivist.bsky.social gives us a masterclass in the advanced tricks of PA catheter placement icuscenarios.com/lightning-ro... #medsky #emimcc

Made some picture frames for the babe’s room

Warming up in Connecticut

Intubation techniques in 2025 #emimcc #medsky