Pediatric appendectomy in Taiwan was associated with a 1.58-fold higher risk of future nontyphoidal #Salmonella infection, with the greatest risk observed in children younger than 5 years. ja.ma/4jX7CAN

ICU culture varies across units… & uptake of EBM varies… but are they related? 🤔 Out today in #journal_CHESTCritCare, @chadhoc.bsky.social & colleagues show us they may be… at least for lung protective vent: www.chestcc.org/article/S294... @accpchest.bsky.social @iwashyna.bsky.social

does anyone know of a good iphone digital pupillometry app that doesn't store data in the cloud (i.e., doesn't have patient confidentiality issues)?

⏱️ Thrombectomy: Time vs Arterial Lines Dr. Rebecca Campbell: Most patients don’t need an arterial line—it didn’t reduce hypotension. Every 10-min delay reduces disability-free survival. Move fast, safely. 🧠💉 #StrokeCare #Thrombectomy #TimeIsBrain #PatientSafety #NACCS

Fantastic to see this published at last An objective assessment of the efficacy of home pulse oximeters on different skin tones Ping @iwashyna.bsky.social Open to comments from all #foamed #medsky www.bmj.com/content/392/...

#emcrit cold platelets may benefit acute haemorrhage as they are activated by cold storage. But cleared faster . Look out for CHIPS trial phase 3

Anyone know if NHS pensions are tax deductible in terms of adjusted net income?

🧵1/15 Delighted to share our study on the naked mole-rat (NMR): a mammal with bizarre thermal biology, notorious longevity, and cancer resistance. But how do NMRs maintain (or fail to maintain) their body temperature? Our latest work digs deep! #ThermalBiology #Thermogenesis

Interesting biomarker for 24 hour and 28 day mortality in critically ill patients (reflects metalloproteinase tissue damage and angiotensin II activity). AUC 0.83 for 24 hour. Interestingly subgroup with elevated biomarker & ACEi use higher mortality ccforum.biomedcentral.com/articles/10.... #emimcc

#child#2 is earthside 🥰💕

What if something quick and free could cut your heart attack risk by 34%? Getting a flu vaccine each year is linked to a 34% lower risk of major cardiovascular events. jamanetwork.com/journals/jam...

Use of Intralipid in a Propranolol/Quetiapine induced cardiac arrest - our poster today at #SOA25 Evidence for lipid rescue is (and will likely remain) limited, but it really was an inspiring and uplifting case to have been a part of - ROSC after 76 mins CPR and an excellent neurological outcome.

My family had a recent experience of hospital care & we saw effect of this type of taskification of care. Pointless delays, miscommunication, unnecessary referrals etc. No one had the patient at the core of their thinking as they did their bit of the job - result was real anguish

These cuts come as high-ranking US officials criticize top journals as ‘woke’ and ‘corrupt’. In May, RFK Jr threatened to bar government scientists from publishing in top medical journals. And several journals received letters in April from DOJ alleging political bias in the research they publish.

Just lmao

Once again, this is why we cannot ask pregnant trainees / early career faculty to attend scientific & medical conferences in states that outlaw abortion, and hence why we absolutely must not hold conferences in these states

Mervyn’s suggestions for the next stages of critical care #soa25

Next up: Professor Rockwood (yes, THAT Rockwood) discusses frailty And here’s his definition #soa25

Our next session is on the recent excellent @ncepod.bsky.social report on rehabilitation after critical illness This can be read here ncepod.org.uk/2025icur.html Spoiler alert: we have much to improve on #soa25

Honestly could have fed Prof Rockwood Questions for an hour!what a fantastic and relevant session on Frailty #SOA25

These are war crimes, missile attacks in areas full of defenceless civilians and children are pathetic - why is there so much inaction on the atrocities being committed by the IDF? We wouldn’t tolerate other nations doing this? www.theguardian.com/world/2025/j...

the volume of an ellipsoid is ABC/2 so if a patient is in hemorrhagic shock with an 3x4x5 cm hematoma in their abdomen, the hematoma *cannot* explain their hemorrhagic shock (estimated 30 cc volume) keep looking for the source of bleeding (which statistically is likely to be a GI bleed) #EMIMCC

If you read one thing today, read this.

I've been diving into evidence on Covid vax in pregnancy & sorting through misinformation, incl the claim Pfizer never reported on its pregnancy trial. I ended up relieved! Check out studies in >1.5 million vaxed pregnant participants in my latest @plos.org absolutelymaybe.plos.org/2025/06/27/d...

I have to say the #CCT #medsky certificate is not very exciting is it?! No gold or silver foil anywhere! My first swimming certificate was better!

#FICM safety bulletin www.ficm.ac.uk/sites/ficm/f...

expert reaction to a Wellcome announcement on a new Synthetic Human Genome research project (SynHG) www.sciencemediacentre.org/expert-react...

The vaccine situation in US government is depressing. Watching a successful (of course imperfect) nation disassemble itself is eerie. What has brought that into being and how do we prevent that in Europe?

Berry picking

Prework walk near #PapworthWood Sound track = reed warbler, sedge warbler, wren, chiffchaff, greater whitethroat

We actually don’t have lots of side effect data on these meds and their availability from online pharmacy with few safety checks is already contributing to overdoses and complications in the non obese in my region #medsky #ansky

Excellent from @helensalisbury.bsky.social on whether the new weight loss drugs are the best route for weight loss and a stark reminder of how few are eligible

The main causes of death of US children are traumatic (cars & guns). Currently, infectious diseases hardly contribute. A century ago the main causes were infections. Vaccinas have made fatal infections extraordinary rare, but antivaccine advocates could reverse this. www.nejm.org/doi/full/10....

GLP-1 RAs slow gastric emptying and may increase aspiration risk No studies have assessed the efficacy of pre-op erythromycin as a prokinetic. This case reports evaluates erythromycin efficacy with gastric ultrasound! #AnSky @drnavsidhu.bsky.social doi.org/10.1002/anr3...

The fact the furosemide stress test does well at predicting who will need to commence/continue RRT is great (& unsurprising) but it doesn’t help us at the bedside. The real question is does earlier initiation/re-continuation of RRT help this cohort? 1/ ccforum.biomedcentral.com/articles/10....

As my #NewPI journey is starting I re-share my latest publication: 👉We uncovered a #phosphate #metabolite sensor, binding and regulating the #autophagy Atg1/ULK1 initiation complex to regulate #pexophagy in response to phosphate availability. nature.com/articles/s41556-024-01348-4

Only a week left to tell us about your priorities in the emergency laparotomy pathway! Take part in our survey to rank the main problems faced in the pathway: tinyurl.com/45rwkxnm @rcoanews.bsky.social @thisinstitute.cam.ac.uk @rcem-2.bsky.social @rcradiologists.bsky.social @asgbi.bsky.social

Time of day can have as much as four fold effect of immune therapy for cancer A a significant replicable finding confirming the important of circadian regulation in immune regulation pmc.ncbi.nlm.nih.gov/articles/PMC... #emimcc #ansky

Stress inoculation training. Does it work? Can it improve emergency front-of-neck airway skills? #AnSky doi.org/10.1111/anae...

It is old school physiology to view lactate as a problem in hypoperfusion. Lactate is a substrate. pmc.ncbi.nlm.nih.gov/articles/PMC...

Also in multiple septic patients, muscle/end tissue biopsies actually show adequate oxygenation but low ATP - shock is as much of a cellular state as a perfusion crisis and do we even need to perfuse “shocked” cells? #emimcc #CCR25

Have many colleagues used this? #ansky

Presented at #CCR25: A trial involving children with severe acute malnutrition and gastroenteritis showed no evidence of a difference in mortality at 96 hours between oral and intravenous rehydration strategies. Full GASTROSAM trial results: nej.md/3TjfSP7 @criticalcarereviews.com

I feel like anyone who said this has never had to put pants on a toddler.

Tbh starvation mimics seem to improve outcomes in animal models in acute phase of illness eg NAD+ precursors pmc.ncbi.nlm.nih.gov/articles/PMC...

Emerging data suggests benefit from balanced solutions for most patients (but harm in traumatic brain injury). Bayesian analysis: benefit is likely to be real. -Dr Myburgh #CCR25

why was it predictable that ICU-ROX would be neutral? interventions that affect mortality strike at the *core* of the disease process (e.g., PCI for OMI) as you move further away from the central disease process, the minutiae of supportive care details become unimportant (eg 92% vs 96% O2) #EMIMCC

#emimcc but are we surprised?

Conservative oxygen therapy with a target SpO2 of 90% did not reduce 90-day all-cause mortality compared to usual oxygen therapy in mechanically ventilated adult patients. #CCR25 @criticalcarereviews.com https://ja.ma/4kG5gWK