Will Ibbotson

@EmergMedDr I think we need to stratify patients. I don’t think anyone is suggesting that a patient with any capability for awareness should have an NMB only intubation. However there are scenarios where this may be appropriate; CPR in progress with some residual muscle tone for example.

@jjibber717 @cliffreid I disagree. The basic tenants of Anaesthetic practice work well for intubation in theatres. The environment outside theatres is unfamiliar to anaesthetists and is generally suboptimal in terms of equipment, access and assistance. Patients are also sicker.

@cliffreid @IbbotsonWill I really distrust this type of suggestion. Basics of airway management & intubation & pt Mx are identical no matter where geographically performed. Well known, basic tenets of anaesthetic practice work no matter where they are.

Our hospital opened at the end of October 2018 Since day 1 of opening we have kept a detailed registry of all intubations in the emergency department We completed our sixth year of data collection this week 1/14

@VirtueOfNothing A question we have been pondering in our airway audit. Is there are role for NMB only intubation and if not (which is the general consensus), what is the drug of choice for ‘induction’?

Does it really hurt anyone to give a bit of ketamine… or some midazolam? Doesn’t have to be whole log, I get that in higher doses it can potentially have deleterious effects. I honestly struggle to see a strong rationale for a paralytic-only intubation.

@RoryStewartUK Really sad I couldn’t make it! Though I agree about the location; the view from my office takes some beating!

Must admit to being more excited to be speaking on the main stage in Sydney Opera House tonight than anywhere else I have ever spoken - what a space, what a building - thank you so much for having me Sydney 🙏

@helloimnicholas Something something, blood supply to muscles, something something.

@RobertJenrick @MailOnline That’s quite a statement. I’m sure you have ample, un-biased evidence to back up that statement. Perhaps you could share it with us so we can decide whether you are expressing a cheap dog-whistle opinion or verified fact?

Everyone knows that a huge number of people are now living in Britain illegally. The vast majority have no right to be here. Enough talk: they must go. 💬 My interview with @MailOnline dailymail.co.uk/news/article-1…

@BorisJohnson To be fair your lies and arrogance probably did more for the potential break up of the union than he ever managed.

Alex Salmond was one of the great political disruptors of the age, the father of modern Scottish nationalism. He was charismatic, clever, caustic and fearsome in debate. I am glad that he never succeeded in breaking up the Union but very sad that he is gone.

@tomparrott_ @qldhealth Congratulations! As an NHS refugee of 7 years I can say you won’t regret it!

@doctorwibble @MDtheDO @ChrisRootMD @ResusPadawan @jstgeorgemd I’m totally going to panic and give the wrong one. I understand that a big enough dose of adrenaline has the same effect as a hypnotic…

@MDtheDO @ChrisRootMD @ResusPadawan @jstgeorgemd You appear to be missing the hypnotic. You’d better plumb in another three way tap. Or just give it through the cannula port.

I love this method for RSI we use on flight: the 3 stop-cock IV method. Closest to patient: sedative Middle: paralytic Farthest: push-dose pressor Streamlines your med delivery for rapid, efficient, and safe intubation. #EMS #RSI #emergencymedicine

@_JaceMullen We are fortunate most of the remote sites we get to have iSTAT POC gear. We can carry EPOC but rarely do knowing iSTAT is fairly ubiquitous. Knowing the PaCO2 relative to ETCO2 is probably the most useful thing, especially in intubated head injury.

Transporting critically ill ventilated patients without POC lab ability (either VBG or ABG) would feel so weird to me. While tools like EPOC aren’t ubiquitous enough to be standard of care I sort of think they should be. A simple fresh VBG can answer a lot of questions

@nickmmark I dropped my pager in the toilet when I was an intern. Clearly I took my life into my own hands fishing it out.

So many questions: WHY did we install toilet knives? And WHO was reaching in the toilet that required this warning?

@beckimarshRA Because that undermines the distinction between the EU and the rest of the world…

@beckimarshRA Helsinki had one bank of e-gates with separate queues for EU and non-EU passports. They just moved the tensa-barriers depending on how many people were in each queue. Though the non-EU queue was definitely maintained longer!

@beckimarshRA Copenhagen the same in June. This was less than half the ‘other passports’ line. The EU queue empty. :(

@RestIsPolitics @RoryStewartUK @campbellclaret Both of the above positions may be true. However reform of the NHS in some guise is inevitable. Thousands of NHS staff have left the health service so I’m interested in how he would address this and potentially entice us back. Reform isn’t a bad thing.

@RestIsPolitics @RoryStewartUK @campbellclaret Rory talks a lot about the NHS needing fundamental, difficult reform. As a British doctor who left the NHS due to the intolerable conditions, how would he make it better for patients, staff and the government?

🚨 QUESTIONS REQUEST 🚨 What would you like to ask @RoryStewartUK + @campbellclaret? Domestic or international, timely or timeless - reply with your questions below 👇

@OrthopodReg Why have I only just had this pointed out to me?!

The Matrix is a movie about computers ruling the world Neo has to “accept a cookie” from the Oracle before she’ll talk to him I *just* got the programming/tech joke, having seen that film a bazillion times. #TheMatrix

@ronansetron Looks like that scene from Harry Potter when the dementors attack

a deserted Greenwich foot tunnel at 9am??

@EmergMedDr We have critical shortages in Australia of Saline and CSL currently. Interesting that this seems to be a worldwide phenomenon