James Cuell

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James Cuell

James Cuell

@JamesCuell

Consultant Anaesthetist - HPB / Transplant. Perioperative Medicine. Can swing golf bats. Father of two - Slave to both. All views my own

Birmingham, England Katılım Mart 2015
224 Takip Edilen158 Takipçiler
James Cuell
James Cuell@JamesCuell·
@DrEilidhMaria @trentconsultant @OBrucey From the proverbial otherside, MRCP, does not provide generalist paediatrics. What serves you well is only a retrospective diagnosis. I’m not trying to preach, just attempting to aid. But I appreciate I am likely to be not helping in any respect. 🎤🫳
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James Cuell
James Cuell@JamesCuell·
@DrEilidhMaria @trentconsultant @OBrucey And once on the other side (training so to speak), you have insight into the limitations of the current system, to aid it for the coming generations of medic to come. I am incredibly grateful of my general medical knowledge in getting both patients and myself out of ‘trouble’.
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James Cuell
James Cuell@JamesCuell·
@DrEilidhMaria @trentconsultant @OBrucey general practice is maybe the last great bastion of generalist medicine, so try and see the trivial and irritating process before you as hopefully providing the future you the ability to contribute some real good when least expected.
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James Cuell
James Cuell@JamesCuell·
@DrEilidhMaria @trentconsultant @OBrucey as an anaesthetist. Just having that itchy feeling at the back of your head because, ‘it’s just not right’ is often earned rather than bought. The best diagnosis is made in the library, but you need to provide the patient time to get to the library, metaphorically speaking.
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James Cuell
James Cuell@JamesCuell·
@willtube4food @Davidmarkpye Also sounds quite similar to liver transplant pts on dissection phase. Does your group have significant collaterals? Is there an enlarged splanchnic circulation? In combination with the hypotension, do they become coagulopathic? I often find this a feature of glycocalyx failure.
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James Cuell
James Cuell@JamesCuell·
@willtube4food @Davidmarkpye Hmmmm, definitely SVR loss? We have started to get quite concerned with the large chemo loads our HPB cohorts are getting and lack of CVS reserve to big insults. ?NTProBNP PreOp to risk stratify?
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Jakob Mathiszig-Lee
Jakob Mathiszig-Lee@willtube4food·
Does anyone have a good explanation as to why patients with high grade ovarian cancer completely fall apart when the peritoneum is opened? Feels like the air hitting the abdominal deposits sets off some sort of huge cytokine storm.
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James Cuell
James Cuell@JamesCuell·
@danny_mercer The ‘normal’ saline that is ‘normally’ prescribed for ‘normal’ patients. All fluid is bad fluid.
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Daniel Mercer
Daniel Mercer@danny_mercer·
Every time I prescribe fluids I hear a certain nephrologist over my shoulder whispering “theres nothing normal about normal saline” And, dear reader, my 🖊️ hovers.
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Robert Sutcliffe
Robert Sutcliffe@liveRPancSurg·
GIF
Marc Besselink@MarcBesselink

@MStott88 @amsterdamumc @Augishealth Thanks ☺️. Great to have you over! Biggest impact on OR efficiency in our setting: no ICU beds required, incision 845hr sharp and 2 senior surgeons from skin-to-skin. Postop 6hrs recovery ➡️ ward. (With Parts of the procedure by residents such as robot galbladder)

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James Cuell
James Cuell@JamesCuell·
@siobhanmckay @e_rangelova Is there any information on outcomes (morbidity and mortality) with patient factors? Frailty, multimorbidity, sarcopenia, nutrition? Some significant ‘complication’ / morbidity numbers in there……….
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Siobhan Mckay
Siobhan Mckay@siobhanmckay·
Vascular resection in pancreatic surgery by @e_rangelova ✅if expect a vein resection do a Catell-brasch so not limited ✅shorter length of vein resection for DP to prevent tension ✅arterial rx 5yr survival 40% ✅ TP with arterial resection to avoid. POPF #RACS23
Siobhan Mckay tweet mediaSiobhan Mckay tweet mediaSiobhan Mckay tweet mediaSiobhan Mckay tweet media
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Aneel Bhangu
Aneel Bhangu@aneelbhangu·
Question 🙋🏽‍♂️ Do PCAs reallyyyyy need those nasal specs If there’s too much opiate, does 2L O2 do the trick Or is it just another thing thing patient down and drying out their airway
GIF
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James Cuell
James Cuell@JamesCuell·
@DeirdreGodfray @sas_sobauk I do so hope so. Fashion is for now, style is for ever, not only in the sartorial sense but also in ones actions and demeanour. I don’t have role models but if I did, this chap sounds like one to have. Thank you sir!
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Imran Sharieff
Imran Sharieff@sas_sobauk·
Seen a lot of senior con making unsavoury jibes at JDs and their IA. Be more like Mr Niall Aston. Lifetime of service, still on the LNC campaigning for the rights of others and also surgical SHO today. #JuniorDoctorsStrikes
Imran Sharieff tweet media
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