Phil Duggleby

@jhartin @emily_cammack @TVWCritCareODN @BucksHealthcare @BHTCriticalCare @ICUsteps @ICS_updates @bhtahp @TheACPRC 130 follow-up clinics in the country, not all have a nurse. Nor a doctor, nor a physio, nor a psychologist, nor an OT, nor a dietician etc....everyone is limited by resources but that doesn't detract from a fantastic patient-centered MDT approach

@emily_cammack @TVWCritCareODN @BucksHealthcare @BHTCriticalCare @ICUsteps @ICS_updates @bhtahp @TheACPRC Surely a “full team” would include a nurse 🧐

Fantastic first ITU follow up clinic face to face as a full team today! (ITU Consultant, Psychologist and Physio) 🙌🏼 Working together as an MDT to improve patient outcomes 👍🏼 @BucksHealthcare @BHTCriticalCare @ICUsteps @ICS_updates @bhtahp @TheACPRC #Rehablegends

4 C bombs #burnout #ICSSOA2016 Cut corners Cynicism Callousness Contempt

The most important thing when transitioning to adult care is to have a portable medical record. Why can't we do this yet?! #icssoa2016

Looks like transition of care to adulthood isn't just a problem in the UK. Does anybody get it right? #icssoa2016

Next up, Louise Rose talking about transition to adulthood #icssoa2016

How to make decisions: Appreciate that consensus is hard, recognise all outcomes, focus on communication and building trust #ICSSOA2016

Families fear the cliff edge of transition from paediatric to adult ICU - do we have the resources to honestly reassure them? #icssoa2016

Is there a need to "show our working" to patients and family when making difficult ethical decisions? #icssoa2016

Too much educational focus on basic science and not enough on ethics and decision making #icssoa2016

Dan Harvey @criticalinsight next up, talking about the ethics of making better decisions #icssoa2016

Complex patients on PICU will get better if given enough time. Don't pretend they're too sick when you're short of resources #icssoa2016

Clinician viewpoint the least important in PICU decision making hierarchy #ICSSOA2016

First mention of difference in admission thresholds between PICU and AICU - are adult intensivists too harsh or paeds too soft? #icssoa2016

Patrick Davies first up - the challenges of the 16th birthday in PICU... #icssoa2016

Paediatrics and the transition to adulthood starting in Room England. Tweet any questions for the experts #icssoa2016

Is the cost of clinical trials making researchers compromise on trial design? Should we be less critical and more pragmatic? #icssoa2016

Impaired neutrophil function a major problem in ICU...time for GM-CSF? #icssoa2016

Half of your ICU patients on a given day will have an infection and 70% will be on antibiotics (Vincent et al JAMA 2009) #ICSSOA2016

Dose response study of IFN beta limited by proinflammatory response at point of marginal gains. Rigoring to self extubation! #ICSSOA2016

IFN-beta reduces loss of CD73 & prevents lung leak in ARDS model hence clinical trials of IFN-beta in ARDS - interesting stuff! #ICSSOA2016