Richard Cashmore

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Endovascular vs Medical Treatment of Basilar Artery Occlusion @JAMANeuro “At 3 years, the clinical benefit of EVT in patients with acute BAO was durable, with substantially better functional outcomes and reduced mortality compared with medical management. These results reinforce EVT as the standard of care for BAO and support broader implementation and timely access to thrombectomy services.” #curingcoma jamanetwork.com/journals/jaman…

I am grateful for the opportunity to contribute to the European Society of Intensive Care Medicine (ESICM) General Intensive Care Ultrasound (GenIUS) Monothematic Session on Neurotrauma. esicm.org/genius/ linkedin.com/in/rmjcashmore/ #ESICM #GenIUS #TCD #TCCD #BrainPOCUS

Original research finds the implementation of a protocol using peripherally infused norepinephrine to be safe, feasible, and associated with a decrease in central venous catheter utilization over time. Read more in #journal_CHESTCritCare: hubs.la/Q03_L1RV0 #MedEd #CritCare

We've updated the FUSIC HD curriculum and reporting form. Changes come into effect from Feb 1st. Click on the link to find out what the changes are, the rationale and full guidance. Comprehensive haemodynamic ultrasound. @ICUltrasonica @cardiacACCP @iceman_ex @Wilkinsonjonny ics.ac.uk/product/fusic-…

@POCUSpeek It is worth noting that the new UFOH (Ultrasound Focused Occult Hemorrhage) protocol places structure at the forefront; it is effectively the 'protagonist' of this clinical approach. pubmed.ncbi.nlm.nih.gov/39708968/

Welcome to the 14th post of #scanuary. It's a month-long marathon of daily tweetorials about #POCUS and its utility in our clinical practice. Today we're going to discuss assessment of assessment of stroke using TCCD. If you find the post useful, please like & retweet. @salmannaeem217 @gokpocus

Pulse oximetry is one of the most widely used medical technologies worldwide, yet it performs less accurately for people with darker skin. This inequity requires urgent action, argues Editorial bmj.com/content/392/bm…

@NicholasChrimes @Anaes_Journal @Nitrousman75 @AAGBI We also need to update this to include standardised display of capnography to avoid misidenification. We have a minimum of 36 traces around the UK, with individual hospitals having up to 13!! It's no surprise traces get misidentified. …-publications.onlinelibrary.wiley.com/doi/full/10.11…

This. 😲 . Totally changed my view of perimesencephalic SAH "They are only nonaneurysmal insofar as an aneurysm is not identified — not because its really true. In fact, it is false — the aneurysms are there — you just need better imaging to see them." neuroangio.org/case-archives/…

Great #FOAM introduction into TCD & TCCD- similarities and differences, from @drmohansai for #scanuary! 🧠🔊Looking forward to the deeper dive!!!!!

TCD/TCCD - Obstacles and opportunities One of the major obstacles for insonating intracranial arteries is the skull. Ultrasound waves simply couldn't' break the barrier of the bone. Thanks to the experiments by Rune Aaslid, existence of insonation windows were identified. They are essentially thin portions of the skull through which ultrasound waves can penetrate the skull and insonate intracranial arteries. Do read this nice article on basics of Brain POCUS by @RMJCashmore and @Dr_AvinashJha doi.org/10.7759/cureus…

Welcome to the 10th post of #scanuary. It's a month-long marathon of daily tweetorials about #POCUS and its utility in our clinical practice. Today we're going to discuss basics of Transcranial Doppler (TCD)/Transcranial color-coded duplex sonography (TCCD). If you find the post useful, please like & retweet @salmannaeem217 @gokpocus

Probably need to move away from the 'Difficult Airway' mantra to a more holistic assessment of threats that can impact on the safe delivery of emergency anaesthesia. STEPS mnemonic could help to raise awareness of such threats

Sink or swim!   Brain is swimming in CSF!   CSF is key for protection, buoyancy, & hormone/waste transport   Most know basic ventricular anatomy well, but not subarachnoid anatomy.   How many cisterns do YOU know?   Here’s a quick guide to the key midline cisterns & what to know for each   Cisterna Magna: Largest of the cisterns Contains CN 9-11 & vertebral arteries Remember this bc the LARGEST cistern contains the LARGEST cranial nerve (vagus) and the two cranial nerves around it   Prepontine cistern: Contains CN 6 & basilar artery Remember this bc the shape of the number 6 mirrors the curvature of the anterior pons, where this cistern lies   Chiasmatic cistern Contains CN 2 & pituitary stalk Easy to remember bc the CHIASM is CN 2   Interpeduncular cistern: Contains CN 3 & mammillary bodies Remember this bc if you lay the number 3 on its side it looks both like the two cerebral peduncles (where this cistern lies) & well, two mamillary bodies   Quadrigeminal cistern Contains CN4 & pineal gland East to remember bc QUAD is the prefix for FOUR   Lamina terminalis: Contains the ACOMM Remember this bc the shape of subarachnoid hemorrhage after ACOMM rupture follows this cistern anteriorly   Now when you look at cisternal anatomy, you will definitely be able to go with the flow!

Kicking off New Year with some exciting stuff - Innovations in Neuro-ultrasound on January 9 ✌️

Need a DURABLE way to remember what causes DURAL enhancement? Feeling left behind when it comes to leptomeningeal disease? Here’s an easy way to remember the differential diagnoses for the two types of meningeal enhancement: LEPTOMENINGEAL Remember: L = Leakage (subarachnoid hemorrhage) E = Epilepsy (recent seizure) P = Pus (infection, either bacterial, viral or granulomatous/fungal) T = Tumor (leptomeningeal metastatic dz) O = Operation (post operative) PACHYMENINGEAL Remember P = Puncture (recent LP), Pus (subdural empyema) A = Autoimmune (sarcoidosis, IgG4) C = Craniotomy (post-op), Chronic subdural H = Hypotension (intracranial hypotension) Y = You’ve got a mass (mets, usually from direct bony extension, meningioma) Now you’ve got a lot information PACH-ed into an easy & memorable mnemonic!

@drmohansai @Dr_AvinashJha Thanks so much @drmohansai - very kind. Quite right- It is rapidly developing and I’m sure will have multiple refinements along the way!

@RMJCashmore @Dr_AvinashJha Yes yes. The proforma is the need of the hour. Much needed to document bedside and for the follow up.

〰️🧠How-2 #BrainPOCUS: A Technical report 🔗pmc.ncbi.nlm.nih.gov/articles/PMC12… #FOAMed an introduction #Brain #Neuro #ICM #POCUS #BrainPOCUS #NeuroPOCUS #TCCD #TCCT #NeuroCrit #Ultrasound #CriticalCare @RMJCashmore @Dr_AvinashJha

@drmohansai @Dr_AvinashJha Thanks @drmohansai that is really high praise!!! 😊 it is basic but hopefully some use to those at beginning!

@RMJCashmore @Dr_AvinashJha This is amazing 🤩🙌👏

11/ Not all MAP >60 is a good MAP. MAP = (CO × SVR) + CVP You want MAP generated by flow (CO), not by: – Excessive SVR (risk of surpassing critical closing pressure) – High CVP (venous congestion, shrinking the Pms–RAP gradient) 👉 See CCP threads for detail x.com/icmteaching/st…