John Rae

We are so proud of the Scotland #turnthepeakspink team who summited Ben Nevis today and joined a live link with teams across the UK doing the same! A phenomenal achievement, an emotional day with all involved linked in some way to donation or transplantation 🩷⬇️

Did you know? You can record your #OrganDonation decision on the NHS App in just a couple of minutes. It’s quick, easy, and could save up to 9 lives in the future. 💕 It's the best thing you'll do today!

@NHSGGC @qeuhccm @Qeuhtheatres

@hughgifford @ProfJDChalmers Better for infection control I assume

@ProfJDChalmers FYI the bow tie is also mandatory in OSCEs………

First time today examining a PhD thesis at Oxford university Really fun and wow! They wear bow ties and hats ! 🎩 The Scottish guy was very underdressed !

(1/x) Intubating critically ill patients in the ICU has some important differences to the ED or OR. It also carries with it a 3% chance of cardiac arrest. Yes, THREE percent (PMID: 33755076) This may be the highest risk procedure we perform in the ICU. Here is how you can make intubation in the ICU as safe as possible. A 🧵 #medtwitter #foamed #foamcc

@IM_Crit_ What triggered the decision to up the Phigh to 32? (And why 32 not 35 or any other value?). Any tips on setting for recruitment but not overdistension

We gradually prolonged Thigh and shortened Tlow (please notice I:E ratio). Phigh was increased to 32

ICU Stories: While walking around the ICU at the beginning of your night shift, you notice that the respiratory therapist increased the FiO2 from 90 to 100% in a mechanically ventilated patient. Bedside monitor shows O2 sat 90%. You decide to read a bit more about the patient:

@emily_fri I would love to hear this talk 😁

Dreaming up a Things We Do for No Reason talk. What would you include? - ABGs - albumin - mixed venous - PRN anti-hypertensives - nebs in non obstructive dz patients

@JoshuaSoane @Steven_Swinford It's not going to get better than this. A reasonable deal requires both sides to compromise

@Steven_Swinford Terrible offer, this must not be accepted. The strikes must go on. 🦀

EXCLUSIVE * Junior doctors have struck an improved pay deal with ministers in a breakthrough that could see their earnings increase by 20 per cent over two years * BMA's junior doctors committee has recommended an offer which would see a backdated pay rise of 4.05% for 2023-24, on top of an existing increase of between 8.8 per cent and 10.3% * They will be given a further pay rise of 6 per cent for 2024-25, which will be topped up by an extra £1,000. This is equivalent to a pay rise of between 7% and 9% * The overall package represents a pay rise of around 20%, with the lowest-paid junior doctors getting the biggest rise in their earnings * BMA's committee has agreed to put the offer to its members, and if accepted it would spell an end to industrial action. But there is no guarantee they will accept it thetimes.com/uk/politics/ar…

@drtintin99 @e1v1m1 @BASStrainees @neuro_at_ic @QSReview @ebrainnet @EducationSCC This is putting me right off my unpasteurised cheese

#MorningPaper case - young female patient had unpasteurised cheese, became unwell and gradually developed worsening mobility and sphincter problems. What's your diagnosis and what would you do? @e1v1m1 @BASStrainees @neuro_at_ic @QSReview @ebrainnet @EducationSCC

Great round up of recently published ICU trials from LIVES

@DavidJuurlink By iv infusion or bolus dose (?frequency) Not available outside critical care settings in our hospital. Can you give any good papers on evidence for improved outcomes?

Making low-dose ketamine widely available for in-hospital pain management is a genuinely transformative intervention. Hundreds of doctors, nurses and pharmacists soon come to see its value. If your hospital isn't doing this, it should.

@coollyndz @jcollm1 Definite scam fishing for your details

Do evri routinely charge for redelivery? Don’t remember ordering anything and can’t work out if it’s a prank text…

I’m not quite sure how to explain what’s happened tonight, because it’s still happening - but here goes… At 4:40pm I jumped on a train from London to Edinburgh.. It was comfy, it was quiet In hindsight, too good to last…

A tax on 3D printed boilers. I've scrapped it. A ban on the breeding of owls for meat. I've scrapped it. Proposals to force everyone to paint their cars green. I've scrapped that too.

@sbABetterLeader @IM_Crit_ Evidence for this approach please?

@IM_Crit_ If y'all used a 100mL 3% intermediate step it'll solve a lot of these issues :P Unless the patient has a Sodium >145, consider going 1:1 with bolus'. 500mL LR - No change 100mL 3% - BP improves, kidneys happy, heart happy (you'll thank me later) 100mL 3% - NOT better, Levo

OK, I am biased here because it's pretty similar to what I am doing but Monnet et al make a reasonable case here for early (or: earli-ER) initiation of norepinephrine in septic shock ccforum.biomedcentral.com/articles/10.11…

It's 45 years since the best ever account of an attempted crime. From the Edinburgh Evening News, 18 August 1978.

We're hiring! Consultant in Critical Care A challenging critical care caseload working with fantastic colleagues & the potential for crofting, climbing, swimming, skiing, sailing or raising a family in fresh air & freedom, the opportunity is here. 👉 nhsh.scot/3sfDcDc

@shevvy09 The problem is DNARs are too blunt an instrument for a highly monitored environment for ICU. For instance - trache blocks, vasopressor pump malfunction, patient goes into VT, heart block etc - CPR totally appropriate and high chance of recovery. Different if inexorable decline

I believe (most) patients in ICU should have a DNACPR order. I’ve never understood why among medical staff that should be controversial. It’s a horrible way to die - and if you already require organ support, and are sick enough to arrest - you will die. newyorker.com/news/the-weeke…

When someone said Greenpeace were on my house I said Downing street? They said no, so I said Chequers? They said no, so I said my Kensington mews house? They said no, so I said my apartment in South Kensington? They said no, so I said not my Santa Monica penthouse? They said no..

Best poster award