Adam Thomas

And with that, @iBookCC just posted our 100th episode. Thanks for everyone's continued support! @PulmCrit

@TheSGEM @MelHerbert @emrap_tweets The medicine is on point. And this 15 hour shift would be a dream! (Medical case wise).

I just saw the first two episodes of The Pitt and was impressed. @MelHerbert from @emrap_tweets is contributing to the show.

2 RCTs testing IV vs IO vascular access in OHCA patients just published in the @NEJM and concomitantly presented at #RESUS24 @ERC_resus ➡️ No difference in 30d survival in both trials ➡️ Higher rate of ROSC with IV access in the #PARAMEDIC3 trial 🇬🇧 nejm.org/doi/full/10.10… 🇩🇰 nejm.org/doi/full/10.10… Congratulations to the authors for randomizing 6082 + 1506 patients to answer this important question!

🚨 🏥 Please Retweet! Early enteral #nutrition (EN) w/in 3 d of ICU admit/intubation improves outcomes! ⬇️ Hospital MORTALITY ⬆️ D/C to Home ⬇️ ICU & Hosp LOS ⬇️ Vent Days ⬇️ Costs 🙋‍♂️Data from >27800 pts in real world practice 🔗 sciencedirect.com/science/articl… #ICUNutrition #FOAMcc @drshahrul80 @ICUnutrition

Hot Take on PROPHY-VAP trial: 🔥Prophylactic 2g ceftriaxone among patients intubated for airway protection reduced pneumonia & ICU/hospital length of stay 🔥Prophylaxis *reduced* total antibiotic exposure 🔥Consistent w/ SuDDICU & ANTHARTIC trials Blog emcrit.org/pulmcrit/proph…

Single-dose cefreiaxone to prevent VAP in ventilated acute brain injury patients Multicenter RCT with 345 pts🇫🇷 Compared to placebo, CTRX reduced VAP (14% vs 32%; HR 0·60 [0·38–0·95], p=0·03) thelancet.com/journals/lanre… @SCCM @KhannaAshishCCM @SCCMPresident #SCCM2024

The liver is awesome. Yet its vocabulary is ... limited. We can all tell when it is upset - high ALT, AST. But that could mean anything! So what's your specific patient's specific reason for high ALT?

True story There have been 15 trials of tooth brushing in the ICU and those trials have demonstrated fewer pneumonias and icu deaths In @JAMAInternalMed jamanetwork.com/journals/jamai…

Great #AHA23 so far: @AHA_Research 🥸8 Trials: 8 take aways below Read the read👇👇 1/ATRESIA: Patients with subclinical atrial fibrillation can benefit from apixaban to reduce the risk of stroke and systemic thromboembolism.

New IDSA/SCCM guidelines on evaluation of new fever in ICU! 🤒 bladder/esophageal > rectal > oral > axillary/ear 🤒CRP and/or procal rec for patients with low/intermediate risk of infection😳 🤒consider test for COVID, resp viruses Fresh blogitorial: emcrit.org/pulmcrit/idsa-…

@khaycock2 @ross_prager @karimbrohi @drjenwolkin @ThinkingCC @srrezaie @emcrit @adampowermd @dan___kim @UAlberta_Sono @WhatsUp_Doc123 @traumaicurounds I’m torn. Usually my priorities as TTL would be focused elsewhere or limited by space/people/time. But I have seen TEE change my management and optimize compressions etc. so for a narrow set of patients I think so. Reassured that right patient/exp provider no injuries caused!

@ross_prager @karimbrohi @drjenwolkin @ThinkingCC @srrezaie @emcrit @adampowermd @dan___kim @UAlberta_Sono @WhatsUp_Doc123 @traumaicurounds @adamdavidthomas I have done TEE in trauma before, but it isn’t common. I think it probably has a role if the circumstances are right.

We all know about #FAST scans in trauma, but what about resuscitative TEE? We studied 54 sick trauma who underwent resus TEE in the trauma bay (or shortly after). Spoiler: if you look, you will find things you weren't expecting... a 🧵shorturl.at/mxE39

STRATUS Trial published @JAMA_current 🩸Cluster trial 25 ICUs >27,000 patients 🩸Switch to “small-volume” tubes that⬇️blood drawn for lab tests may⬇️RBC transfusion↔️effect on testing 🩸Available, cost-neutral, compatible with analyzers – will you switch? jamanetwork.com/journals/jama/…

fresh blog: why the new brain death guidelines are unacceptable 🧠guidelines rec urine tox screen & time-based clearance of intoxicants, *ignoring* toxicology guidelines & toxicologists 🧠arbitrary ranges are required for labs (iCal must be 1 -1.3 mM😳) emcrit.org/pulmcrit/bdgui…

OK here's a run down of why @CRYOSTAT_2 trial results will mark a turning point in the treatment of trauma-induced coagulopathy (TIC) Paper in @JAMA_current: jamanetwork.com/journals/jama/… and some additional resources on our @CommsC4TS web pages: c4ts.qmul.ac.uk/research-progr… Firstly...

Thanks to @accpchest for the opportunity to present high risk #PE data from #FLAME 🔥 at #CHEST2023! (Finally have a good reason to use that emoji!) FT pts w significant decreased primary outcome and in-hospital mortality (1/3) @RosovskyRachel @roblookstein

We order too many CT scans. There, I said it.

Very excited to have the voice and brains behind IBCC podcast and Crackcast, @adamdavidthomas co-instruct this year's Podcast CAMP Nov 30th, Dec 7th, Dec 14th. Plus keynote speaker @srrezaie of REBELCast Details @ podcastcamp.org

in case you use an RSS feed: the new IBCC chapters will be going up on a *separate* IBCC RSS feed. to subscribe, click the link shown below & copy the text that shows up into your RSS reader. and if you've achieved this peak level of nerdiness, I honestly salute you 🫡

@boondocksdoc @PulmCrit Truth. I do!

@PulmCrit Once again with the on-point memes/gifs. @adamdavidthomas needs to up his game. 😂😁 jk you guys are both great. IBCC PE chapter bailed me out the other night at 2 am.

please make this stop you can't use multivariate correction to convert a sow's ear into a silk purse. there's always another unappreciated confounder lurking more specifically: a *new* retrospective correlative study won't clarify a controversial topic laden with studies

@docib @codachange @OliFlower @EMManchester @_NMay @precordialthump @HumanFact0rz @emcrit @stemlyns Just putting this out there… but can you all put the band together again? With #medtwitter dying I think we need to get back to the roots that started all of this. I’ll even commit to getting @PulmCrit on a flight for it!

This is the time of year when we used to travel from all corners to go to #SMACC. Feels like a lifetime ago. They were fun, rejuvenating times and if I’m honest I really miss them.

#Opioid pain relievers do not reduce acute lower back and neck pain, new study suggests: hubs.li/Q01W2WC90