Ben Millette

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Ben Millette

Ben Millette

@ben_millette

Consultant in Intensive Care and Anaesthesia, Trust POCUS lead, Sportsman, Cinephile, Mexican food aficionado

Oxford, England Katılım Ekim 2016
500 Takip Edilen1K Takipçiler
Ben Millette
Ben Millette@ben_millette·
@cliffreid Nice thread. I think it's worth mentioning that the optimal rate of failed ICU extubation is not zero. If it is then you're not pulling enough tubes! There needs to be a balance between the attributable harm of a failed extubation and the harm of continued unnecessary intubation
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Cliff Reid
Cliff Reid@cliffreid·
That's my A to L Extubation Readiness Checklist Do you find this framework useful? Did I miss anything? I've been using it in my own practice and teaching for a few years, but I'm keen to improve it Let me know! 17/17
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Cliff Reid
Cliff Reid@cliffreid·
Extubation Readiness: A to L Checklist We're obsessed with safe intubation, but what about taking the tube out? How do we assess extubation readiness? Here's my simple, alphabet-based A to L checklist: 1/17
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Nick Mark MD
Nick Mark MD@nickmmark·
New favorite physiology paper: Central Venous Pressure in Space. So much space & cardio physiology to unpack here including: - effects of posture, 3g shuttle launch, & microgravity on CVP - change in the relationship between filling pressure (CVP) & LV size - Guyton curves! 1/
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Nick Mark MD
Nick Mark MD@nickmmark·
Today I’ve fallen down a rabbit hole reading about zinc in critical illness. I’m kinda surprised there aren’t more RCTs about supplementing zinc in people with critical illness…
GIF
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Dr Linda Dykes has moved to Bluesky
Dr Linda Dykes has moved to Bluesky@DrLindaDykes·
I want to do a flyer - "Be a sepsis wizard, not a sepsis wazzock". The latter don't consider sepsis mimics, and think shoving the Sepsis Six into anyone with a high NEWS means their job is done. #MedTwitter... give me your personal top 3 Sepsis Mimics, wizard & wazzock traits...
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Dr Simon Ashworth
Dr Simon Ashworth@DrSimonAshworth·
@DrTobyGilbert @DrLindaDykes We’ve seen 2 cases in the ICU I work in this year. It’s hard to see the truck coming towards you with your eyes shut - and it’s the patient that pays.
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Chris Hadfield
Chris Hadfield@Cmdr_Hadfield·
All the USA/Canada space launch sites (please point out errors). Congrats to both countries on negotiating today's Tech Safeguards Agreement for space launches in Canada, protecting sensitive US space launch tech, expertise & data. A big step @maritimelaunch. Details: tinyurl.com/2f5vpfs9 Image: updated from @BryceSpaceTech
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Ben Millette
Ben Millette@ben_millette·
@rbarbosa91 The wire is a coil wrapped around a core and by stretching the coil you exert pressure down its length that straightens the tip
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Ron Barbosa MD FACS
Ron Barbosa MD FACS@rbarbosa91·
I don't have a basic science diagram showing the physics of wire design, but the types of wires used in central lines will straighten whenever they are stretched. Here I am stretching the wire with 2 hands. You can see it straighten. But the key is: how to do it one-handed?
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Ron Barbosa MD FACS
Ron Barbosa MD FACS@rbarbosa91·
🧵regarding the useful technique of 'straightening the wire' during central line placement when the plastic guide is no longer within reach. If you do a lot of central lines (or a lot of percutaneous procedures), this technique will come in handy over and over again. (1/ )
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Ben Millette
Ben Millette@ben_millette·
Well done to the whole #CCR24 team for organising an excellent meeting! Enough research to keep our journal club busy for months yet @CritCareReviews
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Resident Doctors
Resident Doctors@BMAResidents·
We're aware that many doctors are being told their training is being automatically extended due to exceeding TOOT thresholds. This should NOT happen. @gmcuk and @NHSEngland confirm there should be no automatic extensions. See our guidance on TOOT 👇 bma.org.uk/toot-ia
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Ben Millette
Ben Millette@ben_millette·
@f_g_zampieri : we should revisit the ICU mantra of stopping all the patients home medications when critically unwell #CCR24
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Ben Millette
Ben Millette@ben_millette·
@bryan_reidy My brief read of this: basically a way of making a composite endpoint more clinically relevant but also potentially making it murkier to interpret. A cynic might say it's another way of torturing the data until it confesses!
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Bryan Reidy
Bryan Reidy@bryan_reidy·
Anyone have a good explainer on win ratio as an outcome/reporting measure? #CCR24
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Ben Millette
Ben Millette@ben_millette·
@bryan_reidy Agreed. Also my knee jerk response of discontinuing SGLT2i in the critically unwell perhaps needs reevaluating!
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Bryan Reidy
Bryan Reidy@bryan_reidy·
@ben_millette There definitely seems to be a disparity between the anecdotal reporting of ketosis +/- ketoacidosis with what the trials demonstrate. I’m starting to wonder are we just seeing more ketosis from prolonged fasting (in surgical patients) just because we’re looking for it. #ccr24
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Ben Millette
Ben Millette@ben_millette·
A lot to unpack in DEFENDER trial results. Need to get my head around the concept of win ratio! Perhaps not surprising that there was no benefit in a generally critically ill population. Most interesting thing for me is zero euglycaemic DKA cases! #CCR24 jamanetwork.com/journals/jama/…
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Ben Millette
Ben Millette@ben_millette·
@TPP_MD The phrase "game changer" was thrown around a lot today. This is a classic example of 'nerf the control group to show an effect'
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Keşfet

@cliffreid @JessicaMABlair @nickmmark @DrSimonAshworth @DrTobyGilbert @DrLindaDykes @Cmdr_Hadfield @maritimelaunch