Cameron Kyle-Sidell, MD

@tylerblack32 @LionAdvocacy @gorskon The story is much more complicated than that. All sides do injustice to that extraordinary time when they try to “dumb” down complicated events into simple platitudes for the education of others. (Even if the intended message is an appropriate one)

@LionAdvocacy @gorskon @cameronks look, people didn't know what they didn't know, and ventilator remained pretty standard but changed a bit as covid expertise increased. but the cause is covid.

John Ioannidis has much to answer for as one of the originators of this particularly vile conspiracy theory.

Great video from @cameronks covering these concepts emin5.com/2016/04/24/ult…

@srrezaie @emcrit @ThinkingCC @msiuba @IM_Crit_ @khaycock2 @MRamzyDO @UltrasoundJelly @UltrasoundMD @PulmCrit @CriticalCareNow @EMHUM_Haiti @AnnaEMin5 @adamdavidthomas @EMNerd_ @drmarcogarrone @EMSwami @DuncanGrossman

For trainees: Some keys for success: 1. Use long catheter 2. Most important: DON'T look for flash (u should know u are in) 3. Follow catheter in ("see the lantern in the cave") 4. Check your work: find and pump the VARTERY emin5.com/2016/04/24/ult…

Med peeps: Seeing a lot of precious IV US lines blow. Quick tip when placing: Look for the V-ARTERY (turn that vein into an artery)🤔 👇 after insertion, take off tourniquet, move probe up arm past catheter, compress and pump the flush 👇 if you see the VARTERY - all good! 🙌

@drbellezzo Agree in principle to the utility of fem art lines in arrest or peri-arrest situations but also think it’s VERY important to refrain in medicine from saying “every” for anything.

Every patient getting CPR in a US emergency department should have a femoral arterial line.

Yesterday I was called to place an IV in a dying lady with a bad heart. She was old and thin and lay still through the pain and I thought of things I think about when I’m alone. Then she opened her eyes and said thank you, god bless and I realized my eyes had also been closed.

I agree. I fear we are facing a large wave of thrombotic vascular complications from omecron. This variant may well uncover the true nature of the virus — and perhaps make clear the potential driving factor for severe disease — the hyper-activated platelet. @farid__jalali

It really is, above all, sad…so very sad to see people die, or even just be terribly sick, when they probably didn’t have to.

Just saying what I’m (still) seeing: It’s (still) MOSTLY unvaccinated folks dying. And there’s A LOT more vaccinated folks where I live. If you haven’t gotten it, please do. I don’t believe in the job mandates, but there are far more important hills for me and you to die on.

@awgaffney Have u read the following study that Gattinoni discusses? I truly don’t understand why there is such insistence on saying “there’s nothing new here.” ?? 🤔🤷

New study suggests little physiologic difference between ARDS due to COVID-19 relative to ARDS due to other causes, including similar (very high!) mortality. pubmed.ncbi.nlm.nih.gov/33577740/

@jeremyfaust @awgaffney Sorry but this is incorrect. In early Covid there is a very unique dissociation between hypoxemia and anatomical lung damage. What is going on in the lungs of patients that show up to ur ER at day 7 of symptoms is very different than other viral pneumonias.

@awgaffney There’s nothing all that special about this virus. It’s just so contagious and has a kinda bizarrely broad range of outcomes—tho even this aspect of it may be more typical than we realize because are testing so much and finding asymptomatic and mild cases more than we normally do

We’ve moved from an alveolar-centric view of COVID19 to a vascular microthrombotic-centric view (it comes first!). Is it now time to ask what precipitates the vascular injury and move to a platelet mediated vasoconstrictive-centric view of the inciting vascular injury??? 👇🔥

@adamcifu Sepsis RCTs (like ARDS RCTs) are typically doomed to fail because of the extraordinary heterogeneity of the enrolled participants. These are man made criteria, not natural diseases. One should therefore expect a high probability that bio-plausibility will fall short.

@adamcifu Not all bio-plausibility is the same. Pessimism toward translating COVID19 pathophysiologic understanding into effective treatment generated by the failure of sepsis, ARDs or other “syndromic”disease is unfortunate, especially when carried forward by our most thoughtful experts!

1/7 A twitter mea culpa. Yesterday I tweeted this. It was a lazy, hyperbolic tweet.

@Ddrekonja @dr_dmorgan @adamcifu @BenMazer @VPrasadMDMPH @DavisAmd This is a ridiculous statement. Might as well say take the science out of medicine.

@adamcifu @BenMazer @VPrasadMDMPH @DavisAmd My apologies. Didn’t mean to be unkind! COVID19 just highlighted how much I (a relatively newly trained CC doc) didn’t know. I understand bio-plausibility does not equal clinical benefit. But there seems to be alot of bio-plausibility in regards to serotonin and lung injury.

@cameronks @BenMazer @VPrasadMDMPH @DavisAmd Very kind. How about assuming that I did do my homework before tweeting and am just more skeptical than you about the explanation. I've read too many bio-plausible introductions. (Yes, zero-plausibility was poorly done hyperbole--apologies).