Critical Concepts

17.6K posts

Critical Concepts

Critical Concepts

@critconcepts

Critical care PA, FCCM, former EMT. Teaches at https://t.co/dhDfHwVfKo, podcasts at https://t.co/1KA4lxqiiO, blogs at https://t.co/Qf4aPrrBRw. #FOAMcc #FOAMed

Katılım Şubat 2014
911 Takip Edilen14.7K Takipçiler
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Critical Concepts
Critical Concepts@critconcepts·
ORESTES: Set me back upright, swivel me round—there’s no pleasing the sick! I hate being helpless ELEKTRA: Do you want to try putting your feet on the ground? It's been so long. But change is sweet O: Yes by all means. That will seem like good health. Sophocles on ICU mobility
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Critical Concepts
Critical Concepts@critconcepts·
Oh, the sun burns down pitiless upon me And on my crushed white wings--my wings--my wings-- Why did I fly so high? I might by now Be safe, if only--only- Ah, but FLYING
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Critical Concepts
Critical Concepts@critconcepts·
@PulmCrit it's just so elegant to use the vent, but you need to coordinate with your therapists if they're not accustomed to using a vent for NIV... usually need an adaptor
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𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊
𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊@PulmCrit·
we’ve integrated the PREOXI trial into our practice so well that there’s an entire cabinet in ICU dedicated to it 😁 #EBM
𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊 tweet media
𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊@PulmCrit

Fresh post: BSI (bilevel sequence intubation) will become standard therapy based on PREOXI 🔥🔥 How should BSI be optimized? 🤿 CO2 clearance is irrelevant 🤿 maximize ePAP (PEEP) for recruitment 🤿 low driving pressure Post: emcrit.org/pulmcrit/bsi/

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Philippe Rola
Philippe Rola@ThinkingCC·
Excellent thread. “Due to respiratory effort” needs to be noted by learners. Even high CVP IVCs can be collapsed by big swings in intrapleural pressure. thinkingcriticalcare.com/tag/effort-var…
Rafael Melo@intensivaev

An interesting case from now. Patient presented with chest pain and prolonged CRT, tendecy to hypotension. On POCUS assessment, pericardial effusion with thickened pericardium probably due to lung cancer. IVC was dilated but due respiratory effort, collapse wa > 50%. No MV or TV important flow variation.

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Critical Concepts
Critical Concepts@critconcepts·
Hard to balance giving them the involvement they want (and hopefully that is helpful to the project) while ensuring the work gets done, especially as their motivation may drift, eg once they match, or maybe decide to pursue another specialty... @nickmmark @emcrit
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Critical Concepts
Critical Concepts@critconcepts·
Anyone in staff positions (attendings, APPs, etc) have advice for collaborating academically with house staff (residents/fellows)? Have had a hard time involving them in papers etc - they only seem interested for a brief window of time - and may end up ghosting you. #medtwitter
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Critical Concepts retweetledi
Keith Siau
Keith Siau@drkeithsiau·
You are replaceable at work, but you are NOT replaceable at home. A beautiful and poignant reflection that applies to all clinicians.
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Critical Concepts
Critical Concepts@critconcepts·
@PulmCrit Dr. Homer: "you mean the worst headache of your life SO FAR. hey wake up"
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the EMCrit Crew
the EMCrit Crew@emcrit·
EMCrit 422 - SSC 2026 Guidelines: The good, the Bad, and the UGLY - a discussion with lead author, Hallie Prescott A fantastic interview on how the SSC guideline sausage was made and the areas I found contentious [#FOAMed for now] emcrit.org/422
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Critical Concepts
Critical Concepts@critconcepts·
The episode is live icuscenarios.com/lightning-roun… Hopefully those with concerns have some of their questions answered. @emcrit also just dropped an episode with Hallie touching on similar points from an EM perspective. #medtwitter #FOAMcc #FOAMed #sepsis
Critical Concepts@critconcepts

Chair of the new Surviving Sepsis guidelines Hallie Prescott will be recording with us on the @icuscenarios podcast tomorrow - what burning questions should we ask? @PulmCrit @ABsteward @joshmcgoo @EMNerd_ #medtwitter #FOAMcc #FOAMed

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Rafael Olivé Leite
Rafael Olivé Leite@RafaelOliveLeit·
Ask her - why a septic patient is fundamentally different from any other ICU patient regarding hemodynamic and ventilatory support. - whether we still need a sepsis definition, considering that the current management is identical to any other critical patient except for early ABx in some cases
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Critical Concepts
Critical Concepts@critconcepts·
@Roger_Organ @icuscenarios @PulmCrit @ABsteward @joshmcgoo @EMNerd_ I would say most are in the same "when it's getting worse not better" headspace but the push to give sooner seems to be fairly consistent (SCCM basically says give to everyone with septic shock), so I think I've moved to sooner too. but I still would not give for very mild shock
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Keşfet

@drkeithsiau @PulmCrit @traumaicurounds @ThinkingCC @nickmmark @emcrit @RafaelOliveLeit @icuscenarios