djoll

…comment is a perplexing, face-palming admission of intellectual failure. Considered, limited introspection is a performance superpower. 2/2

One of anaesthesia's superpowers is being an aggressively introspective specialty (occasionally too much so, leading to neurotic, double-guessing & nervous anaesthetists). Reading legendary tech-VC Marc Andreeson's "I try to be as minimally introspective as possible"… 1/2

The Unseen Anaesthetist: Trust is the foundation of anaesthetic care ➡️ metajournal.com/blog/114/the-u…

@1goodtern Hehehe. We are classically the snarkily subversive ones in the operating theatre 😝 Wrote this back in July 2020: metajournal.com/blog/105/why-w…

Anaesthetists are absolute classic *team players*.

Oh my word. I've had a realisation about one of the sliding doors moments in the pandemic. I had a chat with a consultant anaesthetist a couple of months ago when he asked me why I wore an ffp3 mask, and a couple of things he said in reply didn't make sense.

A significant proportion of patients experience recallable #dreams during #anaesthesia, apparently higher with #propofol induction & maintenance, and when pre-induction psychological suggestion is used. metajournal.com/articles/35610…

I guess some people just need to touch the stove to learn it’s hot 🔥 🤷‍♂️

V interesting study out of Brisbane, revising previous estimates that suggested sugammadex hypersensitivity could be as high as 1 in 2,500. Crimmins et al. found in their data the incidence was 5-20 times less common (95% CI). → metajournal.com/articles/17640…

"Anaesthesia and Compounding Marginal Gains" – the path from mediocrity to excellence in anaesthesia isn't paved with breakthroughs – it's built on tiny improvements that compound geometrically. metajournal.com/blog/112/anaes…

"Kindness is the oxygen that sustains [anaesthesia] practice." 🙏

@ergopropterdoc Great work by all the authors of 'Still a boys club' 👏👏 interesting (unsurprising) that many of the themes identified also appeared in @TassieObGyn's similar research into AuNZ O&G gender exp → obgynequity.com (frustratingly never published by ANZJOG)

@DrAndrewHuang @parkrunAU Keep at it AH! I’m back at my Park Run too / gradually closing in on my old 22m PB, and then on to 21… 20… 19… Treadmill speed training tonight. 👍

We got to @parkrunAU early. One run closer to 50. Still well off sub-20 @djoll. Struggle to get to sub 25. Carrying an extra 15kg doesn't help. 😂

It's incredibly disappointing that it took 14 years after Florvaag & Johansson's landmark 2009 paper describing a connection between #pholcodine and NMBD #anaphylaxis, for the TGA to finally ban it. How many patients were exposed to avoidable harm? metajournal.com/collections/95…

TGA Australia … FINALLY …banned pholcodine 7 hours ago. After more than a decade of anaesthetists pushing to have this unnecessary & dangerous drug removed from Aust pharmacies, they’ve done the right thing. #anaphylaxis → tga.gov.au/news/safety-al…

@NicholasChrimes @MerlinLarsonMD1 @AirwayMxAcademy Patient’s not aware. Put tube in. …I’ve anecdotally heard that intentional total spinal was a technique used ? in the 70/80s in Sydney for thoracic surgery. Apparently very haemodynamically stable… (well, for that era. 😝 also very stably hypotensive… 😬)

@MerlinLarsonMD1 @AirwayMxAcademy Propofol. Patient may still be aware.

You accidentally inject 20 cc of 2% lidocaine subarachniod. Patient is apneic, unresponsive. ? Plan: 1. Propofol then intubate or 2. Intubate without sedation? Pupils are fixed and dilated. Why? What is mechanism? Image: MacIntosh (1957). TBC.

Let's not keep doing this: a Groundhog Day 🧵 about how to get past the COVID-19 pandemic. "COVID is never going away, so we should just learn to live with it". No, we can do better! There may still be much that can be done, e.g with vaccines (1/): medrxiv.org/content/10.110…

@Otto_English Not disagreeing with your point, but there are many large economies missing from that arbitrary list (?? perhaps this is top UK trading partners): Iran #11, South Korea #13, Australia #14, Indonesia #17 - all larger than S Arabia #18, Nigeria #31, S Africa #39 🤷‍♂️ why?

UK economy to fare worse than every single other major economy including sanction hit Russia. Absolute disaster... we're the one in red.

[FYI / who am I? Medical specialist, several Master degrees, and run medical critical care research site/data miner, with 40k COVID-related articles indexed already: metajournal.com/covid Agree we need to keep open mind, but not so open our brains fall out.! 😝] /end

It's true that there has been too much focus on vaccines alone, this is part of the reductive trap of modern medicine. But vaccines are hugely important part of a N95 😷/ clean air 💨 / vax 💉bundle-of-care. /11

@DavidSacks, @Jason, @friedberg, @Chamath a logical error when discussing mRNA vaccines: Vaccine side effects should be compared with COVID complication risks - which in EVERY age group are orders of magnitude greater than vaccine side effects. (must think probabilistically) /1