Internet Book of Critical Care 📖

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 🫡

the IBCC will look a little wierd for the next few days, it’s getting a minor makeover.

⁦@PulmCrit⁩ chose a reflex 🔨 over a 🩺! That & 👇episode are why ⁦@PulmCrit⁩ is hereby inducted as a #neuroicu 🧠doc! 🙏 ⁦@adamdavidthomas⁩ ⁦@PulmCrit⁩ #ibncc overcast.fm/+OiJpS9pC8

if Adam ever goes missing for a prolonged period of time, check the sound studio… we might have gotten lost in a physiologic rabbit hole 🤣

introducing the Internet Book of NeuroCritical Care (#IBNCC) 🎆 🧠 26 new chapters, to create a full neurocritical care text integrated into the IBCC 🧠 review & podcasts from neurocrit gurus @caseyalbin @drdangayach @rkchoi 😃 🧠 #FOAMed 📲 details: emcrit.org/pulmcrit/ibncc/

@CElvander work is ongoing :) more casts & chapters to come

@JoshHMD thanks!!

despite climate catastrophes in british columbia and COVID, we squeezed in a recording today & we’re trying to get you some good casts for the holidays 🎄. hats off to @adamdavidthomas 🎩

@msenussiMD @CardioCrit @Kartopia hopefully the video format will allow embedding this awesomeness into the IBCC 😛

**COMING SOON** Cardiocrit.org (@CardioCrit ) will be dedicated to a wide range of topics in cardiac critical care using impactful educational video series with the goal of becoming an encompassing resource for all! Created by @msenussiMD @Kartopia. Trailer below!

not simu-live tweeting as absolutely cannot do justice to the excellent @ExtripWorkgroup session at #KidneyWk organized by @weddellite but want to highlight this @DavidJuurlink quotes the IBCC on the big screen! @PulmCrit Salicylate is a huge mimic!

@jackdeliuc @PulmCrit @stEMple_pharmd @EmergPharm @RxEmergency @MichaelSheeser @mbisanzo I think so as long as the diagnosis is correct and you closely monitor the Bp.

@PulmCrit @stEMple_pharmd @EmergPharm @RxEmergency @MichaelSheeser @mbisanzo @iBookCC Hello. Are these nitro high doses relative safe in very elderly pts with SCAPE too?

SCAPE (Sympathetic Crashing Acute Pulmonary Edema) - fresh chapter! 📸 vicious cycle ➡️ rapid deterioration ("flash edema") 📸 bedside dx based on history & POCUS 📸 key tx = CPAP/BiPAP & nitroglycerine gtt (high pressures & high doses). take no prisoners. emcrit.org/ibcc/scape/

emoji hyperlinks 😁 I’ve been struggling to find the cleanest way to insert links into text, and this might be it. different emojis signal where the hyperlink jumps to. here is an interpretation key:

update to pulmonary vasculitis, based on PEXIVAS & Canadian vasculitis guidelines 🍁no routine role for plasma exchange in ANCA vasculitis 🍁no solid data to support steroid pulse, should use caution (eg, limit to 3 days & 500 mg/d methylpred, or less?) emcrit.org/ibcc/dah/

@drshahzaibahmad @PulmCrit agree, remifentanyl gtts may be allright. I must admit that I don't know much about remi since it's very expensive and rarely used for this purpose in the united states.

@PulmCrit @iBookCC I know you don't like opiate infusions in general, but in the UK, some places use remifentanil infusions which would satisfy most of your grievances with opiate infusions.

neuroprognostication post cardiac arrest - fresh chapter! 🔮avoid confounders (benzodiazepines, opioids, 33C). this is good ICU care in general (accelerates wake/wean) 🔮EEG is accurate if done properly (no meds on board, paralysis to eliminate artifact) emcrit.org/ibcc/np/

With that last podcast we just hit a milestone, ?2million downloads. Thanks everyone for your continued support of my bromance with @PulmCrit and his epic efforts at the @iBookCC

@AG_EM33 @PulmCrit @laertezz @waknight4 @UCcritcare @karigorder @NickJohnsonMD @nickmmark @JenelleBadulak @christian_renne hahahaha tempting to do that just to see the ensuing chaos… people are passionate about their airways

@PulmCrit @laertezz @waknight4 @UCcritcare @karigorder @NickJohnsonMD @nickmmark @JenelleBadulak @christian_renne @iBookCC You can be like “Start intubating with Millers all the time” with a couple nice emojis, a GIF, and some sort of table … and we’ll all probably start

#MedTwitter - what advice do you have for an incoming #CriticalCare fellow? ☑️Edu resources/readings? ☑️Real time clinical resources? ☑️Rounding tips & tricks, etc. @waknight4 @UCcritcare @karigorder @NickJohnsonMD @nickmmark @PulmCrit @JenelleBadulak @christian_renne

@NPugliese16 @laxswamy the only thing an ativan drip is useful for is end of life palliative care.

@laxswamy @iBookCC I not only distinctly remember this but am acutely aware and dealing with it because we STILL have providers doing the ativan drip thing despite adequate education AND order set builds

What they said we'd get with vit C for sepsis we ACTUALLY GOT THAT with phenobarb for etoh withdrawal but it really doesn't get the love it deserves.

@laxswamy thanks!! 💯💯 agree: super-delirious intubated EtOH withdrawal patients who linger in ICU have dissapeared from my hospital. we load with phenobarb and dispo to floor the next day (or keep in ICU to treat other issues). 🙌

this thread is dedicated to @iBookCC emcrit.org/ibcc/etoh/

Post cardiac arrest chapter updated! ❄️hypothermia is gone, but avoidance of fever remains critical ❄️integrated, multimodal strategy for management of fever & shivering may limit need for opioids & paralytics ❄️continuous invasive temp monitor still key emcrit.org/ibcc/post-arre…

😍 love the sudden death panscan. added some sweet infographics from FOAMcast to the IBCC chapter on post-cardiac arrest management 🙏🙏 emcrit.org/ibcc/post-arre…