Bhaskar

@nelson_piercy @NickHartGSTT Long term sequellae of critical illness are a real issue and postpartum is a particularly vulnerable time. Good to see #enhancedmaternalcare #emc mentioned too, and recognises the importance of collaborative working and network support for standalone units.

A new Maternity Early Warning Score (MEWS) to be rolled out across the NHS. Derived from real data from >1000 pregnancies, it used statistical modelling to set appropriate thresholds for vital signs, reducing unnecessary alerts. doi.org/10.1136/bmjmed… @UniofOxford @NHSEngland

Calling all physician trainees! Join us at the #PERT2024 for the Physicians-in-Training Bootcamp. This hands-on course is designed to equip you with the latest knowledge and skills in PE diagnosis and management: pertconsortium.org/pert-bootcamp/

@DrSiara @danfurmedge Agree really good points. Yet the asthmatic comes in with classic PE symptoms, no wheeze, still given steroids and nebs cos of the asthma label. PE not considered, no CTPA on initial review (subsequent scan confirmed big PE). There really is a cognitive/reasoning issue here.

@danfurmedge Totally agree. I spent most of my day trying to cancel unnecessary CTPAs, VQ scans and Dopplers. Managed most, but once the seed is planted, some patients (and some clinicians) cannot be reassured without the ‘promised’ next step. 😐

@tscquizzato @SharonEinavMD @ISICEM I've found specialist ICU pharmacists to be a really valuable part of the team and can help share this workload.

In the ICU, decisions come fast and frequent! Intensivists are making over 100 decisions during rounds, mainly on medications Each clinician averages over 200 decisions in a 24-hour period, often based on critical events. Shared by @SharonEinavMD at #ISICEM24 @ISICEM

@StephenLap @anitaobsmed Interesting one. I normally would b-block only once the acute pulmonary oedema is resolving (can be as soon as a few hours) But in someone like this with valve issue and pristine LV maybe it could be introduced earlier to increase filling time? Thoughts?

@icumedix @anitaobsmed and beta-blockade!

Good case. Anticoagulate and furosemide first line. Obstetric cardiology and up skill the generalists more to be done @theUKMCS @DawnAdamson6 @AnnaHerrey @mbrrace

@OAAinfo announces launch of the QRH for Obstetric Emergencies to assist all #OBAnes and colleagues providing best emergency obstetric EBM care. Visit oaa-anaes.ac.uk/qrh @RCoANews @Assoc_Anaes @BAPM_Official @M0MSuk @ResusCouncilUK @BMFMSNews @BICSoc @CollegeODP

@JamesCleverly Apart from being a cruel and frankly idiotic policy amidst a social care crisis, why is "stop the boats" on this poster? Do care workers or their families arrive in boats?

Today in Parliament we have laid an order to ban overseas care workers from bringing dependants. This is just one part of our plan to deliver the biggest-ever cut in migration 👇

@RoyalSurrey Amazing, congratulations!

🎉 Our maternity service has been rated the best in the country by new mums in a CQC assessment summarising the experiences of 25,515 patients across 121 NHS Trusts in England. Read more: ow.ly/Un9U50QAyTQ

Q: What are the contemporary management strategies & associated outcomes in patients w/ high-risk pulmonary embolism? A: Patients w/ high-risk acute PE experienced higher rates of all-cause mortality than patients w/ intermediate-risk PE. bit.ly/3TGLHTD #JACC

@PulmCrit UKTIS and lactmed are useful @medsinpregnancy . The SmPC is often helpful too although it can be wordy @emcdatapharm - admittedly these are all UK/EU sources though.

must admit that I miss the ABCDX system for drug safety in pregnancy. this is what Epocrates & Medscape say about the safety of ibutilide in pregnancy. it’s like a mashup of a haiku and a fortune cookie. what is your go-to reference for drug safety in pregnancy?

Test match cricket is alive and well. ❤️

@PrinjaPaarul presenting about chest pain and red flags in pregnancy #enhancedmaternalcare #obstetricmedicine @BabyLLTraining

Latest UK maternal mortality figures released today. The maternal death rate in 2020-22 was 13.41 per 100,000 maternities. This is significantly 53% higher than the rate of 8.79 deaths per 100,000 maternities in the previous three year period (2017-19). buff.ly/3HfFpCO

🚨NEW #SAFETYFLASH📷Cortico-Steroid Dependency: The Safer Care Committee has highlighted the importance of identifying patients on steroid therapy and advise on the emergency treatment of Adrenal Crisis! For poster production head here: tinyurl.com/CSDSafetyFlash

Exciting news for all those interested in training in #ObstetricMedicine: Applications open for funded places @RCPhysicians Higher Specialty Credential rcplondon.ac.uk/education-prac…

@DrBenLovell Great thread, with a lot of truth. I didn't mind the job, but after a tough shift (esp nights) what was often missing was a "thank you", "well done" or "are you OK". In my experience ICU is much better at this and it really makes a difference (or maybe I'm just needy😅)

Being the Med Reg, a thread 🧵 I have noticed that there are many myths about the med reg role, thrown around both on twitter & in real life, presented as absolute truths. People are making career decisions, or living in mortal dread of being the med reg, based on these myths

Interesting findings. Potentially some confounders but I think the dose related association makes it plausible. A useful addition to evidence to aid counselling & dose titration, but poorly controlled epilepsy carries much higher risk so pls don't stop meds purely based on this

@veerappan91050 Looks fantastic - do you have the Programme yet and will the sessions be recorded? I'm working one of the days but might be able to swap.

on 25th Apr 2024 at International suite the lost session is Controversies - 20th ACCS - Faculties are @SheilaMyatra Dr Ravi Kumar, @avkwong @iceman_ex Prof Michelle chew and Dr Y Kobe. Come and enjoy. @CPDmatch @ICUdocX @icmteaching @ICS_updates @andymoz78 @CC_3N @CMCCN_ODN