Bojan Korda

@AriFilipMD @IM_Crit_ Yes yes yes. Have pulled back patients on ridulous doses (>5ug/kg/min of norepi and adrenaline) in CCB overdose. Hardest fight is getting them to put lots of vials into a small bag of diluent.

@IM_Crit_ As a toxicologist -- I could not agree more. The first thing I tell anyone treating a CCB overdose: "completely discard any notion you had of a 'max dose'." My big concern going up >1-2 mcg/kg/min is that they don't concentrate the pressor and bring along too much fluid.

ICU Facts: There is no way you can work in a 🇺🇸 ICU without hearing the expression "the patient is maxed out on pressors". This means that the pt is on the maximal dose of pressors (usually norepi) allowed by the institutional protocol Even though the “maximum dose” of pressors

🌟 STROKE - Vascular territories and neurodeficits

ICU (Central Venous/Arterial) Line Secrets - Part 1: An ICU where the patients have no central lines & are not connected to ventilators is not a real ICU. This may be a controversial statement but in my humble opinion not far from truth

Brain health: A concern for anaesthesiologists and... : European Journal of Anaesthesiology and Intensive Care journals.lww.com/ejaintensiveca… Perioperative Brain Health should be a Mission of every anesthesiologists and intensivists, including the health of our own brain!

Congratulations to all our EM colleagues in Portugal which has officially recognised EM as a speciality. Fabulous news for many amazing clinicians (and patients) in Portugal.

ICU Stories: While walking around the ICU at the beginning of your night shift, you notice that the respiratory therapist increased the FiO2 from 90 to 100% in a mechanically ventilated patient. Bedside monitor shows O2 sat 90%. You decide to read a bit more about the patient:

@PulmCrit Finally do you think there is a point in doing a ‘loading’ dose with any of these agents?

@PulmCrit Then in my shop we will use ondansetron (or similar) and another agent and time it so that if ondansetron is given at 8hrly, the second agent (often metoclopramide) is given in the middle of the dosing interval. Eg ondansetron 0800 1600 2400 Metoclop 1200 2000 0400

updating the IBCC chapter on antiemetics. any pearls or new articles on antiemetics? strong opinions? myths to be busted?

@BryanGlezerson @PulmCrit Agree with this.

@PulmCrit If you have an admitted patient, a very low dose of propofol (~10 mcg/kg/min) is a stupendous antiemetic and can be used safely in adults and children without sedation.

Very pleased to announce that ASOS-Paeds has been published in The Lancet. Well done and thank you to the ASOS-Paeds investigators. authors.elsevier.com/a/1ioi4_3CjG8u…

Sharing this again for those who need it today.

🧵1st workshop: Paediatric EEG. Great to listen to Patrick Purdon and Choon Looi Bong. Utility of eeg monitoring in very young reinforced. Know you drug signatures and you will be able to recognize for the most part what drug is being delivered when assessing the DSA. #WCA2024

The European Society of Emergency Medicine has published new recommendations on Emergency #Airway Management 🧵

You've probably heard that Bicarbonate has to turn into CO2 to raise the pH. “Don’t give bicarb if you can’t increase ventilation.” But how much CO2 is there in an amp of sodium bicarbonate? A bicarb 🧵 1/

@PriYeah7 Yes

Now that my heart rate is finally back to normal, is it really necessary for you guys to shoot each other in the LARYNX

One advantage of anaesthetising in theatre rather than the anaesthetic bay, is that you keep it a team sport. Surgeons can watch, send good vibes, help as required - just as we do for them.

So can the CT apply for the locum PA shift? Why is the PA being paid more than the registrar when they can do less than an FY1? I hate it here.

I asked ChatGPT to come up with some mildly mocking terms to describe people who believe anaesthesia is possible to achieve in humans. The best three it offered were "Napwizards", "slumberquacks" and "numbologists". I quite like those and might get my NHS name badge updated.

Today is #WorldSepsisDay Sepsis accounts for 11% of maternal deaths in Australia 1:4 of these deaths is caused by Group A beta-hemolytic streptococcus/ GAS somanz.org/downloads/2017… #ThinkSepsis #ActFast #StopSepsis #SaveLives