Tom Neal 💙
148 posts
"Donald Trump is reckless, immoral...he's a stone cold liar."
Here's our full sit down w @GavinNewsom from L.A. Co.'s Emergency Operation Center.
@CAgovernor says he's suing after @realDonaldTrump federalized CA's National Guard without his consent.
Exclusive via @FOXLA:
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@KatherineChin18 @MRCPUK A question worth asking of these cold hearted incompetents. Have you audited back over the last half century? Can you categorically assure us this sort of screw-up-and-over has once never happened before? Or, worse, did you spot it and just sweep it under the carpet last time?
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I’ve finished crying about this and now I’m just full of rage.
How can you do this @MRCPUK? I don’t understand. What do you mean your auditing processes found an error? 1.5 years later?!
A refund and a free booking for a resit is not enough. Show us what went wrong 😩
(n/?)
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First up Artificial intelligence in healthcare
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@WHarropG @maffygirl @nosecglasses @DrRobbieErskine @beckimarshRA @Tremayne0 @PeterMerjavy @AirwayMxAcademy Ketofol is following this …
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@boundless @maffygirl @nosecglasses @DrRobbieErskine @beckimarshRA @Tremayne0 @PeterMerjavy @AirwayMxAcademy Every patient has that sedation “sweet spot” in which they can maintain their own airway without snoring and cardiovascular system without support, but it can be hard to find in some. Indeed, I have spent whole operations seeking but not quite finding the sweet spot…
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1/9 This is my (lay clinician's) understanding of the difference between guidelines, policies, codes of practice and laws.
I welcome any and all addenda and corrigenda 🧵👇
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@maffygirl @nosecglasses @WHarropG @DrRobbieErskine @beckimarshRA @Tremayne0 @PeterMerjavy @AirwayMxAcademy GAWA AKA General Anaesthetic Without Airway. But that’s a critic’s label. More correct, and my preferred naming would be - GAWAD - General Anaesthetic Without Airway Device. But will it play in POAC preamble?
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@nosecglasses @boundless @WHarropG @DrRobbieErskine @beckimarshRA @Tremayne0 @PeterMerjavy @AirwayMxAcademy I would suggest many RA sedations are actually Gedations…
General anaesthetic sedations 😊
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@WHarropG @maffygirl @DrRobbieErskine @beckimarshRA @nosecglasses @Tremayne0 @PeterMerjavy @AirwayMxAcademy For all patients nervous of orthopaedic carpentry noises or susceptible to feeling exposed and vulnerable GAWA-WRA can finally speak its name ?
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@maffygirl @DrRobbieErskine @beckimarshRA @nosecglasses @Tremayne0 @PeterMerjavy @AirwayMxAcademy Most patients asking for a GA are asking for unawareness rather than specifically for a GA, and unawareness can readily be provided by GA + judicious sedation. I give precious few GAs these days but most of my patients are blissfully unaware.
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@MerlinLarsonMD1 As,of course, does the ED50. Like has nociception been covered by the necessary other therapeutic manoeuvres? Regional nerve blocks as a favoured for instance …..
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MAC is an ED50 for volatile anesthetics (50% effective dose for movement). Dropping a vertical line from the ED99 ideally should not cross the line that characterizes the lethal dose (LD). But the lethal dose curve depends on who gives the anesthetic.
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@WHarropG @doctimcook Grains per gallon back in the day. Plenty soldier proof. Until the fiendish Imperials took away our precious Winchester standards in 1826. Serious point: it’s not the units that sow confusion, it’s the interminable multigenerational transition process
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@doctimcook We may be able to slip effortlessly between % and mg/ml but, as demonstrated by the Coroner's 2%/0.2% error, not everyone can be expected to. Prefilled bags of ROPI LIA with a clear label giving "maximum ml/kg patient weight" would help - we all understand ml and kg... don't we?
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A tragic death
bbc.co.uk/news/articles/…
Large volume LA infiltration (by a surgeon) now commonplace joint replacement, plastics & vascular surgery
Falls between stools
- who is the prescriber
- who is responsible for preparation
- who is responsible for complications
Coroner's prevention of future deaths may surprise some
judiciary.uk/prevention-of-…
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@Xeon4f145d96s1 And the redacted bit? Would it make the piece more truthful to have left that in to be read as the writer no doubt intended ?
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Sounds slightly inappropriate for a PA to be doing…
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@adharanand And the medical certificate says what? That the bearer has had full cardiological screening work-up to exclude hypertrophic cardiomyopathy and congenital coronary anomalies? - which are pretty much all an actuary would tip his glass to as a cause of sudden death in park runners.
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No parkruns in France because French law requires every runner to have a medical certificate from a doctor. Just to run/walk 5km. Have to say, that's ridiculous.
parkrun 🌳@parkrun
parkrun France – an update Following recent updates published by the French Athletics Federation, we have unfortunately concluded that parkrun events in France will remain suspended for the foreseeable future. Read a detailed update on our position 👉 parkrun.me/fxi4o
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@SuzRankin @BowenBBC Is this Same Day Emergency Care? #EmergencyMedicine #SDEC #SuzRankin #BowenBBC #frail #frailty #AmbulatoryCare #NHSWales
Jeremy Bowen@BowenBBC
This is my mother Jennifer, who has been waiting on a plastic chair at the Heath Hospital in Cardiff since 4pm yesterday @CV_UHB she’s there because she’s ill. My sister @brigidbowen says Jennifer managed about an hour’s sleep.
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@SuzRankin @BowenBBC Same Day Emergency Care #SDEC #frail #frailty #UrgentCare #AmbulatoryCare #NHSWales
Jeremy Bowen@BowenBBC
This is my mother Jennifer, who has been waiting on a plastic chair at the Heath Hospital in Cardiff since 4pm yesterday @CV_UHB she’s there because she’s ill. My sister @brigidbowen says Jennifer managed about an hour’s sleep.
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@Maplesonabcde @AnaesUnited The picture. Look at it. It’s not a good look.
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6 Resolutions. 6 overwhelming majorities. Thanks to all those that voted for our resolutions - a clean sweep!
We would like to extend our thanks to the College for working with us so constructively.
And lets be proud that we're Anaesthetists. Anaesthetists United.
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@AnaesUnited Totally separate from the debate:- Posting images such as the above is a disgrace - even if AI generated, which I suspect it is. Please refer to the AAGBI plea on their official ‘X’ feed to respect the humanity of all current Associates. The image comes across as frankly ghoulish
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Tom Neal 💙 ری ٹویٹ کیا
Today I can share I'm challenging the PM on the legality of abandoning key Net Zero commitments
I believe the timeline for the UK to meet Net Zero cannot be changed at will by the PM – I contend that he does not have the legal right
The ball is in your court , Prime Minister
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@churchill_alex @kejamieson_ Mere mereological essentialism. As in the Ship of Theseus, or Trigger’s Broom, even? HMS Victory not as a thing, nor even a collection of objectively existing thing parts, but rather as an organisational structure that has perceptual continuity?
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Tom Neal 💙 ری ٹویٹ کیا
This isn’t just vandalism, carpenters marks on HMS #Victory, kept track of beams coming and going during maintenance work. A wooden ship is a constantly evolving work of art. If she’s being looked after properly she won’t go from one year to the next without changes @kejamieson_ @PHDockyard
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Tom Neal 💙 ری ٹویٹ کیا
Most people STILL don’t know what peril they are in. This will be the coolest summer for the rest of your life, and that shouldn’t be just a meme - it should be actually terrifying. The ONLY path out of this heat nightmare is to end fossil fuels ASAP
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