Philippe Rola

Last few days for early bird! Join us in Montreal next september! #HR26 Nothing quite like it... thinkingcriticalcare.com/2026/01/16/fou…

If you considered fluids in this case, please come to HR and help save some of your future patients. thinkingcriticalcare.com/2026/01/16/fou…

It is terrifying that 33% gave fluid to a struggling RV with an underfilled LV. Terrifying.

@nickmmark Have you ever had to call in a plumber at night for an emergency?😳 no chance they move for double that.

This is insanely low for a cardiologist, especially without benefits and in LA.

Christ is Risen! Happy Easter. Joyeuses Pâques.

🤦🏻‍♂️its spreading. @icmteaching @khaycock2 @EMNerd_ @emcrit @PulmCrit @Francofoam1

Et ce n'est que la pointe de l'iceberg. Demain, on publie le document complet. Et ce que vous allez découvrir est encore plus troublant. Le gouvernement Carney a annoncé le projet de Grays Bay au Nunavut, une route vers une mine d'Izok Lake. Mais à qui appartient cette mine? Au gouvernement chinois. 750 millions de vos impôts vont servir à construire l'infrastructure qui permet à une entreprise d'État chinoise d'extraire nos ressources stratégiques de l'Arctique canadien. Les Canadiens paient la route. La Chine prend le minerai. Merci à Benoît Dutrizac et à toute l'équipe de QUB Radio pour la plateforme. Le document complet sort demain. Restez avec nous.

@DrRJWebb @iceman_ex No i just saved the link, there’s a paywall?

@ThinkingCC @iceman_ex Don’t suppose you’ve got a PDF of this?

Now this is interesting.

All those of us who know @Aiemannzahabi know. This is one of the good guys.

@ImagenCardiaca This is not new at all…🤷🏽‍♂️

Acoplamiento ventriculoarterial derecho. Un nuevo parámetro en el estudio de la función del ventrículo derecho 📘 buff.ly/2xGCI37 ◀️ Repaso de la Trukipedia publicada en RETICweb

@alexgauthier92 Bonne chose. Malgre que je sois non-praticant, dans les dernieres annees c’est clair que ce tissu commun est necessaire pour ré-unir l’occident.

On observe aujourd’hui au Québec une recrudescence du christianisme chez les adolescents et les jeunes adultes. Certains l’expliquent principalement par une quête de sens, amplifiée par la visibilité d’influenceurs chrétiens sur les réseaux sociaux. Cette hypothèse est plausible, mais elle reste incomplète à mon sens. Je crois en effet que cette recrudescence reflète également une dynamique culturelle et identitaire. Lorsque des formes religieuses exogènes gagnent en visibilité sur un territoire, la tradition religieuse historiquement constitutive de l’identité collective de ce territoire aura tendance, selon moi, à se réaffirmer Autrement dit, il ne s’agit pas seulement d’un « retour du religieux », mais d’un processus de réaffirmation culturelle, dans lequel le christianisme joue le rôle de marqueur identitaire face à la montée du pluralisme religieux. Évidemment, je ne suis pas sociologue, donc mon analyse est davantage celle d'un citoyen que d'un académicien.

@zaidheartsci @NephroP @Inamanotherapy @khaycock2 You just don’t know what you don’t know. 🤷🏽‍♂️

@NephroP @Inamanotherapy @ThinkingCC @khaycock2 Precisely. In my experience, congestive nephropathy mimics prerenal azotemia. Without POCUS, fluids become iatrogenic nephrotoxins in the setting of venous hypertension.

For the Specialist not trained in the Gen Med here is an important but overlooked tip for your patient's Creatinine problems: If the BUN/Creatinine ratio is >20- Give Fluids. The Creatinine will normalize after 24 hours If the BUN/Creatinine ratio is <20- Call the nephrologist. This is not your patinet to treat !

@Inamanotherapy @NephroP @khaycock2 In fact, one of the reasons pocus did not get taken up very quickly was the lack of billing codes for many docs in many places.

@ThinkingCC @NephroP @khaycock2 If you do POCUS free of cost, more power to you 💪

@Inamanotherapy @NephroP @khaycock2 I don’t have a code to charge pocus, my friend. Just prefer precision medicine.

@NephroP @ThinkingCC @khaycock2 One more thing to add to the bill of the patient I can understand use of POCUS in the ICU But using it routinely in ward patients is a sheer lack of confidence in one's clinical skills

@Inamanotherapy @NephroP @khaycock2 Lol ok.

@ThinkingCC @NephroP @khaycock2 Its because clinical skills are not taught in the west

@Inamanotherapy @NephroP @khaycock2 Lol seen them fail over and over whilst being strongly advocated for.

@NephroP @ThinkingCC @khaycock2 Since when do you need to do POCUS before giving Fluids? Every heard of clinical skills, examination, Clinical judgement ?

@NephroP @Inamanotherapy @khaycock2 Absolutely

@Inamanotherapy BUN/Cr is often elevated in congestive nephropathy. “Prerenal” doesn’t automatically mean volume depletion. Reflexively giving fluids without #POCUS can be harmful. @ThinkingCC @khaycock2

🙌🙌🇨🇦⚜️

@nickmmark @Srivatsa34 @JumpSeatMedic Agree, when we use TEE to adjust compressions, the adjustment is quite limited with Lucas. You can only go a little bit sideways so often times we remove it. Plus, a couple of liver lacerations has gotten me fairly disenchanted.

That’s not what studies have found. A meta-analysis of 24 real world studies n=111,000 cardiac arrests (not CPR on mannikins) found no increase in survival with LUCAS. Use of the LUCAS device was associated with WORSE neurological outcomes compared to CPR. pmc.ncbi.nlm.nih.gov/articles/PMC10… Additionally the device can fail suddenly, causing prolonged interruptions in CPR. sciencedirect.com/science/articl… I totally get using it if rescuers are fatigued, there’s limited people to do CPR, or if you can’t move around (helicopter, cath lab, etc) but let’s not pretend it’s better. It’s demonstrably worse.

The LUCAS device isn’t new or “advanced” it’s been around since 2003. It’s never been shown to produce better survival or neurological outcomes compared to CPR. 2025 AHA guidelines recommend AGAINST using it. Learn CPR. Also this isn’t a heart attack it’s a cardiac arrest.

@WithAScalpel @Srivatsa34 The LV fills the arterial tree, that’s interface one. The arterial tree, then feeds the capillaries, depending on adequate coupling at interface two. It’s quite important to understand the difference.

Understanding the Right Ventricle🤔 👉The RV–lung circulation functions as a low-pressure pathway within the systemic circuit, sustaining LV preload and forward flow. 👉“The RV fills the LV” — the RV serves as a second systemic pump, maintaining circulatory continuity.