Discover and read the best of Twitter Threads about #ICU

Most recents (24)

AIIMS, New Delhi
CLINICAL GUIDANCE FOR MANAGEMENT OF COVID-19 (Version 2.1) 3rd May 2021
#Severedisease
Any one of:
1. Respiratory rate > 30 /min
2. SpO2 < 90% on room air
Admit in #ICU
(1/2)
Respiratory support
• Consider use of NIV (Helmet or face mask interface depending on availability)/HFNC in patients with increasing oxygen requirement, if work of breathing is LOW
(1/3)
• Intubation should be prioritized in patients with high work of breathing /if NIV is not tolerated
• Use conventional ARDSnet protocol for ventilatory management
(1/4)
Read 7 tweets
Guys, I will be making a thread for people in Banglore regarding COVID for them to be able to get beds, food, and other things they might require. DM me links if you have any. #bangalorecovid #CovidResources #CovidHelp
docs.google.com/spreadsheets/d…
Register with BBMP to get beds and at least starting the process. Check this out -
For getting Oxygen cylinders, reach out here. The service is working -
Read 21 tweets
In keeping with its ethos of selfless service to the Nation, the #IndianArmy has created a number of #COVID facilities on a war footing in order to provide extensive medical assistance to veterans and their dependents at a number of places.(1/n)
One such facility has been created at Base Hospital Delhi Cantonment #BHDC where the entire hospital has been converted into a Covid hospital. At the start of the current COVID wave, the Base Hospital catered for 340 COVID beds of which just 250 beds were oxygenated.(2/n)
A plan was quickly put in place to expand the capacity to 650 COVID beds of which 450 beds will be oxygenated by 30 April 2021. The Intensive Care Unit #ICU is also being enhanced from 12 beds to 35 ICU beds by 29 April 2021. (3/n)
Read 8 tweets
#BombayHighCourt bench headed by #chiefjustice Dipankar Datta to hear a #PIL filed by advocate Sneha Marjadi highlighting #OxygenShortage in various govt-run and private #hospitals in #Mumbai. HC on Tuesday had asked the Centre, State and .@mybmc to come prepared
In the last hearing, the bench had ordered the authorities to ensure there is consistent supply of #Oxygen and #Remdesivir, and to also ensure that the public at large is made aware that #Remdesivir isn't a 'MAGIC DRUG' and must be used sparingly
The Bench has assembled. Hearing begins
Read 33 tweets
There's a FANTASTIC ethnography of ECMO in press @AnnalsofSurgery with 380 hours of observations and 47 interviews with families and clinicians of 20 #ecmo patients. There are A LOT of parallels to mechanical ventilation in the #ICU.

@ATSEthicsCOI #CriticalCare #MedTwitter
Phase I of ECMO: Was there ever really a choice? When the options are "miracle" vs "lay there and die" why are we even asking? (besides being legally required)
Phase II: The clinical team believes they own the patient's body. They escalate care until they feel they've hit the "care ceiling" and there's nothing left to do.
Read 7 tweets
"A lethal, fast-paced second wave of the coronavirus pandemic has brought #India’s health care systems to the verge of collapse & is putting millions of lives & livelihoods at risk."

nytimes.com/2021/04/20/opi… #CovidIndia
1/ "The newspapers & social media are scrolls of horror & failure of the health system. There are reports of lines of ambulances with patients waiting outside the largest Covid facility in #Ahmedabad in the western state of Gujarat because ventilator beds & oxygen had run out."
2/ "At a crematory in the central city of #Bhopal, residents reported having not seen as many cremations since 1984, when a gas leak from a Union Carbide pesticide plant in the city killed around 5,000 people."
Read 20 tweets
Announcement from @fordnation sank my heart today. As an ER doctor, person of color and #Scarborough native, I feel defeated 😢. The measures are not going to get wave 3 under control. #BIPOC #ERdoc @SHNcares @torontolife @JustinTrudeau @SCMirror 1/
When I landed as an #immigrant in #Canada, my life started in #Scarborough. My parents (#heros) struggled to find jobs that matched their education. That didn't stop them from working hard / hustling even if it meant 2 jobs at times to keep bills paid and food on the table. 2/
My family lived in an apt building that had mostly racialized/middle-low income families (#affordability). Not much social distancing when large crowds wait for elevators (#EssentialWorkers) or use the shared laundry facilities. This pandemic brings back those vivid memories 3/
Read 12 tweets
Appeal to help the concerned authorities of #maharashtra #COVIDー19
We have a defunct #hospital of 200beds in the city of Pune. Given #COVID19India situation in #Pune where bed availability is zero we are willing to give out our space to both private & government players who have Image
The expertise & team to kick-start this and manage the load. @MoHFW_INDIA @CMOMaharashtra @HospitalsApollo @AdityaBirlaGrp @fortis_hospital @republic
@TimesNow @anandmahindra
#twitterati PLZ RT to the right authorities.
Disclaimer- As a family of doctors we have 0 vested
2/n interest besides helping the #healthcare system and its torch bearers battle this pandemic while saving as many lives as possible.
Read 6 tweets
Nu zelfs jonge #zwangere vrouwen met👑op😱🚑 #care🆘 destentor.nl/binnenland/nu-…🚑ziet hoe #ICantBreathe IC💥s. In 4🚑huizen regio @PolitieUtrecht van🕛daag 206🚑van wie📍63 op #ICU📍🚑noemt⌚moment van versoepel🎲ingen🎢‘rare🕖ng’ aantal👑🚑 op ic’s📍neemt📈toe & veel😱🚑 #jong🆔e💉
As a former Clinical Research Associate I announce an #audit of the 4 hospitals in the #Utrecht region.

@PolitieUtrecht organise it for me & get back to me in writing, here,📍 when & where, per quoted 4 hospitals, I can show up, un-announced🔎 #plandemic
Erin enlisted in @USArmy when she was 17, shortly before #911Truth
& deployed in support of Operation🚑 #Iraqi #freedom💥in 2003

#Bilderberg 2002 youtube.com/playlist?list=…🆘#3 discussed 2003 #Iraq war in 2002 Image
Read 10 tweets
1/ Zu meinem gestrigen Thread bzgl. #ICU-Belastung durch #Covid19AT (ich sag bewusst nicht Auslastung) noch ein paar neue Erkenntnisse bzw Analyse-Versuche was das Zahlenwirrwarr betrifft:
- Man sieht in den meisten Bundesländern dass sich die "für COVID reservierten Betten"
2/ in ruhigen Zeiten ca an der kritischen 33% Belastungsgrenze befinden. Heißt also "so viele könnten wir grad noch verkraften". Kann man von mir aus nachvollziehen, sollte man aber als 100% Covid Auslastung definieren, alles darüber dann als >100%
Kärnten ist etwas vorsichtiger
3/ in OÖ sieht man auch die Orienterung an den 33% und wie dann die Kapazitäten schrittweise erhöht werden wenns gebraucht wird. also den november könnte man schon als 200% Covid-Auslastung sehen.
Read 13 tweets
Die #ICU-Situation in Wien ist laut Corona-Kommission tief-ROT. Das deckt sich auch mit den Berichten von @docjosiahboone und @AlgeMartin .
Das #AGES Dashboard hingegen berechnet eine "Auslastung" von 56%.

Hier beide Darstellungen in einer Grafik
Auch in NÖ ist der von der Corona-Kommission definierte kritische Schwellwert von 33% an der Gesamt-ICU-Kapazität deutlich überschritten.

AGES Dashboard: Alles nicht so schlimm, haben noch Betten reserviert. Wo sind die und wer liefert das Personal?
Burgenland ist ebenfalls rot. Schade dass man diese Einschätzung der Corona-Kommission in keiner Grafik sieht. ich versuche das hier gerade
Read 17 tweets
1/ A thread about Canada's #EmergenciesAct from a lawyer. It is important to discuss this now. The deadlier & faster-spreading #COVID19 #P1 #Variant is spreading across #Canada & something needs to be done to save lives (including against #LongCovid).
2/ The federal Emergencies Act allows the federal Governor in Council (i.e., the prime minister & cabinet) to declare 4 types of emergencies.

This thread will focus on the type of emergency called the #PublicWelfareEmergency.
3/ A #PublicWelfareEmergency is an emergency caused by a real or imminent disease in human beings, in the context of #COVID19.
Read 10 tweets
#PIMS/#MISC uitgelicht.
Samenvatting van #NDR #Podcast #Coronavirusupdate #Folge81 met @KorinnaHennig , @CiesekSandra en prof. Christian Dohna-Schwake, #Kinderheelkunde, #ICU, #infectioloog Leider IC UZ Essen 🇩🇪over #PIMS #MISC
@HarrySpoelstra @kwinkslager @SDicht @PESCOV19
U bent kinderarts en u heeft zelf ook vier kinderen. Als u de situatie bekijkt op scholen. Er is nog steeds geen regelmatige testing en de besmettingen van kinderen stijgen volgens het RKI. Er zijn verschillende redenen om de scholen open te houden of te openen.
Hoe beoordeelt u de situatie van scholen in Duitsland, beroepsmatig en privé? Ergens heb ik een beetje geluk bij het formuleren van mijn antwoord, want de paasvakantie staat voor de deur.
Read 45 tweets
🔥I am excited to share the outstanding interim results from #FLASH registry that were presented yesterday at #SIR2021!!💥

#medthread #tweetorial
1/11
The treatment of #PE has been plagued by high acute mortality rates. Current risk stratification relies on #thrombolytics which carry a significant bleeding risk. #medthread #FLASH

2/11
The #FlowTriever System, the first FDA-cleared mechanical thrombectomy system for #PE, is purposely designed to capture and remove large clot burden from big vessels in a single session without the need for tPA or prolonged #ICU stay. #medthread #FLASH

3/11
Read 11 tweets
Basic of lung #ultrasound #ACVC2021 @hatemsoliman: increasing use, evolving evidence, increasing literature on applicability/value in #ICU
🫁normal parenchyma NOT visible
🫁pleura/lung interface reflects US generating artifacts
🫁ICS -> acoustic window
#POCUS #echofirst #FOAMus
Basic lung #ultrasound 2 #ACVC2021 @hatemsoliman
🦇bat sign: rib shadows on both sides & pleural line + horizontal lines, reflections of pleural line, labeled as A lines, commonly reflecting lung aeration
#POCUS #echofirst #FOAMus
Basic lung #ultrasound 3 #ACVC2021 @hatemsoliman
🫁 lung sliding, shimmering motion of 2 layers of pleura ruling out PTX, but can be lost due to other causes
🫁 lung pulse due to reduced lung aeration with transmission of cardiac pulsation at every beat
#POCUS #echofirst #FOAMus
Read 6 tweets
Shocking account of a hospital whistleblower in #Sibiu on how the #COVID19 patients are sent to #death as a practical default option in the hospital. [1/4]

In Romanian: turnulsfatului.ro/2021/03/07/rdq… #ICU #Romania #hospital #Thread
A whistleblower working in the intensive care unit of the COVID19 hospital in Sibiu recognised that it killed patients by following the intubation procedure in an universal way for the peacefulness of doctors and nurses: "I myself murdered people, because I worked there." [2/4]
It included interventions applied in a robotic way, including through procedures not recommended scientifically. Doctors and nurses unprepared for the job. Careless health workers. Lack of differences in the intervention despite specific comorbidities. [3/4]
Read 5 tweets
Let's do a new tutorial

GI-Bleeding for non-endoscopists

#MedTwitter #GITwitter #livertwitter #ICU #FOAMed
@stevenbollipo @drkeithsiau @ebtapper @jaumebosch9 @GI_Pearls @DrHarryThomas (these are endoscopists)
First rule, stay cool
There are three different GI-bleeding locations:
upper (until suspensory muscle of duodenum)
middle
lower (starting from the coecum)
Read 52 tweets
Dr. Cook begins her #CCC50 Lifetime Achievement Award talk with reflection on her own 1st presentation ever as an #ICU fellow- at an @SCCM Congress! She was struck by the interprofessional group of attendees.(Thread)

#NationalWomenPhysiciansDay #WomenInMedicine #clinicalresearch
Her first lesson learned to impart to us.

BE BRAVE.

An early senior researcher said to her early in career:
"I just don't think research is in your future"

Imagine what #CriticalCare world would have lost if she had listened.

#CCC50 #pulmcc #PedsICU
Dr. Cook: Sometimes dialogue is more important than consensus. You have the TRUST YOUR GUT. #CCC50

You're not growing until you're changing. Defining moments for bravery may come along when you least expect them. Be brave. #WomensPhysicianDay #PedsICU #pulmcc #ICU
Read 14 tweets
Only order tests when it will affect clinical decisions! The routine ordering of tests increases health care costs, doesn’t benefit patients and may in fact harm them.

#FOAMed #MedEd #medtwitter #zentensivist
Transfusing RBCs at a threshold of 7 g/dL is associated with similar or improved survival, fewer complications and reduced costs compared to higher transfusion triggers.

#FOAMed #MedEd #medtwitter #zentensivist
Read 6 tweets

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