@ESICM

@ESICM

@ESICM

@ESICM

@ESICM

Teddy Hla

@teddyhla

@ESICM

Updates on Advanced life supprot by Theresa OLASVEENGEN

Vasopressors and Drugs : recent trial outcomes.
#LIVES2022
@ESICM #als #resuscitation

@ESICM

@ESICM 2020 ILCOR consensus : strong recommendation to use "ADRENALINE" in cardiac arrest, if you dont have it "LIDOCAINE".

Adrenaline to placebo comparison is mainly 1 older trial with latest PARAMEDIC 2

pubmed.ncbi.nlm.nih.gov/30980877/

@ESICM

@ESICM PARAMEDIC 2 - big study
8007 pts, adrenaline 4000, placebo 3999
- a lot of discussion post trial
- need a nuanced interpretation.
- 19 "more good" survivors and 5 "more bad" survivors in adrenaline arm.

nejm.org/doi/full/10.10…

Read 19 tweets

Andrew Petrosoniak

@petrosoniak

If you’re a leader and responsible for decision making in your organization, understanding the Cynefin framework is an absolute must.

Leadership requires modification based on the situation.

Here’s a brief 🧵 contextualized within #resuscitation & #healthcare
1/

@snowded

Created by @snowded this 4 domain framework (5 with disorder) provides decision makers & leaders with a high-level yet practical approach to decision making by appraising the current state & developing an appropriate strategy

Great overview here.
2/
hbr.org/2007/11/a-lead…

Importantly decision making/leadership approaches are dynamic and are adjusted for the current context

Leaders "will need to know when to share power and when to wield it alone, when to look to the wisdom of the group and when to take their own counsel." - Snowden & Boone

3/

Read 16 tweets

Jakob Stensballe

@J_Stensballe

@RePHILL_trial

Trying my best to understand the results of the very important @RePHILL_trial : Excellent work and fab collaboration studying very complex pts in difficult circumstances #WellDoneAll #Congrats
thelancet.com/journals/lanha…
1/9 on my take….

Result are contradictory to current evidense (RCT and non-RCT) and our understanding of the patophysiology of trauma haemorrhage 2/9 #Limitation #GoAgainstTheFlow #NotRight ?

Trial underpowered ? Power calc reduction 20 - 10 % in PE is a little bold maybe + too many factors affecting the PE. #StatisticalAnalysisPlan reconsidered ?
3/9

Read 11 tweets

Young_ERC

@erc_young

@ERC_resus

This week we will discuss #Ventilation during #Resuscitation. As a starter, we’d like to hear from you.

In your practice, which of the following ventilation parameters do you routinely measure during resuscitation?

@ERC_resus #ResusciTuesdays #ResusTwitter #CPR #ALS

@johannes_wittig

Thanks a lot for all your answers.

Let’s reveal the right answer (and more) through this thread with this interesting information brought by @johannes_wittig

An incomplete story of excessive ventilation during #CPR…

In 2004, Aufderheide et al. investigated the harmful dimensions of ventilation during CPR. #OHCA CPR attempts of 13 adults were observed; .. (1)..

Read 17 tweets

Meredith Olsen, MD

@MereLOlsen

As #MedTwitter regulars, you may have already heard that the #SurvivingSepsis Campaign has released the updated 2021 version of the International #Guidelines for Management of #Sepsis and #SepticShock!

But have you gone thru the updates yet?

A #Tweetorial (1/x):

There are 93 #recommendations made in the new publication. I don’t have time to write (or read) that kind of #Tweetorial and neither do you. That’s what the publication is for -> journals.lww.com/ccmjournal/Cit… !

But let’s hit the ✨highlights✨ starring Table 1: (2/x)

Why we care (and we care so much!): Sepsis and septic shock affect millions of people globally each year, and kills somewhere between 1/6 and 1/3 of those diagnosed with the #syndrome. 1/3!!! 😳😢 (3/x)

Read 25 tweets

ERC

@ERC_resus

@wyllie_jonathan

🔛 Newborn resuscitation and support of transition of infants at birth

Chest Compressions - @wyllie_jonathan

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@ERC_resus @ccroehr

@wyllie_jonathan

3 :1 --> 30 cyc/min --> FiO2 1.0 --> Reases every 30 s

@wyllie_jonathan

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@ERC_resus @ccroehr

@wyllie_jonathan

Vascular Access & Drugs

@wyllie_jonathan

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@ERC_resus @ccroehr

Read 6 tweets

ERC

@ERC_resus

@wyllie_jonathan

🔛 Newborn resuscitation and support of transition of infants at birth

Airway & Breathing - Tomasz Szczapa

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@wyllie_jonathan @ERC_resus @ccroehr

@wyllie_jonathan

Initial Airway Support

✔️ aerating & ventilating the lungs is usually all that is necessary

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@wyllie_jonathan @ERC_resus @ccroehr

@wyllie_jonathan

Supine --> Neutral position --> Jaw Lift --> 2 person methods

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@wyllie_jonathan @ERC_resus @ccroehr

Read 10 tweets

ERC

@ERC_resus

@wyllie_jonathan

🔛 Newborn resuscitation and support of transition of infants at birth

Assessment & Stimulation - Mario Rudiger

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@wyllie_jonathan @ERC_resus @ccroehr

@wyllie_jonathan

Rapid Assessment + frequent Re-Assessment

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@wyllie_jonathan @ERC_resus @ccroehr

@wyllie_jonathan

Tone & Colour

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@wyllie_jonathan @ERC_resus @ccroehr

Read 5 tweets

ERC

@ERC_resus

@ccroehr

🔛 Newborn resuscitation and support of transition of infants at birth

Introduction & Overview - John Madar

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@ccroehr @wyllie_jonathan @ERC_resus

@ccroehr

NLS Writing Group

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@ccroehr @wyllie_jonathan @ERC_resus

@ccroehr

NLS Guidelines Novel Format

#RESUS21 #resuscitation #science #guidelines #education #NeoTwitter

@ccroehr @wyllie_jonathan @ERC_resus

Read 4 tweets

James Yates

@heli_med_james

Whilst the new #RESUS21 guidelines don’t introduce any significant changes, here are some take homes that I believe are worth highlighting. A thread....

#FOAMed #FOAMems #cardiacarrest #resuscitation

“Ambulance services should monitor staff exposure to resuscitation and low exposure should be addressed to increase experience”

It will be interesting to see if, and how, ambulance trusts follow this guidance.

“Adult patients with non-traumatic OHCA should be considered for transport to a cardiac arrest centre”

Pathways for OHCA in the U.K. have been variable. Will this stimulate more standardisation? Prehospital staff need to nail the post-ROSC care bundle. Transport times longer?

Read 8 tweets

Michael Griksaitis

@MJGriksaitis

Catching up on #burns patients on the #PedsICU - first up Steven E. Wolf discussing specialised burns care by the surgical team

He starts by discussing the ultimate goals of paediatric burn care:
- no deaths
- no scars
- no pain

We are improving but not there yet

#WFPICCS20

‘Burns are as bad as they are going to get at the start; they can only get better - burns are different to chronic diseases’ - Steven E. Wolf, burns surgeon/Intensivist

#PedsICU #WFPICCS20

What are the strategies for management of the #burn wound?

The key is fix and heal the wound. Then de-intensify the patient as soon as possible.

Remember: #burns wounds will have organisms cultured - but are they causing infection?

#PedsICU #WFPICCS

Read 8 tweets

Alberto García-Salido

@Nopanaden

¿Habéis visto los aparatos para succionar cuerpos extraños de vía aérea?
Sí, ese que Vicente del Bosque anuncia.
Que no os pase como a Vicente: QUE NO OS ENGAÑEN.
Leed esta editorial en #Resuscitation
Solo deben usarse para INVESTIGACIÓN
cercp.org/images/stories…

Este editorial se escribe con motivo de un metaanalisis realizado sobre el tema donde se objetiva QUE NO ES RECOMENDABLE SU USO.
sciencedirect.com/science/articl…

Y como dicen estos autores españoles es el momento de que demos un paso al frente sobre este tipo de ventas.
ESTÁN EN MUCHOS SITIOS.
LO APOYA GENTE FAMOSA.
SON UN RIESGO PUES RETRASAN MANIOBRAS EFECTIVAS.
Así que si conocéis a Del Bosque avisadle.
resuscitationjournal.com/article/S0300-…

Read 4 tweets

Carolina Maciel

@neurologyrules

@American_Heart

1/9
#COVID19FOAM
#StopTheSpread
#ProtectHealthCareWorkers

Joint effort from @American_Heart @ACEPNow @SOCCA_CritCare @AmerAcadPeds @aarc_tweets @ASALifeline guiding #resuscitation efforts in #cardiacarrest in suspected/confirmed #COVID19
bit.ly/3e8QplH
@CircAHA

2/9
General Principles of #ProtectHealthCareWorkers have always applied to first responders in prior #resuscitation guidelines. Remember, first things first:

👉Assess the safety of the scene, make sure that victim, yourself and bystanders are safe

#GetMePPE

3/9

Minimize the number of people in the room

👉 Whenever able, mechanical CPR devices can reduce the number of rescuers required & provide consistent high-quality compressions

Read 10 tweets

Alicia Dennis

@AliciaTDennis

MYTH BUSTER: #anaesthesia & #anaesthetists are hard words to say (I’m one & have trouble!) & people are sometimes confused about what we do (even other doctors!) and that’s fair enough, but we are way more than just people who “put you to sleep” for your surgery #covid19aus 1/

It’s better to think of us as #anesthesiologists (with an american accent!) like they say in the US. We are medical specialists. We have a medical degrees & a specialist qualification, are highly trained having done continuous training until we are often at least 30 years old 2/

We assess all aspects of you before giving you an anaesthetic - Such as your health conditions, your medication, your worries/concerns about what about to happen to you, your pain requirements, & make decisions about the safest anaesthetic to give you for your surgery 3/

Read 12 tweets

Sapna Kudchadkar, MD, PhD 👩🏽‍⚕️

@SapnaKmd

@jerjohzimm

The moment we have been waiting for!! @jerjohzimm #sepsis @PedCritCareMed @ESICM #ccc49 (thread)

#sepsis #PedsICU

bit.ly/3bJIr1k

@PierreTissieres

.@PierreTissieres is up first introducing the process & rationale #CCC49 #PedsICU #Sepsis

@TexKissoon

@TexKissoon tells us “Why Now”? #ccc49 #PedsICU #sepsis

Burden is highest on #children, and deaths occur early in the course

Read 21 tweets

Jeff Simmons MD 🙏🏥

@jeffsimmons

@UABSurgery

#TRAUMA: #medthread on the coagulopathic changes in severe trauma.

This is the WHY behind trauma resuscitation efforts.
#traumaanesthesia #damagecontrol #resuscitation
@UABSurgery @UAB_Anesthesia @uabmedicine 1/

Post-trauma hemorrhage and hypotension leads to a unique physiologic derangement called Acute Traumatic Coagulopathy. Resuscitation requires management of both hemodynamics and coagulation status. 2/

Why does this happen? If you were to simply cut your finger, your body would sense the injury and begin clot formation (platelet>factor signaling>fibrin net>more platelets). But to restore blood flow, it would need to break down that clot. 3/

Read 19 tweets

Tim Montrief

@EMinMiami

I listen to ~90 #Podcasts on a (semi) regular basis. Let me give you a rundown of ALL of them and why you should listen to some amazing #FOAMed, especially for all the new #EmergencyMedicine interns. #FOAMed #MedEd #medtwitter

First of all, you need a good podcast app. I absolutely love Downcast. Great app, gives you more control over playback, downloading, and allows you to categorize your podcasts into playlists (picture 2). This is where you get to customize your #FOAMed experience! #medtwitter

In no particular order,

- Anesthesia and Critical Care Reviews and Commentary (ACCRAC). Great insight into Crit Care from an anesthesia perspective. Coming from EM, this is great to listen to- much different from my day-to-day! #FOAMed #FOAMcc #CriticalCare

Read 88 tweets

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