@docskalski

@docskalski

Most recents (11)

Sarah E

@drsarahedwards

We had out first virtual Radiology learning session today.

A monthly learning meeting between Emergency Medicine & Radiology.

Helping us learn from each other and from our cases

A thread to share our learning from the cases ⬇️

#FOAMed #FOAMrad #FOAMped #SoME #radiology

The types of brain herniations

A great summary by @docskalski

radiopaedia.org/cases/brain-he…

@Radiopaedia

@BMUZIO

A rare case of Tuberous sclerosis and the learning from that

A great summary by @BMUZIO

radiopaedia.org/articles/coup-…

@Radiopaedia @DrVikasShah

Read 8 tweets

Sarah E

@drsarahedwards

A #tweetorial summing up some good resources for Paediatric Minor Injuries from the world of #FOAMed #FOAMped

First #tweetorial on some resources related to Upper Limb Injuries we see in children....

@DFTBubbles

Perhaps one of the most favourite injuries we see?

Elbows

#PulledElbow

dontforgetthebubbles.com/pulled-elbows/

@DFTBubbles

@EM3FOAMed

Elbow's

#SupracondylarFractures part 1

A infographic summing this up from @EM3FOAMed and @drsarahedwards

Read 12 tweets

Alasdair Munro

@apsmunro

Ok a few things have been moving in the world of paediatric #COVIDー19 literature

Time for an updated #tweetorial on SARS-CoV-2 infection in children!

#FOAMped #FOAMed #PedsICU #PedsID #IDtwitter

1/12

So there are fewer cases in children. How much fewer?

Children consistently make up <2% of confirmed COVID-19 cases. These are usually ascertained by testing sick people in hospital

US: dx.doi.org/10.15585/mmwr.…
Italy: jamanetwork.com/journals/jama/…
Madrid: jamanetwork.com/journals/jamap…

2/12

COVID-19 is less severe in children, but often is it severe?

From a Chinese cohort 0.6% needed PICU but lots of community testing involved
pediatrics.aappublications.org/content/early/…

US CDC data has 2% of admissions in PICU (limited data)
dx.doi.org/10.15585/mmwr.…

3/12

Read 12 tweets

Grace Leo

@gracie_leo

@DFTBubbles

What does clinician care and kindness during #COVID19 look like?
Based off #DFTBClinicianCare panel last week.
A comic #tweetorial...

#wellbeing #HealthCareWorkers #Medtwitter #FOAMped
Thanks @DFTBubbles @LizCrowe2 @FreerMary @AlysColeKing @DrJaneMunro @Global_EM @TessaRDavis

Why is #COVID19 so emotionally draining for #healthworkers and so many of us? Information overload, frequent change and pending uncertainty about what the future (and all those graphs) hold. 2/6

So many things we need to consider and plan for....

Read 7 tweets

Alasdair Munro

@apsmunro

OK, time for a tweet summary of what we know from the paediatric literature about #COVID19 in kids SO FAR

Given the disease has only existed for 3 months, it's quite a lot...

#FOAMPed #PedsICU #IDTwitter

1/7

Kids get MUCH less severe disease than adults. Mortality AND critical illness v. low (close to 0%), confirmed from both China and Italian data

pediatrics.aappublications.org/content/pediat…

jamanetwork.com/journals/jama/…
2/7

Kids PROBABLY acquire the disease less often than adults. Low rates seen in symptomatic cohorts, and in S Korea which had higher rates of population screening.

statista.com/statistics/110…

Japanese contact tracing found lower attack rates in children

medrxiv.org/content/10.110…

3/7

Read 8 tweets

Edward Snelson

@sailordoctor

1 A quick tweetorial on childhood immunology that might help to explain why children are less likely to be seriously unwell with #COVID19
Also a warning about neonatal Covid 19 based on what we know about novel infections in this age group.
#FOAMed #FOAMped

2 There are essentially three main stages to human immune system development. The end result is a complex and highly intelligent response to pathogens. This response is most like the employment of an intelligence service to protect the body from infection.

3 The adult immune system can produce that clever and targeted response because it has been educated by thousands of infections that it has previously encountered. It is possible to further educate that immune system with vaccines.

Read 11 tweets

Alasdair Munro

@apsmunro

1/15 #Fever #tweetorial

Parents and paediatricians alike are obsessed with fever

We've all got fever fever 🔥 But it is SO misunderstood

Let's take a look at what fever actually is, and finish off with some myth busting!

#FOAMPed #FOAMed #IDTwitter #PedsICU #PedsID

2/15
Fever (pyrexia) is an elevated core body temperature as part of a physiological response to infection controlled by the hypothalamus

This is opposed to hyperthermia, a pathological elevated temperature

This is important, as your body is IN CONTROL. Fever happens on purpose

3/15
What temperature counts as a fever?

There's no strict definition (there's no really good data on what a "normal" temperature is...), but an arbitrary cut of off 38C is often used.

Its better taken in context; 37.8C following temps >38.5C is probably still a fever.

Read 15 tweets

Alasdair Munro

@apsmunro

1/8 #FOAMPed #PEM #FOAMed

Another chat in CED last night about using Ibuprofen in chickenpox, and thought it would make a nice tweetorial! (for more detail check out end of thread for link to blog and podcast!)

Ever heard you shouldn't given ibuprofen to kids with chickenpox?

2/8
The concern is about increased risk of severe skin infections, in particular the dreaded necrotising fasciitis (nec fasc) with group A Strep (GAS).

This first popped up in the 60's with case reports of a GAS outbreak associated with ibuprofen.

journals.lww.com/pidj/Abstract/…

3/8
A few case control studies have been done since, with small sample sizes (Nec fasc is rare!) which seemed to confirm an association.

But, as you all know, correlation does not equal causation!

adc.bmj.com/content/102/10…

Read 8 tweets

Alasdair Munro

@apsmunro

@ianlewins

1/12
Squeezed Lactate Tweetorial #FOAMPed

Yesterday I commented on an infographic about raised lactate saying an important cause was “squeezed sample”

Astutely, @ianlewins asked for the evidence

I've fallen deep into test-preanalytic literature and it's been a rollercoaster...

2/12
Can a squeezed sample cause a raised lactate?

Why does squeezing matter? Normally because squeezing causes *Haemolysis*, which as the name suggests is destruction of red cells.

If we’re not measuring RBCs why do we care if they burst? 3 reasons...

blog.fisherbioservices.com/avoiding-hemol…

3/12

1-RBCs contains lots of stuff. Some is WAY more concentrated in RBCs than plasma. If you burst RBCs they spill this stuff into plasma and raise the level.

This is true of:

K+, LDH, AST

To a lesser extent, CK, Mg2+, PO4- and maybe Ca2+

degruyter.com/view/j/cclm.20…

Read 12 tweets

Pediatria Completa

@PediaCompleta