Discover and read the best of Twitter Threads about #sccm

Most recents (8)

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
Green Urine: #NEJM
 
....will be seen in #COVID – Why? Massive use of Propofol. While Green Urine is Benign, effects of prolonged over-sedation & immobilization ++ #DELIRIUM are not 😤 Wake them up & get out of bed. Start w/SAT…#A2Fbundle & #PICS

#medtwitter #nursetwitter
1/ re: SATs to avoid over-sedation in #COVID19 pts, Thx @phanton_icu for Protocol Blindness caution & @Nitkjain reminder “Easier said than done.” I’ve been pondering your comments all day & think them ripe for further conversation on #A2Fbundle

#medtwitter #pulmcc #nursetwitter
2/ Remember, protocols like #A2Fbundle are guides & not “1-shoe-fits-all pts.” Correct, we must deviate when needed. However, these 6 principles (ABCDEF) are derived from 35 NEJM, JAMA, Lancet papers +400 others & now >25,000 pts of data. Not chump change.
bit.ly/2JwVA4E
Read 10 tweets
1/ When I play the #criticalcare movie 🎥 of me as an intern or resident back in my head, I see myself as much too robotic 🤖 with my patients, as if plugging in kitchen appliances.

#medtwitter #meded #tipsfornewdocs #medstudenttwitter #nurse #pulmcc #COVID19
2/ The nurse would slip a Foley catheter up his urethra into his bladder. I’d go to the stockroom to get all the materials to slide a plastic endotracheal tube down his trachea to become command-central for his breathing on the ventilator.
3/ Next, I’d methodically place a Swan-Ganz catheter by serial insertion of a needle first, then a wire through the needle, next a dilator over the wire, and finally the catheter itself down into his great vessels and heart. And start the ‘pressors.
Read 6 tweets
1/ Women in #CriticalCare: #Anesthesia/CC

Four EXPERT MD mentees in our CIBS Center (clockwise top left): Heidi Smith (R01 funded for Mini-MENDS), @kimberlyrengel (studies prehabilitation), @christinahayhu2 (pain after ICU) & Tina Boncyk (FAER awardee).
 
#medtwitter #heforshe Image
2/ Women in #CriticalCare: Biostatistics

“Stats-magicians” bring truth from darkness to light at CIBS Center. Our EXPERT is Dr. Rameela Raman (e.g. MIND-USA NEJM). Dr. Ayumi Shintani & @jent103 did stats for CAM-ICU, MENDS & ABC trials & BRAIN-ICU NEJM.

#biostats #epidemiology Image
3/ Women in #CriticalCare: #Surgery

Dr. @MinaFaye = bada$$ #surgeon runs CIBS weekly ICU Support Group w @CLG_PhD & 2 major studies: ISOLATE-ICU (COVID isolation on pts & families), RETURN III (VA Merit RCT of Cog-Rehab post ICU). All this & new mom of Milo James!

#heforshe Image
Read 5 tweets
1/ Women in Critical Care:

👍 Just recorded #ISICEM roundtable w @frubulotta @ElisabethWaele @FlaviaSepsis & Dr. Juffermans. 🎥 🍿 on Sept 16th.

Let’s eliminate prejudice based on gender, sexual pref & color. Here is a Baker’s Dozen of Women ICU Leaders!

#heforshe #medtwitter Image
2/ The first woman leader in Critical Care I discussed was Dr. Christina Jones from UK. She is a Biochemist, Nurse, Masters Social Work, PhD in Psychotherapy.

👊Mother of ICU Support Groups & ICU Diaries. As an expert, she shaped our field!

#sccm #esicm #pulmcc #ICUrehap Image
3/ 2nd world leader in Crit Care presented was Dr. Deborah Cook, from McMaster Univ in Canada. Seminal trials in Ulcer Proph, Bioethics, CCCTG trials, and now edifying us about how to provide healing in the dying process through her 3-Wishes Project.
#endoflife #palliativecare Image
Read 8 tweets
1/ #Sedation & #Delirium in #COVID19:

The cornerstone of best sedation practice in #COVID is not a specific drug. It’s about lightening whatever you use to allow the brain to take over again as captain of the body’s ship.

#medtwitter #tipsfornewdocs #medstudenttwitter #pulmcc Image
2/ Personally, & this is a share of my own weakness, it makes a huge difference when my patient is awake & not sedated. Awake patients immediately become humans with real lives beyond the ICU.

#meded #sccm Image
3/ The outer shell of patients changes in my mind’s eye when they are lying in a drug-induced coma - the person becomes disembodied. I am blind to the person, who doesn’t seem to be with her own body. I know this is a defect in my own abilities as a physician.

#tipsforolddocs Image
Read 5 tweets
How hard is life after the ICU? Let Doug & Melissa tell you. She had #ARDS #SEPSIS & on our CIBS “patient & family” page they make it real!

🎥 bit.ly/3h4ixan

Closing quote: “If you present me with ARDS & cancer, leukemia, I’ll choose the leukemia!”

#PICS #MedTwitter ImageImageImage
#ICU Survivor quote of the day:

“Before sepsis I was active, hiking, biking, rock climbing, running & now I am sedentary with no sex drive (also new) & a great marriage plus 40 lbs. I have seen doctor after doctor & they look at me like I am nuts.”

#MedTwitter #icurehab #sccm Image
And if you only watch one of the “Melissa and Doug” videos 🎥 🍿 watch #3 entitled “Life after ICU.” 😎. It’s paydirt 💰 in learning!!

bit.ly/3h4ixan
Read 3 tweets
A thought as I review the >1000's of posts on twitter, Facebook wall, and conversations with and among really smart folks I respect greatly over the last month: I have heard from some that "the science is unclear, but the freak out factor is huge"
I worry WE, in pursuing non-peer-reviewed “shiny objects” may be forgetting 20 years of evidence treating ARDS/hypoxemia in critical illness due to viral pneumonia. Science requires patience, and some seem to be rushing the scientific method, potentially to their patient's peril.
By adopting unexamined (not just unproven, but unexamined) HYPOTHESES in treatments outside of controlled monitored trials some may, just may be flirting with ethical lines in human experimentation?
Concur with Dr. Fauci...Science and Medicine depend on evidence, not feelings.
Read 6 tweets

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