Discover and read the best of Twitter Threads about #shock

Most recents (16)

#Medium #Mediumship, was reading an old #Tufts@TuftsDaily⁩ article from 2008 interviewing ⁦@jessicaalba⁩ about her film #TheEye, watched the trailer:
you do see how see people died, though, if contacted by the deceased, they share their personality, images of what is relevant, what they think is, which can be difficult; I take #antidepressants, and, am #healing myself from illness, some #trauma, too, and, was seeing more,
earlier in my healing, and believe it is crucial to have a filter/level of #health with, a pretty well-known #medium told me he also got very sick with #pnemonia, I had #mycoplasmapnemonae, in #MeCFS #CFS, had #Lyme #LymeDisease, too, and, the information is for #healing,
Read 39 tweets
🚨Ayer en #cafeclubdelconocimiento hablamos de #rcp y #guiasERC. Os dejo HILO cambios #SVAP :
- Ventilación con dos reanimadores si posible.(Uno sella-otro ventila)
- FR: 25/min (lactante)-20 (1-8a)-15(8-12a)-10(+12a)
- Desfibrilación: 4J/Kg. ⚠️Si + de 6⚡️ ➡️ subir hasta 8J/Kg Image
(2) Corregir causas reversibles: Hs y Ts
➡️Especifican los tratamientos específicos en las recomendaciones de manera más amplia que en las previas. #rcp Image
(3) Fármacos 1 💉:
- Adrenalina precoz si AESP/asistolia en cuanto via IV/IO disponible - Tras 3er ⚡️ en desfibrilables. Dosis 10 mcg/kg. Luego c/3-5min
- Amiodarona 5mg/kg tras tercer y quinta ⚡️desfibrilación
- Bicarbonato: no recomendada salvo hiperpotasemia e intox por ADT. Image
Read 18 tweets
Patient in Janus Jeneral Hospital with neutropenic septic shock. 3ml/hr of single strength noradrenaline - MAP 65, FiO2 30%, Lactate 7. CVP 5. UO 50ml/hr. CTPA negative for PE. AP4C on arrival. #vexus #echo #shock #FOAMed @GUH_ICU_Anaesth @IrishEMtrainees @ICSIreland
Has already had 3L of crystalloid pre admit to crit care.

RVSP = TR Max PG (18.4) + CVP (5) = 23mmHg
Overnight, lacto-bolo reflex sets in & gets 'maintenance' plus multiple boli of IV crystalloid b/c of high lactate.

In the am, increasing shocked state. On norad 20ml/hr SS, vasopressin max, adrenaline 5ml/hr to maintain MAP > 60.

RV & RA acutely dilated on focused US.
Read 7 tweets
Well where do I start with this one!

#Article from #TheLiverpoolVermin who are just as #bad as the #TheScum

🤬#Police #drag man off #Merseyrail #train in #handcuffs after he '#refuses to #wear #mask'🤬…
I've #watched the #video many times in #shock & #horror at the #actions from the #police #FORCE & I've read both #articles #TheLiverpoolVermin & #BritishTransportPoliceFederations #Statement

Something not quite right none of it adds up, the video shows the #Police ARE #Lying🤬
Read 14 tweets
Continuing the vasoactive meds week, we will talk about dopamine. It is a precursor of norepinephrine, inducing its release. There are dopamine receptors in the renal, splanchnic, coronary and cerebral vascular beds; stimulation of these receptors cause vasodilation. #critcare
Again, since our historical "nerdiness" was so well received, this is one of the first papers that talked about dopamin in shock:…
And this is their conclusion:"Because dopamine increases myocardial contractility, selectively redistributes perfusion to essential viscera and allows a pharmacologic titration of effect, it is a logical first-choice catecholamine for treatment of shock and refractory HF."
Read 7 tweets
📌Evaluación y manejo del #Shock en #COVID__19 🦠

•Entre el 5%-10% de los pacientes infectados con el virus SARS-CoV-2 🦠requieren UCI🏥

•Hasta 67% de shock en desarrollo

•Causa principal de muerte hasta en el 7% de los casos

•Factor contribuyente de☠️ hasta en el 33% ImageImage
1️⃣Shock distributivo
2️⃣Shock cardiogénico
3️⃣Shock obstructivo
4️⃣Shock hipovolémico Image
📌Shock distributivo

• Predominante: Séptico
•Limitada información de las coinfecciones
•11-18% coinfección bacteriana(extrapolación de SARS y MERS)
•𝐌𝐚𝐧𝐞𝐣𝐨 𝐜𝐨𝐧𝐬𝐞𝐫𝐯𝐚𝐝𝐨𝐫 𝐝𝐞 𝐥í𝐪𝐮𝐢𝐝𝐨𝐬
•Utilizar variables dinámicas
•Nora TAM > 65 mmHg

Algo nuevo⁉️🤷🏻‍♀️
Read 6 tweets
Not all hypotension is from hypovolemia. Then why load every hypotensive patient with #fluids? 🤔 An excerpt from a previous lecture. Very basic. Intended for #medicalstudent #MedEd
Experts, stay away 😄
First, what happens when somebody is hypovolemic?
The cardiac output drops
Unless doing #POCUS, we are not measuring cardiac output. We are measuring blood pressure. So, why does it drop? because it depends on the cardiac output!
Read 17 tweets
1/10 It’s hard to shut my mind off in the face of #COVID19. As #AcuteCareSurgeons our day/night/weekend jobs taking care of #injured patients and #patients needing #EmergencySurgery for abdominal and soft tissue diseases do not dissipate.
2/10 Yet we are also experts in #CriticalCare and need to prepare to care for patients w/ #respiratoryfailure and #shock due to #COVID19. We are implementing #plans based on the little evidence that exists while trying to stay #safe, #healthy, and #resilient.
3/10 We step into the trauma bay as others threaten to shoot our patient (but police can protect us). We do operations where rHepC/HIV risk is high (but PEP can protect us). We don't shy away from blood, feces or dead flesh up to our eyeballs (but we have #PPE to protect us).
Read 10 tweets
Kicking off @CRT_meeting #CardiogenicShock sessions: Pathophysiology by @drmortkern...
Don’t forget the RV: by #DrJamesGoldstein...
Trials and evidence (presence and absence) in #Shock treatment: by @thiele_holger...
Read 25 tweets
1/ THREAD: Body Language Analysis No. 4414: Alex Bozarjian, news reporter slapped by runner on live TV: "He took my power" — #Nonverbal #EmotionalIntelligence #BodyLanguage #BodyLanguageExpert #AlexBozarjian #Shock #Assault #ThreatAssessment #MeToo
2/ From a body language perspective, the perpetrator's jaw can be seen to be projecting forward [Jaw Jut]. In addition, his lips are pulled inward, between the teeth [Inward Lip Roll].
3/ This facial expression combination [cluster] is indicative of an adrenaline surge and consistent with Ms. Bozarjian's recounting of "it was a heavy impact" and "he hit me hard".
Read 13 tweets
People with courage exist.

We allow children to be kept in concentration camps.

America disgusts me.
I can't wait to go on trial for over 3 years of my life against #TheState!

The #CityOfPortland wants me in jail and I will demonstrate that my peaceful #FreeSpeech was both entirely truthful and correct. #Portland's City Council colluded with @G4S to sign a $10 million contract.
Mayor #TedWheeler's cowardly City Council rammed-through a new 5-year contract without public testimony, and while ignoring KNOWN PUBLIC DISAPPROVAL.

@G4S security also armed, trained & included #OmarMateen in their "security agent" ranks - the #Pulse mass-shooting killer of 49.
Read 9 tweets
More details on the schism between the Hazimis and lesser-extremists in #IS: Abu Anisa al-Dagestani, an Azeri commanded and Hazimi, blames the caliph's insufficiently stern position on takfir for the loss of land and men last year.
According to Abu Anisa al-Dagestani, the caliph reversed the May 2017 expansion by the Delegated Committee of the takfir ruling after his wife had a dream in which Abu Musab al-Zarqawi, Abu Muhammad al-Adnani, and Abu Muhammad al-Furqan came to his house and ignored him. #pt
The caliph reversed the May 2017 takfir ruling by a deft institutional manoeuvre: he invited its author, Ismail al-Ithawi (Abu Zayd al-Iraqi), to a meeting in August 2017 and threatened to kill him if he didn't reverse himself. #pt
Read 5 tweets
It's #12leadthursday-- time to test those #cardio skills! Look out for answers tonight so you don't miss a beat ☺️ #FOAMed #cardiotwitter
Read 6 tweets
Una de las cosas más maravillosas que te pueden pasar es enamorarte, ¿no?. ¿Quién no se quiere enamorar? HILO👇
Todo empezó cuando yo estaba pasando una etapa durilla. Me acababan de echar del trabajo.
Me había costado lo suyo tener algo de estabilidad laboral cuando... Pum! No sé qué de ajustes presupuestarios y que yo no era indispensable.
Read 213 tweets

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