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How to administer oxygen worldwide in March 2020 to minimize viral dispersion: Tricks and Tips. #COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc Thread 1/6 ImageImageImage
When using nasal cannula or High Flow Nasal Cannula consider adding a simple disconnected face mask as a shield to prevent viral spreading. #COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc Thread 2/6 Image
According to Hui et al. High Flow Nasal Cannula could have higher risk of aerosol dispersion in mannequin study. #COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc Thread 3/6

pubmed.ncbi.nlm.nih.gov/25224111/ Image
If you use a NIV mask, mind the leaks: they may be source of infection for healthcare personnel.
#COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc Thread 4/6 Image
Prefer Helmet to deliver oxygen in March 2020. It is the safest way to deliver oxygen and positive pressures minimizing viral spreading. #COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc Thread 5/6
thelancet.com/journals/lance… Image
Remember: patient could be a source of viral spreading during intubation. #COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc pubmed.ncbi.nlm.nih.gov/32052373 Thread 6/6 ImageImage
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Katy W, MD
@katyw2004
Anyone seen this? Making rounds on FB among docs & attributed to Dr. Martha Blum an MD/PhD ID doc in Monterey(I tried to find on twitter but couldn’t) will remove if asked and will happily repost/cite Dr. Blum on twitter #coronavirus #medtwitter #COVIDー19
#FOAMed
@MDaware @RyanMarino @DrHowieMell
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Dr. David Lyness
@Gas_Craic
What is CORONAVIRUS? How might it affect ICU? Let's go back to basics and look at the emerging evidence bases, protocols and risks. #FOAMed #FOAMcc #WuhanCoronavirus #CoronavirusWho
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). #FOAMcc #FOAMed
A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.... which is what the virus that is widely reported on the media, and via the WHO and CDC etc are talking about. #FOAMed #FOAMcc
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Dr. David Lyness
@Gas_Craic
What is going on with VITAMIN C in Critical Care? From basics to current day conundrums. #FOAMed #FOAMcc #VitaminC You can use the @threadreaderapp to read this Tweetorial!
First - let's look at what Vitamin C is. Unlike most mammals, we can't actually synthesise it! It's a water-soluble vitamin: lpi.oregonstate.edu/mic/vitamins/v…
Which is why it needs ingested, or... supplemented.
It's most important function (from a critical care perspective) likely comes from its function as an anti-oxidant. #FOAMed #FOAMcc intechopen.com/books/vitamin-…
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Dr. David Lyness
@Gas_Craic
Today we're going to take a look at BIOENERGETICS in ICU in this quick Tweetorial :-) #ESICMphysio #FOAMed #FOAMcc
Bioenergetics = biochemistry concerned with the energy involved in making and breaking of chemical bonds in the molecules found in biological organisms. It can also be defined as the study of energy relationships and energy transformations and transductions. #ESICMphysio
Mitochondrial functions incl production of energy, activation of programmed cell death, and a number of cell specific tasks, e.g., cell signaling, control of Ca2+ metabolism, and synthesis of a number of important biomolecules. ncbi.nlm.nih.gov/pmc/articles/P…
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Dr. David Lyness
@Gas_Craic
So - the candidates from #ESICMphysio are off to engage in their workshops - so I thought... let's hold a virtual workshop here on MECHANICAL VENTILATION! #FOAMed @ESICM
Let's start off at the very beginning. This is a HUGE topic... obviously not going to cover everything. But let's start off at the very beginning and look at my Tweetorial from yday from Prof Barnes talk on the physics of ventilation... #ESICMphysio
@MedCramVideos do a REALLY good series for beginners - for free - on YouTube - 5+ videos on Ventilators and how they work: youtube.com/results?search…
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Wandering_ER | 𝙒𝙖𝙡𝙞𝙙 𝙈𝙖𝙡𝙠𝙞
@wandering_er
Reading more about venous air embolism after putting in/removing ~10 CVCs in last 2 weeks is kind of freaking me out so I decided to do a deeper dive

#FOAMed #FOAMcc #EmergencyMedicine
🔺Symptoms: acute onset dyspnea, cough, syncope, AMS, “mill wheel murmur" (specific but not sensitive)

🔺Clinical manifestation: acute R-heart failure, cardiogenic shock (hypotension, oliguria, JVD), acute embolic stroke (air bubbles pass thru patent foramen ovale)
🔺Clinical Dx but can use:
🔹EtCO2: decreased due to increase physio dead space & worsening V/Q mismatch
🔹EKG: signs of R-heart strain (R axis deviation, RBBB, peaked P waves), non-specific ST changes
🔹TTE/TEE: Air in cardiac chambers, RV dilation
🔹CXR: pulmonary edema
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