Thread by @ChrisCarrollMD

@karanskahlon: Why do we get ABG's? Do we even care about compensated hypercapnia? (spoiler: no!) #CHEST2020

@karanskahlon: Do we need ABG's to assess oxygenation? (Also No). #CHEST2020

@karanskahlon: Or we just getting ABG's to check a box? ("euboxia") #CHEST2020

@karanskahlon: So when do we need ABG's? Are you doing it just because you can't see the patient? #CHEST2020

@karanskahlon: More information is not better information. Do we just use arterial lines because we can't imagine an ICU without them? #CHEST2020

@karanskahlon: Your #zentensivist medal is on its way! #CHEST2020

Now @mnarasimhan discussing unnecessary lab draws in the ICU. #CHEST2020

@mnarasimhan: A knowledge gap between orderers and people using the data and there is wide variability in frequency of labs. #CHEST2020

@mnarasimhan: So how can we reduce unnecessary labs? Huddles. Education. Technology. #CHEST2020

@mnarasimhan: How do we reduce daily CXRs? #CHEST2020

@mnarasimhan: What's the literature show? Probably no need for routine daily CXR's (just as needed). #CHEST2020 thelancet.com/journals/lance…

Great talk on reducing unnecesary interventions @mnarasimhan! Loved it!!! #CHEST2020

@mnarasimhan: "NO EVIDENCE OF HARM FOR LESS TESTING" Louder for people in the back!!! #CHEST2020

@MaksimKorotun: Can we reduce CVC use with peripheral vasopressor use? #CHEST2020

Love the history lesson @MaksimKorotun! First catheterization of vein in 1733 by English clergyman! en.wikipedia.org/wiki/Stephen_H… #CHEST2020

@MaksimKorotun: No significant complications with peripheral vasopressor use in their single center trial. #CHEST2020 journalofhospitalmedicine.com/jhospmed/artic…

@MaksimKorotun: However, peripheral vasopressor use requires system level measures including close communication with nursing, pharmacy and physicians. #CHEST2020

@msiuba! #zentensivist: takes a holistic approach to the art of caring for the critically ill. #CHEST2020

@msiuba: A #zentensivist works to remove unnecessary interventions and treatments. #CHEST2020

@msiuba: Focusing on what is essential and maximizing shared decision making #CHEST2020 atsjournals.org/doi/full/10.34…

@msiuba: Clinical mastery is essential to practicing in this manner. Requires deep understanding of physiology and pathophysiology, and understanding of risk tolerance. #CHEST2020 #zentensivist

@msiuba: The downsides to our therapies are often unappreciated, and the upsize to our therapies are often overestimated. Sensible medicine important. jamanetwork.com/journals/jama/… #CHEST2020

@msiuba: Doing less takes a lot more effort. Way easier to just do things. Takes a lot of time to explain why NOT doing something, but a moral imperative to do this. #CHEST2020

Absolutely LOVED your talk, @msiuba! Thank you! #CHEST2020