My last session for #ATS2022 day 3 is “Priorities from a Joint-Society ATS Policy Statement on Palliative Care in Serious Respiratory Illness”!
First we have Dr. Donald Sullivan with “Fundamental Principles of Palliative Care in Respiratory Disease and Highlights from the Policy Statement.” #ATS2022
Definitions #ATS2022
Goals for this group #ATS2022
Development process of the policy statement #ATS2022
Fundamental values and principles of palliative care #ATS2022
Next we have Larry Gershon with “Stakeholder Engagement: A PAR Perspective on Palliative Care in Serious Respiratory Disease.” #ATS2022
You should first understand who the patient is as person and what they want and need before explaining palliative care and other interventions. #ATS2022
Next we have @KathleenLindell with “Engaging Caregivers as Critical Members of the Care Team.” #ATS2022
Who is a caregiver? #ATS2022
Recommendations for caregiver involvement #ATS2022
Why is this important? #ATS2022
The first step in supporting caregivers is identifying them. #ATS2022
There are condition specific needs for patients with serious respiratory illnesses, like lung transplant patients and those with medical equipment. #ATS2022
Caregiver support tools can help us identify how to help them and their needs. #ATS2022
Resources for caregivers #ATS2022
Take home message! #ATS2022
Next we have Dr. Tracy Fasolino with “Health Disparities and Equitable Access to Palliative Care in Pulmonary Medicine.” #ATS2022
COPD burden is higher in rural America and in women. #ATS2022
Communication considerations and strategies #ATS2022
Next up is Natasha Smallwood (@NatashaSmallwo4) with “The Ins and Outs of Respiratory Disease: Comprehensive Symptom Management.” #ATS2022
Symptom management recommendations #ATS2022
Palliative care principles #ATS2022
Comprehensive Symptom Assessment #ATS2022
There are a ton of validated symptom assessment tools for different symptoms. #ATS2022
Good symptom management follows from good disease-directed treatment. #ATS2022
After disease-directed treatment the next step in symptom management is non-pharmacologic approaches before pharmacologic treatment of those symptoms. We do not have enough good evidence-based treatments for symptoms. #ATS2022
Remember that the patient is in charge! #ATS2022
Next up is Dr. Richard Mularski with “Innovative Palliative Care Delivery Models.” #ATS2022
Palliative care delivery topics #ATS2022
ATS statement recommendations #ATS2022
This was the earlier statement on palliative care. #ATS2022
Disease progression #ATS2022
There are different palliative categories settings #ATS2022
Dr. Alison Turnbull is up next with “It’s the Journey Not the Destination: Goals of Care/Advance Care Planning in Respiratory Disease.” #ATS2022
Continuum of advance care planning integration in serious respiratory illnesses #ATS2022
Con argument against advance care planning #ATS2022
Pro argument for advance care planning #ATS2022
References if you’d like to learn more #ATS2022
Great episodes of the GeriPal podcast #ATS2022
How they responded to this debate. #ATS2022
Dr. Christopher Cox will now talk on “Methodologies, Models, and Measurements: Research Priorities in Palliative Care.” #ATS2022
The big issues: We don’t know who needs it most, how to best deliver it, and how to measure its effects, or who should do the work! #ATS2022
Future study design considerations #ATS2022
Future study content areas to consider #ATS2022
Study content areas continued #ATS2022
There is still a lot of work to do here! #ATS2022
Next up is Dr. Anne Wilkinson with “Hoping for the Future While Planning for the Worst: Palliative Care in States of Emergency.” #ATS2022
Natural disasters are becoming more frequent and more severe! #ATS2022
Emergency state recommendation #ATS2022
In order to incorporate palliative care into disaster planning we must first ensure that we have enough available palliative cate services (hint: we don’t have enough already). #ATS2022
Eight critical elements in planning a palliative care response #ATS2022
It’s a difficult subject but it’s better to have the conversations in advance and plan for the worst case scenario. #ATS2022
And last but never least we have Dr. Anand Iyer (@anandiyermd) with “PalliPulm, the New Frontier: Integrating Palliative Care in Pulmonary Medicine Through Primary Palliative Care.”
#ATS2022
He’s gonna focus on the first box of primary palliative care. #ATS2022
There are not enough palliative care specialists between too few fellowships, a growing aging population, and loss of providers due to burnout. #ATS2022
Options for training people in primary palliative care. These are great, but we need more accessible options! #ATS2022
There are multiple domains in quality palliative care. #ATS2022
We need to bridge these two specialities with primary #PalliPulm! #ATS2022
Here are a couple of references to review for more information. #ATS2022
How do you communicate with a patient who is confused about “competing” things happening simultaneously, like palliative referral and lung transplant work-up?

“We are going to hope for the best but prepare for the worst, and I’m going to be with you as we do both.” #ATS2022
What a great seminar by this awesome group of #PalliPulm advocates!

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More from @gretchemaben

Oct 2
Today I took a Freedom Trail tour in Boston and learned a lot. Read on to brush up on some history!
William Blackstone signed up for an expedition to come from England to North America in the mid-1620s. He sets up a farm in what is now Boston.
The king of England and the church were not getting along in 1630, so people came over because they wanted a more strict church (puritans) and landed in Charleston, which is marshland.
Read 64 tweets
Sep 9
Here’s something I don’t understand. If I had $10 million invested with a 4% return, I would have $400,000 in interest every year. Even with my mortgage and taxes and a new car every year, I could still buy all the books, take incredible care of my pets, and travel the world. 1/
This amount would also be more than enough to completely retire and open my animal sanctuary which would be self-sustaining (I have it all planned out). And of course this would be without even touching the principal balance. 2/
Don’t get me wrong, I have absolutely no intent of ever having this kind of money. But here’s what I don’t understand - why in the world are we giving all these tax breaks to people with millions and millions of dollars. There are 759 BILLIONAIRES in the U.S. alone! 3/
Read 9 tweets
Mar 21
Travel Tips Thread!

Many of you have reached out, asking me what company I used to plan my trips. I actually plan the vast majority entirely myself. So since so many of you seem curious, here’s how I do it: 1/
Disclaimer 1: For certain polar locations I have booked cruises through Quark Expeditions. These include my trip to Antarctica, as well as upcoming trips to Greenland and Svalbard. I particularly like this company due to their focus on environmental protection and education. 2/
Disclaimer 2: I did use a travel agency for my most recent trip to Africa, because it is very difficult to book, safari and transfers there without someone with expert knowledge of the area. 3/
Read 32 tweets
Jan 22, 2023
My final #SCCM2023 tweetucation session for today is “Late-Breaking Studies Affecting Patient Outcomes”!
First we have “Continued Enteral Nutrition Until Extubation Compared to Fasting Prior to Extubation in the Intensive Care Unit: A Clustered Randomized Trial” with Stephan Ehrmann (@stephanehrmann)! #SCCM2023
Nearly all ICUs impose some form of fasting before extubation, but this time seems to be decreasing. #SCCM2023
Read 121 tweets
Jan 21, 2023
Patient enrollment #SCCM2023
Patient characteristics #SCCM2023
These slides show that they did indeed have a difference in therapies given. #SCCM2023
Read 56 tweets
Jan 21, 2023
My next #SCCM2023 tweetucation session is “Late-Breaking Studies That Will Change Your Practice”!
First we have Dr. Ivor Douglas (@com543) with “Restrictive vs Liberal Fluid Management for Sepsis-Induced Hypotension”! #SCCM2023
So what is the optimal fluid resuscitation strategy in shock? #SCCM2023
Read 10 tweets

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