You've probably heard that Bicarbonate has to turn into CO2 to raise the pH. “Don’t give bicarb if you can’t increase ventilation.”

But how much CO2 is there in an amp of sodium bicarbonate?

A bicarb 🧵
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Atrial Fibrillation Occurring During Acute Hospitalization: A Scientific Statement From the American Heart Association: Circulation

AHA Statement from out council: AHA Acute CV Care

Here is a summary 👇👇👇

Just a reminder that patients on ventilators can often hear us.

Talk to them how you would if they were awake. Introduce yourself. Be kind. Explain what’s happening (before you examine them or do a procedure). They deserve this. #meded

Working with 1,000s of patients tells me that #Delirium in the ICU is profoundly and sometimes permanently traumatic - ranking among the worst experiences of their life. WesElyMD CIBS Center #pics

Here’s another pulmonary physiology question that *everyone* who gives O2 to patients ought to know:

What is the primary mechanism by which supplemental oxygen can increase PaCO2 in someone with severe COPD?

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Great session bright and early on airway management in severe hypoxemia! A nice review of the evidence. #chest2022

Clear winner #CHESTsputie #chest2022

After an intense ICU event (eg. emotional family meeting or code), especially with trainees, take time to debrief with your whole team. Pause to acknowledge & process emotions & give a safe space to have them. Don’t just go back to the grind as we do. That stacks up #unwellness .

ALWAYS assume your patient can hear you, and that they are likely having anxiety/pain they can’t express

Nothing gets the imposter syndrome going quite like being asked to review a paper. I find myself scared to be critical of anything bc the writer is *obviously* smarter/knows more/etc so I can’t possibly be able to correct them…

Is this a thing or is it just me?
#medtwitter

In 8 years I’ve written and read >20,000 SOAP notes.

Most could be improved.

3 tips to writing better notes:

1/🧵 What is #PICS & why does it matter in #COVID ?

After #ICU care, people are often left to wonder, “Am I ever going to get better?”

This article is excellent but it’s behind a paywall, SO I’m pasting 🔑 teaching excerpts in this thread…Elizabeth Llorente

bit.ly/3O4xdYa

Two years ago, I extubated a patient & held their hand until they passed, with family watching by zoom. It was one of my first patients who died from COVID19.

Today, I called the family to check in on them.

What’s clear: there are scars from this pandemic that have not healed😞

Being able to learn from our patients alongside our students my mentors… I LEARNED SO MUCH!! #PostICU Nicole Herbst Amanda Wiggins Casey Albin, MD Greg Martin Emory Critical Care Emory EM @NugentMD