📣 It’s essential we develop a nationally commissioned network for the management of cardiogenic shock & the provision of MCS in the UK 🇬🇧 - despite pressure from Intensive Care Society 💙 British Cardiovascular Society British Heart Foundation & others this is still desperately needed 🤔👉

Really interesting results of an important PARAMEDIC-3 trial. IO access first line did not reduce time to vascular access or drug delivery in OHCA and was associated with ⬇️ rates of ROSC. I think we often think IO is easier than it is and I think this trial supports that

LNC chairs being called in to be told of 'just how serious our financial position is' up and down the country. Sounding pretty system wide. Message to trusts; "if you haven't got the money then you can't have the work". It's a *national* health service, not run on staff subsidy.

Microclots? Not al all. Reported particles are not blood clots, so anticoagulant drugs are not a plausible treatment #longcovid #MECFS tinyurl.com/b83vmnym

UHB U Turn We know our worth as doctors and hope this has sent a powerful message to all trusts considering similar actions.

Collective action is unfortunately the only thing trusts/ employers like University Hospitals Birmingham listen to Strong resolve from doctors 💪🏾 An important message to employers who adopt cheap tactics And reminder to doctors to organise and negotiate EC rates to actually match workload

@aldomatariMD NHS England Roy Lilley 💙 There's poor evid that hospital league tables work. Prof Tom Marshall et al wrote this articl 22 yrs ago & it's still v relevant Wes Streeting Department of Health and Social Care "Performance league tables: the NHS deserves better" pmc.ncbi.nlm.nih.gov/articles/PMC64… 𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @CraigNikolic David Oliver (also on Blue Sky) Sebastian Rees

Very nice overview of the current state of affairs in cardiogenic shock (published this week in The Lancet):

Really important work from #BOXtrial team - SCAI classification is as applicable to OHCA population as CS for acute and medium term outcome #AHA Alastair Proudfoot Segun Olusanya (He/Him) [email protected]

Supply of anaesthetists is constrained by inadequate numbers of training places and poor retention. This year, there were 3,520 applications for an available 540 core anaesthetic training places and 640 applications for 390 higher training places.

1/ Back to the basics today: let's talk about common pitfalls in obtaining cardiac #POCUS images ❤️ Here are some very common image acquisition errors in basic views, as well as the simple moves to correct them ✅ 🧵

Research priorities in #regionalanaesthesia identified by anaesthetists have been published, BUT the views of patients, carers & other healthcare professionals have not been considered. Enter the Regional Anaesthesia UK (RA-UK) priority setting partnership!

It appears that our medical regulator, GMC has been employing social media specialists to monitor the posts of individuals raising patient safety concerns about PAs, including my own account. To say that this is a fact finding mission, to improve communication is

Great summary from Ed Barnard Ed Barnard of the EAAA RAID Group innovation for OHCA POCUS and SPEAR Great work by Shad on both of these papers

💊 Evidence supports NICE guidelines in encouraging clinicians to use amoxicillin (a narrow-spectrum #antibiotic) for mild to moderate pneumonia. Amoxicillin is as effective as a broad-spectrum antibiotic for many people hospitalised with pneumonia 👉 evidence.nihr.ac.uk/alert/amoxicil…

Only 25% of F2 doctors successfully entered speciality training in 2022, likely due to a lack of training spots. Hundreds of doctors that are unable to train to be your GP, your surgeon, your psychiatrist. All while the waiting lists are rising. When will Wes Streeting act?

Pulmonary embolism and clot in transit- a proposed algorithm where the role of the Pulmonary Embolism Response Team (PERT) is highlighted for risk stratification and treatment Work led by Marco Zimarino and mario di marino and friends Link to paper ➡️heart.bmj.com/content/early/… Thank

Yes it does for PCT but no evidence for CRP to reduce antibiotic duration. Fantastic editorial by Marion Campbell to critique methods used and provide perspective on interpretation of secondary analysis explored regarding the strength of the PCT intervention

🫁#ARDS severity based on oxygenation impairment does NOT reflect respiratory mechanical properties & MV setting, VILI prerequisites/determinants. Respiratory support should be tailored more closely to lung mechanics/CO2 clearance rather than oxygenation🔓bit.ly/41weEWk

When firefighters are sent out in crews of just three in a fire engine, lives are put at risk. The fragmentation of the fire and rescue service has led to a dangerous post-code lottery for firefighter crews. To protect firefighters and the public, we need national standards.