My strongest memory of COVID: I was sat in a respirator. They are horrible to wear. It made my nose stream and I'd gone deaf in one ear from pressure on my temperomandibular joint from the mask straps. I was tired. So, utterly, dog tired. I'd just reviewed a man, in his 50s

NG tubes

Today over 80 Fellows of Royal College of Physicians (with >20 Professors of Medicine, 3 elected RCP council members) have signed an expression of concern outlined below around the actions of the leadership of Royal College of Physicians that continue to place patients at risk from harm. In the March EGM,

If you are going to lie Penny Mordaunt why not go all out: - no care for anyone above Fitzpatrick II - mandatory kidney donation if you are poor - BMA council murdered by Boris with a musket - doctors to work for free because practicing medicine is a privilege

BLING III: In critically ill patients with sepsis, continuous vs intermittent β-lactam antibiotic infusions did not significantly reduce 90-day mortality. ja.ma/3VEouCa #CCR24

Among adults in the ICU who had sepsis or septic shock, the use of prolonged β-lactam antibiotic infusions was associated with a reduced risk of 90-day mortality compared with intermittent infusions, finds meta-analysis. ja.ma/4beJZhv #CCR24

I’ve spent 6 years at med school, 5 years in general medical training, 2 years in specialist cardiology training and are referred to as “a junior doctor” yet the fact that NHS management thinks a 2 year degree makes a “heart specialist” tells you all you need to know

If you remember nothing else about this government’s last 5 years, remember that they broke the rules they made and partied while we were in lockdown. It has always been one rule for them and one rule for the rest of us.

HAPPY MISERABLE TORY DAY TO ALL WHO CELEBRATE.

Interesting related fact came up in our Trust Trauma Audit today: In the last 5 years at the Royal London, no patient with traumatic cardiac arrest and thoracotomy who survived prehospital & ED phases of care had chest compressions during resuscitation.

The old attending showing up at 215 am who can fix anything from a central line to a printer

Zaf is a taxi driver. He’s born and bred Sunderland He broke down when he described the hate he’d received This was seconds before racial slurs were thrown, telling him to “go back to his own country” A short clip. Hard, but important, so please watch

You destroyed a library. It was MORE than a library, it was a food bank, a source of heat for people in the winter, a place for kids from low income families to use the internet, or do their homework. Why destroy something so vital? Yeah you’re so patriotic guys.

Giving a human factors talk next month at a critical care conference Hmm... BMJ study found ICU trainees urine was x2 as concentrated as their patients Even a 1-2Kg loss of body water can reduce analysis/decision making by 15-20% Drinking regularly helps maintain performance

Realised I hadn’t tweeted (x’d?) in a while, but the Southern hemisphere is distracting

COPD - It did HAPPEN JAMA:

For perspective, our locum reg rates overnight are $220 an hour

Which one of you lot admitted the fully dependent 88y/o with respiratory failure to HDU overnight?! bbc.com/news/articles/…

Duration of cardiopulmonary resuscitation and outcomes for adults with in-hospital cardiac arrest: retrospective cohort study bmj.com/content/384/bm…