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pietrop87.bsky.social
first10em.com/an-rct-of-he...

About #STEMI, #evidence based

#medicine and what really matters to patients outcomes
Good piece of #foamed by @first10em.bsky.social #emergencymedicine #criticalcare #foamcc #emergencydepartment
An RCT of heparin in STEMI - First10EM
Fister 2026 is an RCT of prehospital heparin in STEMI - this is a critical appraisal
first10em.com
October 28, 2026 at 6:32 AM
theelso.bsky.social
Pharmacology of vasopressors & inotropes during #ECMO
🫀hemodynamic dysregulation
🩸unique considerations during ECLS: in-parallel circulation + afterload mismatch, concomitant circulatory devices + unloading
💉 catecholamines & derivatives
💉 non-catecholamines
#FOAMcc #FOAMecmo
🔓 rdcu.be/MZ5Q1syp79Ua
October 23, 2026 at 9:25 AM
imcrit.bsky.social
Tissue perfusion → hemodynamic phenotype → intervention → reassessment

#foamed #foamcc #emimcc
October 17, 2026 at 3:00 AM
imcrit.bsky.social
One final thought:
I wish we had more participation from Chinese clinicians/researchers on social media. China produces important clinical research; discussions like this would be better if the investigators themselves could join us. We are missing valuable perspectives.

#emimcc #FOAMed #FOAMcc
October 15, 2026 at 12:42 AM
foamecmo.bsky.social
How to implement #CRRT in #ECMO? Best practices by Joint ADQI & @theelso.bsky.social Consensus Conference are out!
📋 institutional standards for delivery
🔧 technical considerations
⚠️ integration into ECMO vs use of separate access sites
🔑 KPIs
🩸 choice of anticoagulation
#FOAMcc
🔓 bit.ly/4hLY0K2
October 14, 2026 at 9:30 AM
criticalcummute.bsky.social
From our latest podcast: Act one advice for new consultants, from Raj Basu: Maximize your exposure. Minimize your liability. Join the committee, but don't let much ride on it. Learn what you enjoy.
#CriticalCare #FOAMcc #ICU #MedEd #TheCriticalCareCommute
October 13, 2026 at 6:11 PM
criticalcummute.bsky.social
New episode: your medical career in three acts. Set-up, villain, resolution.
Pediatric intensivists Raj Basu and Denise Goodman on mentorship, mid-career drift and knowing when to step back.
open.spotify.com/episode/3jjk...
#CriticalCare #FOAMcc #ICU #MedEd #TheCriticalCareCommute
Your Career in Three Acts. With Dr Denise Goodman and Raj Basu
The Critical Care Commute Podcast · Episode
open.spotify.com
October 11, 2026 at 3:30 AM
imcrit.bsky.social
Of course, a normal BP doesn't exclude ongoing bleeding or compensated shock. Context matters. But often, this is a gradual Hb drop that the body has had time to adapt to.

The Hb tells us how severe the anemia is. The patient tells us whether they need the ICU.

#FOAMcc #FOAMed #emimcc
October 9, 2026 at 2:07 AM
drfreeze.bsky.social
Some of our lectures from the Barts/Nepean Advanced Critical Echo (ACE) Course are now being uploaded to view on the Echo Nepean Youtube channel!

A delight to present our first one- the legendary Felipe Teran discussing echo in cardiac arrest

youtu.be/1GZRC-KkeUE?...

#foamed #foamcc #echofirst
Dr Filipe Teran - US in cardiac arrest (lecture @ Barts advanced CCE course, London: Sept 2026)
YouTube video by Echo At Nepean
youtu.be
October 4, 2026 at 3:04 PM
imcrit.bsky.social
🔟 The core ICU rule.

Treat the physiology, not the monitor prompt.

"Suction" tells us what the machine is feeling. It is our job is to figure out what is happening.

#emimcc #foamed #foamcc
October 3, 2026 at 8:19 PM
scienda-io.bsky.social
Emergency & critical care, same 24 hours: 235 new papers.

Top-5% journals → 24
Top 10% → 32
Top 25% → 88

Toxicology & Overdose alone: 46 new papers, 8 in a top-5% journal. #MedSky #FOAMed #FOAMcc
September 30, 2026 at 7:33 PM
imcrit.bsky.social
ICU hot take:

A white-out lung is not, by itself, an indication for intubation and bronchoscopy.

Intubating someone for a “therapeutic bronch” without first putting an ultrasound probe on the chest should be a federal crime.

#POCUS #FOAMcc
September 28, 2026 at 12:34 AM
criticalcummute.bsky.social
Season 6 opens live from CRUS WEST 2026.

Is POCUS a therapy or a fire alarm? Must it cut mortality when the oximeter never did?

Peter Brindley vs Brian Buchanan, Leo Smythe and Leon Byker.
[episode link]
#CriticalCare #FOAMcc #ICU #MedEd #TheCriticalCareCommute
September 23, 2026 at 6:16 PM
theelso.bsky.social
📢 The 3 SWAAC ELSO 2026 research webinar sessions are now available to watch on demand! What you'll take??
🎥 1️⃣ Foundations of #ECLS research & epidemiology
🎥 2️⃣ ELSO Registry: structure, access, research use
🎥 3️⃣ ECLS Research in low-and middle-income countries
Open #FOAMcc #FOAMecmo
🖇️ bit.ly/4rv2bx4
September 22, 2026 at 7:21 PM
imcrit.bsky.social
I usually include it in the admission orders for most of my ICU patients along with DVT and GI prophylaxis...!

T deficiency behaves less like an obscure vitamin deficiency & more like a potentially reversible form of mitochondrial energy failure.

#foamed #foamcc #meded #emimcc
September 20, 2026 at 7:57 PM
scienda-io.bsky.social
Emergency & critical care, same 24 hours: 188 new papers.

Elite tier → 1
Top 5% → 18
Top 10% → 36
Top 25% → 91

One paper clears the top bar. Sepsis & Septic Shock: 37 new, 3 in a top-5% journal.

#MedSky #FOAMed #FOAMcc
September 17, 2026 at 8:09 PM
imcrit.bsky.social
What is the most appropriate next step?

A. Nasal packing
B. Ceftriaxone
C. Lumbar drain
D. Craniotomy with dural repair

What’s your answer and why?

#foamed #foamcc #emimcc
September 15, 2026 at 2:32 AM
imcrit.bsky.social
Unpopular opinion (that shouldn't be unpopular):

If the BP drops right after turning off pressors, the answer is restarting the drip, NOT giving a 500 mL normal saline bolus or 250 ml of albumin.

Stop treating vasoplegia with a fluid bolus.

Agree or disagree?

#foamed #foamcc #emimcc
September 13, 2026 at 12:58 PM
imcrit.bsky.social
D) Call Cards to evaluate for urgent cardiac cath to stent the native RCA
E) Add dobutamine for inotropic support
F) Give 1 L NS bolus

#foamed #foamcc #cabg #emimcc
September 9, 2026 at 6:47 PM
scienda-io.bsky.social
Emergency & critical care, last 24h: 194 new papers
19 of them in a top-5% journal — the ones worth your time.

Read the tier that matters, skip the rest.
#FOAMed #FOAMcc #CritCare #EmergencyMedicine #MedSky
September 9, 2026 at 8:37 PM
theelso.bsky.social
Also check previous sessions:
1️⃣st ELSO Registry live Q&A 🎥 youtu.be/20oPl6N1ZVI
2️⃣nd ELSO Registry live Q&A 🎥 youtu.be/qoELY5ofrOk
3️⃣rd ELSO Registry live Q&A 🎥 /youtu.be/4sqU2UNb1mo
Tips & Tricks to Data Entry 🎥 youtu.be/VasZ-Oa7EKM
How to collect Registry Data 🎥 youtu.be/Fl2RhFRAqZs
🔓 #FOAMcc
September 9, 2026 at 7:04 PM
imcrit.bsky.social
easier to appreciate

Some textbooks include the incorrect instruction to “increase sweep speed.” For this particular assessment, slower can be better.

#foamed #foamcc #pocus #hemodynamics #emimcc
September 7, 2026 at 12:52 AM
imcrit.bsky.social
A number without metabolic context is just background noise

Treat the patient, not the monitor!

#foamed #foamcc #emimcc
September 4, 2026 at 5:37 PM
imcrit.bsky.social
I have never practiced this way. In a patient this sick, escalating vasoactive support without a POCUS-informed assessment of the underlying hemodynamics does not make sense to me.

Numbers should not replace physiology.

#FOAMed #foamcc #emimcc
September 3, 2026 at 3:29 PM
imcrit.bsky.social
"Clinical intuition" is a fancy term for educated guessing, and frankly, I’m not smart enough to roll those dice...

I use #POCUS because I require proof of what’s happening (or not happening...). Call it low intellect; I call it help for keeping critically ill patients alive

#FOAMed #foamcc #meded
August 22, 2026 at 5:47 PM