Sven Grauman

Swedish Anaesthetist. Resus-/CC-/Prehosp-/HEMS-/EM fiddler. Mountain dweller.

[Sven Grauman @AlpineGreyman]

Short on time for CME? Try these OnePagers. Short but sweet and could be stored in your pocket as well. Well done!

[ICU OnePager @OnePagerICU]

Today's pair of ICU #OnePagers concerns invasive monitoring devices used in the ICU: Arterial lines & external ventricular drains. How do these devices work? What subtle clues are present in the waveforms?
Lots of great physiology to unpack! #FOAMed #FOAMcc

[Sven Grauman @AlpineGreyman]

@VikingOne_ Good on you Mate! Well Done!

[Sven Grauman @AlpineGreyman]

Excellent Tweetorial on why NOT to diagnose ECG-configuration on cardiac monitors.

[Nick Mark MD @nickmmark]

Here’s a situation many of us have seen in the ICU or ED: “It looked like there was ST elevation on the monitor but when I took a 12 lead it was gone?!”

A STEMI went MIA? Here’s a #tweetorial all about why ST segments look different on monitors.

#FOAMed #FOAMcc
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[Mustafa מוסטפא 🇺🇸 Μασταφα @CombatJourno]

I'm hopelessly stuck in Kabul with my wife and child.

Like myself, hundreds of other journalists are also stuck here.

I have an 11—months old daughter.

Please pray for her safety.

[Magda Gad – Gad World @gad_media]

Lokalisera tolkarna nu? När landet redan har fallit! Det skulle gjorts för minst en månad sedan! Eller varför inte för flera år sedan, och besparat dem allt detta lidande! https://t.co/xtNpGPcCJz

[Magda Gad – Gad World @gad_media]

Har aldrig skämts så mycket för att vara svensk. Att Sverige lämnade tolkarna och annan personal som har hjälpt Sverige på plats och skyddat svenska soldaters liv. Att de nu lämnade dem och deras familjer till avrättning. Sverige, hur kan ni leva med er själva.

[Eric Topol @EricTopol]

It's not just Delta.
Two countries with the same time course of Delta dominance yet notable divergence in spread and fatalities

[CJA - Canadian Journal of Anesthesia @CJA_Journal]

A performance comparison of the most commonly used minimally invasive monitors of cardiac output | https://t.co/NJmhip3O5d #CJA #CJA2021 #Anesthesia #Anesthesiology

[Shannon Fernando @shanfernands]

But there is nuance.

I agree with what @BenjaminAbella has said - the population matters. We also cannot ignore the results of HYPERION, in a population so different than what we saw in TTM2.

To say "TTM is dead" is premature in my opinion, especially with the 95% CI we show.

[Shannon Fernando @shanfernands]

So where does this leave us?

Well I think we can all agree that the data does not support ROUTINE use of TTM in ALL comatose patients following OHCA. And we can say that deeper temperatures have not translated into better outcomes.

New guidelines will likely reflect this.

[Shannon Fernando @shanfernands]

Our SR/NMA on the use of #TTM in out-of-hospital cardiac arrest is out in @yourICM.

With no more major trials planned on this question coming anytime soon, this was needed.

A brief thread on our findings, and what they mean for TTM in OHCA:

https://t.co/O9h0x0dRt7

[reuben strayer @emupdates]

This is best practice emergency department management of atrial fibrillation.

https://t.co/9HyMhMayBu

Thank you, again, Canadians.

[Sven Grauman @AlpineGreyman]

@Stenapan @LeifRognas Roughly 10-20 ml, excluding mask/tube/filter.

[Sven Grauman @AlpineGreyman]

I agree w Mapleson (though no own experience in PH setting). I would prefer a good BVM w PEEP-valve before NRM+NC for practical reasons + O2-consumption (not an issue w Danish distances 😜). But as third option, sure.

[Leif Rognås @LeifRognas]

@NicholasChrimes @SonoRambler @London_Coomber @AlpineGreyman @TotalResus @TheResusRoom @GarnAlan @BigSick20 @drlauraduggan @ErikaPanaro @Ilcor_org @ERC_resus @SorenRudolph @PHEM_cast @HansvanSchuppen @airdoc I would argue, that even in a pre-hospital / retrieval / transport setting BVM should not be first (=Mapleson) or second (=non-rebreather mask with reservoir + nasal canula) choice for preoxygenation

[Tim Coats @TJCoats]

This video ought to be compulsory viewing for all of us. For ED staff a quick look at the care home transfer information sheet will tell you what the patient likes to be called. Otherwise just ask.

[Sven Grauman @AlpineGreyman]

Use these numbers and info as a conversation starter. Allow for a lot of uncertainty but don’t let that cloud the overarching point.

https://t.co/BpVL6VgJ5L

[Joel M. Topf, MD FACP @kidney_boy]

Cool. Now do placebo.

(Am I right that neither of these drugs have been shown to help cariogenic shock in placebo controlled trials?)

[Josh Farkas MD 💊 @PulmCrit]

after years of arguing about what flavor of inodilator is best for cardiogenic shock, turns out it doesn't actually matter 😂
https://t.co/s8frILcnQB

[Fredrik Granholm @TotalResus]

HT @_Anesthesiology Phenylephrine vs Ephedrine #anesthesia #microcirculation