💙Andy Martin

Intensive care and Anaesthesia Consultant, Man United supporter.

[Taqua Dahab @TaquaDahab]

Many thanks for the 140 ICM Residents who joined us tonight for the @FICMNews festive webinar on ❄️ 🎁:
Preparing for your first ICM Consultant Job 🤓
I hope you found it useful!

Supporting resources are available at the FICM website under Stage 3 Resources:
https://t.co/yv2YjB1bEJ

[Critical Care Reviews @CritCareReviews]

Today's Paper of the Day is on brain death/death by neurologic criteria: What you need to know
https://t.co/JKgcYjlUQ5

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2024

[POCUS 101 @Pocus101]

Thanks to the AMAZING @TheSonoGraphics team for these Advanced Echo Cards! Available to download FREE on POCUS 101!
👉🔗https://t.co/yynidLrxZI

✅TEE
✅Cardiac Output
✅Tamponade
✅Diastology
✅EF Calcs
✅Right 💔 Failure
✅Wall Motion Abnl
✅And MORE!

See 👀 Cards 👇 #POCUS

[NephroPOCUS @NephroP]

#POCUS in cardiac arrest
#FOAMed #FOAMcc
🔗 https://t.co/tI8cbzPoQF

[Critical Care Reviews @CritCareReviews]

Today's Paper of the Day is on how to ventilate obstructive and asthmatic patients
https://t.co/JKgcYjlUQ5

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2024

[Dr. AK 🇮🇳 @docakx]

🌟 ATRIAL FIBRILLATION - 17 simple rules for management

2024 ESC Guidelines for the management of atrial fibrillation

[Ross Prager @ross_prager]

(1/x) As you might know, I research venous congestion in critically ill patients. This is a fascinating field but is changing a TON as new evidence emerges.

Here are my top 5 learnings about venous congestion in the past months.

A 🧵

Pinging some experts in the field for their tips 👇

[Jasmine Sethi @JasmineNephro]

🫘✍️Diuretics Classes and action

From @PyrlsApp

[Eddy J. Gutierrez, MD @eddyjoemd]

Watching the platelet count drop in our patients is unnerving. Sure, there are some cases where we can explain it, but we oftentimes need to pull the trigger and check for HIT. Here’s a great review on taking care of these patients. 🎩 tip to the authors.

https://t.co/4Ise540F2X

[NephroPOCUS @NephroP]

Vasopressors for the management of septic shock.
#FOAMed #FOAMcc #MedEd
Courtesy: De Backer, et al. Crit Care 26, 372 (2022).

[𝘈𝘯𝘢𝘦𝘴𝘵𝘩𝘦𝘴𝘪𝘢 @Anaes_Journal]

Here is an excellent summary of evidence-based peri-operative management recommendations for patients taking GLP-1 agonists.

🔗https://t.co/GmNx3EpNrI

[Joe 'Financial Opinionator' Green @JoeTGreen]

Delighted to pop onto the @BBCLeicester Breakfast Show to chat with @asapchance_ about the financial discounts, offers and savings available to the over
60s.

As I've discovered, there's a lot more out there than you may realise!

Have a listen, save yourself a fortune!

[💙Andy Martin @AndyMartin5]

@HeySamuelHey Congratulations! Well done!

[🩺 Hari (హరి 🇮🇳) Kalagara @KalagaraHari]

Excellent talk by @khaycock2 on navigating Fluid Responsiveness & Tolerance in sepsis. #POCUS #VExUS @ThinkingCC @siddharth_dugar @NephroP @NibrasBughrara @pdsalinas @Jose_Diaz_Gomez @SCCM @iceman_ex @icmteaching @ICUltrasonica @Wilkinsonjonny @drmohansai @Thind888 @msiuba

[Critical Care Reviews @CritCareReviews]

Impact of hyperoxia on the gut during critical illnesses

CCR Journal Watch
https://t.co/Sp06oA6IDG

Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://t.co/nitMzacLrj

[Critical Care Reviews @CritCareReviews]

Myoclonus: Differential diagnosis and current management

CCR Journal Watch
https://t.co/Sp06oA6IDG

Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://t.co/nitMzacLrj

[Dan Kim @dan___kim]

Infographic depicting the myriad of ways #POCUS can be used in cardiac arrest and the immediate post-ROSC state

This is from a new editorial "How I use ultrasound in cardiac arrest" by @avkwong @chiara_robba in @yourICM
🔗https://t.co/P5s8kUxQ27

[Critical Care Reviews @CritCareReviews]

Today's paper of the day is on fluids and early vasopressors in the management of septic shock: do we have the right answers yet?
https://t.co/JKgcYjlUQ5

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2023

[Segun Olusanya (He/Him) [email protected] @iceman_ex]

So I will be talking tomorrow at @BTSrespiratory in London about “the forgotten ventricle”

My man @msiuba has however completely outdone me with a much better talk on the subject

Everyone check this out https://t.co/y8sCxdStwQ

#foamed #foamcc

[Dr.Kartik Sonawane @KartikBSonawane]

" THORACIC WALL BLOCKS:
An Art of Looking Between the Lines"

#Thoracicwallblocks
#Chestwallblocks
#Parasternalblocks
#PECSblocks
#SAPblocks #PVB #ESPblock #RISSblock #ITPblock

My 10 points between 6 LINES:

ANTERIOR CHEST WALL BLOCKS:

(A) Medial to the Midclavicular line:

PMM covers ribs & ICMs in the parasternal region. External ICM becomes the Anterior Intercostal Membrane anteriorly (Posterior Intercostal Membrane is formed by Internal ICM posteriorly).

1. Parasternal blocks: Probe placed sagitally over the parasternal region. LA deposition- Between PMM and ICM for Superficial parasternal block OR between internal ICM and transversus thoracic muscle for Deep parasternal (Transversus Thoracic Plane) block. Coverage- Anterior cutaneous nerve T2-T6. Vascular landmark- Internal mammary A. in TTP block.

(B) Between Midclavicular - Anterior axillary lines:

Muscles from superficial to deep include PMM, PMnM, and SAM above ribs & ICMs.

2. PEC ZERO (Modified Clavipectoral Fascial Plane) block:* Probe placed vertically between the clavicle (proximally) and 2nd Rib (distally). LA deposition- Above and below PMnM. Vascular landmark- Acromial branch of TAA.

3. PEC 1 (InterPectoral plane) block: Probe over 2nd Rib. LA deposition- Between PMM and PMnM. Vascular landmark- Pectoral branch of TAA. Coverage- LPN & MPN.

4. PEC 2 (Pecto-Serattus Plane) Block: Probe over 3rd Rib. LA depostion (2 injections)- Between PMM-PMnM & PMnM-SAM. Coverage- LPN & MPN, ICNs T2-T6.

(C) Between Anterior - Posterior Axillary lines:

Muscles include SAM (anterior to midaxillary line). LDM & SAM (posterior to midaxillary line) above the ribs.

5. BRILMA (on 4/5th ribs) and modified BRILMA (on 7/8th ribs): Probe placed at midaxillary. LA depostion- Between SAM and Ribs. Coverage- Lateral cutaneous nerves T2-T7 (BRILMA) and T5-T12 (modified BRILMA).

6. SAP 1 (superficial SAP): Probe between Midaxillary- Posterior axillary lines. LA deposition- Between SAP muscle and LDM at 4/5 th ribs level. Coverage-Intercostobrachial N., T3-T9, LTN, and TDN.

SAP 2 (Deep SAP): LA deposition below SAM at 4/5 th ribs level. Vascular landmark- Thoracodoral A above SAM. Coverage- Intercostobrachial N. and T3-T9.

POSTERIOR CHEST WALL BLOCKS:

(D) Probe kept parasagittal 2.5 cm lateral to the midline:

7. Thoracic PVB: LA deposition above pleura by piercing superior costotransverse ligament.

8. Inter Transverse Process (ITP) Block: LA deposition anterior to C-T ligament in the retro CT space.

(E) Probe kept parasagittal 4 cm lateral to the midline:

9. Thoracic ESP Block: LA deposition below ESPM by hitting the tip of the TP.

(F) Probe between TP and Scapula:

10. RISS (Rhomboids Intercostal Sub-Serratus plane) Block: LA deposition between RHM-ICM along the Medial border and below SAM at the inferior angle of the Scapula. Coverage- T2-T11 dermatomes.