Lee Berry

RN , ACCP, USS and POCUS enthusiast. Deluded football player / manager. Ex 90s dance child.

[Lee Berry @Bezza_lee]

@CharlieWalsham_ Could not agree more

[Dr Richard Webb @DrRJWebb]

@DrHuw @UHSFT I can tell you, the ACCPs on PICU, on retrievals, are some of the finest colleagues I’ve ever had, and I’d trust any of them with my own child however sick he was. They’re not equivalent to a registrar; they are, within their own right, phenomenal at their job.

[Lee Berry @Bezza_lee]

@ItsJamesHall Absolutely James feel very much the same. Used to watch match of the day, football focus and soccer AM religiously. I find the way football is played (over coached) lack of flair painfull. Still love big national tournaments but sadly the joys been sucked out of the game

[Jonny Wilkinson @Wilkinsonjonny]

New interface👍
Same job
Sweep the latest🧹
Keep them for later🛟

Papers, sites, Substack, podcasts, what’s buzzing, still live, still sifted.🗞️

Each desk has its own pile:
ICU bag
Gel bag
Emergency bag.

Not another dump of everything🗑️

[Airway of the Month @AirwayOTM]

Prefer the case in 30 seconds? ⏱️

🫁🎥 October AOTM—in 30 seconds.

The tube hides the target. A posterior mispass follows. 👀

🎯 Re-center. Keep the target visible.

💧 Clear the view. Re-identify landmarks.

✅ After visual passage, confirm with waveform capnography.

🔗 Go here for the Full case: https://t.co/JhKIK7AFrp

#AirwayOfTheMonth #FOAMed

[Fumiya Yoneyama, MD, PhD | WithAScalpel @WithAScalpel]

Fundamental Principles of Hemodynamics: Ohm’s Law & Laplace’s Law

👉Hemodynamic Ohm’s law defines flow as Q = ΔP/R : pressure gradient drives flow, while vascular resistance opposes it.
👉Laplace’s law relates wall stress as T = (P × r)/(2h) : stress rises with ↑P or ↑r and falls with ↑h.
👉Clinically, these principles frame SVR/PVR, ventricular pressure/volume overload, hypertrophy/dilation, etc

[Critical Care Reviews @CritCareReviews]

Precision fluid therapy in sepsis: fluid responsiveness vs. fluid tolerance

CCR Journal Watch
https://t.co/Sp06oA7gte

[Sateesh chandra @DrSateeshPCCM]

Early Cycling

The flow time scalar shows an upward deflection during the initial phase of expiration in a patient-triggered breath. This occurs because neural inspiration continues even after the end of mechanical inflation, a phenomenon known as early cycling.

[Sama Hoole @SamaHoole]

In 1967 Britain had more electric vehicles on its roads than every other country on earth put together, and they were all delivering milk.

There were tens of thousands of them. The milk float: open sided, battery under the floor, top speed of about 15 miles an hour, and a whine you could pick out in your sleep. It was charged overnight at the depot and was back there by lunchtime.

It carried glass bottles. Each one was collected from your step the next morning, washed and refilled. A bottle went round like that 20 or 30 times before it broke. The foil cap went for scrap. There was no other packaging.

The milk had come from farms within a few miles, through a local dairy, and was on the step before 7.

So here is what the country had. A zero-emission delivery fleet. Reusable containers with a return rate any modern scheme would kill for. No plastic. A supply chain you could cycle the length of. A man who noticed if an old lady's bottles were piling up, and knocked.

It was dismantled in about 15 years, because a supermarket could sell milk a few pence cheaper in a plastic jug as a way of getting you through the door.

Every piece of that system is now the subject of a government target for 2040.

It was running in 1967, silently, in the dark, and nobody thought it was worth a mention.

[Lee Berry @Bezza_lee]

@KellyGoodmanPhD @drterrysimpson How does one get awarded a PhD when clear evidence research and facts appear beyond them?.
Whichever institution awarded you this should be on the phone to recall it post haste

[Critical Care Reviews @CritCareReviews]

Beyond Fluid Responsiveness: Why Venous Congestion Matters in Sepsis

CCR Journal Watch
https://t.co/Sp06oA7gte

[Eddy J. Gutierrez, MD @eddyjoemd]

Since esophageal pressure monitoring and electrical impedance tomography are so frequently discussed in the literature, as a community hospital intensivist, I have to ask: do you all routinely use these in academic centers? 🎩 tip to the authors.
https://t.co/sSr8PFzSBW

[Lee Berry @Bezza_lee]

Thunderbastard 😢

[A Funny Old Game @sid_lambert]

It’s 31 years since Tony Yeboah unleashed this truly biblical Thunderbastard at Selhurst Park.

Sweet Lord Above. What a strike.

[Mark Crossley @bignorms]

22 yrs yesterday since the passing of the greatest manager ever (in my eyes) thanks boss for changing my life and I hope your resting well ❤️

[EchoTech @EchoTech_4]

In lung ultrasound, recognizing an artifact is only the beginning. The real clinical value comes from
understanding how findings fit together across the chest
.and what they mean in context
The BLUE protocol provides a structured way to connect
ultrasound patterns with the assessment of acute
respiratory failure, helping guide the next diagnostic step
rather than relying on a single sign.
Lung sliding, the distribution of findings, and additional
assessment for DVT or PLAPS can all change how the
pattern is interpreted.
Knowing how these elements work together can make
bedside lung ultrasound more systematic and clinically
useful.

[Andrew Cumpstey @acumpstey]

@topmedtalk#AI: @acumpstey @ChappellDesiree & guests John Whittle & Duncan McPherson discuss how early AI research shares safety & governance with other research while medical device regulation applies the same legal principles to AI as to other devices

https://t.co/73m1fQovqU

[Rhenals acuña @RhenalsMedint]

La sorpresita de la tarde.

[𝗦𝗮𝗹𝗲𝗲𝗺 𝗡. 𝗛𝗮𝗺𝗶𝗹𝗮𝗵 🫁 @SaleemHamilah]

STATIC vs. DYNAMIC COMPLIANCE 🫁

Understanding lung compliance can help you identify whether the problem is coming from the lungs or the airways.

STATIC COMPLIANCE
Cstat = VT ÷ (Pplat − PEEP)

Measures compliance when airflow is zero.

↓ Cstat → Think decreased compliance / stiff lungs
• ARDS
• Pulmonary edema
• Atelectasis
• Pneumothorax
• Fibrosis

DYNAMIC COMPLIANCE
Cdyn = VT ÷ (PIP − PEEP)

Measures compliance during active airflow and is affected by airway resistance.

↓ Cdyn → Think:
• Bronchospasm
• Secretions
• Kinked ETT
• Airway obstruction

TMC TIP:

↓ Cstat + ↓ Cdyn → Decreased compliance

Normal Cstat + ↓ Cdyn → Increased airway resistance

Easy reminder:
STATIC → Pplat
DYNAMIC → PIP

Know the difference. Find the cause. Ace the TMC.

#RespiratoryCare #LungCompliance #StaticCompliance #DynamicCompliance #MechanicalVentilation