James Nathan

Intensive Care/Anaesthetic SpR in London. Interests in resus, transfer/retrieval, SRF and MLS, as well as the pursuit of Salmo Salar on the fly.

[Elior Champ Rugby @Champrugby]

Welcome to The Proving Ground, @Blackheath_1858 💥

[James Nathan @FlyFishing_Dr]

@Blackheath_1858 Is the match going to be streamed online anywhere?

[Callum Williams @cmwilliams99]

Had my final year induction on Monday with talks about UKFP applications.

Unsurprisingly significant disillusionment about maybe being randomly allocated a placeholder and then facing CT1 bottlenecks and unemployment.

The majority already planning their exit from the NHS…

[Resuscitation Council UK @ResusCouncilUK]

Defibs significantly increase the chance of surviving a cardiac arrest, yet in 2023, they were used in just 8.3% of cases outside hospitals.

This is why greater public awareness and education is needed. These devices save lives, but only if people have the confidence to use them.

[James Nathan @FlyFishing_Dr]

This is very low hanging fruit when it comes to improving outcomes, plus increasing access to AEDs. We talk about the chain of survival but if we can't get more people learning the basics, then survivorship will never improve. @wesstreeting @bphillipsonMP @ResusCouncilUK

[Resuscitation Council UK @ResusCouncilUK]

CPR training is on the curriculum, but many students are still missing out. We’re urging governments to implement systems that ensure every student actually receives this vital training.

Help make it happen. Sign the petition: https://t.co/0pyekQxjKe

[Resuscitation Council UK @ResusCouncilUK]

In the UK, fewer than 1 in 10 people survive a cardiac arrest.

That’s not good enough, and it’s why we’re working towards a day where everyone has the skills to save a life.

With widespread CPR knowledge, we can change these odds and save more lives.

[ANZICS @anzics]

Dear friends and colleagues,

It is with overwhelming sadness that we share news of the death of our colleague, mentor and friend, Rinaldo Bellomo. During recent days, both he and his family have received dedicated, expert and compassionate care from some of the finest in our ICU community. We share their pain and sense of loss.

Over several decades, Rinaldo has made a profound and enduring impact on ICU practice in Australia, New Zealand and around the world. As a passionate researcher he challenged conventions, championed evidence-based practice in the care of the critically ill and supported countless colleagues in their research careers. As a compassionate mentor, colleague and friend, he touched and enriched numerous lives, and will be greatly missed. His loss will affect our whole community and in due course there will be opportunities to come together to celebrate his life.

This will be a difficult time for many, but we know that our memories of Rinaldo’s relentless enthusiasm, warmth, optimism and boundless energy will help us all through the weeks ahead. In lieu of flowers, Rinaldo's family would welcome donations to support his research legacy at https://t.co/29kO6OeHxe

Our sincere condolences and best wishes go out to his family, friends and colleagues.

Craig Carr, on behalf of the ANZICS community

[IMCrit @IM_Crit_]

ICU Hemodynamics:

If you are managing patients with #vasoplegicshock, this is a nice review article:

[James Nathan @FlyFishing_Dr]

@LeylsTurk I'd never actually noticed that was written on the tag on the bleep.

[Farrukh @implausibleblog]

Lady in stripes, "I'm a 29 year old doctor and I'm also disabled. I've been told my entire life, if you work hard you'll get rewarded" #BBCQT

"My sister also has a degree"

"Both of us are working hard but we are not likely to have the same wealth our parents had"

"I'm not likely to own a house by the time I'm 30"

"I'd be irresponsible if I brought a child into this world because I don't have enough money to go from pay cheque to pay cheque"

"Because as a doctor didn't even meet our pay needs we agreed on when we ended the strikes"

"And to face that I'm looking at unemployment in August"

"I want to be a GP but there's only 4,000 spots for us in the UK to train, and there are 15,000 applicants"

Fiona Bruce, "Who do you hold responsible for that?"

Lady in stripes, "There's been no increase in higher training positions for the past 10 years"

"And we're also competing with doctors all over the globe"

"The whole, if you work hard you'll be rewarded, has gone out the window"

[James Nathan @FlyFishing_Dr]

@DrEilidhMaria Welcome to the joint-best hospital specialty alongside Intensive Care. Great supportive training experience.

[Peter Brennan @BrennanSurgeon]

News article in BMJ about tiredness in doctors following a survey by Medical Defence Union

Being awake for > 18 hours can the same effect on decision making as being x2 over the UK alcohol limit

Thanks for asking me to comment & quoting our BMJ article on fatigue in NHS staff

[James Nathan @FlyFishing_Dr]

@JerseyGIdoctor Well said

[James Nathan @FlyFishing_Dr]

@mitcharj 🤞 this will finally happen. What are the plans for the old site once Overdale is complete?

[British Journal of Anaesthesia @BJAJournals]

The individualised open-lung approach to intraoperative mechanical ventilation - is there an opportunity for personalised lung protective ventilation? #anaesthesia #ventilation #perioperative

https://t.co/d61CdogCEW

[British Journal of Anaesthesia @BJAJournals]

Operating room workers are at risk of preventable harm due to surgical smoke plume. Daniel Rodger calls for Governmental action to protect healthcare workers. #smoke #surgery #harm

https://t.co/Lirkda6Hqm

[FICMNews @FICMNews]

The updated @AoMRC Code of Practice for the Diagnosis and Confirmation of Death comes into force today, 1 January 2025. See the website for more:
https://t.co/aIoGHGWJGG

[James Nathan @FlyFishing_Dr]

@DrMattThomas1 Keep up the good work. Remember that you are more than capable of this given your anaesthetic and ICM training thus far. Do you have an ICM ES or are they one of the medical consultants? I hope either way that they are being supportive.

[James Nathan @FlyFishing_Dr]

@DrMattThomas1 How much of your time is split between wards and acute take? I tried to find a few things I could teach during my time, namely improving cannulation skills and LPs.

[James Nathan @FlyFishing_Dr]

@JerseyGIdoctor A wonderful colleague to work with and excellent at her job. Starting to think I left the island just in time.