Mike Scott

EM/IM/CCM. My posts represent me/my opinions and nothing/no one else; do NOT constitute medical advice

[Mike Scott @HandsomeMikeMD]

@LawnerBen I still contend the frontal bone approach is a reasonable IO technique...also, saw code black doc, thought it was great/important

[Mike Scott @HandsomeMikeMD]

@LawnerBen @CodeBlackCBS saw the preview, "people come here for miracles," and got angry...

[Mike Scott @HandsomeMikeMD]

@GioraNetzer @JohnGreenwoodMD @doc_mga http://t.co/TxTVS9NCEA. Touche; guess ardsnet says tipping point = 8mL/kg...

[Mike Scott @HandsomeMikeMD]

@LawnerBen oh, I'd cric in the field. Just wouldn't tell my accountant to bone up on laryngeal anatomy so he could do the same...

[Mike Scott @HandsomeMikeMD]

@LawnerBen reminds me of a few conversations we had my intern year - and yet, not even I'm crazy enough to suggest laypeople do a cric...

[Giora Netzer @GioraNetzer]

@JohnGreenwoodMD @doc_mga @HandsomeMikeMD Per Carl Shanholtz: ARDSnet (ARMA) study, tidal vol to 7-8 mL for dysynchrony/stacking w Pplat< 30

[Mike Scott @HandsomeMikeMD]

@GioraNetzer @doc_mga @JohnGreenwoodMD first time I've ever heard you reference a post-hoc analysis without a heavy amount of disdain...

[Mike Scott @HandsomeMikeMD]

@srrezaie (2/2) this trial was telling us something important RE harm of fluids/boluses, just nobody's figured out what that is yet...

[Mike Scott @HandsomeMikeMD]

@srrezaie but same treatment effect in pre-hoc non-malaria subgroup? Again, I don't have the answer, but feel like in 20 yrs we'll see (1/2)

[Mike Scott @HandsomeMikeMD]

@doc_mga @JohnGreenwoodMD not ignoring - trying to figure out where the risk-benefit tipping point is...7? 8? 9? 10?

[Mike Scott @HandsomeMikeMD]

@JohnGreenwoodMD @doc_mga but this study says 7-10 mL/kg worse outcomes than <7...

[Mike Scott @HandsomeMikeMD]

@srrezaie what are your thoughts on FEAST trial RE idea of early/aggressive fluids being pillar of sepsis care? (FYI, I don't have an answer

[Mike Scott @HandsomeMikeMD]

@doc_mga @JohnGreenwoodMD (also pointedly NOT mentioning open lung ventilation - let 'em pant?!?!)

[Mike Scott @HandsomeMikeMD]

@doc_mga @JohnGreenwoodMD continue to wonder if giving in to "air hunger" is new version of shooting for normal abg...

[Mike Scott @HandsomeMikeMD]

@doc_mga @JohnGreenwoodMD but is 6 mL/kg + sedation better or worse than 7-8 mL/kg awake?

[Mike Scott @HandsomeMikeMD]

@JohnGreenwoodMD PS - from sounds of it I may need to come get some spareribs...

[Mike Scott @HandsomeMikeMD]

@JohnGreenwoodMD @doc_mga And, bigger question - do you snow them to get synchronous? Liberalize to ubiquitous "6-8 mL/kg" range?

[Mike Scott @HandsomeMikeMD]

@JohnGreenwoodMD @doc_mga @CritCareMed Don't know - I still get a lot of push back; current hospital only does it if ALI pathway ordered

[Mike Scott @HandsomeMikeMD]

https://t.co/ArpYLGktNi @JohnGreenwoodMD @doc_mga

[Critical Care Medicine @CritCareMed]

Most Popular: Lung-Protective Ventilation With Low Tidal Volumes and the Occurrence of Pulmonary Complications... http://t.co/6Lc85A62ia

[Mike Scott @HandsomeMikeMD]

@JohnGreenwoodMD **touches finger to nose**