Yesterday I received one of the highest and most ancient honors in London, the Freedom of the City. But the celebration soured into an experience of indignity when upon arriving, I found that there was no ramp for me to access the stage.
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It's that time of year again! Here's one approach to neurologic examination (the most important diagnostic test!) of the comatose patient for those rotating in #neurology or the #ICU for the first time.
If you intubate you need to read the #PREOXI trial!
-n=1301 people requiring intubation in ED/ ICU were randomized to preoxygenation with oxygen mask vs non-invasive ventilation (NIV)
-NIV HALVED the risk of hypoxemia: 9 vs 18%
-NIV reduced mortality: 0.2% vs 1.1%
#CCR24
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A woman presents after a v fib cardiac arrest, ROSC achieved at 30 mins. She has been comatose for 2 days. No sedation. Fever prevention has been achieved.
36 hours after arrest, she develops generalized myoclonus.
This is a dismal prognostic sign… right?
Image: PM 27351833
This absolutely broke me.
I work and train in the ICU without a question of whether there will be enough oxygen, power and resources that day to keep my patients alive.
Imagine being a healthcare provider at #AlShifaHospital
How do you ever unsee this and continue to work?
At Al-Shifa hospital #Gaza is without power. We have premature babies who need incubators, we have patients in the ICU who need respirators, we have over 600 patients that need medical care. A hospital needs power. We need an immediate ceasefire.
Of the many things that happen in a hospital when the power goes out, one haunts my memory, a story I have also heard over and over from other doctors who also worked in a hospital when it suddenly went dark
A thread about mothers and their children👇🏽
Congratulations to Drs. Joan Sargent, Scott Halperin, and Tommy Brothers who were recently recognized by the Association of Faculties of Medicine of Canada #dalproud https://t.co/TKCWgHnVtj
We've gotten used to scrolling. We've gotten used ignoring news that does not directly involve us. We've normalized suffering in certain parts of the world to the point that disasters are no longer breaking news. The truth is we don't like discomfort,
Cont.🧵👇
#syria#turkiye
me papers to read 🥹 And a mentor showing vulnerability in how they cope with the sad aspects of medicine, all the while teaching humility and grace ❤️ A truly positive hidden curriculum 😊#Thankful#MedTwitter#MedEd
One of the best aspects of medical education is the development of a genuinely healthy resident-attending relationship. One where the trainee is *truly* comfortable voicing their discomfort and where the mentor knows the limits of their knowledge. Recent examples for me ☺️:
Telling my staff, “this is all I know about disease X, did I get that right?” Followed by us both chuckling over my explanations and then an incredible explanation. My staff saying “I don’t know” to a question, following up a week later after consulting a colleague, then sending