Joelsons

ICU physician - ECMO Specialist (E-AEC)

[Rafael Melo @intensivaev]

How strong is the evidence behind the Surviving Sepsis Campaign?
In our new paper, we analyzed more than two decades of SSC guidelines, including 554 statements across seven publications.
The result is striking.
From 2008 to 2026, the proportion of recommendations supported by high-certainty evidence fell from 15.8% to 2.3%, while strong recommendations decreased from 69.7% to 18.0%.
Perhaps even more importantly, in the 2026 guideline, one-third of strong recommendations are still supported by low- or very-low-certainty of evidence. This means we should be very careful about confusing guideline recommendations, implementation priorities, and certainty of evidence.
Guidelines should support clinical judgment — not replace it.
Happy to see this work published in the Journal of Critical Care.

https://t.co/2DuliSFIlc

[Joelsons @Joelsons10]

Finalizando os testes do nosso boneco de punção ECMO
Inscrições acabando
Confira o cronograma em:

https://t.co/cmrxDsmpWA

[Tovia Goldstein @RealToviaG]

Can I just kidnap two random kids on the streets of NYC and expect the government to release 40 serial killers per kid, or is this something we only expect the Jews to do?

[André Lajst @AndreLajst]

“Nunca antes na história um lado afirmou ter sofrido um genocídio e, ao mesmo tempo, ter vencido a guerra que provocou.”

— Hillel Neuer @hillelneuer

[Joelsons @Joelsons10]

@Joaokm @delegadoramagem Acho q os dois estão errados

[Joelsons @Joelsons10]

@visegrad24 🇧🇷

[Ross Prager @ross_prager]

A med student asked me what being an ICU doctor was like…. after struggling for a bit I used the analogy of a symphony conductor.

As an ICU doc I don’t know how to play the violin, cello, or French horn (nursing roles, RT, or pharmacist) however, I am responsible for knowing when each of those sections aren’t performing at their best and to try to help. Perhaps that is getting the 1st violin (charge nurse) to help mentor, or taking a bit of time to teach and facilitate deliberate practice.

This analogy also recognizes the fact that the music (patient care) continues almost entirely without me! However, without someone waiving a baton the tempo may become to fast, to slow, or things might slowly become out of tune.

I like this analogy as it celebrates the fact that to provide excellent patient care (beautiful music) we require every section of the orchestra to perform at its best.

This is why I love being an ICU doc.

#MedTwitter #foamed #ICU

[Joelsons @Joelsons10]

@caioblinder Manda boicotarem o médico que tratou o câncer do Lula!!! Arthur Kats! Judeu...

[Nils Svendsen @nils_svendsen]

Never stop talking about the hostages.
Never stop talking about the hostages.
Never stop talking about the hostages.
#BringThemAllHome

[Joelsons @Joelsons10]

@DYannopoulos Hi Demetris, big fan here! We met at the last EURO-ELSO congress in Portugal, and I got a picture with you. 📸 Wondering if you have any early data from the ECPR truck study? Patient count and survival rates? Thanks for your help!

[Joelsons @Joelsons10]

@hoje_no Hospital com pacientes e não terroristas... Por isso o mundo não fala nada... Se tivessem terroristas lá dentro, túneis, armas e bombas aí sim seria um absurdo o ataque....

[Joelsons @Joelsons10]

@IM_Crit_ #1 was CAD?

[Joelsons @Joelsons10]

@ianwardd @BiaArantes Santa casa!!!!! 😍

[Joelsons @Joelsons10]

Fun fact

Quando um ciclista está andando na rua e um carro passa perto dele, ele fica puto (e com razão), xinga e gesticula.
Quando um atleta está correndo na ciclofaixa, o ciclista vai, passar bem perto, quase atropela e ainda fica puto, xinga e gesticula.

[IMCrit @IM_Crit_]

Fact #1:
In the "average" patient, a dose of 100 mg iv furosemide is safer than 1 liter iv crystalloids

Fact #2:
In every patient, a dose of 100 mg iv furosemide is ALWAYS safer than 1 liter iv crystalloids

[Joelsons @Joelsons10]

@DYannopoulos April fool's day?

[Joelsons @Joelsons10]

@Paul_Wischmeyer @drdangayach @iceman_ex @iamyourgasman @SICUPharmD @chungk1031 @laxswamy @nickmmark @LifeWithoutDiet @Tweet_Nutrition @brownam130

[Joelsons @Joelsons10]

@Paul_Wischmeyer @drdangayach @iceman_ex @iamyourgasman @SICUPharmD @chungk1031 @laxswamy @nickmmark @LifeWithoutDiet @Tweet_Nutrition @brownam130 Better choice is not use any sedation an let you patient awake (even intubated or in ECMO).

[The Innovation | Medicine @Innov_Medicine]

Good demonstration of a TAVR

[Joelsons @Joelsons10]

@iamyourgasman @Paul_Wischmeyer @drdangayach @iceman_ex @SICUPharmD @chungk1031 @laxswamy @nickmmark @LifeWithoutDiet @Tweet_Nutrition @brownam130 Before Covid that was the normal standart... Once you sedate for the procedure you kept the patient only with fentanyl.
With Covid it was hard to get.
Now "after" Covid we are getting there. We try to kept at rass -1/0 all patients.

[Joelsons @Joelsons10]

@yilmazynep @OGdukeneurosurg 😮