Julian Fuller

Anaesthetist, enjoying life, Greenland, the sea, & medicine. Ex ocean racer, exec member of ASMS, passionate for our Healthcare System. LCHF 4 wt

[Julian Fuller @JulianCorbettF]

Proud of what we have achieved at our hospital, in getting ready for what we hope does not eventualise. Anything would be better than the overflowing ICUs of London, Italy & Spain, never mind New York. Fingers crossed we locked down in time here in NZ!

[nzherald @nzherald]

At North Shore Hospital in Auckland, an entire building had been repurposed - its former Elective Surgery Centre - to treat solely Covid-19 patients.

https://t.co/8UWrYf1FRK

[Cricket Draft Insight 🏏🔴⚪️🏆 @draftinsight]

James Fuller’s seven wickets on T20 Blast Finals day yesterday, took him to 201 T20 career wickets. 75 of those wickets were taken when playing for Hampshire!

[Maxwell O'Dowd @Maxiboi23]

So you’re telling me, associate sides have to play in a 3 year 50 over tournament, to qualify for a qualifier to qualify for another tri-series qualifier to then qualify for a World Cup.

[Hampshire Cricket @hantscricket]

THE MAJOR IS ON HIS WAY TO BIRMINGHAM FOR A RECORD 12TH TIME 🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉🚌🎉

[Alvin Foo @alvinfoo]

This is possibly the best example of guerrilla marketing by an airline all year - SAS - Scandinavian Airlines😍

[Hampshire Cricket @hantscricket]

EVENING MAJOR ❌
AFTERNOON MAJOR ✅

WHAT A VICTORY IN THE @VitalityBlast 😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍😍

[Zachary Foster @_ZachFoster]

Hi Jonah,

I'm Jewish. Many of my closest friends are Jewish. I love them all. My family is Jewish, I love them all too. My community is Jewish. Love them too. I love Judaism. I host shabbat dinners, celebrate Jewish holidays, sing Jewish prayers, study Torah & Talmud, and love Jewish culture, history and expression.

Judaism existed for thousands of years before Apartheid Israel came into existence, and Judaism will exist for thousands of years after Apartheid Israel collapses.

That's because the ideology of Apartheid Israel is Zionism, an ideological movement that set out to build a Jewish state with a Jewish majority working at Jewish-only cooperatives living in Jewish-only colonies owned by Jewish-only land authorities operating Jewish-only schools in a country of overwhelmingly non-Jews. What could possibly go wrong?

A short summary: That's why, when Zionists bought land in Palestine from the 1900s-1948, they uprooted the people living on the land because they weren't jewish. https://t.co/HRdm0V6YDS and https://t.co/5et8PsWW0Y

That's why, when Zionists created cooperatives in Palestine in the 1910s, 1920s and 1930s, they insisted on "Hebrew Labor", i.e., "Jews only" -- no Arabs allowed. That's why, in the 1930s, Zionists expelled Palestinian Arabs from working at Jewish companies and business. https://t.co/oXfyJsXdja

That's why, in 1948, Zionists militias ethnically cleansed 750,000 Palestinians from their homes. https://t.co/A6l95xmTfe

That's why, from 1949-1956, Israeli forces shot & killed b/w 2,700-5,000 overwhelmingly unarmed Palestinians trying to return to their homes after the war. Because they were the wrong religion/ethnicity https://t.co/s2RBvsdjMw

That's why Israel expelled another ~30-40,000 Palestinians from Israel from 1949-1959. https://t.co/1d4VqUk5lc

That's why Israel expelled another ~250,000 Palestinians from Gaza & the West Bank when it occupied those territories in 1967. https://t.co/aDxfsfnf9l

That's why Israel continued to expel Palestinians from the occupied territories from 1968-1993, many hundreds of thousands of them. https://t.co/16FarJ83q4

The Zionists wanted to create a Jewish State with a Jewish majority in a land of overwhelmingly Palestinians. That's why Israel has become such a pariah state over the years, because it's insistence on jewish rule in a country with so many Palestinians. That's why Zionism has led Israel to become an apartheid state, according to every relevant human rights organization ( @ICAHD in 2010, @UNESCWA in 2017, @YeshDin in 2020, @AdalahCenter in 2020, @btselem in 2021, @hrw in 2021, @fidh_en in 2021, @alhaq_org in 2022, @Addameer in 2022, @AlMezanCenter in 2022, @cacalqudsuni in 2022, @AdvocacyJlac in 2022, @miftahpal in 2022, @ICJ_org in 2022, @DAWNmenaorg in 2022, @amnesty in 2022)....

....Since it cannot grant the ~5-6 million occupied Palestinians Israeli citizenship. Israel chose apartheid and Jewish supremacy over democracy.

Zionism also explains why Israel is now committing genocide (according to @amnesty , @hrw , @btselem , @MSF , IAGS, @alhaq_org , @UNHumanRights , @UN_HRC , @pchrgaza , @AlMezanCenter , @WarOnWant , @PHRIsrael , @fidh_en , PHROC, @LemkinInstitute , @theCCR , @ECCHRBerlin , @unitedforrights @JURDIasso , @TheElders , @Oxfam ), because, what a Zionist dream it would have been had Palestine been a land without any people on it! the ideology incentivized genocide.

So, please don't conflate Judaism -- that has existed for thousands of years -- with your modern, fascist anti-Jewish political ideology founded on the principles of forcible displacement & genocide.

Judaism will last as long as their are humans on the planet. Israel is imploding in real time.

[Manisha Mishra @manishamishra24]

This 2 hour Harvard interview with Lee Kuan Yew, the man who turned Singapore from a tiny island into one of the richest nations on Earth, will teach you more about leadership, discipline, and nation-building than most business books ever will.

[Tim Cook @doctimcook]

The evidence is uncertain
There is logic to its use inasmuch as

-aspiration is a significant complication and efforts to prevent it merit careful examination
-cricoid occludes the upper GI tract (hypopharynx)
-the metrics for correct cricoid are well defined
3 kg
one hand
unable to sustain > 5 mins
-it’s easy to teach (closed 50 ml syringe, compress air from 50-32 ml) achieves good accuracy +/-0.5 kg which keeps in effective and safe range
-when applied correctly it has either nil or minimal impact on airway management
-if its causing a problem, take it off and you’ve lot nothing

The biggest challenge is
-teaching it correctly
-correctly identifying cricoid ( we should use more USS)
-misinformation and a view that absence of evidence equals evidence of absence of benefit

Embrace and accept uncertainty

So I use RSI in high risk cases

[Tim Cook @doctimcook]

@BruceBiccard has to be one of the most self-effacing and most impressive people I know

An absolute pleasure to attend Bruce’s inaugural lecture as Nuffield Professor of Anaesthesia inOxford

A man with true passion for Africa, academia, anaesthesia and surgical equity

Delighted for you Bruce
@NDCNOxford @UniofOxford

[Tim Cook @doctimcook]

Why not use RSI for all patients on a GLP1 agonist?

First - because (as per my previous tweet) the risk of aspiration is >600-fold lower than the risk of having a full stomach

Second because RSI is not a benign technique
- increases risk of failed intubation 8-fold
- increases risk of anaesthetic overdose (CVS instability etc)
-increases risk of anaesthetic under dose (awareness)
Etc etc etc

If using muscle relaxants and TT when otherwise would be using an SGA
-increases risk of airway complications at insertion and removal from use of TT
-increases risk of anaphylaxis from NMBA
-and awareness (from NMBA)

So I think quite a few reasons to pause before deciding swathes of folk need RSI

[Ben Kentish @BenKentish]

Hi again @RachelReevesMP - I got this today from a young doctor from a low-income family. She can’t afford to buy a house because, while she’s paying back £2,560 in student loan repayments a year, you’re charging her interest at a rate of £7,800 a year.

Which part of this is “fair”?

[Irlandarra @aldamu_jo]

"when those who make the law break the law in the name of the law there is no law" Justice for Renee Good

[Molly Ploofkins @Mollyploofkins]

Did Renee Nicole Good's hit ICE officer Johnathan Ross with her car?

Take another look...

[Wu Tang is for the Children @WUTangKids]

Insane….ICE Nazis kidnapped 4 members of Oglala Sioux Tribe….released 1 and now can’t "locate" the other 3

"There is nobody more American than American Indians! We are America, how can you possibly target Native Americans? It's legally impossible!"

[Jesus Freakin Congress @TheJFreakinC]

🚨 Another day, another video of ICE agents illegally harassing a U.S. citizen for “proof of citizenship” while she walks through her own neighborhood in Minneapolis.

In the video, a woman is surrounded by masked ICE agents.

One agent tells her, “Do you have ID? If not, we’ll have to put you in our car and ID you.”

That statement alone is unlawful.

She calmly states, “I’m a U.S. citizen.”
The agent immediately demands ID anyway.

She correctly explains that she is not required to carry identification while walking in her neighborhood. There is no law requiring citizens to carry papers, and ICE does not have the authority to detain someone without reasonable, articulable suspicion of a specific crime.

At that point, the agents escalate.

They begin asking where she was born.
She responds, “Minneapolis is my home.”

The agents claim they are conducting an “immigration check” and repeat the question. That is not a legal basis for detention. Citizenship is not determined by place of birth alone, and ICE has no authority to conduct random street interrogations of people not suspected of immigration violations.

When she again refuses to show ID, an agent threatens, “We’re going to put you in our car then.”

That is an explicit threat of unlawful detention.

She says, “I should be able to walk around at 3 without being afraid for my life.”

Instead of disengaging, the agent again demands ID and again demands to know where she was born. She repeats, clearly and correctly, “It doesn’t matter where I was born. I’m a U.S. citizen.”

The agent then attempts intimidation, warning her that lying about being a U.S. citizen could result in federal charges, despite having no evidence she was lying and no lawful basis to continue the stop.

Only after repeated refusals to comply with an illegal detention do the agents finally walk away.

This wasn’t law enforcement. It was a fishing expedition, relying on fear, intimidation, and the false belief that Americans must carry papers to exist in public.

If masked federal agents can threaten to kidnap a U.S. citizen off the street for refusing to answer questions they have no legal right to ask, then the question isn’t whether rights are being violated.

The question is how long Americans are expected to tolerate it.

[Jürgen Nauditt 🇩🇪🇺🇦 @jurgen_nauditt]

In Nazi Germany, it was too late after just a few months.

It will soon be too late for you in the USA as well.

What are you waiting for?

[DoctorsVote @DoctorsVoteUK]

It's irresponsible and dangerous to have not bothered sorting this out for over a year.

It's irresponsible and dangerous to continue to run a waiting list of over 7 million.

Doctors have no confidence in him.

We need a minister who can do the job.

[Julian Fuller @JulianCorbettF]

Same situation in New Zealand.

[Dr Dan Goyal @danielgoyal]

OK, let’s do some maths (yeah)

We use £15b per year from the NHS budget to pay private providers

That could:

- Double the number of GPs (~£7b)

AND

- Increase NHS hospital capacity by 30% (~£8b)

So, I ask again, Wes, can we have one good reason for using private providers?

[Sir William Browder KCMG @Billbrowder]

The Wall Street Journal alleges that the real motivation behind Trump’s eagerness to force Ukraine into an ugly surrender is the idea that a lot of people close to him can make a lot of money doing business and deals in Russia.

If this is true, beyond the disgusting morality of this and the huge geopolitical risks that it creates, none of these people salivating over their future riches are going to make a penny, and perhaps do a lot worse.

I was once the largest foreign investor in Russia and I can say with certainty that the Russians aren’t going to let anyone profit in any way. They will talk nice at the outset to attract the investment, but once it’s there, they will steal, defraud, arrest, torture or even kill to make sure that no American makes any money. I’ve seen it so many times it’s almost universal.

So, this shocking initiative is not only terrible policy, it’s spectacularly stupid business.

https://t.co/2RvCkY1iGb

[Tim Cook @doctimcook]

The original Cormack and Lehane paper
-widely cited
-but how well do you know it?