Claire M

Part-time gamer, Full-time nerd. Critical Care nurse with a passion for all things food, fluffy animals and science! All views my own ❤️

[Claire M @MisShortie]

@PhuzzyBond I quit playing many years ago. I lost love after the PotC update with Disney. Now I know that was a big thing For the company but it just made the lore of the game that I was so I vested in feel
So disjointed. Once the story kept stop starting, the spark went. It’s a shame.

[Claire M @MisShortie]

@AuntieGotGame PayPal: MisShortie 😬❤️

[Claire M @MisShortie]

@Keir_Starmer Staffed by whom?! You can’t even get nurses to staff the wards or doctors in hospital as there are job freezes to save money. It’s a joke.

[Claire M @MisShortie]

@honeymoon250 Naps

[Claire M @MisShortie]

@Bigwavee00 Yeah 💁🏻‍♀️

[Claire M @MisShortie]

@RealLifeWookie

[Leonhart @LeonhartYT]

🚨GIVEAWAY!🚨 PSA 10 Umbreon!
1. Follow Me
2. Retweet This
Winner announced on 3/31

[Claire M @MisShortie]

@asylumgc8 Take the time out as you need but always know there are loads of us ready to check if you need us ❤️

[Claire M @MisShortie]

Yay Jen! @royalhospital

[NUH CritCare CNEs @NUHCritCareCNE]

Fantastic presentations from Dr Cantelow, @ClareLlewellyn4, Jen Watts and Akshay from Nottingham, Chesterfield and Leicester sharing all the great things going on about Maternal Critical Care in various trusts! Great to see how much is going on and how important this topic is!

[Claire M @MisShortie]

@elonmusk Elon getting fact checked by his own site 💁🏻‍♀️

[Rehab for life @cathyemmens]

Another touching moment from this week - a patient was desperate to see their pet and needed a mood boost so......meet Thomas, a beautifully behaved cat who actually made everyone in HDU smile ☺ #pettherapy @ACC_EastMids @cc_sn1 @crhcriticalcare

[Claire M @MisShortie]

@wenisprinkles Come join me and my girlies in Fortnite. It’s actually not too shitty.

[Claire M @MisShortie]

@LaSinity 40.

[Claire M @MisShortie]

@RealLifeWookie @linkinpark It was brilliant! Got me right in the feels. I think Emily did an amazing job as those are some huge shoes to fill. The new song is taking the band in a great direction. I’m looking forward to hearing more stuff.

[Claire M @MisShortie]

@myPotatoGames That sounds like a super chill cozy game 🥰🥰

[SrivatsaNagachandan @Srivatsa34]

🚨Unlocking Secret to Optimal Drug Therapy in ICU: Why CVC Tip Position Matters More Than You Think! 🚨

In high-stakes environment of ICU,every decision can significantly impact patient outcomes.A recent study uncovers a crucial but often overlooked detail: the positioning of CVCs relative to CDCs during CRRT 🏥.

✨ Why This Matters:
CVCs are lifelines for critically ill,delivering vital medications like antibiotics,vasopressors & sedatives.However,placement of CVC tip in relation to CDC tip can dramatically alter how these drugs are cleared from body & affect their Vd. This insight is vital for ensuring that patients receive precise drug dosages they need.

🔍 Key Findings:

1.Drug Clearance Variability:
•The study shows that when CVC tip is positioned cranially(further from the heart) relative to the CDC tip,clearance of antibiotics like gentamicin (GM) & vancomycin (VM) significantly increases.For example,GM clearance jumps from 17.3 ml/min to 26.2 ml/min as the CVC tip moves from +2 cm to -4 cm relative to CDC. This finding suggests that similar effects could occur wit other critical drugs,including vasopressors/sedatives,potentially impacting their efficacy & therapeutic levels.
2.Implications for Patient Care:
•Increased clearance could mean reduced drug levels in bloodstream,potentially leading to subtherapeutic dosing.This is particularly concerning for vasopressors & other meds wit narrow therapeutic 🪟,where precision is paramount 🎯.Moreover,changes in Vd drug could alter the hemodynamic stability and sedation levels in critically ill patients.
3.Stable Serum Levels:
•While dialysate concentrations changed with catheter positioning, serum concentrations of antibiotics remained stable in the short term. However, this may not hold over extended periods, and the implications for other medications require further exploration 📈.

🚀 Looking Ahead:

•Call for Clinical Trials:To bring these findings into practice,trials are needed to assess long-term effects of CVC positioning on clearance & Vd of critical drugs,including vasopressors,sedatives, antibiotics & their impact on patient outcomes.
•Guideline Development:This study highlights the need for detailed guidelines on catheter placement during CRRT to minimize drug clearance variability & ensure consistent therapeutic dosing 📚.
•Wider Research: Future studies should investigate how positioning affects clearance & Vd of other essential medications used in the ICU,potentially leading to more personalized catheter placement strategies 💊.

📝 Takeaway:
The distance bw CVC & CDC tips is more than just a technicality—it’s critical factor that can influence effectiveness of drug therapy during CRRT.Optimizing catheter placement could enhance patient outcomes by ensuring precise drug delivery & stability.

💡 Let’s continue to innovate and refine our practices to give our patients the best possible care! 💪

https://t.co/Y7q5QUd7b5

#CriticalCare #ICU #CRRT #CVCPlacement #DrugClearance #PatientSafety #Pharmacokinetics #IntensiveCare #HealthcareInnovation #ClinicalResearch #complication #patientsafetyfirst
#NerdyMedicine #MedX #MedEducation #Medtwitter #FOAM #FOAMed #FOAMcc #EDIC #FFICM #FICM #FCICM #IDCCM #IFCCM #CTCCM

Respected sir’s
What is ur thoughts about this ? & What is ur practise ? Love to know ur opinions
@KrKrramanathan @nephrocc @criticaredoc @RanjitUnnikris1 @Drnasap @ThinkingCC @drvimalzenICU @ross_prager @khaycock2 @Thind888 @srinivas3271 @iceman_ex @avkwong @Manoj_Wickram @IM_Crit_ @critconcepts @PulmCrit

[Claire M @MisShortie]

@JaneyGodley Ha ha! Oh dear. You ok hun?!

[Claire M @MisShortie]

@Number10cat My Ron doing what he does best. Bugger all 🥰🥰

[Claire M @MisShortie]

To the executives. And they are lucky that nothing happened to my patients. Because they would be screwed.
Screw you for making me feel this way.
Screw you for putting me in that position. And I hope the £200 quid saved was worth it.

[Claire M @MisShortie]

It’s been a tough couple of nights shifts for me on ITU. Not because of the patients but because of staffing and the politics of nursing. For the first time ever in my career I felt like just a number. I felt so under valued and that I had no voice. My advocacy for patients 1/?

[Claire M @MisShortie]

I am sad. I am angry. And I am ashamed. This is what it has come to? Putting critically ill patients lives at risk. I am NOT proud to care. My respect for the hospital has gone out the window. And I feel lucky that my @nmcnews PIN is still intact. Nursing is a joke 6/?