Roger Organ

Hoi!
Aye you!

[Roger Organ @Roger_Organ]

Think Ive just worked out the key to severity of illness and poor outcomes in #coronavirus #COVID19

[Krafty Kuts @Krafty_Kuts]

Big ups to Fish Octagon for supporting my new single Changes out now on @atgrecords https://t.co/eQselqr6hi

[Kyle Gunn @Kyle_Gunn97]

Any Scotland pods, radio or TV channels looking for World Cup insight, please reach out. At home all tournament and opinions at the ready!

[Being Scottish @BeingScots]

On this day 48 years ago: Archie Gemmill scored Scotland's most iconic goal at the Argentina 1978 World Cup 🏴󠁧󠁢󠁳󠁣󠁴󠁿 Just tae get yies in the mood ⚽️

[Roger Organ @Roger_Organ]

@mickyfagan67 Wtf?!

[Paddy Power @paddypower]

Introducing the must-have item for England AND Scotland fans for the World Cup.

Fancy getting your hands on one?

Simply REPOST in order to be in with a chance of winning one!

18+ GambleAware | #WorldCup markets available on the Paddy Power app

[Roger Organ @Roger_Organ]

Goooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooolllllllll!

[Roger Organ @Roger_Organ]

@0x_Timi @rshotton @Dannythefink Physical development in terms of the start of the football season.
Simple as that.
cf Outliers by Malcolm Gladwell

[Swearing Sports News @SwearingSport]

Ronaldinho didn't need two takes.

[Gareth Nickless @NicklessG]

@Roger_Organ @LucyGoBag A good short article from a couple of years ago.
An MSO I used to work with said there was talk the term was going to be abolished.

The problem with ‘never events’ | BMJ Quality & Safety https://t.co/E3Oa1SLQ5k

[Kay Adams @heykayadams]

The Tartan Army is winning the World Cup. 🏴󠁧󠁢󠁳󠁣󠁴󠁿 Let me tell you why...

[Michi 🐈 #šhïñëTHRŪthëŠHÄDĒ 🐈 @MichiSRS]

@heykayadams @TartanArmyGroup @UpAndAdamsShow This thread might be useful for you then!
https://t.co/14LBMeaROB

[Ally Fogg @AllyFogg]

@ZiaYusufUK

[Roger Organ @Roger_Organ]

@drkeithsiau Plus I have serious questions about this diagnosis - olanzapine would be a treatment for, not a cause of, serotonin syndrome.

[Roger Organ @Roger_Organ]

@drkeithsiau You mean "serotonin syndrome" rather than "SSRI syndrome", yes?

[Gareth Nickless @NicklessG]

The importance of obtaining and accurate medication history and thinking whether an ADR could be responsible

[Roger Organ @Roger_Organ]

@NicklessG Especially in this particular scenario where there are 3 separate DDx

[Josh Farkas MD 💊 @PulmCrit]

ARISE-FLUIDS has arrived and it's awesome 🥳

For over a decade, the Surviving Sepsis Guidelines recommended that septic patients get at least 30 cc/kg fluid. In the United States, these guidelines were weaponized into performance metrics, pressuring clinicians to prescribe arbitrary volumes to every patient.

Evidence-based clinicians have LONG known that this guideline lacked evidentiary support. For example, I've attached a picture of a blog I wrote about this back in 2017. Despite the lack of evidentiary support and some evidence of harm, the Surviving Sepsis Guidelines INSISTED on perpetually recommending 30 cc/kg fluid resuscitation.

We finally have a prospective RCT demonstrating that mandating early administration of 30 cc/kg fluid (as compared to early vasopressors) doesn't help and may actually cause harm.

It's important to note that all of the hard endpoints in this trial were neutral (e.g., mortality, days free of organ support).

I still think that 30 cc/kg fluid is a pretty reasonable volume of fluid for *most* patients. But the study does suggest that giving too much fluid may promote edema - so we should be *thoughtful* about this intervention rather than mandating it for every septic patient.

Based on the subgroup analysis, the fluid-conservative strategy may have helped the subgroup of pneumonia patients the most. This is statistically nonsignificant but aligns with my expectation. ARDSy patients often don't respond well to fluid. (In contrast, I really doubt that a liter of fluids in either direction matters for most urosepsis patients.)

This is a great example of the over-reach of guidelines and protocoled medicine. People get all upset about practice variation, so sometimes they try to stomp it out using guidelines and protocols. But these guidelines are highly fallible, so what may occur is that you standardize care in a way that harms everyone equally. 🤦‍♂️

[Underworld @underworldlive]

Live Jam in the Hangar with KI/KI. More on YouTube.

[Celtic Football Club @CelticFC]

🎶 Martin O'Neill, Martin O'Neill... 🎶 💚