Tom Billyard

Intensivist, organ donation advocate, husband, father. Not necessarily in that order. He/him. (@[email protected])

[Tom Billyard @BillyardTom]

@SDrjlshannon @WelshGasDoc This is from the 2024 MCCD regulations for England and Wales.
Feels a bit like a slightly sloppy piece of legislation where no-one realised the implications.
Hope you have told your English counterpart!

[Tom Billyard @BillyardTom]

@WhistlingDixie4 @PremierITLtd Good news (maybe?)! The contract is ending soon and the trust is not renewing it.
I would say any replacement can only be better than this unintuitive pile of rubbish, but I worry that would invite the medical appraisal software equivalent of "hold my beer".

[Tom Billyard @BillyardTom]

@WhistlingDixie4 @Arrivalists_ 2 disappointments about the Narnia books, which I really enjoyed as a child:
1. They were thinly-veiled Christian propaganda
2. Turkish Delight is nowhere near as wonderful as Edmund and the white queen made it seem

[Tom Billyard @BillyardTom]

@AndrewJD

[Tom Billyard @BillyardTom]

@AndrewJD (Good luck for tomorrow. I predict you will be fine.)

[Tom Billyard @BillyardTom]

@AndrewJD UHCW cardiac critical care has the only bed 13 in the whole hospital.

[Tom Billyard @BillyardTom]

@pulmtoilet @WhistlingDixie4 Trajectory is the key work. @stemlyns covered this paper, and that seemed to be their key message - unless in extremis you can observe for a short period to see the trajectory. Short period probably isn't 4 hours though

[Tom Billyard @BillyardTom]

@pulmtoilet @WhistlingDixie4 I think this is important. 2/3rds due to alcohol intoxication- that isn't a patient population I often have to intubate.
In the UK it's the mixed overdose that is the problem - antipsychotic/gabapentinoid/opioid/benzo +/- alcohol. Not sure this study tells me how to manage these

[Tom Billyard @BillyardTom]

@WhistlingDixie4 That is superb.
I need to carry a copy to read when I am being too negative!

[Tom Billyard @BillyardTom]

@WhistlingDixie4 Post bypass AKI is something I struggle to get excited about, unless they need RRT and this intervention made no difference to that.

[Tom Billyard @BillyardTom]

@WhistlingDixie4 Raises more questions than answers for me.
Not a patient centred outcome - no patient cares about AKI stage 2, it's just a number. Question is what it does to long term risk of kidney failure, amd this trial can't answer that.

[Tom Billyard @BillyardTom]

@WhistlingDixie4 Sometimes, when talking about how stupid it is that we still have a monarchy, people reply that they'd rather have that than a President Trump.
Mad really, when just the other side of the Irish Sea is such a wonderful example of what an elected president can be like.

[Tom Billyard @BillyardTom]

@WhistlingDixie4 @RoyalMail @Postvox This sent me down a Google rabbit hole - I wanted to know what the stamp meant!
HWDC is Heathrow World Distribution Centre.
The stamp means you underpaid - postage to Ireland went up to £2.50 on 2nd April. I suspect that's why it took so long.

[Tom Billyard @BillyardTom]

@juliaisobela Have you read Fern Brady's 'Strong Female Character'?
It's a really powerful detection of the reality of autism. I couldn't put it down.
Everyone who says that 'we are all a bit autistic' should have to read it, and then be asked if that is really what they want

[Tom Billyard @BillyardTom]

@WhistlingDixie4 Happy 4 years!

(We are still very lucky to have you)

[Tom Billyard @BillyardTom]

@WhistlingDixie4 @ronansetron Thanks to the Dublin tourism people I now know it means that you are delighted.
What is so delightful about being on a pig's back, I may never know!

Tír gan teanga, tír gan anam

[Tom Billyard @BillyardTom]

@WhistlingDixie4 @ronansetron Google translates this as: there is not a cloud in the sky and we are on top of the pig.
The bit about clouds I get, but the pig?

[Tom Billyard @BillyardTom]

@WhistlingDixie4 I bought 4 supposedly low maintenance plants and this is the only one that has survived. I'm hoping that isn't a metaphor for something.
It doesn't need the aerial roots, you can just cut them off.

[Zack Ferguson @zackferguson]

Ambulances can’t get to dying people because they’re stuck outside of hospitals full of patients we could discharge if we just had more carers in the community, so I’m delighted that the government has taken decisive action to ban these carers from living with their families.

[Tom Billyard @BillyardTom]

@DocCSarah @trentconsultant NB this is all totally fictional, I definitely haven't been scarred by a simple change to improve patient care still not being approved over 6 months later.

[Tom Billyard @BillyardTom]

@DocCSarah @trentconsultant Telling you it has to go through 3 apparently identical committees, which only meet monthly and you've just missed the deadline for the next meeting.
Asking why the policy hasn't been approved by a totally unrelated department.