Charith R'pathirana

#EmCritNerd #SriLankan ,#Crawler, #Traveller, #sportgeek #LifeisFLUX #FOAMed #ED_ICU

[Charith R'pathirana @Charithsr]

#detox your gut and mind

[Charith R'pathirana @Charithsr]

World is moving away from generalised to individualised medicine, more n more negative #RCT

[Charith R'pathirana @Charithsr]

@juliogilpereira @The_Nanashi_O @doctor_roig @DruvBhagavan @DidlakeDW @ecgrhythms @SumonCh66773015 @syamkumarmd @FloydECGs @DrRajeshG1 @DocNikko @TahaMD_EM @EcgOxford @Vadeboncoeur_Al @AslangerE @smithECGBlog @EM_RESUS @UlhasDr @JoaoMSantos13 @vandadevesaneto @BMarmelo @DavideMoreira3 @CraveiroNuno @Goncalo_RMF @Luis0F0Santos Fasicular VT

[Charith R'pathirana @Charithsr]

@kaushila87 Pure NAGMA may benefit but routine use in critically ill may not change
That's why it depends on the situation

[Charith R'pathirana @Charithsr]

The debate on #ballancedcrystalloids vs #NS is like asking would you like tea or coffee ?
Some may like one of them where someone will like it depending on the situation and more or less it has the same effect
#Evidencebasedagility

[Charith R'pathirana @Charithsr]

@kaushila87

[Charith R'pathirana @Charithsr]

@kaushila87 No it's not second class by any means
You may also call it #healtheconomics

[Charith R'pathirana @Charithsr]

@AG_EM33 6.86 DKA survived

[Charith R'pathirana @Charithsr]

@kaushila87 I also use it alternatively at times considering cost and availability

[Charith R'pathirana @Charithsr]

@kaushila87 Hypercloremic acidosis is a fact but depending on the situation you need to change
Specially in elderly and those with risk of cerebral oedema I prefer NS whereas in septic and young AKI choice is LR
Infact latest evidence suggest there's no benefit in mortality and AKI

[Charith R'pathirana @Charithsr]

So another covid prediction #evidencedbasedagility #MICHELLE Trial support long term
use of anticoagulation in high risk patients
But the real efficacy of #rivaroxaban is doubtful considering the underlying pathobiology

[Charith R'pathirana @Charithsr]

#Economy is always more important than #science

[Charith R'pathirana @Charithsr]

You may die from #covid without #pneumonia
Never forget there are long term consequences
Many wouldn't believe me then even now but surely will when a western world publish some data

[Charith R'pathirana @Charithsr]

Alternatives are there always
#individualizedcare #Protocols won't save #lives

[Charith R'pathirana @Charithsr]

@harshi_yapa PEEP

[Charith R'pathirana @Charithsr]

Future of treating sepsis lies on blocking specific biological immune targets #endofantibiotic era

[Charith R'pathirana @Charithsr]

Even simple bagging #bvm is enjoyable when you have a #Resuscitationist mindset

[Charith R'pathirana @Charithsr]

Giving a dignified death is apart of maximally aggressive palliative care

[Charith R'pathirana @Charithsr]

I'm curious than ever