Hennie Van der Merwe

Saskatchewan physician - building bridges on strong foundations - balancing critical care, hospital medicine & family life. Carpe Diem, et noctem

[Hennie Van der Merwe @docvanmed]

IncrEMentuM 2026 👌🏻

[Haney Mallemat @CriticalCareNow]

The Modern Airway Strategy
With high-quality disposable tech, fiberoptic power is finally "barbarian-proof" and available 24/7. Don't use 2026 tech with 1940s strategies—master tool synergy and combined techniques to save lives. #MedTech #FOAMed #AirwayManagement

[Haney Mallemat @CriticalCareNow]

Master the "Side-Step" to save the airway
Forget the stress of awake fiberoptics. Use a hyperangulated blade to hold the view, then step aside for a second operator to guide the scope. It’s "point and click" intubation that turns a crisis into a team win. #FOAMed #VAFEI

[Haney Mallemat @CriticalCareNow]

Stop confusing VL with hyperangulated laryngoscopy

VL is the tech (camera + screen), while DL is the technique (line of sight). You can do both at once with standard blades. Hyperangulated blades are specialized tools, not a default upgrade. 🚑
#FOAMed #AirwayManagement

[Simon Carley @EMManchester]

A great man. Greatly missed: John Hinds.

⁦@DocJohnsMum⁩

[Ross Prager @ross_prager]

(1/x) Intubating a critically ill patients is the most dangerous procedure we do in the ICU (3.1% cardiac arrest rate) not because of hypoxia or tube placement, but hemodynamic collapse 🫀

(Russotto et al. JAMA 2021)

A 🧵on making high risk hemodynamic intubations as safe as possible.

[Tamas Szakmany MBE @iamyourgasman]

Thanks for all individuals and businesses who has shown incredible kindness and support to us. It’s greatly appreciated. We will get through this and our care will be transformed. Over and out.

[Tamas Szakmany MBE @iamyourgasman]

7. The team response to this has been fantastic. But it’s not a sprint it’s a marathon. Pace yourself and your colleagues. Support each other. And have some rest switch off Twitter and the news, wash your hands, stay at home and flatten the curve so we can do our best.

[Tamas Szakmany MBE @iamyourgasman]

6. There is NO proven treatment. Please enroll all patients in a #COVID19 RCT such as #RECOVERY #REMAPCAP we need to find out what works and what doesn’t and we can only do it if we study the potential effects systematically. Once we have good data, we will start THAT treatment!

[Tamas Szakmany MBE @iamyourgasman]

5. Working in full PPE is tiresome. Regular breaks, hydration etc is key 🔑 support your staff as they learn with you and try to explain why you are not doing the “normal” ICU things we do. Don’t forget them though, your non-COVID19 pts need that approach!

[Tamas Szakmany MBE @iamyourgasman]

4. Timing of procedures is important see first point that it’s not a “normal” icu pneumonia. Don’t rush any decision as change in position of pt can have dramatic effect on oxygenation. If you act, have your slickest available operator to perform whatever task needs performing.

[Tamas Szakmany MBE @iamyourgasman]

3. Communication w/ relatives is difficult as you can’t do F2F. Getting to grips with videoconferencing via secure channels (Thanks @oggsky and team!) especially important when views as not aligned.

[Tamas Szakmany MBE @iamyourgasman]

Still don’t understand what’s the best way to catch superinfection. CRP is up after day 2. We use PCT and it’s fine when sky high, but what about 2.0-3.0?? More data needed. Patients tolerate drying out without haemodynamic instability. Shock is not a prominent feature.

[Tamas Szakmany MBE @iamyourgasman]

2. They seem to like high PEEP as reported before. You can’t wean this fast as with a “normal” pneumonia. All this means light sedation doesn’t work and causes asynchrony. AKI is common and if caught early responds well to diuretics combo. Bloods are weirdly normal.

[Tamas Szakmany MBE @iamyourgasman]

Some #medtwitter #CritCareControversies musings on #COVID19 after my first week. (Thread)
1. It’s a new disease. Normal ICU routines don’t seem to work. When you think they are ready to wean from the vent, they are not. Desaturation is common and deep.

[Dr Eric Levi @DrEricLevi]

It is a real possibility that I might lose some of my colleagues to #covid19 #coronavirus. Have you ever thought of that?