Nick Gowing

Anaesthetist: Trauma, kids, ultrasound... Bluegrass aficianado

[Nick Gowing @nicholasgowing]

@lotusgav @BlockIt_Hot_Pod Yup you’d never bother after watching one put in under direct vision

[Nick Gowing @nicholasgowing]

@GongGasGirl @jeffgadsden R = 16cm unless you are @SHAQ . This is why baby Jesus gave us 16cm CVCs. 20cm lines are for L lines only

[Nick Gowing @nicholasgowing]

@amit_pawa @DrRobbieErskine @expertknee @BlockIt_Hot_Pod @jeffgadsden Anyone doing this for hips? Would love to give it a go

[Nick Gowing @nicholasgowing]

⁦@GongGasGirl⁩ East-side gassers only in an emergency pls

[Nick Gowing @nicholasgowing]

@rocu_bene Except it’s not one or the other. Perfectly reasonable to gain control w provider 1 putting in an IO and provider 2 putting in a CVL. Maintains forward momentum

[Nick Gowing @nicholasgowing]

@KangarooBeach @daveairways @intersurgical False. Shape is exactly the same coming out as going in

[Karim Brohi @karimbrohi]

CRYOSTAT2 results #ccr23:

- Early *empiric* administration of high-dose cryoprecipitate to trauma patients activating the major haemorrhage protocol did not improve 28-day mortality.

- possible evidence of harm if given very early or in penetrating trauma patients...

[Paul Young @DogICUma]

The @PATCHTrial, led by @RussellGruen, a study of pre-hospital TXA for severe trauma in adults at high risk of acute traumatic coagulopathy treated in advanced trauma systems, has been published today in @NEJM. #CCR23 Here’s a summary of what we did...
https://t.co/fl3m8liWB2

[Karim Brohi @karimbrohi]

UK-REBOA results:

REBOA increased mortality at 90 days and at all interim time points.

REBOA increased deaths due to bleeding at 3 hours and 90 days.

REBOA substantially delayed time to definitive haemorrhage control.

💢🎈💢

#ccr23

[Nick Gowing @nicholasgowing]

@lotusgav Especially given that red cells rarely the product we need for elective procedures at risk of bleeding…. Thanks for the updates gav, loving it so far!

[Nick Gowing @nicholasgowing]

@lotusgav Agreed Gav. Not sure how we’ll ever chip away at 30 day Postop mortality otherwise though…

[Nick Gowing @nicholasgowing]

@lotusgav Yes it was definitely a thing. It was on ABC

[Nick Gowing @nicholasgowing]

@J_L_T_M Never give quickly to a conscious patient… they vomit. Don’t believe in seizures or hypotension.

[Nick Gowing @nicholasgowing]

@GongGasGirl Maybe. But in an era of staffing issues etc, I bet we’re more efficient keeping radiographers in an environment they can control and are used to. We are pretty good at taking ICU patients anywhere (angio suites, MRI etc)

[Nick Gowing @nicholasgowing]

@rocu_bene @doctorhelgi Tell that to iTACTIC… or do your own RCT 🤫

[Nick Gowing @nicholasgowing]

@periopTTEcho @PeterWark1710 Agreed! Saving lives turning down the FiO2 one teabreak at a time 😉

[Cliff Reid @cliffreid]

Peripheral noradrenaline vs metaraminol on ICU

Metaraminol more $$$, no benefit

Suspected noradrenaline extravasations required no additional management

Small single centre study but in keeping with the body of literature on this topic

https://t.co/hV5nAa5fSA

#Dogmalysis

[Nick Gowing @nicholasgowing]

@periopTTEcho @lotusgav It’s the token case where you’d rather be too heavy on the induction than too light

[Nick Gowing @nicholasgowing]

@periopTTEcho @lotusgav Agreed. That’s my approach too. Pedagogically good to accentuate the heightened importance of analgesia in these ones though I reckon