Gene Fisher

PICU Specialist @GAChildrens, 25+ years. Clinical Service Chief. Foundations of Leadership Co-Dir. Husband, Father of 4, loves to wander the hills. @WVU Alum!

[Jonathan Tjarks @JonathanTjarks]

Does My Son Know You? https://t.co/37lKB9pGgJ via @ringer

[NEJM @NEJM]

Persons who had received two doses of the #COVID19 vaccine had serum that poorly neutralized omicron. Those who had recovered from infection and then vaccinated, or who had been vaccinated and had breakthrough, had high levels of neutralizing activity. https://t.co/Dpans55pPa

[Benjy Renton @bhrenton]

A new @CDCMMWR finds that 2 doses of the Pfizer vaccine are 91% effective against MIS-C in kids 12-18, a post-infection inflammatory syndrome. None of the vaccinated kids hospitalized with MIS-C required life support, compared to 39% of unvaccinated kids.
https://t.co/Po5aztOucL

[Gene Fisher @PICUGene]

Important way to build families up as team members as we move into an era where we should assume our notes are available to patients/families as soon as we complete them. It also forces the clinician to cool off and make sure they understand the patient/parent point of view.

[Michelle Kittleson MD PhD @MKIttlesonMD]

#TipsForNewDocs

Patient doesn’t accept your recommendation. How to document?

No: "Patient refuses X.”

Yes: "Patient declines X due to __. I explained the indications, risks, benefits of X. S/he expresses understanding of the consequences of his/her decision."

#kittlesonrules

[Gene Fisher @PICUGene]

Documentation time detracts from patient time. Certain styles may minimize documentation time and allow more time for the other things we need to do as clinicians and as community members.

[American Thoracic Society (ATS) @atscommunity]

Characterizing styles of clinical note production and relationship to clinical work hours among first-year residents: https://t.co/sYoEz80HQG

[Critical Care Medicine @CritCareMed]

#OpenAccess #Editorial #COVID19

Mariscalco : Fundamentally Changing Pediatric Respiratory Illnesses…and Less “Bread and Butter

Editorial: https://t.co/RSDtMOHtXf

Article: https://t.co/jBsNz9DvMO

#CritCareMed @SCCM #pedsICU #publicpolicy

[Gene Fisher @PICUGene]

670,000. NO one in this nation and on this globe has been left untouched by this virus. We mourn their loss and pray for peace for those who mourn. What great things might they have done? We must do better.

[Andrew Solender @AndrewSolender]

More than 670,000 white flags have been planted on the Washingon Mall to honor each American death from coronavirus.

It’s incredibly difficult to capture the sheer scale of this project with one photo, or even one video.

[Gene Fisher @PICUGene]

#PedsICU dogma was "heroic" to delay trachs. Less sedation & more mobility likely more "heroic." see also Holloway , Spaeder , Basu . Assoc of timing of trach on clinical outcomes PICU patients. PCCM 2015 Mar;16(3):e52-8. doi: 10.1097/PCC.0000000000000336. PMID: 25581633.

[Salim Aljabari @AljabariSalim]

Routine Tracheostomy in #PedsICU. Adolescents trached within 7 days of mechanical ventilation did better. I hope this paper leads to a multicenter RCT.

[Gene Fisher @PICUGene]

@SapnaKmd Agree that this is wrong on SO many levels!
1. More nightmares?
2. Wake up every morning looking for O2 and BVM?
3. Teach me to ignore alarms?

[Gene Fisher @PICUGene]

Anyone know if this holds true in #PedsICU patients? Any speculations as to why there is a difference?

[ATS Blue Journal @ATSBlueEditor]

Early Bacterial Identification among Intubated Patients with COVID-19 or Influenza Pneumonia: A European Multicenter Comparative Clinical Trial

🔓 Open Access
🔗 https://t.co/WflIMHy6ZX

[Dave Blake, PhD @_stah]

Should be in around 8-9 days (9-22 or 9-23) that we crest 675,000 US deaths making the COVID-19 pandemic more deadly in the US than the 1918 Spanish Flu pandemic.

[Gene Fisher @PICUGene]

Great guidance in providing nuanced communication with families and team members. We are privileged to work with children and families.

[Pediatric Critical Care Medicine @PedCritCareMed]

Decision-Making, Ethics, and End-of-Life Care in Pediatric Extracorporeal Membrane Oxygenation: A Comprehensive Narrative Review

@drkatiemoynihan et al @TessieOctober: https://t.co/szYYRoge9c

#PedsICU #PedsPC #ECMO #Ethics @SCCM @WFPICCS

[American Board of Pediatrics (ABP) @ab_peds]

Spreading misinformation about a lethal disease is unethical, unprofessional, and dangerous and goes against everything we, and our colleagues at @TheABFM and @ABIMcert, stand for.

Read the full statement: https://t.co/dP8UgNVbT2

[Gene Fisher @PICUGene]

@CritCareMed @kusum0y0 @SCCM #PedsICU peeps need to consider this as we admit more COVID + kids. I wonder how many clinicians resist proning because it is "hard," but are willing to start "cool" new meds with unknown safety profiles?

[Gene Fisher @PICUGene]

@DespiteTheTimes 1. Agree and understand 2. Are you suggesting that #PedsICU service turns us into Hobbits? (Hmm, loyal, steadfast, determined to see what is good in people and hope in a better future, maybe we ARE hobbits)

[Gene Fisher @PICUGene]

@padmasayee Thank YOU for the that exceptional essay.

[Gene Fisher @PICUGene]

A Pink Salwar | NEJM https://t.co/3M5T9q1ozd As clinicians we balance population statistics/risks with each unique individual person for whom we are privileged to provide care. We must hold onto our own humanity to treasure theirs.

[Gene Fisher @PICUGene]

@KaapstadMK If they don't cite the specific reference in the chapter you can't make such an assumption. Without a reference such statements should be taken with a grain of NaCl

[Gene Fisher @PICUGene]

Touches on the current moral & emotional stresses on HCW. “It's very easy to judge the unvaccinated. As a doctor, I see a better alternative - STAT” https://t.co/zCyku4SB5m