Will Spears

Neurocritical Care Fellow @The_BMC @bmcneurology, proud dog dad to @pennyandmichelin

[Will Spears @we__spears]

@doctorORbust This photo can only be taken with wine…🙂

[Will Spears @we__spears]

@vasisht @emily_fri Our group is working on a protocol for exactly this! SBTs at 4am for everyone and discussion with RTs before am signout

[Will Spears @we__spears]

@S__Baksh Seems mostly true from my experience but not as scary as they make it sound. The part about not negotiating needs with your PD is def wrong though

[Will Spears @we__spears]

@DanHarrisonMD @critconcepts @PulmCrit @IM_Crit_ @emcrit @caseyalbin @DrUsaamahKhan @yasminaghajan @HeraKamdar @SWahlster @judyhtchang @patmchen @sigman_md Agree, would prob not realistically have a patient oriented outcome. I might think of an outcome like total vasopressor needed, for ex more central art line may = less norepi to meet higher MAP goal. But whether this leads to different outcomes, who knows

[Will Spears @we__spears]

@PulmCrit @DanHarrisonMD @IM_Crit_ @emcrit @critconcepts @caseyalbin @DrUsaamahKhan @yasminaghajan @HeraKamdar @SWahlster @judyhtchang @patmchen @sigman_md Interesting NCC study might be central vs peripheral invasive hemodynamic monitoring in aSAH?

[Will Spears @we__spears]

@PulmCrit @DanHarrisonMD @IM_Crit_ @emcrit @critconcepts @caseyalbin @DrUsaamahKhan @yasminaghajan @HeraKamdar @SWahlster @judyhtchang @patmchen @sigman_md Really great article. We often have prolonged art lines for vasospasm in aSAH, frustrating to see multiple radial lines fail in some cases, and probably less accurate. Lots to consider

[Will Spears @we__spears]

@Brandon_Beaber @rkchoi Depending on immune status could also consider toxo, esp with age and basal ganglia involvement

[Will Spears @we__spears]

@rkchoi @PulmCrit Wonder if serial ONSD would make more sense in this scenario? Already available in the ICU, probably easier for most providers

[Will Spears @we__spears]

@DanHarrisonMD @PulmCrit @IM_Crit_ @caseyalbin @andrewyu8 @critconcepts @HeraKamdar @yasminaghajan @sigman @DrUsaamahKhan Interesting! Was thinking about this recently when I had a patient with small vessels and an unusually prominent ulnar

[Will Spears @we__spears]

If I’ve learned anything from airway elective so far, it’s that anesthesia attendings have the jaw-thrusting finger strength of elite rock climbers..

[Will Spears @we__spears]

@emily_fri Was just in this situation! Used my left hand, but felt very awkward, esp as a trainee without a ton of experience. Might try leaning over from the R next time. How does sitting on the bed help?

[Thomas Ford, MD @DrThomasFord]

Really wonderful write-up in the @nytimes today about EVT. I’ve had the privilege of seeing some incredible outcomes following thrombectomy, although more work is needed to get as many people access to treatment as possible. https://t.co/xbUMrTOcwG @NguyenThanhMD @AbdalkaderMD

[Will Spears @we__spears]

@theABofPharmaC Very cool! We have a dot phrase for shivering but this is much better, especially for consults

[Will Spears @we__spears]

@PulmCrit Hard to take it seriously even as board review when it doesn’t even include all brainstem reflexes, no mention of prerequisites or ancillary testing to name a few…and imaging should always be done

[Will Spears @we__spears]

@MicieliA_MD Agree with @a_charidimou, would not tPA for a rapidly improving and no disabling deficit, but extremely low threshold for MT, I find these patients often worsen and then it may be too late.

[Casey Albin, MD @caseyalbin]

At #NCS2022… probably reflecting on how we all treat cerebral edema a little bit differently…

@Char237237 & an all star, all woman group are looking to figure out HOW differently👉👉: https://t.co/YCe7Wv11gR
Pls take!
@drdangayach @aartisarwal @NeurocritCareJ @neurocritical

[Will Spears @we__spears]

@IM_Crit_ If I’m feeling ok during a week of night shifts, I’ll wake up in the afternoon and work out before going in. Consistency has been lacking though, and transitions back to days are hardest.

[Will Spears @we__spears]

Me: earnestly studies for neuro boards and now realizes what all the attendings were talking about during conference.

[Will Spears @we__spears]

Lessons learned from a neurologist after first month in the MICU: 1- Lots of critical care left to learn, 2- Ultrasound is super fun, 3- Running rounds is scary but necessary. Looking forward to month 2 back in NCC!

[Will Spears @we__spears]

@doctorORbust I’m jittery with anticipation…