…face-palming admission of intellectual failure.

Considered, limited introspection is a performance superpower. 2/2

One of anaesthesia's superpowers is being an aggressively introspective specialty (occasionally too much so, leading to neurotic, double-guessing & nervous anaesthetists).

Reading legendary tech-VC Marc Andreeson's "I try to be as minimally introspective as possible" comment is a perplexing,… 1/2

I wrote about the anti-acetaminophen advice:

Tylenol, Tyranny, and Misogyny

“This is a broader project of bad science weaponised to undermine trust and weaken institutions … science is being twisted for ideological goals, to reinforce sexism & inequity.”

→ www.metajournal.com/blog/118/tyl...

ANZCA and FPM STATEMENT

Paracetamol use in pregnancy

We are aware of recent claims from the US questioning the safety of paracetamol use in pregnancy. These claims are not based on new evidence. Our full statement is here: tinyurl.com/5yye2npu

I collected the main evidence investigating #acetaminophen / #paracetamol use in pregnancy & possible neuro development effects here: www.metajournal.com/collections/...

Ahlqvist’s 2024, 2.5 million subject sibling-controlled cohort study is the most reassuring.

Advice remains unchg’d outside US!

This flu virus is spreading and scientists say it has pandemic potential Since 1959 the avian flu virus H5N1 has been popping up around the globe. Now scientists believe it could spark the next pandemic.

An important long read. Key elements of highly pathogenic H5N1 incl: 1. It’s already a major ‘pandemic’ of birds with big impact, (2) it’s adapting to mammals, (3) it’s not yet in Oz, (4) we need robust pandemic preparedness, including clean indoor air strategies. www.abc.net.au/news/2025-03...

Utah Could Become America's First State To Ban Fluoride In Public Water - Slashdot NBC News reports that Utah could make history as America's first state to ban fluoride in public water systems — even though major medical associations supporting water fluoridation: If signed...

Make Cavities Great Again? 🦷🤦‍♂️

“Utah Could Become America's First State To Ban Fluoride In Public Water”

NB: recent Australian study found no sig difference in childhood IQ from fluoridated water. → journals.sagepub.com/doi/full/10....

yro.slashdot.org/story/25/03/...

#idiocracy

A Texas child who was not vaccinated has died of measles, a first for the US in a decade A child who was not vaccinated has died from measles in West Texas. It's the first death in an outbreak that began late last month and the first from measles in the U.S. since 2015.

The consequences of an anti-expert culture are only just beginning.

The first US measles death in a decade is a sad, avoidable tragedy. I’m sure RFK Jr will be right on this… 🙄

apnews.com/article/meas...

Why do experts seem less certain than everyone else? (Why is there surging expertise-rejection?)

In anaesthesia, embracing uncertainty means knowing what you don't know. True expertise means being comfortable with complexity and change:

www.metajournal.com/blog/115/exp...

#expertise #uncertainty

(Via @AaronDavid@mastodon.world)

Thanks Abhijoy! 🙏 Happy NY!

Thanks Ross. Greatly appreciated 🙏

Thanks Stu. 🙏 Sent to The Age, The Guardian, ABC and Crikey... 🤪

The Unseen Anaesthetist: Trust is the foundation of anaesthetic care
➡️ www.metajournal.com/blog/114/the...

Nope. Architecturally possible to federate in the future, and has some federation-adjacent characteristics, but still very much centralised in current form.

“If I had eight hours to chop down a tree, I'd spend the first six hours sharpening my axe.”

- Abraham Lincoln, alluding to preoxygenation and positioning on a potentially problematic patient (probably)
#ansky #medsky

Do you say raw milk tastes better than pasteurized?

It’s fat.

Milk undergoes quality control before sale.
On top of pasteurization, that involves skimming fat.

Unprocessed milk? 3.5 - 5% fat.
Whole milk? 3.25% fat.
2%? Duh, 2%.
1%? Yup.
Skim? <0.5%.

You like the taste of fat.

1/

Bluesky and enshittification No one is the enshittifier of their own story.

Cory Doctorow’s critique of Bluesky as refuge from Twitter is mandatory reading for all of #MedSky & #AnSky as we (re)build a med SoMe community here (perhaps wandering through the garden of Mastodon on the way…)
#enshittification
doctorow.medium.com/https-plural...

Does your role (eg consultant, resident, nurse etc) affect how quickly you learn to use HAVL if you already know how to use DL?

No.

12 tracheal intubations were needed to reach proficiency across all clinician groups.

#AnSky #MedSky #AirwaySky

https://buff.ly/3CVoXIZ

India takes out giant nationwide subscription to 13,000 journals Deal allows scholars to read paywalled articles for free and will cover open-access fees

This is a pretty incredible move by India:
US$715 million deal with 30 global academic publishers for nationwide access to 13,000 journals. (And because this also covers some Open Access journals, the rest of the world benefits from Indian's published research.)
www.science.org/content/arti...

It’s an interesting question (though note this article was from over a decade ago) - mostly I suspect it’s clustering because of the sheer publication volume of Fuji, Boltd & Rueben - and now Ueshima - rather than something systemic. Also sig response in stat methods to ID fraud before publication.

In Australia, most of us have never seen or used etomidate, unless in the UK or NZ. It’s never felt like we’re missing out! 🤣

When to use Tranexamic Acid (TXA) in bleeding
www.rpthjournal.org/article/S247...
#trauma #anesthesiology #surgery #surgeon #MedSky #MedEd #paramedics #BioInformatics #neuroscience #USMLE #Neurosurgery #Neurology #obgyn #TranexamicAcid

That BMJ review of Long Covid therapies does not show what it says it does The BMJ have published a “living systematic review” of interventions for the management of Long Covid. It sets out to gather all relevant studies, and to comb their findings in order to see what works...

A new BMJ review claims that #LongCovid can be treated using CBT and physical exercise

As ever, the devil is in the detail

TL; DR the authors' own risk-of-bias analyses show that their own conclusion is unwarranted

(Too bad they hid the crucial deets in an online supplement!)

cc #pwME #MECFS

+1 for feature request, +100 for what looks like Flutter development 😜

a baby rhino is playing with snow in a zoo enclosure . Alt: a baby rhino is playing with snow in a zoo enclosure .

Talking of Bier, @orthopodreg.bsky.social the story of how he developed spinal anaesthesia is pretty wild

A story of cocaine, cigars, and German army helmets. #AnSky #MedSky #HistoryMedSky

We’re getting better! PORC of 2.2% in this single center study (vs 10-15% in past). More routine NM monitoring & more common sugammadex use? #AnSky

editorial from @bmj.com and paper: Poor staff retention is associated with higher patient mortality. Have said it before & I’ll say it again. If you don’t care for the carers, they cannot care for their patients.
www.bmj.com/content/387/...

The HME filter should handle that fine for most short-to-medium length cases.

Interesting 2022 follow-up study from the same researcher, Dr George Zhong - shows the nuance inherent in many environmental/GWP trade-off decisions. Great that this work is being done. 👏