Forgive me , but also …

Yup
I have always said the safest intensivists are the ones that have mastered the use of a handful of drugs and know how to use them safely to steady the ship and/or get them out of a sticky situation . Safe intubation is a prime example , use 3-5 things masterfully and that’s safest for all.

This dramatically changes my practice…to exactly what I’ve been saying for decades.

(Also, I strongly advocate for getting really familiar with one of them, the one you have handy)

I also have it on good authority that @omnintensivist.bsky.social and @pccmdoc.bsky.social both enjoyed a non peer reviewed ancient version of this , so we just had to do it properly !

Which calcium preparation should we use in paediatric resuscitation? A comprehensive review of basic physiology, pharmacokinetics, and clinical evidence - Journal of Anesthesia, Analgesia and Critical Care Background The optimal choice between calcium gluconate (CaGN) and calcium chloride (CaCl₂) for hypocalcaemia correction during paediatric critical illness and resuscitation remains debated. This literature review aimed to compare the efficacy and safety profiles of both preparations to determine an evidence-based clinical preference. Methods A comprehensive review of in vitro, in vivo, and clinical trials involving critically ill patients was conducted, focusing on the pharmacokinetics, therapeutic efficacy (measured by the rise in ionised calcium, iCa2⁺), and comparative adverse event profiles, particularly the risk of extravasation injury. Results Both CaGN and CaCl₂ effectively correct hypocalcaemia when equivalent elemental calcium doses are administered. CaCl₂ holds a significant dosing advantage in volume-restricted or extreme emergent scenarios due to its higher concentration of elemental calcium (27.2 mg/mL vs. 9.0 mg/mL for 10% solutions). Whilst the hepatic metabolism requirement for CaGN has been widely refuted, limited paediatric data suggest CaCl₂ may yield a greater response in mean arterial pressure (MAP) in critically ill children. Crucially, the safety profile favours CaGN; a substantial body of evidence indicates that the risk and severity of tissue necrosis following extravasation are markedly higher with CaCl₂. Conclusion The selection of a calcium preparation must be conditional and context-dependent. We recommend reserving CaCl₂ for central venous administration in volume-restricted or extreme emergent settings, whilst CaGN is the preferred choice for peripheral line administration or routine maintenance due to its superior safety profile.

Ever wondered whether calcium gluconate is superior to calcium chloride in paediatric resuscitation ? Fret no more as our new paper in the Journal of Anesthesia, Analgesia and Critical Care is now out and open access .
Have a read 👇 #pedsicu #foamED

link.springer.com/article/10.1...

Guest post: Forget pickles and ice cream. I published a fake paper on pregnancy cravings for prime numbers Image generated by Google Gemini I had grown weary of the constant stream and abuse of spam invitations to submit manuscripts to journals and to attend fake conferences on the other side of the wor…

This is both hilarious and scary.
@retractionwatch.com

🚨A reminder to all that work with sick children that @8:50 am UK tomorrow 13/11 we’re running the @PaedEmergencies course on @YouTube for free
A great success the last 5 years with>2000 live participants& >20,000 streams per course to date
#pedsicu
Link👇
www.paediatricemergencies.com/conference/p...

Sage Journals: Discover world-class research Subscription and open access journals from Sage, the world's leading independent academic publisher.

My editorial on how tribalism poses a significant threat to patient safety has been published today in @journalofchc.bsky.social
Thank you @stephen8mck.bsky.social for the opportunity
See it. Stop it . Sorted .
Open access
Have a read 👀
#pedsICU
#PatientSafety
journals.sagepub.com/doi/10.1177/...

Sage Journals: Discover world-class research Subscription and open access journals from Sage, the world's leading independent academic publisher.

My editorial on how tribalism poses a significant threat to patient safety has been published today in @journalofchc.bsky.social
Thank you @stephen8mck.bsky.social for the opportunity
See it. Stop it . Sorted .
Open access
Have a read 👀
#pedsICU
#PatientSafety
journals.sagepub.com/doi/10.1177/...

Abstracts for #PCCS2025 in Belfast close in 2 weeks (30th May), don’t miss the deadline! Follow this link to submit an abstract or book a ticket to the conference or any of the pre-conference workshops.

www.pccsbelfast25.com

#pedsicu #giantsteps #PCCS2025

8 years since my worst ever shift as a children’s intensive care doctor
Gone but never forgotten #manchestertogether
🐝❤️MANCHESTER ❤️🐝

Fifteen-minute consultation: A guide to paediatric post-resuscitation care following return of spontaneous circulation Paediatric resuscitation is a key skill for anyone in medicine who is involved in the care of children. Basic and advance paediatric life support courses are crucial in teaching those skills nationwid...

My paper :Fifteen-minute consultation: A guide to paediatric post-resuscitation care following return of spontaneous circulation
Is now out as an open access featured article @ADC_BMJ @ArchivesEandP
The biggest challenge starts post-ROSC
#pedsicu #foamed
ep.bmj.com/content/110/...

We look forward to welcoming you all to Belfast ICC on September 11th/12th 2025 for the annual #PCCS2025 conference.
Abstract submission is now open
#pedsICU

👀👇
auth.oxfordabstracts.com?redirect=/st...

Great fun ! And arguably the best Irish pub in London ☘️
Your kids are even more awesome than you . Same again next year ? Glasgow this time ?

A year ago today, fantastic day in London, family meet up with @drkanaris.bsky.social #PedsICU

That is quite the move, both geographically and career wise !
Makes our move to Cambridge (to set up a new retrieval team ) look tiny . How are you finding the new gig ?

a little boy is walking down a sidewalk while holding a cell phone in his hand . ALT: a little boy is walking down a sidewalk while holding a cell phone in his hand .

The scenes ! Missed you on the binfire site tho!

Nice to see you on here old friend . I miss the old Twitter days . It’s a 💩show now

I yielded to @pccmdoc.bsky.social ‘s pressure but I also needed my @omnintensivist.bsky.social fix to be honest . And reduce the time spent on the binfire that is “the other site”

a man wrapped in a yellow blanket with the words " could you teach me " on the bottom ALT: a man wrapped in a yellow blanket with the words " could you teach me " on the bottom

Right @pccmdoc.bsky.social , I’ve taken your advice and joined @bsky.app . Show me the way ! Where are all the #pedsicu peeps at ?