The clarity is absolutely spectacular…..The Pillars of Creation by the James Webb Space Telescope 💫😲💫✨💫💙💫

Critical Illness in an Adolescent with Influenza A(H5N1) Virus Infection | NEJM Influenza A(H5N1) viruses are an emerging zoonotic threat and have spread widely throughout birds in North America. Recently, influenza A(H5N1) infection led to serious illness in a teenager in Canada.

So the kid in BC with H5N1 was very sick to the point of needing ECMO. While the majority of human cases have not been severe, this virus has the potential to be as bad as other H5N1s.

At population scale, even infrequently, this is millions of people.

www.nejm.org/doi/full/10....

Tranexamic Acid in Patients Undergoing Liver Resection This randomized clinical trial assesses the effect of tranexamic acid vs placebo on the need for blood transfusion among patients undergoing cancer-related liver resection.

Rather surprising news and an actual gamechanger for our practice.

Tranexamic acid in liver cancer cases makes no difference re blood loss/transfusion, but leads to more *non-thrombotic* complications.

Pendulum for TA is swinging back after HALT & HeLiX.

jamanetwork.com/journals/jam...

So..we all do thoracic epidurals !!
Would you rather have a carefully considered and delivered thoracic spinal puncture performed by an experienced anaesthetist with a 27g needle OR a 16g thoracic epidural placed by a trainee??…just a thought 🧐

Dear proceduralists: when I ask you “how much longer?” I’m (usually) not rushing you, I just (usually) want to re-dose a timed medication properly. Usually.

It's hard for the surgical team to understand. But I always lead off with, "I'm not pressuring you, but..."

And that's right, it just so we know what next steps we would take for the benefit of the patient

Stable and boring

I use “management of”:
Safety
Pain
Consciousness
Paralysis
Amnesia.