Just released: decoder chart incorporating the secret messages in the new PE guidelines:

New Guideline for End-of-Life Care in the ICU Time for hospitals to do more. Will they?

Hospitals need to do more to help clinicians with end of life care, says a major society guideline. Will they?
open.substack.com/pub/pulmccm/...

Haha, 12 years in I am starting to learn the medium here. Not natural for long formers like us.

People think they understand things, and then they find Jon

Post-Cardiac Arrest: 2025 Guideline Update The American Heart Association and the European Society for Intensive Care Medicine each updated their post-cardiac arrest guidelines in 2025.

The 116 page 2025 post cardiac arrest guidelines from AHA and ESICM, broken down with some light commentary.

Can Lungpacer® wean your patient off the vent? What you need to know about the new FDA-approved diaphragm-buzzer

FDA approves a high-risk device with a <10% chance of success, and CMS agrees Medicare will pay $23,650 per case, without requiring the marketer to show it’s superior to a plausible risk-free competitor that costs $75.

Can Lungpacer® wean your patient off the vent?
www.pulmccm.org/p/can-lungpa...

THE REAL-WORLD BOARDS: Question #1 An 82-year-old woman in refractory V-fib arrest arrives in the E.D. Your move.

Please answer this “boards” question on VF: what would you do?
www.pulmccm.org/p/the-real-w...

"Sepsis bundles": No good evidence of benefit A randomized trial testing SEP-1 against usual care is long overdue

Do you know the gross story of how “sepsis bundles” came to be the law of the land, even though they don’t help?

Are you treating the patient, or their family? Both, according to the newest society guideline update

New society guideline says physicians are responsible for providing “family centered care”

www.pulmccm.org/p/are-you-tr...

Why don't oncologists refer to palliative care? And will their own society's strong recommendation ever change their minds?

www.pulmccm.org/p/why-dont-o...

Sedation, Analgesia, and Sleep Guideline Update: Melatonin Reviewing the evidence for the newest PADIS recommendation

Melatonin for sleep and delirium prevention in the ICU : does it actually help?
www.pulmccm.org/p/sedation-a...

Fresh IBCC chapter: Measles in the adult hospitalized patient

🤒 tx = mostly supportive, but there are important nuances

🤒 viral pneumonia has parallels to COVID

🤒 encephalitis appears to be ADEM (not neuroinvasion), treatable with steroid

chapter: emcrit.org/ibcc/measles/ #EMIMCC

Maybe reschedule that Friday surgery for Monday Large cohort study adds evidence for the "weekend effect"

www.pulmccm.org/p/maybe-resc...

BOLO: CDC receiving multiple reports of serious adverse events with injectable ceftriaxone, state health authorities say

www.pa.gov/content/dam/...

How long should CPR be performed after cardiac arrest in the hospital? A series to help inform the final life-and-death decision

www.pulmccm.org/p/how-long-s...

Should thrombolytics be given >4.5 hours after stroke onset? Improved outcomes despite intracranial hemorrhages in a new meta-analysis

Neurologists’ job just got harder
www.pulmccm.org/p/should-thr...

The new "sepsis tests": do they work? Part 2 of a series

Reviewing the new “sepsis tests” in this series of posts.

open.substack.com/pub/pulmccm/...

Appreciate you saying this. It felt uncomfortable to post it, good to hear it resonated. Thank you

Thank you for sharing this!

Not trash talking them! Calling them out on this one (important) issue and asking, why?? (Hmm maybe I am one of the ones making this less fun 😆)

That is a very interesting read. even trying to be as charitable as possible, it doesn’t reflect well on the specialty’s culture (regarding this specific issue) and the practice patterns it tends to produce. Thank you.

Thanks for the repost Josh! and for waving the flag for bluesky- found my way here from your post on pulmcrit. My father in law is actually a retired oncologist - but he’s not on here 😆 Matt

Why don't oncologists refer to palliative care? And will their own society's strong recommendation ever change their minds?

open.substack.com/pub/pulmccm/...

Thank you so much for connecting us all!

New "sepsis tests" are here: how well do they work? Part 1 of a series

open.substack.com/pub/pulmccm/...

vasopressin challenge: this group evaluated 1U bolus of vasopressin to evaluate patient responsiveness

I love this for a few reasons:

[1] allows vaso to have rapid onset (rather than taking 30-60 min to build up)

[2] we can get a sense of whether the vaso is helping

🧵 1/5 #EMIMCC

Glad to be here! This looks promising…

@sethina.bsky.social could you please add @pulmccm.bsky.social to a starter pack?