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Apropos of nothing in particular, for a specialty that’s supposed to be very tech savvy, I will never cease to marvel at how some colleagues can’t work PowerPoint in Teams #AnSky #ICMSKy

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Also, if you see an isolated tachycardia, ask why #ICMSky

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On the evidence of last week, we need to allow people to dual in gerries and ITU. And SPC too.

Does anyone know of a region running SSYs in frailty/palliative care? #ICMSky

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Good luck to all those rotating today, and I hope induction isn’t too painful #RotationDay #AnSky #ICMSky

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You’d hope. It sounds like, courtesy of @drmumsjt.bsky.social the @rcoanews.bsky.social is moving in the right direction direction. No response from the other organisations as yet, however #AnSky #ICMSky

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Second session I've been in where delirium vs. poor weaning of opioids on ITU has been mentioned #ICMSky #WSM2026

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For what it's worth, even if they come up with a solution to prevent Grok generating intimate images without consent, we as an anaesthetic/ICM community should think hard about whether we use a platform that allowed this to happen in the first place #AnSky #ICMSky

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That’s because it doesn’t work.

When I worked in the same liver transplant centre I was told that the only indication for MARS/SPAD was as a bridge to super urgent transplant when an initial graft failed.

AFAIK this hasn’t changed in the intervening 15 years #ICMSky

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Nowt wrong with thio. We’ve had more issues with propofol inductions #ICMSky

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I don't think I'll ever put a PA catheter in again #ICMSky

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Is this one of those papers where the authors don’t realise how outlying their normal practice is? #ICMSky

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It’s probably not wrong, given endless alarms and hard sound-reflecting surfaces. None of this helps with delirium, but mitigation has to be built in rather than added @ics-updates.bsky.social #ICMSky

We looked at the ear things, apparently they largely get ignored.

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100% this #ICMSky

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Given that pneumatic VTE cuffs are rampantly delirogenic, this is unsurprising #ICMSky

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Again.

Can we stop flogging the selective decontamination horse now, please? #ICMSky

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Why do we keep repeating this one? #ICMSky

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I’m sure jugular bulb oximetry used to be a thing, but I don’t work in a neuro centre #ICMSky

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Reading the @ics-updates.bsky.social #EnvironmentalSustainability Recipe Book - strong encouragement for #ICMSky staff to get involved in health advocacy.

Presume this is license for the many cycling ICM staff to get involved in their local #ActiveTravel group? 🤔

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Was looking for the words to say exactly this #ICMSky

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This is a very good question - we know FiO2 >0.6 is associated with harm #ICMSky

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There's a lot of "I don't know"

Does bringing someone to ITU give the family false hope? Is there moral distress on the staff providing aggressive therapy that they know is likely futile? Do 'trials of ITU' ever work (anecdotally, goals of therapy don't get reviewed as robustly as hoped)?

#ICMSky

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I think the answer has to be a mini-MDT before any particularly high-risk laparotomy. I am not at all sure that there can be generalisation, though I've a vague recollection of a #NELA presentation from a few years ago at the @ics-updates.bsky.social #SoA which discussed risk factors #AnSky #ICMSKy

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What could be better than pharmacy pointing out the error of my ways in shimmering green ink though? #ICMSky

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This is really powerful #ICMSky

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Afternoon tea and toast on the nursing station also went and never returned. This was something good for team cohesion and knowing what was going on on the unit #ICMSky

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Can anyone point me at some guidance that says the physicians should come and post take their patients admitted to ITU? I’m sure I’ve seen something recently but I’m damned if I can remember where. #ICMSky #MedSky

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An interesting finding, especially as there’s been some discussion about using volatile on ITU for people it’s difficult to sedate (and not to mention the eCO2 impact) #ICMSky #GreenerICM

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This is also why we shouldn’t be using the eGFR as a measure of renal function in the acutely unwell #ICMSky

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Anyone remember the conclusions of the #NELA talk at the @ics-updates.bsky.social #SOA23? #ICMsky

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I'm not sure. I rarely do RSIs on my anaesthetic sessions, but in ICM I'm not convinced sugammadex is all that relevant, as in the setting of critical illness, if the tube won't go in then it's likely the only option on the table is FONA. #ICMSky

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