Critical Concepts

epic case 🤯

man trying to eat a better diet asks ChatGPT how to eliminate chloride, it advises him to use *bromide* instead

he buys NaBromide from the internet

develops bromism (with psychosis)

key diagnostic clue = negative anion gap!

(more on low anion gap emcrit.org/ibcc/agma/#l...) #EMIMCC

This week on the show, Leeah Sloan gives us the straight scoop on the new CHEST critical care APP certification program.

icuscenarios.com/lightning-ro...

#medsky #emimcc

I need one of those graphic T shirts Facebook keeps trying to sell me with an image of a grizzly doing curls. Caption: “Weight bear”

#medsky

Interesting. Thanks!

For pancreatitis?

Looking to subscribe to the Academy? To celebrate our 1-year anniversary, we're running a sale for the month of August: use the code AUG25 for 20% off all new subscriptions. Check it out!

#medsky #emimcc

Always associated this with gluconate. Chloride too?

From our new lesson in the SICU program: Abdominal emergencies and damage control surgery

Available at icu101.com

#medsky #emimcc

not common but it’s there. I’m thinking about patients on 4-6 liters O2 baseline, etc - doesnt take much to precipitate ICU admit

man openevidence is good

I have usually assumed nobody is really getting critically ill from the latter, but I admit I don't have proof of that. There must be some data on it somewhere. (Or maybe not... hard to diagnose these.)

Interesting you feel azithro “only” provides better Legionella coverage; what other “atypical” organism should we care about?

APPs—come do a CCM fellowship with me in WV!

www.camcmedicine.edu/departments/...

Want to spend a couple days learning All the Things? Come hang at the Vanderbilt APP Critical Care Bootcamp this September! I'll be speaking, but so will some rockstars, so you can grab lunch during my sessions.

#emimcc #medsky

www.eventbrite.com/e/2025-advan...

New lesson in our POCUS program: Vascular ultrasound! From DVTs to aortic pathology and everything in between.

at icu101.com

#medsky #emimcc #POCUS

We are dipping our toes into post-grad APP training and this was such a helpful and timely episode.

Where are we at with post-grad APP training residencies/fellowships in critical care? We chat with Melissa Bridges for the inside scoop on what makes a good program, who should attend one, getting in, and more. icuscenarios.com/lightning-ro...

#medsky #emimcc

A seat at the table, in terms of both clinical care and governance/leadership

Being viewed as a resource and member of the team rather than overhead (only noticed when there’s a problem)

Holy cow

Andrew Schulman gives us the scoop on medical musicians, and how music can help our critically ill patients. icuscenarios.com/lightning-ro...

#medsky #emimcc

switching to mero is that dart-shaped thing on the right

when the first two pressors don’t work

Yeaaa buddy! If you’ve never tried to accredit a CME program, it’s… a process. Thanks to everyone for their patience. But if you need credits, now we’ve got ‘em.

#emimcc #meded #medsky

You're doing your #POCUS echos wrong - here's how.

icuscenarios.com/lightning-ro...

#medsky #emimcc #echo

On a side note I agree completely. It depends on how departments “use” this space. Often juniors present. Cursory discussion and off you go. Rather than the in depth and if one can get institutional memory as these “fads” go in and out of fashion then it is a 👌

#EMIMCC

No more perfusion scans! Radial access for all! Lots of interesting thoughts on the cutting edge of thrombectomy from Justin Fraser.

#medsky #emimcc

icuscenarios.com/episode-89-t...

clinical humility arises from realizing that sometimes people say the dumbest shit and end up being right

and sometimes I say the smartest shit and end up being wrong

#medsky #emimcc

Absolutely. Maybe get a diagnostic study if borderline

An important distinction!