Manoj Wickramasinghe

Tickets for #lactic25 are selling fast! Check out the programme below. Including the legendary
@dogicuma.bsky.social

Register here👉 clockworkmedical.com/meeting/lact...

#ICU #critcare #AIM #EM #emergencymedicine #CPD #FOAMed #medicalconference #leeds #LTHT #leedshospitals #yorkshire

What do people think about some sort of "POCUS on call" service? I'm thinking a practitioner with advanced multimodality skills who could respond to requests for POCUS from multiple hospital departments. Anyone know of anything like this that exists?

Here’s one for #Scanuary: wondered how beekeeping and #POCUS relate? Chap11 in #Scars&Stains explores pearls and pitfalls of POCUS in a seemingly dissimilar parallel.

amzn.eu/d/aVEQTTW

@manoj-w.bsky.social @casualtysrus.bsky.social

Today's Paper of the Day is organ crosstalk and dysfunction in sepsis

criticalcarereviews.com/latest-evide...

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025

It’s a pleasure to be part of the upcoming Critical Care Symposium in Manchester on the 24-25 April

Featuring an absolute smorgasbord of excellent critical care content

I’ll be co-chairing the ECMO session and teaching POCUS

Would love to see some of you there!

www.critcaresymposium.co.uk

As Promised

Season 3 - Episode 1 of #BILIH #BlockItLikeItsHot @bilih.bsky.social is out now!

Featuring one of our favourite blocks, the #Paravertebral!

Join @jeffgadsden.bsky.social and I on this fun episode
#RAsky #AnSky #PainSky
Spotify link: open.spotify.com/episode/0aUX...

The Association of Anaesthetists have published new guidelines on blood components & their alternatives!

Tranexamic acid has been proven to ⬇️ bleeding in most surgical settings.

But what dose of TXA should you use in different clinical contexts?

#AnSky #MedSky #HaemSky

https://buff.ly/4hbI4O6

I ”Kneed” To Know More Block It Like It’s Hot · Episode

And - if you get bored on your next commute, do check out our @bilih.bsky.social @jeffgadsden.bsky.social on Knee blocks here #WSM2025 @assocanaes.bsky.social

open.spotify.com/episode/6LKW...

YouTube video by Dr Amit Pawa Anterior Femoral Cutaneous Nerve Block

Was great to see and catch up with you at #WSM2025 too @sthjournalclub.bsky.social !

That video is fantastic from @jeffgadsden.bsky.social !

I also have one here

youtu.be/bAxMvcTf0kU?...

Transducer in the wrong position? 😂 Intra-op medication like clonidine?

The second trial result for #CCR25 in Titanic Belfast
in June is GASTROSAM

Gastroenteritis Rehydration of African Children with Severe Acute Malnutrition

Join us in June for the best critical care trials in the world

Register at criticalcarereviews.com/meetings/ccr25

HR2025 - Fluid Tolerance, all Things VExUS & Shock Hemodynamics | CCUS.meducate <p>HR2025 is about putting it all together. We’ve been talking about the venous side for a long time and it has been fantastic seeing how much it has taken off. There’s enough data out there to show a...

#hr2025 will be an absolutely excellent event.

I’m looking forward to joining in and talking about ventilation, ECMO, and POCUS.

It would be great to see as many of you there as possible.

Register here: ccusinstitute.wixsite.com/ccus/events/hr…

@katiewiskar.bsky.social @thinkingcc.bsky.social

I mean, I'm pleased that clinicians "beat" #AI - but this kind of study totally misses the point of medical exams.
We examine doctors by written exam as only one of many assessment types, on the (usually valid) assumption that it predicts real-world performance.

1/

bmjopen.bmj.com/content/14/1...

Sepsis-induced cardiogenic shock: controversies and evidence gaps in diagnosis and management

CCR Journal Watch

criticalcarereviews.com/latest-evide...

CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...

It's Jan 1st, so we reset the Paper of the Day record

Every day we'll review one topic & cover the entire spectrum of critical care across 2025

The papers are open access & available on the website or via email

Interested? Join in!

criticalcarereviews.com/latest-evide...

Echocardiography in the Ventilated Patient: What the Clinician Has to Know

CCR Journal Watch

criticalcarereviews.com/latest-evide...

Get the latest critical care literature every weekend via CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...

No doubt you’ll be amazing in that role ❤️

Congrats Gillian!

FirstWord

🔥 FDA just *rejected* full approval for Adnexxa 🔥

likely due to increased thrombosis risk in ANEXA-I trial

IMHO the best strategy is to keep this off your hospital's formulary (thereby avoiding endless circular debates about Adnexxa vs PCC)

firstwordpharma.com/story/5921956 #EMIMCC

It’s becoming an increasingly relevant topic that were debating regularly in the CICU. Should we stop SGLT2i in critically ill decompensated heart failure? When should we start? #cccsky #emimcc #cardiosky

Annals of Internal Medicine: Heterogeneity of Sepsis Presentations and Mortality Rates

🦠We call a lot of things “sepsis”

🔎Our #AnnalsofIM study examined how broad this grab bag really is

⚠️Among ~75,000 patients with sepsis, we found remarkably wide spectrum of presentations & outcomes across infection source & organ dysfunction patterns

Thread ⬇️
#medsky #emimcc #idsky #pharmsky

As an isolated study, I would take a transduced CVP any day. IVC is useful as part of a VExUS assessment looking at venous congestion at organ level which can be more useful than a CVP alone. And obviously when there isn’t a CVC present…

Really enjoy your episodes!

Episodes — Critical Care Time

🔥🔥 Join us on @criticalcaretime.bsky.social to hear Drs. Paul Wischmeyer and Alin Gragossian share their experiences #BeneathTheDrape on this week’s episode. Links 👇

🌎 tinyurl.com/3d7p4e9f
🍎 tinyurl.com/3737eusu
🟢 tinyurl.com/mry33267
🎥 tinyurl.com/2nchzw5c

Management of pain and sedation in the intensive care unit

CCR Journal Watch
https://criticalcarereviews.com/latest-evidence/journal-watch

Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://criticalcarereviews.com/newsletters/subscribe

We present another publication-quality chapter from ShockWaves, the 1st chapter in the RHC section.

Sergio Caravita presents a masterclass on the invasive PA waveform.

Section editors: Sophia Airhart and Zach I'lGiovine

shockwaves.icu/app/page/1O3...

PulmCrit: ADAPT and SCREEN trials are full of sound and fury, signifying little I think ICU docs may have developed a bit of an RCT problem; not an addiction, but perhaps a dependency. It all started off fine at first. RCTs are the

Fresh blog: the ADAPT and SCREEN trials are full of sound & fury, signifying little

🤷‍♂️ Sepsis screens & procal-based ABX duration are highly context-dependent interventions. Effects will vary depending on baseline usual care.

🤷‍♂️ They lack generalizability.

emcrit.org/pulmcrit/ada... #EMIMCC

Interesting. The best study I can see looking at this is www.obstetanesthesia.com/article/S095...

Increased dose dependant risk of Fetal bradycardia with intrathecal opioids. Postulates theories beyond maternal hypotension for Fetal bradycardia.

Are combined spinal-epidurals better than labour epidurals?

Are anaesthetists who do not universally adopt CSEs disadvantaging patients?

Universal use of CSE would likely:
⬆️ burden of PDPH morbidity
⬆️ risk of fetal bradycardia & maternal pruritus

#ObGynSky #AnSky

https://buff.ly/41rbYJs

I used to put all my arterial lines in like this, until I saw the
“Out-of-Plane Dynamic needle tip tracing”-light

(You can tell how old this is by the machine!)

Don’t @me about landmark being easier!

What is your preferred technique?

#AnSky #MedSky #POCUSky