Matt Devine

article: https://pubmed.ncbi.nlm.nih.gov/37377263/ IBCC chapter about acute liver failure: https://emcrit.org/ibcc/alf/

updated the acute liver failure chapter

biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure)

now rec'd for clinically overt encephalopathy (Grade 2-4)

if admitting to ICU for ALF & encephalopathy, just dialyze

emcrit.org/ibcc/alf/ #EMIMCC

What does it feel like to have a high neuraxial block?

I was nauseated and dizzy, I couldn’t cough and I felt as if I couldn’t swallow properly. I tried to take a deep breath and it felt like it took a huge conscious effort to do so."

#AnSky #ObSky

Does the implementation of a standardised ROTEM®-guided transfusion strategy reduce the use of blood coagulation products for PPH?

#AnSky #MedSky #ObSky

doi.org/10.1002/anr3...

Deputy Director Anaesthetics - ANZCA Location: Redland Hospital, Brisbane South, Queensland Application closes 31 December 2025

As Deputy Director, you'll play a key role in leading anaesthetic services, supporting the Director Anaesthetics, and ensuring safe, high-quality patient care.

Staff Specialist Anaesthetics - ANZCA Location: Redland Hospital, Brisbane South, Queensland Application closes 24 November 2025

As a Staff Specialist in Anaesthetics, you will provide expert clinical care and leadership across a range of surgical specialties at Redland Hospital. You'll work collaboratively with multidisciplinary teams to ensure safe, effective and compassionate patient care.

YouTube video by Coda Change Hinds vs May Debate -- Cricoid To Press, or Not to Press

www.youtube.com/watch?v=0oXd...

Tomorrow is National Anaesthesia Day and we’re looking forward to celebrating anaesthetists around Aus and NZ. Don’t forget to tag us @anzca.bsky.social in your #NAD25 photos or send them through to communications@anzca.edu.au. You might be featured in the next ANZCA Bulletin! bit.ly/3J2CDW4

CCR Down Under 2025 Critical Care Reviews Meeting Down Under - The Edge, Federation Square, Melbourne, December 9th - 10th, 2025

The 8th & final trial for CCR Down Under is ECMO Rehab

➡️100-patient RCT testing early mobilisation during ECMO to reduce 6-month disability
➡️Will mobilisation improve outcomes?

Join us in Melbourne, December 9/10
criticalcarereviews.com/meetings/ccr...

Eerily familiar in many environments I’ve seen and worked in.
We need better training for those clinicians who are expected to step up to lead.

Today's Paper of the Day is:

Non-Neuraxial Chest and Abdominal Wall Regional Anesthesia for Intensive Care Physicians

https://criticalcarereviews.com/latest-evidence/paper-of-the-day

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

Editorial: Bullying: a silent threat to clinician well-being and patient safety

#AnSky #MedSky #bullying #wellbeing

doi.org/10.1111/anae...

Figure 2. Oxygen Exposure and Arterial Oxygenation by Treatment Group in Patients With Enhanced Data Collection

Conservative oxygen therapy with a target SpO2 of 90% did not reduce 90-day all-cause mortality compared to usual oxygen therapy in mechanically ventilated adult patients.

#CCR25 @criticalcarereviews.com

https://ja.ma/4kG5gWK

Image shows PDF.

Editorial: The UK-ROX trial demonstrates that targeting lower oxygen saturation in critically ill patients is safe but does not improve outcomes.

#CCR25 @criticalcarereviews.com

https://ja.ma/4ngdtmn

Physician associates to be renamed to stop them being mistaken for doctors Exclusive: Government-ordered review concludes term in NHS should be changed because of risks to patients’ safety

The complicity of NHS England, the GMC, the Colleges & establishment medics in this experiment on NHS patients has been scandalous.

It should never have taken years of grassroots doctor whistleblowing to expose.

But this is a small step in the right direction.

www.theguardian.com/society/2025...

They should be renamed as Clinical Assistants. Any use of ‘doctor’ or ‘physician’ in the name risks further confusion for patients.

Paralysis Suxamethonium Rocuronium Reversal This FRCA primary VIVAcast explores achieving NMJ Paralysis, Suxamethonium Vs Rocuronium and achieving Reversal pf NMJ blockade

🪢 Paralysis: Sux vs Roc & Reversal — onset, duration & sugammadex hacks. 👉 buff.ly/JYNCU1i #FOAMed #medsky #ansky

🔥 Critical Care Reviews Meeting 2025 🔥

🧠 Not just talks — conversations that matter

🌍 Leading clinicians
📊 Dissect the biggest trials
🤔 Challenge assumptions
🔮 Explore what’s next
🧵 Insights beyond the paper

📺 Free global livestream

#CCR25
https://criticalcarereviews.com/meetings/ccr25

In adult patients undergoing tracheal intubation in real-world operating theatre settings, universal VL showed clear advantages over direct laryngoscopy.

This is the largest comparative analysis conducted to date!

#AnSky #AirwaySky #MedSky

doi.org/10.1111/anae...

Flyer for the Critical care Reviews Meeting 2025, from Titanic Belfast, June 11th to 13th.

🚨 The best critical care trials in the world
⚡ Groundbreaking medicine
#CCR25

📺 Full, free livestream from Titanic Belfast
criticalcarereviews.com/meetings/ccr25

Flyer for the UK-ROX trial results presentation at #CCR25

🚨UK-ROX TRIAL Results at #CCR25🚨

📍 ~100 🇬🇧 ICUs
👥 ~16,500 pts
🎯 Conservative vs usual oxygen therapy in invasively ventilated adults
🩺 Outcome: Mortality day 90

🤔 Will less oxygen save lives?

📺 Free livestream — but it's better in person!
🔗 criticalcarereviews.com/ccr25

Editorial: Looking before we leap: treating postoperative anaemia with iron

#AnSky #MedSky #HaemSky

doi.org/10.1111/anae...

When using a hyperangulated videolaryngoscope have you tried "reverse loading" a tracheal tube on to a preformed stylet?

The stylet & tracheal tube are shaped forcibly in the opposite direction to the normal curvature and to match the shape of the blade.

#AnSky #AirwaySky

doi.org/10.1111/anae...

Critical insights for intensivists on Guillain-Barré syndrome

CCR Journal Watch - tracking the critical care literature daily
criticalcarereviews.com/latest-evide...

Point of View: A Holistic Four-Interface Conceptual Model for Personalizing Shock Resuscitation

CCR Journal Watch - tracking the critical care literature daily
criticalcarereviews.com/latest-evide...

Watch: British surgeon's 'anxiety' of operating in Gaza Dr Rose has been describing life at Nassar Hospital in Gazan city of Khan Younis.

www.bbc.com/news/videos/...

YouTube video by Dr Amit Pawa Tips for successful ESP Block - An Update

I’ve posted a quick update to my ESP talk based on my @ANZRA_X talk this year and including some useful insights from Ki Jinn Chin & Mauricio Forero

Check it out here:

youtu.be/6mY_m_uoqvs?...

#RAsky #AnSky

It's a great paper which has been well cited!

Cardiac arrest in obstetric patients receiving anaesthetic care: results from the 7th National Audit Project of the Royal College of Anaesthetists

doi.org/10.1111/anae...

ANZCA 2025: Annual Scientific Meeting This is the slide set for my talk at the ANZCA 2025 ASM: Futureproof The aim was to provide an evidence-based review of the management of traumatic major haemorrhage, along with an update of clinic…

Slide-set for my talk at the @anzca.bsky.social ASM on the Management of Traumatic Haemorrhage

sthjournalclub.wordpress.com/2025/05/02/a... #ASM25CNS

In Cairns till Tuesday representing @anaesjournal.bsky.social and @assocanaes.bsky.social - happy to chat about potential submissions!

I learned that in Australia voting is compulsory and happens on a Saturday, you know, like a normal civilized country.

Unflappable @chrimesy.com at #ASM25CNS
#VortexApproach
Bravo 👏👏