Palliativist

4AT - Rapid Clinical Test for Delirium Detection 4AT: rapid assessment test for delirium detection. Designed by Alasdair MacLullich (University of Edinburgh), Tracy Ryan and Helen Cash (NHS Lothian). Used in clinical care by doctors, nurses, occupational therapists and other healthcare professional

Made the 4AT #delirium assessment tool with 2 colleagues in 2011 to help improve the rates of detection in my hospital at the time. Also made a website - www.the4AT.com - to help with dissemination.

Pleased to say it has now been widely adopted & has a large evidence base.

A Christmas present from @drjrubenstein.bsky.social & Dr Tammy Pegg.
If we talk clearly about the end of life, we put those frantic & unlived moments of unhelpful #CPR into context so their futility is clear.
CPR is fantastic first aid in a crisis. Ordinary dying isn't a crisis.
Talk about it.

Souhaitons tous un excellent anniversaire à Nicolas Sanson, cartographe 🇫🇷 né un 20 déc. 1600. Historien, géographe de Louis XIII, il a révolutionné la cartographie en introduisant une précision inédite et une représentation géographique et scientifique, influençant durablement la discipline.

A positive delirium screen should trigger diagnosis and care.

When it doesn’t - we haven’t actually helped the patient and their family.

We’ve created a bureaucratic fiction, not better care.

🚨The courage, the honor, the truth and candor missing from the U.S. government in this moment has one unadulterated Congressperson who is standing up to the lies: Senator Mark Kelly. Spread this message, this truth, this courage.

Towards a dedicated quality of recovery scale for regional anaesthesia

#AnSky #MedSky #RASky

doi.org/10.1111/anae...

Some studies show that in some undergraduate degrees nurses get no formal #delirium training.

For an emergency that affects 1 in 6 hospital patients.

Help me understand why this is.

Examples of solutions have existed for several years (eg @iownhs.bsky.social ambulance service, @nhswalesexecutive.bsky.social Wales ambulance service) so why are these not being taken up by other areas?

Did you know that if you show up to work in a pair of scrubs and a fleece for a day of palliative consults no one will say anything and it’s very comfortable and much easier?

The French hen in St. Paul

They may not want to hear it, and it may incense them, but the parallels between what the Nazis did then, and what Trump and MAGA are doing today, are striking, chilling—and as any expert on authoritarianism will tell you, straight out of the same toxic, but dog-eared, playbook.

Good morning everyone.
I’m at the #BGSconf this morning talking about delirium.
Caught @cswarbrick1’s excellent talk on the impact of delirium and the results of Snap3.

Delirium increases length of stay, mortality and all complications.

If your patient has delirium post op, they usually have some other complication too. Check for infection, thrombosis etc, but also think “is this patient bleeding?”

Trump Truth social post: “I love the smell of deportations in the morning…” Chicago about to find out why it’s called the Department of WAR 🚁🚁🚁

Take off that Cavalry hat, you draft dodger.

You didn’t earn the right to wear it.

Stolen valor at its worst.

“Make your calls. Go to your town halls. Ask your state and local officials what they are doing under state and local law. Rest. Hydrate. Make soup for the hungry. Don’t let people tell you that you’re doing it wrong… Not a marathon. A relay. Find your team. Thank you.”
@dahlialithwick.bsky.social

"Just a bit muddled" - avoiding saying "delirium" - doesn't cut it.

It's unprofessional.

Use the right word: DELIRIUM.

#delirium

What are her goals of care? How to you present your case if she decides that, indeed, aggressive care is her choice and do you address the potential complications conversation?

STAGGERING: This new study of 133 countries is the first to estimate the impact of all USAID’s work. In 2 decades, it has saved *92M* lives. Current cuts, if not reversed, are forecast to cost up to *14M* lives thru 2030. www.thelancet.com/journals/lan...

No

Myth: Keep #delirium patients in bed, & wait until they get better before involving physiotherapy.

Fact: Mobilisation is essential & can greatly aid recovery from delirium.

Treatable? Not sure, preventable maybe. Terrifying from the consequences. The number one surgical complication in elderly patients.

I once had a >90yo who required hospitalizations every 2-3 weeks, one needing intubation. In a hard conversation, I recommended hospice. The family tells me he had 6 wonderful weeks at home, the longest hospital-free period for nearly a year, before dying in his sleep.
Sometimes doing less is more.

If you feel compelled to speak-up and write about trauma care for the elderly part of our population, please join us and share your research in a dedicated issue of OBM Geriatrics.
Dr. Frederick Rogers and I have been offered to be the guest Editors.
www.lidsen.com/journals/ger...

The Democrats Need Their Own Project 2025: Elie Mystal Provides a Blueprint

Legal analyst @elienyc.bsky.social argues there are ten popular laws, forged by racism, greed & bipartisan complicity, that are ruining America & need to be undone by Democrats

thelefthook.substack.com/p/the-democr...

Pm Private GIF ALT: Pm Private GIF

I would like to nominate Maxwell Smart for national security advisor.

Basel, Switzerland

This should be every Democrat's reaction to an unelected billionaire gutting our federal government and services with no oversight or accountability.

Proprioception et schéma corporel Comprendre comment intervient la proprioception dans l’élaboration du schéma corporel permet de comprendre l’importance de son rôle dans le contrôle et la coordination des mouvements (e…

2019 > #Proprioception et schéma corporel tinyurl.com/26v6wv7b #ScienceCQFD

The overlooked cause of dementia that doctors can prevent We are advised to cut risk of dementia through exercise and eating healthy – but are never warned to try to avoid an episode of delirium while in hospital, although it is linked with a three-fold high...

Delirium is an underrecognised risk factor for future dementia...sometimes preventable, and perhaps treatable if we prioritise research in this area @amaclullich.bsky.social @proflizsampson.bsky.social @gerisoc.bsky.social inews.co.uk/news/health/...