Awesome conference, so much good stuff :-)
I get why people resign from positions of authority when organisation/leadership goes down the wrong path (yes, looking at the RFK vaccine nonsense)
BUT
Who do you think replaces the leavers? A similarly minded person, or someone more allied to those views?
We give way, and so facilitate
Looking for help…!
#CriticalCarePharmacist
#Oxford
www.jobs.nhs.uk/candidate/jo...
😘
Whole day was great
UKCPA Critical Care Symposium
@ukcpa.bsky.social
Jonathan presents the UK respiratory metagenomics implementation, route to routine. @ukcpa.bsky.social was great 👍
Just a week to go until the launch of the NCEPOD report Recovery Beyond Survival - a review of the quality of rehabilitation care provided to patients following an admission to an ICU.
Register now to for the lunchtime webinar on 12 June👇
bit.ly/NCEPODwebinar
My sincere thanks to all my critical care pharmacy colleagues for contributing data, and to UKCPA for the use of resources to make the study happen
Overall we found the UK has moved over to using PPIs for SUP, there is some blanket prescribing going on, enteral feeding is commonly used as stopping criteria, though SUP is not stopped in some locations meaning deprescribing processes are needed
Stopping criteria were dominated by “patient fed” (65% of units)
In three quarters of those, that meant “full enteral feed”, in the remaining quarter that largely meant “any enteral feed”.
Neither SUP-ICU, nor REVISE used enteral feeding as stopping criteria
About a fifth of units reported they administered SUP to all patients, contrary to guidelines that advocate only giving SUP to critically ill patients with risk factors
Overall, we gathered information from over two thirds of UK critical care units, twice
Unsurprisingly, there was a large shift towards the use of PPIs for SUP between 2020 and 2024
We gathered SUP practices again in 2024, just prior to the publication of REVISE (which had the potential to change practice again)
www.nejm.org/doi/abs/10.1...
However, the appearance of COVID and the withdrawal of ranitidine somewhat ruined the experimental conditions
We aimed to more completely characterise UK practice before the publication of PEPTIC (H2RA as first line SUP agent, or PPI as first line SUP agent)
We then wanted to see how or if practice would change after the publication of PEPTIC
jamanetwork.com/journals/jam...
In the work up to SUP-ICU, an observational study recorded SUP practices across several countries
This revealed that unlike other countries, UK practice was divided between H2RA and PPIs
onlinelibrary.wiley.com/doi/abs/10.1...
Have stress ulcer prophylaxis practices changed in the UK since the publication of PEPTIC?
Yes, but highly likely nothing to do with PEPTIC
journals.sagepub.com/doi/10.1177/...
#COVID5years
Quotes that made us laugh in the moment are added to a whiteboard
My niece asks pertinent questions for a school project
Dear ICU pharmacist colleague. Please complete our brief clinical pharmacysurvey for adult ICU. @rsbournie.bsky.social @markborthwick.bsky.social @chrisremmington.bsky.social
@esicm.bsky.social @sccmcriticalcare.bsky.social @ukcpa.bsky.social
#together
#weareICU
docs.google.com/forms/d/e/1F...
#COVID5years
Impromptu hugs between nursing staff before a shift in the critical care covid bays
#COVID5years
A little ‘thank you’ light show is projected onto the hospital
Parallels are made between the Nightingale facility nearing completion, and pandemic flu facilities 100years earlier
We start collecting handprints from our ICU workers
docs.google.com/forms/d/e/1F...
Dear Intensive pharmacist, please complete our short international survey . This one for pharmacists, more coming for pharmacy team, including pharmacy technicians #bepartofresearch @markborthwick.bsky.social @chrisremmington.bsky.social and team
Really interesting thread Segun
Balancing sufficient assurance of knowledge, skills, behaviours and experience vs overburdening is difficult, and key
We all -public, payers, colleagues- need some form of objective assurance of competence, not none
(in medicine, nursing, pharmacy, physio, etc)
#COVID5years
PIPA going strong
Clinical trials aseptic unit making hundreds of propofol and NMB syringes each day
Clinical pharmacy services to crit care now 7 days a week, 12hours a day
#COVID5years
Renal replacement fluid supplies now under pressure, and start to be micromanaged
Regular counts commence to report back to NHS central, we write on anything handy
#COVID5years
Neuro ICU takes all general ICU work, other expanded/specialist units take covid patients
PIPA in full flow
Clinical trials mass produce propofol and atracurium syringes
Nationally:
Propofol supply begins to wobble
Epoprostenol demand surges and detabilises supply
#COVID5years
A more robust near patient IV prep area is developed - Pharmacy Intravenous Preparation Area (*PIPA*)
Staff trained in IV making and ANTT in a medical school facility
Nurses, medical students, pharmacy technicians, pharmacists collaborate
Critical care surges into cardiothoracics
#COVID5years
After the IV making service falls over, a new collaboration gets it on its feet again
Outpatient areas are earmarked for an expanded service, shielding nurses and medical students are added to the initiative
More critical care areas are converted to covid bays
#COVID5years
The near patient IV making service falls over: new staff supporting the weekend are not trained in time, the weekday staff are exhausted
Clinical trials aseptics unit start production of prefilled syringes of propofol and atracurium
Home haircuts begin
