Daniel Jolley
@djoll.bsky.social
Australian Anaesthetist/Anesthesiologist
MBBS FANZCA MMed(Periop) MBA(Innov)
Interests in how med evidence flows and finds us, obs anaesthesia, human factors/NTS, trail running 🏃 MTBing 🚲 #AnSky #MedSky
→ www.clinicalfox.com | www.metajournal.com
MBBS FANZCA MMed(Periop) MBA(Innov)
Interests in how med evidence flows and finds us, obs anaesthesia, human factors/NTS, trail running 🏃 MTBing 🚲 #AnSky #MedSky
→ www.clinicalfox.com | www.metajournal.com
I wrote about the anti-acetaminophen advice:
Tylenol, Tyranny, and Misogyny
“This is a broader project of bad science weaponised to undermine trust and weaken institutions … science is being twisted for ideological goals, to reinforce sexism & inequity.”
→ www.metajournal.com/blog/118/tyl...
Tylenol, Tyranny, and Misogyny
“This is a broader project of bad science weaponised to undermine trust and weaken institutions … science is being twisted for ideological goals, to reinforce sexism & inequity.”
→ www.metajournal.com/blog/118/tyl...
Tylenol Tyranny And Misogyny « metajournal.com
www.metajournal.com
September 26, 2025 at 5:12 AM
I wrote about the anti-acetaminophen advice:
Tylenol, Tyranny, and Misogyny
“This is a broader project of bad science weaponised to undermine trust and weaken institutions … science is being twisted for ideological goals, to reinforce sexism & inequity.”
→ www.metajournal.com/blog/118/tyl...
Tylenol, Tyranny, and Misogyny
“This is a broader project of bad science weaponised to undermine trust and weaken institutions … science is being twisted for ideological goals, to reinforce sexism & inequity.”
→ www.metajournal.com/blog/118/tyl...
Reposted by Daniel Jolley
ANZCA and FPM STATEMENT
Paracetamol use in pregnancy
We are aware of recent claims from the US questioning the safety of paracetamol use in pregnancy. These claims are not based on new evidence. Our full statement is here: tinyurl.com/5yye2npu
Paracetamol use in pregnancy
We are aware of recent claims from the US questioning the safety of paracetamol use in pregnancy. These claims are not based on new evidence. Our full statement is here: tinyurl.com/5yye2npu
September 23, 2025 at 7:05 AM
ANZCA and FPM STATEMENT
Paracetamol use in pregnancy
We are aware of recent claims from the US questioning the safety of paracetamol use in pregnancy. These claims are not based on new evidence. Our full statement is here: tinyurl.com/5yye2npu
Paracetamol use in pregnancy
We are aware of recent claims from the US questioning the safety of paracetamol use in pregnancy. These claims are not based on new evidence. Our full statement is here: tinyurl.com/5yye2npu
I collected the main evidence investigating #acetaminophen / #paracetamol use in pregnancy & possible neuro development effects here: www.metajournal.com/collections/...
Ahlqvist’s 2024, 2.5 million subject sibling-controlled cohort study is the most reassuring.
Advice remains unchg’d outside US!
Ahlqvist’s 2024, 2.5 million subject sibling-controlled cohort study is the most reassuring.
Advice remains unchg’d outside US!
www.metajournal.com
September 24, 2025 at 12:27 PM
I collected the main evidence investigating #acetaminophen / #paracetamol use in pregnancy & possible neuro development effects here: www.metajournal.com/collections/...
Ahlqvist’s 2024, 2.5 million subject sibling-controlled cohort study is the most reassuring.
Advice remains unchg’d outside US!
Ahlqvist’s 2024, 2.5 million subject sibling-controlled cohort study is the most reassuring.
Advice remains unchg’d outside US!
Reposted by Daniel Jolley
An important long read. Key elements of highly pathogenic H5N1 incl: 1. It’s already a major ‘pandemic’ of birds with big impact, (2) it’s adapting to mammals, (3) it’s not yet in Oz, (4) we need robust pandemic preparedness, including clean indoor air strategies. www.abc.net.au/news/2025-03...
This flu virus is spreading and scientists say it has pandemic potential
Since 1959 the avian flu virus H5N1 has been popping up around the globe. Now scientists believe it could spark the next pandemic.
www.abc.net.au
March 29, 2025 at 9:22 PM
An important long read. Key elements of highly pathogenic H5N1 incl: 1. It’s already a major ‘pandemic’ of birds with big impact, (2) it’s adapting to mammals, (3) it’s not yet in Oz, (4) we need robust pandemic preparedness, including clean indoor air strategies. www.abc.net.au/news/2025-03...
Make Cavities Great Again? 🦷🤦♂️
“Utah Could Become America's First State To Ban Fluoride In Public Water”
NB: recent Australian study found no sig difference in childhood IQ from fluoridated water. → journals.sagepub.com/doi/full/10....
yro.slashdot.org/story/25/03/...
#idiocracy
“Utah Could Become America's First State To Ban Fluoride In Public Water”
NB: recent Australian study found no sig difference in childhood IQ from fluoridated water. → journals.sagepub.com/doi/full/10....
yro.slashdot.org/story/25/03/...
#idiocracy
Utah Could Become America's First State To Ban Fluoride In Public Water - Slashdot
NBC News reports that Utah could make history as America's first state to ban fluoride in public water systems — even though major medical associations supporting water fluoridation:
If signed...
yro.slashdot.org
March 2, 2025 at 3:20 AM
Make Cavities Great Again? 🦷🤦♂️
“Utah Could Become America's First State To Ban Fluoride In Public Water”
NB: recent Australian study found no sig difference in childhood IQ from fluoridated water. → journals.sagepub.com/doi/full/10....
yro.slashdot.org/story/25/03/...
#idiocracy
“Utah Could Become America's First State To Ban Fluoride In Public Water”
NB: recent Australian study found no sig difference in childhood IQ from fluoridated water. → journals.sagepub.com/doi/full/10....
yro.slashdot.org/story/25/03/...
#idiocracy
The consequences of an anti-expert culture are only just beginning.
The first US measles death in a decade is a sad, avoidable tragedy. I’m sure RFK Jr will be right on this… 🙄
apnews.com/article/meas...
The first US measles death in a decade is a sad, avoidable tragedy. I’m sure RFK Jr will be right on this… 🙄
apnews.com/article/meas...
A Texas child who was not vaccinated has died of measles, a first for the US in a decade
A child who was not vaccinated has died from measles in West Texas. It's the first death in an outbreak that began late last month and the first from measles in the U.S. since 2015.
apnews.com
February 26, 2025 at 9:59 PM
The consequences of an anti-expert culture are only just beginning.
The first US measles death in a decade is a sad, avoidable tragedy. I’m sure RFK Jr will be right on this… 🙄
apnews.com/article/meas...
The first US measles death in a decade is a sad, avoidable tragedy. I’m sure RFK Jr will be right on this… 🙄
apnews.com/article/meas...
Why do experts seem less certain than everyone else? (Why is there surging expertise-rejection?)
In anaesthesia, embracing uncertainty means knowing what you don't know. True expertise means being comfortable with complexity and change:
www.metajournal.com/blog/115/exp...
#expertise #uncertainty
In anaesthesia, embracing uncertainty means knowing what you don't know. True expertise means being comfortable with complexity and change:
www.metajournal.com/blog/115/exp...
#expertise #uncertainty
February 24, 2025 at 8:55 AM
Why do experts seem less certain than everyone else? (Why is there surging expertise-rejection?)
In anaesthesia, embracing uncertainty means knowing what you don't know. True expertise means being comfortable with complexity and change:
www.metajournal.com/blog/115/exp...
#expertise #uncertainty
In anaesthesia, embracing uncertainty means knowing what you don't know. True expertise means being comfortable with complexity and change:
www.metajournal.com/blog/115/exp...
#expertise #uncertainty
(Via @AaronDavid@mastodon.world)
February 24, 2025 at 2:54 AM
(Via @AaronDavid@mastodon.world)
The Unseen Anaesthetist: Trust is the foundation of anaesthetic care
➡️ www.metajournal.com/blog/114/the...
➡️ www.metajournal.com/blog/114/the...
December 30, 2024 at 8:42 AM
The Unseen Anaesthetist: Trust is the foundation of anaesthetic care
➡️ www.metajournal.com/blog/114/the...
➡️ www.metajournal.com/blog/114/the...
Reposted by Daniel Jolley
Do you say raw milk tastes better than pasteurized?
It’s fat.
Milk undergoes quality control before sale.
On top of pasteurization, that involves skimming fat.
Unprocessed milk? 3.5 - 5% fat.
Whole milk? 3.25% fat.
2%? Duh, 2%.
1%? Yup.
Skim? <0.5%.
You like the taste of fat.
1/
It’s fat.
Milk undergoes quality control before sale.
On top of pasteurization, that involves skimming fat.
Unprocessed milk? 3.5 - 5% fat.
Whole milk? 3.25% fat.
2%? Duh, 2%.
1%? Yup.
Skim? <0.5%.
You like the taste of fat.
1/
December 9, 2024 at 12:35 PM
Do you say raw milk tastes better than pasteurized?
It’s fat.
Milk undergoes quality control before sale.
On top of pasteurization, that involves skimming fat.
Unprocessed milk? 3.5 - 5% fat.
Whole milk? 3.25% fat.
2%? Duh, 2%.
1%? Yup.
Skim? <0.5%.
You like the taste of fat.
1/
It’s fat.
Milk undergoes quality control before sale.
On top of pasteurization, that involves skimming fat.
Unprocessed milk? 3.5 - 5% fat.
Whole milk? 3.25% fat.
2%? Duh, 2%.
1%? Yup.
Skim? <0.5%.
You like the taste of fat.
1/
Cory Doctorow’s critique of Bluesky as refuge from Twitter is mandatory reading for all of #MedSky & #AnSky as we (re)build a med SoMe community here (perhaps wandering through the garden of Mastodon on the way…)
#enshittification
doctorow.medium.com/https-plural...
#enshittification
doctorow.medium.com/https-plural...
Bluesky and enshittification
No one is the enshittifier of their own story.
doctorow.medium.com
December 10, 2024 at 12:01 AM
Cory Doctorow’s critique of Bluesky as refuge from Twitter is mandatory reading for all of #MedSky & #AnSky as we (re)build a med SoMe community here (perhaps wandering through the garden of Mastodon on the way…)
#enshittification
doctorow.medium.com/https-plural...
#enshittification
doctorow.medium.com/https-plural...
Reposted by Daniel Jolley
Does your role (eg consultant, resident, nurse etc) affect how quickly you learn to use HAVL if you already know how to use DL?
No.
12 tracheal intubations were needed to reach proficiency across all clinician groups.
#AnSky #MedSky #AirwaySky
https://buff.ly/3CVoXIZ
No.
12 tracheal intubations were needed to reach proficiency across all clinician groups.
#AnSky #MedSky #AirwaySky
https://buff.ly/3CVoXIZ
December 4, 2024 at 9:06 AM
Does your role (eg consultant, resident, nurse etc) affect how quickly you learn to use HAVL if you already know how to use DL?
No.
12 tracheal intubations were needed to reach proficiency across all clinician groups.
#AnSky #MedSky #AirwaySky
https://buff.ly/3CVoXIZ
No.
12 tracheal intubations were needed to reach proficiency across all clinician groups.
#AnSky #MedSky #AirwaySky
https://buff.ly/3CVoXIZ
This is a pretty incredible move by India:
US$715 million deal with 30 global academic publishers for nationwide access to 13,000 journals. (And because this also covers some Open Access journals, the rest of the world benefits from Indian's published research.)
www.science.org/content/arti...
US$715 million deal with 30 global academic publishers for nationwide access to 13,000 journals. (And because this also covers some Open Access journals, the rest of the world benefits from Indian's published research.)
www.science.org/content/arti...
India takes out giant nationwide subscription to 13,000 journals
Deal allows scholars to read paywalled articles for free and will cover open-access fees
www.science.org
December 3, 2024 at 7:41 AM
This is a pretty incredible move by India:
US$715 million deal with 30 global academic publishers for nationwide access to 13,000 journals. (And because this also covers some Open Access journals, the rest of the world benefits from Indian's published research.)
www.science.org/content/arti...
US$715 million deal with 30 global academic publishers for nationwide access to 13,000 journals. (And because this also covers some Open Access journals, the rest of the world benefits from Indian's published research.)
www.science.org/content/arti...
In Australia, most of us have never seen or used etomidate, unless in the UK or NZ. It’s never felt like we’re missing out! 🤣
Etomidate can be replaced by Ketamine and low dose propofol or remimazolam and lidocaine .. why etomidate ? #ansky #medsky #anesthesiology #anesthesia #criticalcare
December 2, 2024 at 7:37 PM
In Australia, most of us have never seen or used etomidate, unless in the UK or NZ. It’s never felt like we’re missing out! 🤣
Reposted by Daniel Jolley
When to use Tranexamic Acid (TXA) in bleeding
www.rpthjournal.org/article/S247...
#trauma #anesthesiology #surgery #surgeon #MedSky #MedEd #paramedics #BioInformatics #neuroscience #USMLE #Neurosurgery #Neurology #obgyn #TranexamicAcid
www.rpthjournal.org/article/S247...
#trauma #anesthesiology #surgery #surgeon #MedSky #MedEd #paramedics #BioInformatics #neuroscience #USMLE #Neurosurgery #Neurology #obgyn #TranexamicAcid
December 2, 2024 at 1:12 AM
When to use Tranexamic Acid (TXA) in bleeding
www.rpthjournal.org/article/S247...
#trauma #anesthesiology #surgery #surgeon #MedSky #MedEd #paramedics #BioInformatics #neuroscience #USMLE #Neurosurgery #Neurology #obgyn #TranexamicAcid
www.rpthjournal.org/article/S247...
#trauma #anesthesiology #surgery #surgeon #MedSky #MedEd #paramedics #BioInformatics #neuroscience #USMLE #Neurosurgery #Neurology #obgyn #TranexamicAcid
Reposted by Daniel Jolley
A new BMJ review claims that #LongCovid can be treated using CBT and physical exercise
As ever, the devil is in the detail
TL; DR the authors' own risk-of-bias analyses show that their own conclusion is unwarranted
(Too bad they hid the crucial deets in an online supplement!)
cc #pwME #MECFS
As ever, the devil is in the detail
TL; DR the authors' own risk-of-bias analyses show that their own conclusion is unwarranted
(Too bad they hid the crucial deets in an online supplement!)
cc #pwME #MECFS
That BMJ review of Long Covid therapies does not show what it says it does
The BMJ have published a “living systematic review” of interventions for the management of Long Covid. It sets out to gather all relevant studies, and to comb their findings in order to see what works...
thesciencebit.net
November 28, 2024 at 10:05 PM
A new BMJ review claims that #LongCovid can be treated using CBT and physical exercise
As ever, the devil is in the detail
TL; DR the authors' own risk-of-bias analyses show that their own conclusion is unwarranted
(Too bad they hid the crucial deets in an online supplement!)
cc #pwME #MECFS
As ever, the devil is in the detail
TL; DR the authors' own risk-of-bias analyses show that their own conclusion is unwarranted
(Too bad they hid the crucial deets in an online supplement!)
cc #pwME #MECFS
Reposted by Daniel Jolley
Talking of Bier, @orthopodreg.bsky.social the story of how he developed spinal anaesthesia is pretty wild
A story of cocaine, cigars, and German army helmets. #AnSky #MedSky #HistoryMedSky
A story of cocaine, cigars, and German army helmets. #AnSky #MedSky #HistoryMedSky
a baby rhino is playing with snow in a zoo enclosure .
Alt: a baby rhino is playing with snow in a zoo enclosure .
media.tenor.com
November 24, 2024 at 10:29 AM
Talking of Bier, @orthopodreg.bsky.social the story of how he developed spinal anaesthesia is pretty wild
A story of cocaine, cigars, and German army helmets. #AnSky #MedSky #HistoryMedSky
A story of cocaine, cigars, and German army helmets. #AnSky #MedSky #HistoryMedSky
We’re getting better! PORC of 2.2% in this single center study (vs 10-15% in past). More routine NM monitoring & more common sugammadex use? #AnSky
How common is residual neuromuscular block after general anaesthesia? New single-centre study of patients from a post-anaesthesia care unit & systematic review. #anaesthesia #nmbas #Ansky
www.bjanaesthesia.org/article/S000...
www.bjanaesthesia.org/article/S000...
November 25, 2024 at 1:27 AM
We’re getting better! PORC of 2.2% in this single center study (vs 10-15% in past). More routine NM monitoring & more common sugammadex use? #AnSky
Reposted by Daniel Jolley
editorial from @bmj.com and paper: Poor staff retention is associated with higher patient mortality. Have said it before & I’ll say it again. If you don’t care for the carers, they cannot care for their patients.
www.bmj.com/content/387/...
www.bmj.com/content/387/...
November 24, 2024 at 8:51 PM
editorial from @bmj.com and paper: Poor staff retention is associated with higher patient mortality. Have said it before & I’ll say it again. If you don’t care for the carers, they cannot care for their patients.
www.bmj.com/content/387/...
www.bmj.com/content/387/...
Interesting 2022 follow-up study from the same researcher, Dr George Zhong - shows the nuance inherent in many environmental/GWP trade-off decisions. Great that this work is being done. 👏
The original study was benchtop using a test lung.
We then did a lesser cited follow up clinical study.
Long story short, FGF 2 suffice for non laparoscopic surgeries. FGF 4-6 for laparoscopic surgeries.
High FiO2 negates any potential environmental benefits.
www.bjanaesthesia.org/article/S000...
We then did a lesser cited follow up clinical study.
Long story short, FGF 2 suffice for non laparoscopic surgeries. FGF 4-6 for laparoscopic surgeries.
High FiO2 negates any potential environmental benefits.
www.bjanaesthesia.org/article/S000...
DEFINE_ME
www.bjanaesthesia.org
November 24, 2024 at 9:21 PM
Interesting 2022 follow-up study from the same researcher, Dr George Zhong - shows the nuance inherent in many environmental/GWP trade-off decisions. Great that this work is being done. 👏
Reposted by Daniel Jolley
The original study was benchtop using a test lung.
We then did a lesser cited follow up clinical study.
Long story short, FGF 2 suffice for non laparoscopic surgeries. FGF 4-6 for laparoscopic surgeries.
High FiO2 negates any potential environmental benefits.
www.bjanaesthesia.org/article/S000...
We then did a lesser cited follow up clinical study.
Long story short, FGF 2 suffice for non laparoscopic surgeries. FGF 4-6 for laparoscopic surgeries.
High FiO2 negates any potential environmental benefits.
www.bjanaesthesia.org/article/S000...
DEFINE_ME
www.bjanaesthesia.org
November 24, 2024 at 12:10 PM
The original study was benchtop using a test lung.
We then did a lesser cited follow up clinical study.
Long story short, FGF 2 suffice for non laparoscopic surgeries. FGF 4-6 for laparoscopic surgeries.
High FiO2 negates any potential environmental benefits.
www.bjanaesthesia.org/article/S000...
We then did a lesser cited follow up clinical study.
Long story short, FGF 2 suffice for non laparoscopic surgeries. FGF 4-6 for laparoscopic surgeries.
High FiO2 negates any potential environmental benefits.
www.bjanaesthesia.org/article/S000...
Reposted by Daniel Jolley
The updated version does state that increased flows have an increased environmental impact
This was one of the articles considered when the updated Green Theatre Checklist was being written (which will be released very soon!)
www.bjanaesthesia.org/article/S000...
This was one of the articles considered when the updated Green Theatre Checklist was being written (which will be released very soon!)
www.bjanaesthesia.org/article/S000...
DEFINE_ME
www.bjanaesthesia.org
November 24, 2024 at 9:31 AM
The updated version does state that increased flows have an increased environmental impact
This was one of the articles considered when the updated Green Theatre Checklist was being written (which will be released very soon!)
www.bjanaesthesia.org/article/S000...
This was one of the articles considered when the updated Green Theatre Checklist was being written (which will be released very soon!)
www.bjanaesthesia.org/article/S000...
💯 agree / The value of a "rescuer" arriving is more than just a 2nd pair of hands, its the new, fresh eyes brought to reset fixation in the room. Still sometimes VERY hard not to jump in before establishing your own situational awareness:
Endsley's Perception/Comprehension/Projection hierarchy
Endsley's Perception/Comprehension/Projection hierarchy
As an anaesthetist called into emergency situations the amount of information to process while responding in a time critical manner requires calm, a fresh mindset, a rapid assessment of what’s happened, what’s been tried & what needs to happen now. Key is how the team is functioning & leadership
Being a 'good rescuer' is:
• counterintuitive eg the advice to stand back & analyse rather than pile in & do something
• counter-cultural eg using checklists rather than relying on memory
Specific rescuer training would reinforce these skills.
#AnSky #MedSky #HFESky
https://buff.ly/3COBTjM
• counterintuitive eg the advice to stand back & analyse rather than pile in & do something
• counter-cultural eg using checklists rather than relying on memory
Specific rescuer training would reinforce these skills.
#AnSky #MedSky #HFESky
https://buff.ly/3COBTjM
November 24, 2024 at 2:26 AM
💯 agree / The value of a "rescuer" arriving is more than just a 2nd pair of hands, its the new, fresh eyes brought to reset fixation in the room. Still sometimes VERY hard not to jump in before establishing your own situational awareness:
Endsley's Perception/Comprehension/Projection hierarchy
Endsley's Perception/Comprehension/Projection hierarchy
This great lab study from 2020 surprised me at the time - challenging our assumptions about fresh gas flow rates and economic/environmental costs. #AnSky
[ Higher FGF (~6L/min) during TIVA reduces costs without sig environmental impact. ]
Summary → www.metajournal.com/articles/103...
[ Higher FGF (~6L/min) during TIVA reduces costs without sig environmental impact. ]
Summary → www.metajournal.com/articles/103...
November 24, 2024 at 12:57 AM
This great lab study from 2020 surprised me at the time - challenging our assumptions about fresh gas flow rates and economic/environmental costs. #AnSky
[ Higher FGF (~6L/min) during TIVA reduces costs without sig environmental impact. ]
Summary → www.metajournal.com/articles/103...
[ Higher FGF (~6L/min) during TIVA reduces costs without sig environmental impact. ]
Summary → www.metajournal.com/articles/103...