Mitch Page
@mitchpage3.bsky.social
Paramedic, student, nerd, “ropes bro”
Reposted by Mitch Page
I'm revising the IBCC septic shock chapter based on ANDROMEDA-SHOCK II
would love any feedback & critique on this
ANDROMEDA algorithm is nice, but it's too complicated for everyday use. We need something simpler.
& maybe it's time to push for IR thermography 😍
emcrit.org/ibcc/sepsis/... #EMIMCC
would love any feedback & critique on this
ANDROMEDA algorithm is nice, but it's too complicated for everyday use. We need something simpler.
& maybe it's time to push for IR thermography 😍
emcrit.org/ibcc/sepsis/... #EMIMCC
November 10, 2025 at 1:16 PM
I'm revising the IBCC septic shock chapter based on ANDROMEDA-SHOCK II
would love any feedback & critique on this
ANDROMEDA algorithm is nice, but it's too complicated for everyday use. We need something simpler.
& maybe it's time to push for IR thermography 😍
emcrit.org/ibcc/sepsis/... #EMIMCC
would love any feedback & critique on this
ANDROMEDA algorithm is nice, but it's too complicated for everyday use. We need something simpler.
& maybe it's time to push for IR thermography 😍
emcrit.org/ibcc/sepsis/... #EMIMCC
Reposted by Mitch Page
🫀SCCM 2024 - Guidelines on Adult Critical Care Ultrasonography 🏥:
Conditional recommendations-
🫢 Acute dyspnea / resp failure
💧 Targeted volume management
❤️ Cardiogenic shock
🦠 Septic shock
+/-⚖️ Cardiac arrest
#POCUS #ICU #PCCM @sccmcriticalcare.bsky.social
tinyurl.com/5a7w3k8k
Conditional recommendations-
🫢 Acute dyspnea / resp failure
💧 Targeted volume management
❤️ Cardiogenic shock
🦠 Septic shock
+/-⚖️ Cardiac arrest
#POCUS #ICU #PCCM @sccmcriticalcare.bsky.social
tinyurl.com/5a7w3k8k
October 28, 2025 at 2:10 AM
🫀SCCM 2024 - Guidelines on Adult Critical Care Ultrasonography 🏥:
Conditional recommendations-
🫢 Acute dyspnea / resp failure
💧 Targeted volume management
❤️ Cardiogenic shock
🦠 Septic shock
+/-⚖️ Cardiac arrest
#POCUS #ICU #PCCM @sccmcriticalcare.bsky.social
tinyurl.com/5a7w3k8k
Conditional recommendations-
🫢 Acute dyspnea / resp failure
💧 Targeted volume management
❤️ Cardiogenic shock
🦠 Septic shock
+/-⚖️ Cardiac arrest
#POCUS #ICU #PCCM @sccmcriticalcare.bsky.social
tinyurl.com/5a7w3k8k
Reposted by Mitch Page
Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
Silva et al: Safety of Peripherally Administered 23.4% Sodium Chloride
Link: link.springer.com/ar...
@neurocritical #neurocritcare
Link: link.springer.com/ar...
@neurocritical #neurocritcare
Safety of Peripherally Administered 23.4% Sodium Chloride
Neurocritical Care - For patients with increased intracranial pressure, prompt initiation of hyperosmolar therapy with 23.4% sodium chloride may minimize permanent neurological damage and prevent...
link.springer.com
October 28, 2025 at 5:38 PM
Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc)
If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC
@joshkimbre.bsky.social getting cited by the updated ACLS guidelines about pacing is pretty cool.
Great paper if you haven’t read it
pubmed.ncbi.nlm.nih.gov/38407212/
Great paper if you haven’t read it
pubmed.ncbi.nlm.nih.gov/38407212/
False Electrical Capture in Prehospital Transcutaneous Pacing by Paramedics: A Case Series - PubMed
These findings suggest a high proportion of patients undergoing TCP are at risk of false electrical capture despite a recorded palpable pulse. While our analysis is limited to a single EMS network, these data raise concerns regarding the incidence of prehospital false electrical capture. Further res …
pubmed.ncbi.nlm.nih.gov
October 28, 2025 at 6:19 PM
@joshkimbre.bsky.social getting cited by the updated ACLS guidelines about pacing is pretty cool.
Great paper if you haven’t read it
pubmed.ncbi.nlm.nih.gov/38407212/
Great paper if you haven’t read it
pubmed.ncbi.nlm.nih.gov/38407212/
In case anyone is wondering the answer is that it absolutely is that dangerous.
Indigenous to parts of South and Southeast Asia, Australia and the Pacific islands, the fruit of the pong-pong tree features prominently on Season 3 of "The White Lotus." What's the story behind it?
This article contains spoilers.
This article contains spoilers.
The ‘White Lotus’ Pong-Pong Tree Fruit Really Is That Dangerous
Indigenous to parts of South and Southeast Asia, Australia and the Pacific islands, the fruit contains a toxin in its seeds that attacks the heart.
www.nytimes.com
April 8, 2025 at 2:26 PM
In case anyone is wondering the answer is that it absolutely is that dangerous.
Reposted by Mitch Page
AOC: I want to live in an America that guarantees healthcare to every person.
I want to live in an America that has a living wage for every person
I want to live in an America where you have free speech to express yourself and not be afraid of being put on a list or deported.
I want to live in an America that has a living wage for every person
I want to live in an America where you have free speech to express yourself and not be afraid of being put on a list or deported.
March 21, 2025 at 3:34 AM
AOC: I want to live in an America that guarantees healthcare to every person.
I want to live in an America that has a living wage for every person
I want to live in an America where you have free speech to express yourself and not be afraid of being put on a list or deported.
I want to live in an America that has a living wage for every person
I want to live in an America where you have free speech to express yourself and not be afraid of being put on a list or deported.
This is really worrisome
New: Trump-controlled NIH begins targeted purge of LGBTQ+ research.
Citing "agency priorities," some grants were terminated on Friday, leaving researchers with uncertain futures.
Two researchers share their stories:
open.substack.com/pub/insideme...
Citing "agency priorities," some grants were terminated on Friday, leaving researchers with uncertain futures.
Two researchers share their stories:
open.substack.com/pub/insideme...
New: Trump-controlled NIH begins targeted purge of LGBTQ+ research.
Citing "agency priorities," some grants were terminated on Friday, leaving researchers with uncertain futures.
open.substack.com
March 3, 2025 at 5:59 PM
This is really worrisome
Reposted by Mitch Page
Missouri has been running the pilot for Project 2025 for a couple of decades.
With a GOP Supermajority, over 30% of our schools are on a four-day week. We fund vouchers for private religious schools. Our starting teachers are 50th in the nation for pay and they pay for their own supplies.
With a GOP Supermajority, over 30% of our schools are on a four-day week. We fund vouchers for private religious schools. Our starting teachers are 50th in the nation for pay and they pay for their own supplies.
March 3, 2025 at 1:03 PM
Missouri has been running the pilot for Project 2025 for a couple of decades.
With a GOP Supermajority, over 30% of our schools are on a four-day week. We fund vouchers for private religious schools. Our starting teachers are 50th in the nation for pay and they pay for their own supplies.
With a GOP Supermajority, over 30% of our schools are on a four-day week. We fund vouchers for private religious schools. Our starting teachers are 50th in the nation for pay and they pay for their own supplies.
Reposted by Mitch Page
Agree or disagree?
December 28, 2024 at 5:56 PM
Agree or disagree?
Reposted by Mitch Page
My top tip after a week of ICU
- 15mm and 22mm connections in airway circuits aren’t perfectly circular
- pushing them together, they can just come apart quite easily
-push *and twist* and they sort of jam together and are much more secure
✨Push and twist for breathing circuit happiness ✨
- 15mm and 22mm connections in airway circuits aren’t perfectly circular
- pushing them together, they can just come apart quite easily
-push *and twist* and they sort of jam together and are much more secure
✨Push and twist for breathing circuit happiness ✨
November 29, 2024 at 7:54 PM
My top tip after a week of ICU
- 15mm and 22mm connections in airway circuits aren’t perfectly circular
- pushing them together, they can just come apart quite easily
-push *and twist* and they sort of jam together and are much more secure
✨Push and twist for breathing circuit happiness ✨
- 15mm and 22mm connections in airway circuits aren’t perfectly circular
- pushing them together, they can just come apart quite easily
-push *and twist* and they sort of jam together and are much more secure
✨Push and twist for breathing circuit happiness ✨
Reposted by Mitch Page
One off doses of antihypertensives for asymptomatic hypertension is associated with increased risk of AKI.
Similarly randomly throwing darts in the air for no reason is associated with increased risk of ADITH.*
Will this madness never end?
*A dart in the head
jamanetwork.com/journals/jam...
Similarly randomly throwing darts in the air for no reason is associated with increased risk of ADITH.*
Will this madness never end?
*A dart in the head
jamanetwork.com/journals/jam...
jamanetwork.com
November 26, 2024 at 7:06 PM
One off doses of antihypertensives for asymptomatic hypertension is associated with increased risk of AKI.
Similarly randomly throwing darts in the air for no reason is associated with increased risk of ADITH.*
Will this madness never end?
*A dart in the head
jamanetwork.com/journals/jam...
Similarly randomly throwing darts in the air for no reason is associated with increased risk of ADITH.*
Will this madness never end?
*A dart in the head
jamanetwork.com/journals/jam...
Reposted by Mitch Page
Octavia Butler being a time traveler or seer, will forever be a hill I'm willing to die on, because there's just no way. Parable of The Sower was published in 1993. Look at this date. #BlackBookSky #BookSky
November 19, 2024 at 1:44 PM
Octavia Butler being a time traveler or seer, will forever be a hill I'm willing to die on, because there's just no way. Parable of The Sower was published in 1993. Look at this date. #BlackBookSky #BookSky
Reposted by Mitch Page
more evidence to support short-course antibiotic therapy after severe brain injury to prevent pneumonia 😃
small study, but consistent with PROPHY-VAP trial
prior evidence along this vein is reviewed here: emcrit.org/pulmcrit/pro... #EMIMCC
small study, but consistent with PROPHY-VAP trial
prior evidence along this vein is reviewed here: emcrit.org/pulmcrit/pro... #EMIMCC
Late-breaking science session #ReSs24! First up the PROTECT trial examining ceftriaxone PPx after cardiac arrest @nickjohnsonmd.bsky.social @pulmtoilet.bsky.social @imcrit.bsky.social @pulmcrit.bsky.social
November 16, 2024 at 6:40 PM
more evidence to support short-course antibiotic therapy after severe brain injury to prevent pneumonia 😃
small study, but consistent with PROPHY-VAP trial
prior evidence along this vein is reviewed here: emcrit.org/pulmcrit/pro... #EMIMCC
small study, but consistent with PROPHY-VAP trial
prior evidence along this vein is reviewed here: emcrit.org/pulmcrit/pro... #EMIMCC
Reposted by Mitch Page
Late-breaking science session #ReSs24! First up the PROTECT trial examining ceftriaxone PPx after cardiac arrest @nickjohnsonmd.bsky.social @pulmtoilet.bsky.social @imcrit.bsky.social @pulmcrit.bsky.social
November 16, 2024 at 5:09 PM
Late-breaking science session #ReSs24! First up the PROTECT trial examining ceftriaxone PPx after cardiac arrest @nickjohnsonmd.bsky.social @pulmtoilet.bsky.social @imcrit.bsky.social @pulmcrit.bsky.social
Reposted by Mitch Page
Septic shock requiring three or more vasopressors was associated with 57.6% in-hospital mortality. (That's it?!?!? - seems low)... 342 ICUs. Free article.
#emimcc #FOAMed
pubmed.ncbi.nlm.nih.gov/39529908/
#emimcc #FOAMed
pubmed.ncbi.nlm.nih.gov/39529908/
Septic Shock Requiring Three Vasopressors: Patient Demographics and Outcomes - PubMed
Septic shock requiring three vasopressors is associated with exceptionally high mortality. Knowledge of patients at highest risk of mortality in this population may inform management and expectations ...
pubmed.ncbi.nlm.nih.gov
November 16, 2024 at 8:27 PM
Septic shock requiring three or more vasopressors was associated with 57.6% in-hospital mortality. (That's it?!?!? - seems low)... 342 ICUs. Free article.
#emimcc #FOAMed
pubmed.ncbi.nlm.nih.gov/39529908/
#emimcc #FOAMed
pubmed.ncbi.nlm.nih.gov/39529908/