Yusuf Malik
@yusufmalik.bsky.social
Emergency Physician trained in 🇮🇪&🇬🇧 and now practicing in 🇨🇦
Reposted by Yusuf Malik
A tricky thing about modern society is that no one has any idea when they don’t die.
Like, the number of lives saved by controlling air pollution in America is probably over 200,000 per year, but the number of people who think their life was saved by controlling air pollution is zero.
Like, the number of lives saved by controlling air pollution in America is probably over 200,000 per year, but the number of people who think their life was saved by controlling air pollution is zero.
April 7, 2025 at 4:13 AM
A tricky thing about modern society is that no one has any idea when they don’t die.
Like, the number of lives saved by controlling air pollution in America is probably over 200,000 per year, but the number of people who think their life was saved by controlling air pollution is zero.
Like, the number of lives saved by controlling air pollution in America is probably over 200,000 per year, but the number of people who think their life was saved by controlling air pollution is zero.
Reposted by Yusuf Malik
Reposted by Yusuf Malik
The death of expertise...
March 7, 2025 at 7:51 PM
The death of expertise...
Reposted by Yusuf Malik
In 1890, the Tariff Act came into place in the United States. It placed tariffs on imports of up to 50%.
While touted as a way to build American industry, there was also the hope it would force an annexation of Canada. It backfired.
Let's learn more.
🧵1/10
While touted as a way to build American industry, there was also the hope it would force an annexation of Canada. It backfired.
Let's learn more.
🧵1/10
March 4, 2025 at 4:53 PM
In 1890, the Tariff Act came into place in the United States. It placed tariffs on imports of up to 50%.
While touted as a way to build American industry, there was also the hope it would force an annexation of Canada. It backfired.
Let's learn more.
🧵1/10
While touted as a way to build American industry, there was also the hope it would force an annexation of Canada. It backfired.
Let's learn more.
🧵1/10
Reposted by Yusuf Malik
Jornal Nacional showing the truth.
January 21, 2025 at 12:27 AM
Jornal Nacional showing the truth.
Reposted by Yusuf Malik
Clinicians were generally less concerned about sepsis among patients with abnormally low temperature and WBC count than patients with abnormally high temperature and WBC count #idsky #EMIMCC #medsky
Sepsis is a heterogeneous syndrome without a defined or specific set of symptoms.
🆕️✨️What Clinicians Think About When They Think About Sepsis?!
Results From a Survey Across the University of Maryland Medical System
Hypotension?
Fever?
High WBCs? #idsky #EMIMCC #medsky
journals.lww.com/ccejournal/f...
🆕️✨️What Clinicians Think About When They Think About Sepsis?!
Results From a Survey Across the University of Maryland Medical System
Hypotension?
Fever?
High WBCs? #idsky #EMIMCC #medsky
journals.lww.com/ccejournal/f...
What Clinicians Think About When They Think About Sepsis:... : Critical Care Explorations
AND PARTICIPANTS:
A survey was distributed to physicians and advanced practice providers across a multihospital health system during April 2022 and May 2022 querying likelihood of suspecting sepsis ...
journals.lww.com
December 10, 2024 at 9:39 PM
Reposted by Yusuf Malik
1/ 7th Day of Pharmacy Advent
Let’s talk about anticoagulation in cirrhosis – a nuanced topic where balance is critical. Pts w/ ESLD face unique challenges d/t unpredictable pro- and anticoagulant changes. Let's dive deeper 👇
#medsky #pharmsky #GPsky #HMsky #emimcc #nursesky
Let’s talk about anticoagulation in cirrhosis – a nuanced topic where balance is critical. Pts w/ ESLD face unique challenges d/t unpredictable pro- and anticoagulant changes. Let's dive deeper 👇
#medsky #pharmsky #GPsky #HMsky #emimcc #nursesky
December 7, 2024 at 7:44 PM
Reposted by Yusuf Malik
ICU Resuscitation Thoughts:
Every 2 years this time of the year I have to provide my hospital-employer with proof of my recertification in ACLS. I usually take an on-line course which one can finish in a few hours. Sadly, this biennial ritual is also a reminder that we keep following the same #CPR
Every 2 years this time of the year I have to provide my hospital-employer with proof of my recertification in ACLS. I usually take an on-line course which one can finish in a few hours. Sadly, this biennial ritual is also a reminder that we keep following the same #CPR
December 7, 2024 at 6:21 AM
ICU Resuscitation Thoughts:
Every 2 years this time of the year I have to provide my hospital-employer with proof of my recertification in ACLS. I usually take an on-line course which one can finish in a few hours. Sadly, this biennial ritual is also a reminder that we keep following the same #CPR
Every 2 years this time of the year I have to provide my hospital-employer with proof of my recertification in ACLS. I usually take an on-line course which one can finish in a few hours. Sadly, this biennial ritual is also a reminder that we keep following the same #CPR
Reposted by Yusuf Malik
BRASH syndrome ECG:
- subtle peaked T-waves from hyperkalemia
- bradycardia is *disproportionately* severe, as compared to the extent of hyperkalemia-induced morphology changes
(more on BRASH: emcrit.org/ibcc/brash/)
(ECG credit: ecg.bidmc.harvard.edu/maven/dispca...) #ECGsky
- subtle peaked T-waves from hyperkalemia
- bradycardia is *disproportionately* severe, as compared to the extent of hyperkalemia-induced morphology changes
(more on BRASH: emcrit.org/ibcc/brash/)
(ECG credit: ecg.bidmc.harvard.edu/maven/dispca...) #ECGsky
November 28, 2024 at 11:32 PM
BRASH syndrome ECG:
- subtle peaked T-waves from hyperkalemia
- bradycardia is *disproportionately* severe, as compared to the extent of hyperkalemia-induced morphology changes
(more on BRASH: emcrit.org/ibcc/brash/)
(ECG credit: ecg.bidmc.harvard.edu/maven/dispca...) #ECGsky
- subtle peaked T-waves from hyperkalemia
- bradycardia is *disproportionately* severe, as compared to the extent of hyperkalemia-induced morphology changes
(more on BRASH: emcrit.org/ibcc/brash/)
(ECG credit: ecg.bidmc.harvard.edu/maven/dispca...) #ECGsky
Nice nibble of revision for frostbite management. @tshanahan0584.bsky.social you are probably seeing loads of this?
November 26, 2024 at 4:26 AM
Nice nibble of revision for frostbite management. @tshanahan0584.bsky.social you are probably seeing loads of this?
Reposted by Yusuf Malik
Of course BlueSky is a bit glitchy.
It would be like if you invited 10 people to dinner but 1000 showed up and then were like but wait why isn’t there enough pasta and did you think about making paella and what’s in this salad anyway oh and by the way a few of us are vegan and can’t eat any of this
It would be like if you invited 10 people to dinner but 1000 showed up and then were like but wait why isn’t there enough pasta and did you think about making paella and what’s in this salad anyway oh and by the way a few of us are vegan and can’t eat any of this
November 22, 2024 at 1:01 AM
Of course BlueSky is a bit glitchy.
It would be like if you invited 10 people to dinner but 1000 showed up and then were like but wait why isn’t there enough pasta and did you think about making paella and what’s in this salad anyway oh and by the way a few of us are vegan and can’t eat any of this
It would be like if you invited 10 people to dinner but 1000 showed up and then were like but wait why isn’t there enough pasta and did you think about making paella and what’s in this salad anyway oh and by the way a few of us are vegan and can’t eat any of this
Reposted by Yusuf Malik
You only have a fixed number of good decisions in a day.
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
November 19, 2024 at 8:20 PM
You only have a fixed number of good decisions in a day.
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
"In this paper, we suggest that perhaps more consideration should be given to the diastolic blood pressure in bleeding trauma patients. The diastolic blood pressure is critical for coronary perfusion, and in turn the cardiac output responsible for cerebral blood flow."
#EMIMCC
#EMIMCC
Is it time to reframe resuscitation in trauma?
Trauma remains a significant cause of mortality and morbidity. Non-compressible torso haemorrhage is one of the key drives of these mortality data. Our contemporary management has focused on damage co...
emj.bmj.com
November 20, 2024 at 6:59 PM
"In this paper, we suggest that perhaps more consideration should be given to the diastolic blood pressure in bleeding trauma patients. The diastolic blood pressure is critical for coronary perfusion, and in turn the cardiac output responsible for cerebral blood flow."
#EMIMCC
#EMIMCC
Non-invasive BP measurement overestimated SBP and MAP at low values and underestimated them at high values. When BP really matters get an art line.
sjtrem.biomedcentral.com/articles/10....
#EMIMCC
sjtrem.biomedcentral.com/articles/10....
#EMIMCC
Non-invasive versus arterial pressure monitoring in the pre-hospital critical care environment: a paired comparison of concurrently recorded measurements - Scandinavian Journal of Trauma, Resuscitatio...
Background Blood pressure monitoring is important in the pre-hospital management of critically ill patients. Non-invasive blood pressure (NIBP) measurements are commonly used but the accuracy of stand...
sjtrem.biomedcentral.com
November 20, 2024 at 6:41 PM
Non-invasive BP measurement overestimated SBP and MAP at low values and underestimated them at high values. When BP really matters get an art line.
sjtrem.biomedcentral.com/articles/10....
#EMIMCC
sjtrem.biomedcentral.com/articles/10....
#EMIMCC
Reposted by Yusuf Malik
Small vs large chest drains for haemothorax. How low can we go? (A - prob smaller than you think).
#FOAMed
@stemlyns.bsky.social www.stemlynsblog.org/jc-small-ver...
#FOAMed
@stemlyns.bsky.social www.stemlynsblog.org/jc-small-ver...
JC: Small versus Large-Bore Thoracostomy for Traumatic Hemothorax.
Traditionally, large-bore chest tubes have been standard for managing haemothorax, but smaller tubes are now proving just as effective in stable patients, with added benefits like reduced pain and few...
www.stemlynsblog.org
November 19, 2024 at 3:24 PM
Small vs large chest drains for haemothorax. How low can we go? (A - prob smaller than you think).
#FOAMed
@stemlyns.bsky.social www.stemlynsblog.org/jc-small-ver...
#FOAMed
@stemlyns.bsky.social www.stemlynsblog.org/jc-small-ver...
St Emlyn's blog on SRMA for <14F Vs >20Fr chest tube for traumatic HTx.
1. Small bore is probably fine in stable patient
2. Not enough data to change practice for most severely injured / in extremis.
Worth a read #EMIMCC
1. Small bore is probably fine in stable patient
2. Not enough data to change practice for most severely injured / in extremis.
Worth a read #EMIMCC
JC: Small versus Large-Bore Thoracostomy for Traumatic Hemothorax.
Traditionally, large-bore chest tubes have been standard for managing haemothorax, but smaller tubes are now proving just as effective in stable patients, with added benefits like reduced pain and few...
www.stemlynsblog.org
November 19, 2024 at 5:40 PM
St Emlyn's blog on SRMA for <14F Vs >20Fr chest tube for traumatic HTx.
1. Small bore is probably fine in stable patient
2. Not enough data to change practice for most severely injured / in extremis.
Worth a read #EMIMCC
1. Small bore is probably fine in stable patient
2. Not enough data to change practice for most severely injured / in extremis.
Worth a read #EMIMCC
Reposted by Yusuf Malik
Radial arterial lines are the default in most 🇬🇧 ICUs but can be wildly inaccurate in cases of profound shock.
These pics are taken seconds apart, after inserting a Femoral PiCCO line, systolic BP 121mmHg higher!!!
I’ve seen big discrepancies before but nothing of this magnitude! 😲
1/
These pics are taken seconds apart, after inserting a Femoral PiCCO line, systolic BP 121mmHg higher!!!
I’ve seen big discrepancies before but nothing of this magnitude! 😲
1/
November 16, 2024 at 9:57 AM
Radial arterial lines are the default in most 🇬🇧 ICUs but can be wildly inaccurate in cases of profound shock.
These pics are taken seconds apart, after inserting a Femoral PiCCO line, systolic BP 121mmHg higher!!!
I’ve seen big discrepancies before but nothing of this magnitude! 😲
1/
These pics are taken seconds apart, after inserting a Femoral PiCCO line, systolic BP 121mmHg higher!!!
I’ve seen big discrepancies before but nothing of this magnitude! 😲
1/
Reposted by Yusuf Malik
In those super sick patients on high doses of pressors, keep it in your back pocket!
Nb:
And no the transducer was not on the floor…
@pulmcrit.bsky.social has a great blog post on the topic for anyone wanting to learn more 📖
emcrit.org/pulmcrit/a-l...
2/2
Nb:
And no the transducer was not on the floor…
@pulmcrit.bsky.social has a great blog post on the topic for anyone wanting to learn more 📖
emcrit.org/pulmcrit/a-l...
2/2
PulmCrit: A-lines in septic shock: the wrist versus the groin
Historically, emphasis has rested on the distinction between noninvasive versus invasive BP (e.g., cuff pressure vs. radial arterial pressure). Attention focused on whether noninvasive oscillometric ...
emcrit.org
November 16, 2024 at 9:57 AM
In those super sick patients on high doses of pressors, keep it in your back pocket!
Nb:
And no the transducer was not on the floor…
@pulmcrit.bsky.social has a great blog post on the topic for anyone wanting to learn more 📖
emcrit.org/pulmcrit/a-l...
2/2
Nb:
And no the transducer was not on the floor…
@pulmcrit.bsky.social has a great blog post on the topic for anyone wanting to learn more 📖
emcrit.org/pulmcrit/a-l...
2/2
Reposted by Yusuf Malik
Critical care intubation hills I’m willing to die on (collating an occasional series from elsewhere).
Each hill is based on experience and other people’s research (I claim no other expertise) #EMIMCC #PCCM #AnSky
Each hill is based on experience and other people’s research (I claim no other expertise) #EMIMCC #PCCM #AnSky
a cartoon drawing of a mountain with the sun shining through it
Alt: a cartoon drawing of a mountain with the sun shining through it, a dinosaur climbs the mountain and roars
media.tenor.com
November 17, 2024 at 7:26 PM
Reposted by Yusuf Malik
The NINJA trial: Do you replace the fingernail after nail bed repair? #FOAMed first10em.com/the-ninja-tr...
February 19, 2024 at 4:08 PM
The NINJA trial: Do you replace the fingernail after nail bed repair? #FOAMed first10em.com/the-ninja-tr...
Reposted by Yusuf Malik
An experiment to see whether any medical people are here #ecg #ekg #medicine (do hashtags even work yet?)
Middle aged man complained of worsening chest pain (ECG 1) then had a VF cardiac arrest. Resuscitated successfully but now has ECG 2
What exactly has happened? (No points for “heart attack”!)
Middle aged man complained of worsening chest pain (ECG 1) then had a VF cardiac arrest. Resuscitated successfully but now has ECG 2
What exactly has happened? (No points for “heart attack”!)
February 5, 2024 at 8:45 AM
Reposted by Yusuf Malik
Last shift (night) at Blackburn ED and in the #NHS for a year at least. Time for a nap. And then ✈️ to 🇦🇺 this evening
Great to have my final shift with my good friend and colleague @yusufmalik.bsky.social
Great to have my final shift with my good friend and colleague @yusufmalik.bsky.social
January 22, 2024 at 9:00 AM
Last shift (night) at Blackburn ED and in the #NHS for a year at least. Time for a nap. And then ✈️ to 🇦🇺 this evening
Great to have my final shift with my good friend and colleague @yusufmalik.bsky.social
Great to have my final shift with my good friend and colleague @yusufmalik.bsky.social