Do you have access to Terlipressin in the US? We use it quite a lot, 4 hourly dosing so can usually be given on the ward and sometimes keeps them out of the ICU (when not in MOF..)

Agree the POCUS pendulum has probs swung a bit too far in some areas.

I think it can be helpful occasionally - i.e. cardiac standstill as a negative prognostic marker in prolonged arrest maybe?

Certainly shouldn’t prolong the pulse check or get in the way of good ALS

LV vent? More of a guess than a confident answer..

If there are categories, I would add “performative cricoid pressure”, which involves lightly touching the neck without applying any real force as to not distress the patient when we don’t think cricoid is really necessary but are afraid of litigation..

Probably the worst of the three.

Very interesting! All endovascular or did you have to go on circ arrest?

Leiomyosarcoma? Or thrombus?

The caveat with in-plane is that it’s fairly easy (I find) to accidentally slide off the jugular and onto the carotid if they are side by side.

It does prevent going through the back wall and cannulating a posterior artery though I guess.. no one failsafe technique.

Not sure why APRV is such a polarising subject. It does seem to work in some patients (?recruitability), very difficult to get hard data on this.

Would also argue that is has a more favourable adverse effect profile than VV ECMO so why not try?

Everyone should ideally leave twitter and come to bluesky for several reasons.

- Unify the discussion

- Safe space for everyone (eg LGBTQ)

- Stop supporting twitter (which is now a vehicle of misinformation & political manipulation)

- Twitter is currently NSFW (eg frankly pornographic content)

I’d say TIVA for most elective work where smooth offset, less of PONV etc is most important.

Don’t tend to use it for high stakes emergency work (sick laparotomy, big traumas) - worried about giving lots of propofol in those and also reducing anaesthetic complexity lets you focus on resuscitation

Apart from all the reasons you stated, I also think the FICM favours anaesthesia residents, not so much in terms of content but in the way it is delivered (anaesthetists will be used to viva examinations, and the OSCE is very different from PACES)

Interesting argument! Out of interest, what motivated you to sit EDIC as well?

Interesting as the effusion does not look huge, but presumably acute hence the rapid progression to tamponade?

Would definitely say RA collapse and maybe some RV collapse on diastole when I try to slow it down

How do you use it on your unit? Only ever used it as infusion on ICU but seen it given as bolus in cardiac anaesthesia for RV dysfunction coming off bypass.

Nebulised conceptually makes sense but never seen this in practice

Agree, our approach of having a different storage layout in almost every theatre is baffling. Should be able to standardise within institutions if not across.

Same with clinical rooms on wards - assembling equipment for a procedure often takes longer than procedure time..