Reminder for clinicians: we aren’t obligated to perform interventions that are futile.

This includes CPR

If your patient’s death is inevitable and interventions to prevent it are at maximum, CPR is futile.

It only harms the patient.

Make your patient DNR, despite what the family says.
Its humane

Non-conventional DKA pearls (that should be):

- Start glargine in the ED (don’t wait until the gap closes)
- Scrap the NPO dogma
- Use LR instead of NS, and don’t drown them in 7 liters of fluid

These tips will shorten length of stay and improve HCAPS scores 🦋

Regarding data, a hierarchy exists - at the top is randomized, multicenter, placebo-controlled trials.

Plenty of these confirm vaccine safety and efficacy including for Covid-19

However, most folks can’t relate

So I offer an anecdote- I never had a fully vaxxed Covid patient die

Friendly reminder:

Patients don't need to be strictly NPO after midnight for a surgery the next day. The humane and guideline based best-practice?

Clear liquids after midnight until 6 for an OR time of 8

If you own bitcoin or any cryptocurrency, be fearful when others are greedy.

If you don’t own any cryptocurrency- don’t start now when the hype cycle is at max capacity. You’ll be exit liquidity

Being “on pressors” is not a universal signal of imminent mortality. It constitutes a spectrum.

- The patient that was on 50 mcg/min of norepi last night and now on 2= not very sick

- The patient on 20 mcg/min of norepi and not responding after just initiating it- alarm bells should go off

What’s your biggest pet peeve in medicine?

Mine- contrast is not nephrotoxic, let’s get the appropriate imaging done for the patient 🫂

Covid vaccine data:
Multiple randomized, placebo controlled trials involving different countries and well over 30,000 patients. Then rigorous peer review and post-marketing studies. No other drugs are studied this extensively

RFK Jr: “I’m not anti-vaxx, but they need to be studied more”

I add a couple of people every day but there are many more of you who work with critically ill patients. Drop a comment here and I'll add you! But check to see if you're already on it first 😁 go.bsky.app/NC7iD2K

The incoming Secretary of Health and Human Services believes:

- HIV is not the cause of AIDS
- Vaccines cause autism
- The Covid vaccines increased mortality
- “Raw Milk” will somehow be beneficial
- Ivermectin is effective in treating Covid
- Chemicals in water make people trans

I dissent

Added you to go.bsky.app/DvGjDh6

Hi Blue Sky! I am a Critical Care Physician and believe in Evidence based medicine.

Motivated by the anti-science movement leading the new administration, I hope to find reason where the sky is blue 🦋