There are a lot of fabulous echo images here this week! You are all posting some brilliant stuff to keep us all interested and excusing the pun, in the loop! Thank you…

Also, lots of journal club stuff going on on the Twittersphere!

Papers, blogs and a lot more….settle down and get your CME done quick here!

News!

iFAD mentions Northampton!

Manu Malbrain continues his great work in spreading the fluid safety word. Here, you can check out the blog. Below that, you can watch the video of his talk from ISICEM Brussels.

Aoife is in print!!

So our Aoife Abbey (@whistlingdixie4) is releasing her first book about the trials and tribulations of an ICU doc. I can’t wait for this and we will review it for you when it’s out…Jan 2019

Papers and Stuff!

STOP BEFORE YOU BLOCK!!

Sorry for shouting! A lovely piece by Iain Moppet on this subject in anaesthesia.

Annual Updates

Here is the selection from the annual updates in intensive care.

Diastolic dysfunction…can you diagnose it?

This is a fabulous article by Marcus Peck et al on this rather difficult to diagnose disorder….it’s more common than you think!

Get the DDAVP out to treat hyponatraemia…really!?

A fabulous #NEPHJC chat this week regarding the paper on Aakash Shingada’s lovely infographic below. Click it to see the Twitter moment!

Lets rip into APRV shall we?

The ICMJC was back this week again, this time focussing on the Zhou et al paper on APRV. This is a brilliant session held by Aoife Abbey and Nitin Arora and is well worth tuning into. You can find the excerpts of the session here

See the original paper here

Our infographic on it is also here

Strain is certainly not just the LV!!

This is an excellent and novel paper where the authors boldly describe ‘Strain’ on ICU services. This could form a scoresheet for all of us to look at our units’ levels of activity. One we will certainly be looking at here in Northampton. Thanks to Adrian Wong for pointing this one out.

Tastes like s@@t…but it may safe your life!!?

So, FMT or faecal microbial transplant may not be everyones ‘bag’, but actually, there is a lot of evidence to suggest it may restore G.I function in severe illness. Could placement of what comes out and put back in, actually reduce ICU LOS and improve poitcome….read on!

Blogs

I/O Vs. I.V…will one Vs. the other do you a dis-service?!

Great blog here from CoreEM, which from the outset says, if you arrest and have IO access, you fair worse! But…read on…

Secondary endpoints – ignore them all!!

Should we? The answer may be no…particularly in critical care. Read this lovely piece by Josh Farakas. Goes with a piece we featured last time on mortality focus by PulmCrit.

TXA OD!!!

A lovely piece by EmDocs on tricyclic overdose and what to look for.

Take a re-read about WPW!

A lovely, brief, snippet reminding us all about WPW and what to look for on the ECG.

Not all about echo!

Here is a nice 10 point article on the assessment and optimisation of volume status in CCF.

TBL talk stroke!

TBL take us through the DEFUSE-3 trial. Is it best to do a double with these patients? Thrombectomy AND medical therapy together?

MAP’s where it’s at!

NIBP Vs Invasive and outcomes…which is best and why?

The origins of (AB)normal Saline

A nice article delineating thew early usage of IV fluids.

Amazing POCUS!

So is this a simple case of HCM?

Not quite…this is the heart of a Friedrich’s ataxia patient….very similar! Thanks to Fernando Morcerf for sharing these. Some fantastic speckle tracking images!!

Is it a bird….is it a plane….no, it’s the gallbladder!?

Looks like sub-hepatic fluid!! But no, just an unusually positioned GB!

Ever seen this?!

There’s a membrane dividing up the left atrium…Cortriatriarum!!

Plaque or fluid

Justin Kirk-Bailey explains how you can tell it’s fluid, not a pleural plaque. No M-Mode sinusoid sign on a plaque and NO colour flow either…therefore this is fluid.