Seeing a straightforward patient - 3min. Paperwork & process around seeing the patient, 15min. Interruptions while dealing with paperwork & process, 30min. 45 min for a patient that spends 3 min with me. I’m not value for money. Reminds me of this paper. citeseerx.ist.psu.edu/docume…

Fragmented systems - often contributed to by the passionate people who set up amazing Pre-Hospital services - Founders Syndrome - be able to identify when 'your baby' needs to be in someone else's hands  - Michael Dickson @_retrieval #retrieval2025

Starting points to make your PHARM service more inclusive - @LeechCaroline @_retrieval #retrieval2025

Inclusivity runs right through from role models, mentoring, Job description, selection process, and employment - @LeechCaroline @_retrieval #retrieval2025

Are you aware of the Barriers to Inclusivity in your PHARM service? - @LeechCaroline @_retrieval #retrieval2025

Pre-Hospital Teams - focus not on our professions but on our patients - Prof Mike Christian @_retrieval #retrieval2025

Innovation & Dissemination - continually raises the bar in Pre-Hospital Care - Prof Mike Christian @_retrieval #retrieval2025

"Today's Critical Care is Tomorrow's Advanced Care" - Prof Mike Christian @_retrieval #retrieval2025

Perception by some that 'Critical Care' is a defined set of knowledge / skills to be taught & delivered but 'Today's Critical Care is Tomorrow's Advanced Care' - Prof Mike Christian @_retrieval #retrieval2025

Inter-professional Pre-Hospital teams resulted in 41% increased patient survival vs uni-profession - Mike Christian @_retrieval #retrieval2025

Mike Christian on power of cognitive diverssity in Pre-Hosp / Retrieval teams @_retrieval #retrieval2025

ICU Line Secrets: Is there anything about "lines" that has not been done or studied already? Not much, I guess, so these actually are not secrets, just things I had to do the last couple of weeks & hopefully you also find useful in your practice Here it begins: 1. "Twin lines"

Incorporation of prehospital TOE in cardiac arrest resuscitation is feasible. Identifying the area of maximal compression early in the resuscitation may improve OHCA outcome and aid in the ECPR decision making tree. Larger trials are needed #resuscitation #OHCA #ECPR #prehospital

I underwent explainaesthesia this week and emerged knowing a LOT more about hyperangulated videolaryngoscopy thanks to Nicholas Chrimes youtu.be/aYo7kqu9QpA

Mental models in Cardiac Arrest resuscitation. Bind blown by @cliffreid “CPR is not the treatment of cardiac arrest” @Incrementum2025 #incrementum2025

⁦@EmICUcanada⁩ what is your max dose of NE peripherally?

⁦@EmICUcanada⁩ talking push dose NE.

Thursday shift ⁦@UMEmergencyMed⁩ #foamed #WhiteBoardTeaching

The Netherlands now has nationwide availability of prehospital ECPR! From today, our #HEMS team of Amsterdam is equipped with #ECMO as part of the OnScene trial. Now all Dutch HEMS can provide ECPR. 🚁🇳🇱 More info on onscenetrial.com And check out youtu.be/3hCBeQ6FsSM?si=g6bc…

(5/x) Finally, here's a case where the ECG heart rate that is displayed LIES! In this case, you can see that the patient has a bigeminy. The ECG is showing a heart rate of 91, however, there is only ONE arterial line beat for every two electrical beats. Thus, the effective heart rate is actually ~45 BPM. This is surprisingly common, and without arterial line can be missed. Another clue can be looking at the pulse ox pleth tracing. This also happens with rapid atrial fibrillation where the HR is reading 130s but only 70-80BPM if you look at the arterial line. That is another indication to me that potentially rate/rhythm controlling the patient will help their hemodynamics.