Simply Better Education | Resuscitationist | Educator | Innovator | Entrepreneur | Driven to Learn & Share Knowledge | πŸ™ƒ #Airway #FOAMed #SALAD #TNCC #ENPC

Edenton, North Carolina
Joined May 2017
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Today @TheLancet published our AMIE study with @BIDMC_Medicine, the first prospective study of patient-facing conversational diagnostics in a real clinic. AMIE is a research system people can chat with before doctors appointments. Testing AMIE outside the lab with real urgent care patients showed how technology can help gather medical histories safely. Clinicians reported that the summaries helped them prepare for visits in 75% of cases and influenced their approach to care in more than half. AMIE’s differential diagnoses also matched the doctors’ final diagnoses 90% of the time giving clinicians more time to focus on patient care. It’s Google’s first-ever paper in The Lancet’s main journal!
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SNAP-3: 7,128 UK patients aged 60 and over having surgery in 214 hospitals. Median hospital stay was 12.5 days with delirium and 1 day without. After adjusting for age, frailty, multimorbidity and type of surgery, delirium added 5.2 days (95% CI 3.8 to 6.5), and the odds of death within a year doubled. Observational, so some influences were not measured. doi.org/10.1016/j.bja.2026.0…
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NICE says the diagnosis of delirium should be written in the person's notes and in their GP record. SIGN says the discharge letter should say the person had delirium, and that everyone who has had delirium should be reviewed by the primary care team. A letter that names the delirium, its cause, whether it has cleared and what the family were told gives the GP something to act on.
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Saturday night shift with some good cardiac cases #WhiteBoardTeaching #foamed
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Lexie Hull brought the heat for tonight's first pitch at the @indyindians game ⚾️
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Never gets old watching Caitlin punk Dijonai πŸ˜‚πŸ˜€πŸ˜‚πŸ˜€
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Handing over the @nyulangone Division of Cardiology to @SVRaoMD in pretty good shape! Thankful for great colleagues who still believe in and support the tripartite mission of academic medicine - even in these most challenging of times.
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π—₯π—²π˜€π˜‚π˜€π— π—²π—± retweeted
Handing over the @nyulangone Division of Cardiology to @SVRaoMD in pretty good shape! Thankful for great colleagues who still believe in and support the tripartite mission of academic medicine - even in these most challenging of times.
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Comparative effects of early physical interventions on preventing intensive care unit-acquired weakness: a systematic review and component network meta-analysis tinyurl.com/237dddvw #icurehab #A2Fbundle
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ICU diaries: From measuring outcomes to understanding what it means when others write your story authors.elsevier.com/c/1nSGY…
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ICU delirium patterns matter. Recurrent and persistent delirium were associated with higher 30-day mortality, while resolved delirium had mortality similar to no delirium. doi.org/10.1111/nicc.70514 #Delirium #CriticalCare
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Good Guy Greg tells the family before the operation: "Delirium is common after surgery. Here's what to watch for. Call us." Five minutes that saves five days. #delirium
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Daycare calls me. That's never good. For them. Daycare: "your son hurt his elbow and won't move his arm. Can you come take him to a doctor's office?" Me (ex Special Forces Medic): "A real doctor is on the way to you now. I am 6 mikes out. Alert me of status changes." I arrive at daycare. I locate the patient. 21 month old male. Scene is not safe. I drag the patient to cover and concealment behind a seesaw, away from the other small terrorists in the AO. I begin my assessment. Blood sweep negative for massive hemorrhage. Mental status: conscious and verbal but confused (answers "dada" when asked for blood type). One breath every 2 seconds. Bilateral rise and fall of the chest. Strong carotid pulse, strong bilat radial pulse. Teeth and tongue intact no blood no mucus no dip or foreign objects. Eyes PERRLA, negative JVD/trach deviation, C-spine intact upon palpation. Heart sounds strong upon auscultation. Percussion negative for hemo-T. Abdominal quads normal upon palpation. Pelvis negative for book sign. Arms and legs negative for crepitus. However, Patient indicates discomfort in right arm upon palpation and supination/flexion of the elbow. Nursemaid's elbow. I begin interventions. Supination/flexion technique complete at 1215. Palpable clunk on successful reduction. I write the time on his chest in Sharpie. I tape a popsicle to his hand and tell the patient to suck but do not bite/chew. I write "1 x popsicle (10g sugar)" on his chest in Sharpie. I reassess the patient after performing interventions then package the patient for handoff to daycare/higher level of care. I yell at daycare over the Blackhawk in my head: "21 month old male!!! Nursemaids elbow!!! Treated with supination/flexion technique at 1215!!! Patient has 1 x popsicle onboard!!" Daycare: "sir please leave." Me: "you should have called my wife."
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Over 110 organizations are coming together for this year’s conference β€” and we can’t wait to welcome them! πŸŽ‰ From industry leaders and innovative partners to emerging organizations making an impact, this year’s event will be filled with meaningful connections, collaboration, and opportunities to engage with professionals from across the field. We look forward to seeing everyone soon! Not yet registered? There is still time! Register today. americandeliriumsociety.org/… #ADS26DEN #americandeliriumsociety #deliriumawareness #delirium
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πŸ” No safe benzodiazepine threshold exists for delirium in critically ill children. Avoidance strategies should replace dose-minimization approaches in PICU sedation protocols. ➑️ Read the #openaccess research in CCE: ow.ly/Pi0m50Z0oOE #PedsICU #CritCareExplore @SCCM
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Enhancing continuity of care: Codevelopment of an intensive care unit transitions in care bundle I love it sciencedirect.com/science/ar…
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Noting that a patient is "confused" just isn't enough. Don't assume any cognitive impairment is dementia - it may be delirium. A brief conversation with the family can provide critical information. #Delirium
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Benzodiazepines and delirium in PICU: 2nd analysis of 1,006 children and 10,644 patient-days: "No safe benzodiazepine threshold was identified in critically ill children, with delirium risk increased even at minimal doses" @DrDaleNeedham @SapnaKmd journals.lww.com/ccejournal/…
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"You can't properly assess for delirium when someone already has dementia." Wrong. New meta-analysis (Keane et al. 2026): 4AT shows 88% sensitivity, 79% specificity in dementia populations. 5 studies. 1,304 patients. International data. #delirium #dementia
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🧠 Delirium is the only dedicated delirium journal. πŸ‘100% open access. πŸ‘Ultra-low fees (Euro 20 submission, Euro 280 publication). πŸ‘All study types welcome & rapid 4-week peer review. #delirium #medtwitter
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