Jon Lillie💙
@DrJonLillie
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225
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145
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445
Paediatric Intensivist and “ECMOlogist” 😊 challenging dogma. views my own
London, England
Joined June 2018
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Pinned Tweet
VV
#ECMO
case series, two cannulae accessing neck and returning to the Femoral vein
#VjVf
is possible in infants down to 2.1kg.
Some discussion yesterday at
#EuroELSO2021
paper out today!
#PedsICU
@ELSOOrg
#DestroyDogma
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How has our NHS come to this?
🚑 arrived FIVE hours ago to ED ?❤️
My dad still has NINE other patients in 🚑🚑ahead of him.
He has been looked after by the most fantastic paramedics but they should be out attending to other 999 calls.
THIRTEEN years of underinvestment
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562
Sitting in labour ward with your wife: could there be a more inappropriate book to be reading
@amateuradam
?
Has anyone read
#thisisgoingtohurt
in a worst location?
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270
Single page Clinical guideline out for
#PIMSTS
from
@STRS_Evelina
is here:
Sorry Immunomodulation dosing is only on internal document as we are still refining!
#PedsICU
#COVID19
@WFPICCS
@SCCM
@ESPNIC_Society
@PICSociety
@PICJournalWatch
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85
Venovenous ECMO cannulation using femoral vein is possible down to 2.1kg. Thanks to entire Evelina ECMO team for pushing boundaries! Don’t worry
#PedsICU
we will hopefully publish in a medical journal too! Presenting case series at
#jpccim2019
3
19
77
You cannot fault the staff who are doing their absolute best.
My dad had cardiac bloods and two ECGs but the HOSPITAL is FULL.
It is September.
If we are not coping now what will the winter be like?
@Conservatives
please allow us to fix our NHS.
1
8
76
#NursesStrike
Despite lovely patient,1 of the toughest shifts
#PedsICU
nurses:
-look after the sickest 👶👦
-give the family huge support in THE worst moments
-take a huge toll on their ❤️ 🧠
- are leaving in droves
Pay 👩⚕️👨⚕️more? Why wouldn’t You give them WHATEVER they need?
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7
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Daithi certainly was challenging as a👶 and rumour has it that the purple team was created just for him!
@STRS_Evelina
team effort.
What an amazing 👦 he is now-huge respect to Martin and Seph to have got organ donation law to this point. Good luck from
@EvelinaLondon
@GSTTnhs
No matter what happens over the next few hours, this will be the best photo of the whole trip.
We went back to where it all began in Evelina yesterday and Dáithí got to meet the people who saved his life time, and time again.
To Dr Jon Lillie and the Purple Team, we love you 💗
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Thank you to all for amazing teamwork! Forest PICU becomes
@Evelina
Adult ICU; over to you
@mrbrownsauce
and
@ECMODocNI
, good luck and skill for treating max number of adults!
5
12
59
Happy Easter! Wouldn’t want to be anywhere else than
@EvelinaLondon
@STRS_Evelina
-great team on overnight pulled out all the stops.
#Backstronger
tonight!
1
6
57
New year’s wish: May those opposite
@GSTTnhs
show people the same kindness that
#NHS
shows. Thanks to the wonderful team at
@STRS_Evelina
for dedicated busy
#NHSNYE
that reflects the crazy year.
#PedsICU
4
3
54
Management of fluids in paediatric DKA: concerns over new guidance. Please read article- potentially a two fold increase in fluid has been advised without reference or new evidence cited.
#PedsICU
@PICJournalWatch
.
4
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#pedsICU
and
#ED
intubators- free link to 📖 of >1000 intubations of infants. Weight predicts ETT length for oral and nasal tubes.
🙏
@STRS_Evelina
&
@KingsCollegeLon
med students who looked at ALOT of X-rays!
Retweet to share formula.
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#LockdownLessons
What have you learnt in Lockdown?
For me my biggest lesson is: *Do NOT allow children to cut your hair!*
@finegoulden
told me I should have phoned in sick!
What have you learnt?
@Dr_Hari_Krishna
@MJGriksaitis
@amateuradam
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Please see link to
#ECMO
sim- only 10mins
Me=😬 team= 😇😎🤓
Great sim session and collaboration between
@STRS_Evelina
,
@EvelinaLondon
,
@mirjanaxxx
from
@GreatOrmondSt
and Ajay Desai from
@RBHCharity
for
#EuroELSO2021
#PedsICU
@ELSOOrg
2
20
46
Better than journal club is our
#ECMO
book club! This is absolutely fantastic book which we looked at in
@STRS_Evelina
meeting. Beautifully written and illustrated.
Well done! Ten copies ordered for
@EvelinaLondon
families
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47 through PICU but at the peak we had 18 patients in HDU so took decision to triage through PICU. 31 required inotropes/ pressers so would fit typical ICU criteria.
Perhaps the largest cohort of paediatric
#PIMSTS
in the UK?
47 patients!
Presentation of
@EvelinaLondon
experience by
@DrJonLillie
#EuroELSO2020
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#MISC
#pims_ts
Inflammation causing disease post-COVID remains rare in children but our study shows those living In socioeconomic deprivation and certain ethnic minorities are at increased risk. Respect to
@dr_jonbroad
J Forman
#PedsICU
@STRS_Evelina
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@Conservatives
After 12 hours in a front line ambulance my dad was discharged after excluding cardiac pathology.
You cannot fault the staff. Everything (apart from 🩻!) was done in the ambulance, including bloods/doctor /nurse seeing him- Patient location ambulance 1809.
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Inspiring talk at
#JPCCIM2019
by
@IAmAntBennett
talking about his amazing and positive life after prolonged
#ecmo
course and multiple cardiac arrests.
Thank you Anthony! Let’s say “YES!” more when we think “no”.
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@STRS_Evelina
phone app Paediatric Emergency Tools is now FREE on iOS and android.
Please check it out
Google-
Any feedback welcome
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Amazing way to respond to drug incidents... Rather than send another email saying”prescribe better”, this was amazing week of interaction, quizzes and cake... appeals to our competitive natures and stomachs!
Lessons in
#medication
#patientsafety
during
@STRS_Evelina
#PedsICU
#DrugAwareness
week
@EvelinaLondon
@GSTTnhs
Always easier to swallow when washed down with some delicious (syringe!) cake...
Visit our
#guidelines
page for emergency drug calculators:
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✅ Intro to
#ECMO
course for
@EvelinaLondon
and
@BromptonHeart
#pedsICU
teams. The future is 🌞 for these “ecmologists”!
Candidate Take homes: I feel so positive about ECMO now vs “
#Simulation
is a nightmare”
Guest speaker
@AnnichGail
inspired from 🇨🇦
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When to put someone on
#ECMO
for
#sepsis
?
Survival benefit seen when mortality without ECMO is ~50%
Even if you are able to KNOW when this point is for your patient-many 👩⚕️ 👨⚕️ push conventional treatment harder. What % risk do you cannulate for sepsis?
#EuroELSO2021
#PedsICU
1
12
31
Making complex heart diagnoses in the womb when the heart is the size of a rice grain?
Sometimes we take what our colleagues do for granted!
It is truly remarkable. Great talk
@trisha_vig
@jmsimpsonmd
@STRS_Evelina
@EvelinaLondon
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4
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All but one of our general patients enrolled in
@OxyPicu
due to crazy September with minimal
#PedsICU
beds available in London. Well done to all the team
@STRS_Evelina
for finding a way to keep admitting 👶 🧒
#NHS
nurses need a proper pay rise!
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nasal ETT associated with ⬆️length of ventilation confounded by clinician behaviour which not modelled!
E.g If patient expected to be ventilated a long time ➡️ many clinicians will CHOOSE to switch to nasal from oral ETT.
Hope for prospective study when have some “free” time!
Variation in Early
#PedsICU
mx and duration of
#IMV
in
#Bronchiolitis
:
@PedCritCareMed
@BeckyMitting
@DrSamRay
@KatHolls
@SofiTheDoctor
@DrJonLillie
et al.,
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Sats 88-92% for acute
#PedsICU
admissions- are people changing the alarms on their monitors on Monday?
@STRS_Evelina
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I once, wrongly, argued with
@finegoulden
that
#moraldistress
was a concept only made up by People to write papers rehashing evidence around
#depression
or
#stress
or
#burnout
. This thread shows what moral distress truely is and how it can be helped by compassion.
#NHSheroes
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You have been up all night
#PedsICU
#ECMO
and now you have 8 retrievals to enter into the computer. What do you do?
🥄 +
@lotusbiscoffUK
will get me through the day!
What is your secret on call pick-me-up?
@finegoulden
@DrKanaris
@pic_pram
@DrSamRay
@tomjbrick
@sbattrawden
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#OhCraps
! I will get in trouble with my colleagues who have named it
#pimsts
and
@STRS_Evelina
The unpredictable nature of the cardiac dysfunction In combinatiom with vasoplegia def makes me think Oh Crap!
Excellent naming by
@DrJonLillie
for the Kawasaki-like syndrome seems with SARS-CoV2 in children.
#PedsICU
#COVID19
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This should not be your headline page
@BBCNews
Why is THE headline not that multiple London hospitals have reached their oxygen capacity- that critically ill patients are being desperately shuffled between hospitals? That this is worse than April...
#UKCOVIDCrisis
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#EuroELSO2021
ending and know I still have way too much to learn when
@AnnichGail
puts up a slide like this that says “simplified version”. 🤣🤣🤣
#ecmo
@EuroELSO
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7
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Great talks on monitoring during paed
#ECMO
although whether it’s
#EEG
,
#NIRS
or 🤖 it still seems we can only detect secondary injury and not intervene. Focus should be on early ECMO before primary injury and loss of autoregulation. VV also better than VA.
#EuroELSO2021
#PedsICU
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Can it really be called a “holiday” if you have to pack a washing up bowl?🏕 🏴
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Do you support infants with respiratory failure using VA ECMO?
Please read-it’s Free!
-multisite cannulation is effective way to deliver VV ECMO down to 2.1kg
-Median VIS was 50 pre cannulation (=epi 0.5mcg/kg/min) so ⬆️ inotropes NOT contraindication for VV
@STRS_Evelina
*FREE* feature article!
Multisite Veno-Venous Cannulation for Neonates and Nonambulatory Children
@DrJonLillie
et al 🇬🇧:
Editorial
@GraemeMacLaren
,
@RyanPBarbaro
&
@DrGilesPeek
:
#PedsICU
#ECMO
@SCCM
@WFPICCS
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1
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You know I am never one to disagree...
but as intensivist my new preference is:
#CRISPS
Coronavirus Related Inflammatory Shock Pancarditis Syndrome. We have seen 25 of these CRISPS have and it describes what we see in PICU while
#PIMSTS
is more nebulous...
@DrSamRay
@finegoulden
@SapnaKmd
@DIAMONDS_2020
@lizWWyld
hmmm...lets all say it in chorus. it does get easier.
*P*aediatric *I*nflammatory *M*ultisystem *S*yndrome *T*emporally associated with *S*ARSCoV2. a simple
#PIMSTS
in short
@RCPCHtweets
@bpaiig
@lizWWyld
@PICJournalWatch
@BarneyUoB
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Paper of the year (cos no one reads past abstract of EOLIA)! Adrenaline improves OHCA survival from 2 to 3% BUT the extra survivors can’t walk and need daily assistance: Should we be using multiple doses of adrenaline in picu (cerebral vasoconstriction)?
#PARAMEDIC2
trial: RCT of
#Epinephrine
in
#OutofHospital
#CardiacArrest
(Adults) Interesting results, consistent with what was expected. Do we need similar study in kids?
#PedsICU
#pedsEM
@NEJM
1
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#PedsICU
#WFPICC2018
inspired by
@SapnaKmd
, this is my first tweet at age of 38... what an achievement! (then discover that mark Rogers became a professor at 37!)
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Come work with us
@STRS_Evelina
for 1 year fellowship in 👶 bronchoscopy and
#ECMO
- apply now:
People come for the skills- they stay because of the TEAM!
@PedsICU_tweets
2
8
24
Really interesting review of methylene blue from
@Yale
. Dogma says not to use due to concerns of unpredictable vasoconstriction and concerns of NEC. This review suggests we should maybe think again....
#jpccim2019
@PICJournalWatch
@PICSociety
@STRS_Evelina
@MJGriksaitis
1
6
23
@Dr_Hari_Krishna
@PICJournalWatch
@pic_pram
@pus27
@lyvonnetume
@josephcmanning
@JosLatour1
@RobertCTasker
@rolystrike
@drnazimapathan
@docwt
@jmenzies1
Shane as an Aztec king doesn’t communicate on twitter!
@docmcdevelina
@sarahanna161
@finegoulden
6
4
22
#EuroELSO2021
watched by
@STRS_Evelina
#ECMO
team... enjoying a
@DietCoke
break!!!
Any chance
@CocaCola
of sponsorship!
0
5
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What a week of education at
@evelina
for
@PICStrainees
( and consultants)!
ecmo sim day,
@STRS_Evelina
outreach training in Hastings and now training with
@ChildrensAirAmb
.
@PICJournalWatch
0
8
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A picture is worth a thousand words! You can tell who dragged who up Arthur’s seat!
0
1
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I mean quite simply excess
#fluid
in
#NICU
#PedsICU
or
#ICU
is never good unless it’s at
@STRS_Evelina
#Christmas
party
Fluid overload (FO) is associated with higher rates of mortality and morbidity in
#pediatric
and adult populations. But, is there any association between FO and mortality in critically ill neonates? 🧐📚
Let's check it out👇
#NICU
0
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1
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😊Proud of this paper, most of all for collaboration of three London
#PedICU
showing shorter LOV in centre that used Nasal
#ETT
and no midaz. Too many differences to demonstrate which factors had greatest impact- roll on RCT!
Delighted to see our collaborative work published...phenomenal leadership from the wonderful
@BeckyMitting
. Invasive Mechanical Ventilation for Acute Viral... : Pediatric Critical Care Medicine
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4
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Downstairs in
@STRS_Evelina
PICU we are ALL migrants from 🇿🇦 🇿🇼 🇰🇪 🇪🇸 🇵🇹 🇷🇴 🇧🇪 🇮🇪 🇮🇹 🇬🇷 🇱🇰 🇮🇳 🇦🇺 🇳🇿 🇯🇲 🇸🇮 and those “from” 🏴 🏴 and 🏴 are keen to migrate if Brexit happens!
#brexitNHSRIP
@amateuradam
Completely true!
Say this as an immigrant 🇳🇿 that runs a paediatric cardiology service dependent on colleagues from
🇮🇳 🇵🇰 🇲🇾 🇱🇻 🇹🇷 🇮🇹 🇮🇹 🇬🇷 🇬🇷 🇦🇺 🇮🇷 as well as 🏴 🏴 🏴
Diversity is our strength
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0
4
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Fantastic format
#EuroELSO2020
@STRS_Evelina
#ECMO
team able to watch speakers of highest quality for free! Major advantage of these webinars for
#PedsICU
47 through PICU but at the peak we had 18 patients in HDU so took decision to triage through PICU. 31 required inotropes/ pressers so would fit typical ICU criteria.
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1
6
19
Blood is not red? 💙
Don’t oscillate 🔇
Protect those lungs 🫁
ECMO’s your mate! 😰➡️🌪🪢🥰
#ECMO
#PedsICU
@SapnaKmd
@MJGriksaitis
@manalalasnag
@RobertCTasker
@finegoulden
@Martin_Kneyber
@mrbrownsauce
@geraintjl
Roses are red
You can improve the prognosis
Don’t give “normal” saline
In metabolic acidosis
#PedsICU
#medicalvalentines
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2
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Lancet paper gives all the data and Miriam’s article beautifully portrays how it was to be at
@EvelinaLondon
in the eye of the
#PIMSTS
⛈
Important collaboration published
@LancetChildAdol
:
#COVID19
associated
#PIMSTS
#MISC
in UK
#PedsICU
@PICJournalWatch
@pic_pram
@BarneyUoB
@DrJonLillie
@lizWWyld
Read account
@ADC_BMJ
from 1st unit to report cases
@STRS_Evelina
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0
7
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@StarredBastard
@AngryCardio
@discokitten
@TheLancet
@STRS_Evelina
We tested stool, throat and BAL: PCRs were negative, IgG and IgM were positive hence the article saying this is hyperinflammation POST infection
1
1
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#WFPICCS18
#PedsICU
fantastic presentation by Andrew Nyman of
@EvelinaLondon
approach to stenting airway in cardiac disease.
1
13
20
Great work by our
@STRS_Evelina
ECMO team. Higher heparin dosing required to maintain adequate Anti-Xa for
#MIS
-C patients
@AlisonPienaar
@MMustafaFRCS
Thrombophilia in pediatric patients with MIS-C secondary to
#COVID19
on
#ECMO
: markedly higher fibrinogen levels vs non-MISC ECMO patients, and high incidence of thrombotic events despite elevated heparin dosage in this case report.
#FOAMecmo
@asaiojournal
0
8
20
1
5
19
#ELSO2021
wonderful talk by
@AnnichGail
demonstrating that survival of children on prolonged respiratory
#ECMO
is not as bad as people suggest. 35% at 7 weeks (patient selection clearly confounder)
#PedsICU
1
6
18
Are you interested in 👶 VV
#ECMO
and learning 👶
#bronchoscopy
?
@EvelinaLondon
ECMO/ airway fellowship from March 2023.
Application Closing date 14th of July
#PedsICU
@STRS_Evelina
0
10
20
Next step neonatal percutaneous cannulation delivered by
#PedsICU
clinicians. Amazing day
@OspedaleGaslini
with Andrea Moscatelli
What (really) is
#ECMO
& when should you consider it in neonates/children?
Technical basics-VA/VV-Indications-Complications-Outcomes-Follow-up
@DrJonLillie
@ArchivesEandP
@ADC_BMJ
#PedsICU
#PedsCICU
#NICU
#Paediatrics
#PedEM
@EuroELSO
@PaediatricFOAM
0
8
17
3
4
18
If you insist
@Dr_Hari_Krishna
I named it
#OH_CRAPS
Hyperinflammatory COVID Related: Abdomen_Pancarditis_Shock
I am not clever enough to understand immunology so just repeated what I said every 3 hours of my on call with each new admission! Bet
@PedCritCareMed
will go for
#PCHIS
1
1
18
Thought provoking talk by Tim Jones
@Bham_Childrens
proposing that it is better to take down Acutely failing
#Glenn
(on left) or
#Fontan
(right) rather than
#ECMO
.
@EuroELSO
#PedsICU
#EuroELSO2021
⚠️atrial septal obstruction can be acquired and missed during Fontan
0
10
18
Amazing PICU team about to swim the English channel/ La manche
Team A are all set to swim at midnight tonight! They will be heading down to Dover this evening to meet the pilot. Wind has settled and the sea is looking calm 🤞🏻 T-12 hours!!
#Channelswim
#NHS
#fundraiser
#PedsICU
#charity
#swim
4
6
22
1
3
17
Do’h! The most important photo forgotten!
✅ Intro to
#ECMO
course for
@EvelinaLondon
and
@BromptonHeart
#pedsICU
teams. The future is 🌞 for these “ecmologists”!
Candidate Take homes: I feel so positive about ECMO now vs “
#Simulation
is a nightmare”
Guest speaker
@AnnichGail
inspired from 🇨🇦
1
3
32
0
2
15
Let’s face on the ground facts! It’s mid-September and we have swathes of nurses off due to
#TrackandTrace
or a fever in their child and they are unable to get tested. The winter will be a
#NHSDisaster
unless you sort this.
We're doing more
#coronavirus
testing per head than other European countries, & we have record capacity.
825
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All posts filled until spring 2024- apply now if you would like to work in lovely fun supportive team.
Disclosure: we don’t hug and eat cake every day
We're recruiting for a Senior Clinical Fellow
#PedsICU
#PedsCICU
@EvelinaLondon
@GSTTnhs
#PedsAnes
#Anesthesia
🗓️Feb/March 2024
🛏️23 beds
🏥1,200 admissions/yr
🫀 🫁 cardiac & general
🚑integrated retrieval service
📚teaching/learning
Deadline: 9th July
0
7
9
3
1
16
Believe me it was great to see the mall cleared for my great great morning run this morning. Thanks to the incredible Men and women of the
@metpoliceuk
I got a record time of 28 minutes for 5k which no one has ever done before.
#TrumpVisitUK
0
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I really empathise with you in
#PED
for trying to pick out
#PIMSTS
#MISC
! In
#PedsICU
we have the benefit of time/bloods/MDT and we still find it hard. April-we didn’t recognise it but now we are (?over)-investigating a lot of febrile but well children.
@STRS_Evelina
As someone who has (happily) been on maternity leave during all of COVID, this is something I envisage is one of the trickiest things to navigate
How do we avoid over calling PIMS-TS without missing other pathologies?
@DrJonLillie
@LondonPaeds
2
1
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0
2
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Thank you to
@ELSOOrg
for letting us propose an alternative approach to VAECMO for neonatal resp failure with
#VVMS
#ECMO
@STRS_Evelina
@VanessaStanley7
@PedsICU_tweets
References all hyperlinked in newsletter
1
5
16
Great work by
#ECMO
team
@GSTTnhs
. All
#COVID
ECMO patients had CT: 1/3rd PE but additional 1/4 had ischaemia without thrombus-
#immunethrombosis
in microvasculature? Non-COVID controls would be good
@PICJournalWatch
#PedsICU
0
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@picucat
@DrSamRay
The paramedics are sadly use to this-borrowing a softer mattress from somewhere!
Apparently, it is not uncommon for the paramedic dayshift to handover to the nightshift and they come back the next day to the same patient…
If this carries on we will lose these paramedics to 🇦🇺
2
1
14
Baby Cloruro! Our first neonate percutaneously cannulated- Teaching by Moscatelli
@OspedaleGaslini
Collaboration:
@EvelinaLondon
@STRS_Evelina
@RBHCharity
and
@semmelweishu
@PedsICU_tweets
Next step neonatal percutaneous cannulation delivered by
#PedsICU
clinicians. Amazing day
@OspedaleGaslini
with Andrea Moscatelli
3
4
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2
1
15
Come for the London Life*🎡⛲️🌃
Stay for the love of
#PedsICU
in a lovely team!
*Disclaimer. London life applies to the great fun after work before getting on train back to non-London postcode. No one other than oligarchs and MPs in their 2nd homes can afford to live here.
New Level 2 Paediatric Critical Care Unit opening this summer
@EvelinaLondon
!
Interested in hearing more about working as a
#nurse
on
#HDU
& links with
#PedsICU
?
Drop in to Sky PCCU Nursing Open Day
Wednesday 20th July 09.00 - 16.00
More info 💻Helen.Reynolds1
@gstt
.nhs.uk
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Draining via the neck/returning via the femoral is practical as majority of venous return is via SVC in infants (4/5th in 👶) and femoral vein too small to accommodate larger access cannula.
@STRS_Evelina
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9,000+ users in 65 countries can’t be wrong! Newly rebranded as
#paediatric_emergency_tools
App for Apple and android! All Guidelines will automatically upload.
Feedback welcomed!
Have you downloaded the newly updated
@STRS_Evelina
#app
yet?
Have access to
#drug
#calculators
&
#clinicalguidelines
for
#paediatric
#PedsICU
#PedsAnes
#PedsED
#emergency
management in the palm of your hand - all for the price of a(n expensive
#London
!) coffee...
#STPN19
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Never thought I would block you
@fionam_miles
- today may be the day! No temptation: very happy at
@STRS_Evelina
in well-resourced NHS, earning mega💷💷, with work life balance, AND can get a nice NZ🍷from
@Tesco
so no need to reminisce about lazy days at
@MudbrickVineyrd
...
Fantastic and rare opportunity- Picu consultant posts at Starship hospital NZ. link below. Please share. Or apply!
@DrJonLillie
@drzaf_pic
@Matt_Marvey
@jvc2006
@neilspenceley
@davidjvaughan
@HorsleyCarl
@psirides
@brierl_jb
@Peterlaussen1
@PeterCox
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Great
#PedsICU
by
@PicPod_Podcast
on
#EIT
.
Potential for using for 👶 now and gives information that helps decision making Re:
#PEEP
optimisation.
@PCCStrainees
study day at
@STRS_Evelina
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@docmcdevelina
@EvelinaLondon
Rocking the circuit change on Evelina ECMO sim day. Paeds ECMo fellowship starting this year! Evelina ECMO growing!
@finegoulden
@MJGriksaitis
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💙We are telling the truth. 💙 Please listen. We are not in cahoots with
@BorisJohnson
, we get no money from drug companies (unfortunately), It’s not in our interests to home school our kids (or our livers’) but
#COVIDCrisis
is real.
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Thanks for editorial
@RobertCTasker
and for highlighting that the huge majority of patients from the
#FLUID
trial by
#PECARN
were awake at presentation and less sick than the ones we have aimed
@STRS_Evelina
guidance at and who we worry about in
#PedsICU
It’s is an excellent follow up from
@DrJonLillie
@docmcdevelina
@finegoulden
and
@arannicq
‘s initial article citing concerns about the new BSPED DKA fluid management guidelines . Definitely worth a read (and thank you
@RobertCTasker
)
#pedsicu
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@SapnaKmd
No medical documentary will ever beat
#ER
for giving inspiration. Fantastic talk by
@babyheartsurger
with some help from Dr Peter Benton on cannulation! Having fab time on
@EvelinaLondon
#ECMO_course
With
@finegoulden
@sarahanna161
@arannicq
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Hurray! Honour to speak to such a wide-reaching community!
I’m sold on VV multi-site Cannulation for neonates.
Following
@DrJonLillie
talk “Cannulation strategies versus pre-ECLS haemodynamics - the therapy or the disease that impact neurological complications? (is the cannulation)”
#EuroELSO2023
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Great work to the editors for keeping us all in check... Format looks really good with bite size chapters dispelling some
#PedsICU
myths
Countdown to publication of our
@OUPAcademic
#PedsICU
book in the
#ChallengingConcepts
series.
3 weeks to go!
Available from 5 November:
Co-edited with
@aakashdeeparora
@finegoulden
(& Sai: not on twitter)
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#EuroELSO2022
Great collaboration-simulation of hypoxia on neonatal VV
#ECMO
.
@GOSHCharity
@EvelinaLondon
and
@MalaikaMendonca
#EduCorer
6th May 0900-1000 CRRT, 1030-1130 CDH, 1145-1245 transport, 1400-1500 Recirculation in VV ECMO, 1515-1615 Neurological nightmares, easy way into the complex cases☀️
@ECMOdaily
@AparnaHoskote
@FOAMecmo
@Mat_DiNardo
@HeidiDalton26
@DrJonLillie
@MalaikaMendonca
@marisavie
🌞
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Obviously everyone excited about another neonatal VVDL
#ECMO
cannula coming to market (MC3 crescent) but Our
@STRS_Evelina
experience is that multi site cannulation is stable and effective (once you convince surgeon to site femoral cannula)
@Speggio
(1): It was superb listening to
@DrJonLillie
himself advocating for VV-ecmo for paediatric/neonatal respiratory failure! Loved his disclosure sharing his belief and comparing 8Fr experience versus a cut-up of a dual lumen cannula!
#ELSO2021
#PediECMO
#PedsICU
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😞This is disappointing review of this paper by
@DFTBubbles
. This paper does not “reassuringly show…the risk of cerebral injury during
#DKA
treatment is not increased by declining sodium concentrations”! Let me explain why this isn’t the “Bottom Line”
@pedsicu
What's the link between salt and cerebral injury in DKA? Rhiannon McBay tells us in her
@DFTBubbles
review of the latest paper from the
@PECARNteam
FLUID trial
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#STRSConf18
astounding data showing LTV expansion at Evelina. Amazing Nurse specialists and team to manage this.... how can we manage this going forward?!
@finegoulden
@docmcdevelina
@DrSamRay
@STRS_Evelina
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Clever+++ RCT by
@KathMaitland
#COAST
underpowered as stopped early+mortality ⬇️
Take home on 1st read:
Children with pneumonia+median sats 88% (IQR 86-90) randomised to permissive hypoxaemia (sats >80% 😳) did just as well those given ⬇️or ⬆️ flow oxygen
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Concerns about dual lumen cannulae now magnified as Origen no longer manufacturing. VV Multisite cannualtion possible in neonates, access neck return via femoral. Submitting our first 10 cases with 1 year follow up ASAP
@PICJournalWatch
@STRS_Evelina
#Neonates
with
#respiratory
failure supported by VV
#ECMO
has declined from 58% to 16% in the 🇬🇧: Why?
Read and find out!
@DrJonLillie
et al:
@SCCM
@ESPNIC_Society
@WFPICCS
@PICSociety
#PedsICU
#NICU
#neoEBM
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Respect to Luergn! 🚙
This is the most interested I have been in a car chat since the 1990s!
@EuroELSO
#EuroELSO2021
When to put someone on
#ECMO
for
#sepsis
?
Survival benefit seen when mortality without ECMO is ~50%
Even if you are able to KNOW when this point is for your patient-many 👩⚕️ 👨⚕️ push conventional treatment harder. What % risk do you cannulate for sepsis?
#EuroELSO2021
#PedsICU
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@FOAMecmo
@EuroELSO
@asaiojournal
@MarkGlasgowPICU
@iceman_ex
@jez_tong
@Pipes_n_pumps
@jan_belohlavek
@mirjanaxxx
@jrdelbrio
@ECMOprincess
Hi fidelity sim hopefully will keep your interest! Certainly caused us some stress! Please attend paeds stream EUROELSO on Wednesday
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👇 best talk have heard on incivility: really made me think and how it creeps into our own practice.
Thank you
@deetssleeps
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#WFPICCS18
#PedsICU
Great HFNC summary slide re flow rates from Peter rimensberger. Jury is still out. Probably better than low flow but does not reduce LOS-USE CPAP if significant resp failure
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What a difference two months makes...
the same board in January reflecting all the incredible Paediatric nurses on a shift providing care to adult ICU patients
#PedsICU
#NHS
The indomitable
@STRS_Evelina
#PedsICU
spirit
Our most popular
#wellbeing
initiative yet...
#PubCountdown
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Amazing work
@DrSamRay
! Destroying dogma decade of paeds/ PICU ahead! Exciting.
Fantastic work
@DrSamRay
showing non-linear relationship between temperature & heart rate on
#PedsICU
: HR ⬆️ by ~10bpm for each degree C to 38C, then 20bpm to 39C then only ~15bpm beyond - Adaptive? Compensatory? How much incr in CO? More qus than answers!
#physiology
#ESPNIC19
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This is real. On call this week. It’s worse than the first time.
Read this:
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He really is an inspiration. Hundreds of schools/ football clubs/ individuals now working together to provide free meals through the school holidays.
@Christi35895049
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@EvelinaLondon
team will focus on
#PIMSTS
#MISC
in our cohort of 70+ children: wisdom and overview from ID team, images with impact from cardiology and I will have to resort to think of something funny to say 😬
#PedsICU
#COVID19
We have a paediatrics themed
#GlobalVirtualGrandRounds
tomorrow at 6pm!
@DrJonLillie
@owenimiller
Dr Julia Kenny & Dr Jennifer Handforth will explore "Covid in Children"
#CovidMedEd
#MedTwitter
Sign up FREE:
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#STRSConf18
great presentation by
@KAM4LPatel
from
@BSUH_NHS
@Rockinghorse67
study shows only 1 child readmitted out of 200 children admitted with bronchiolitis who required cpap or HFNC. Perhaps we can now look at how we can reduce LOS further!
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