Mosa AlShabeeb
@Mosapositive
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Following
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Board Certified Adult Critical Care, KKUH, KSA
Riyadh | Qatif, KSA
Joined December 2013
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Pinned Tweet
A collection of my medical tweets for easier catch.
#هطرقة_طبية
#ICU
#criticalcare
#medtwitter
#twittorial
#MedStudentTwitter
#surgerytwitter
#ventilator
#how_to_become_intinsivist_within_10minutes
#ksumc_icu
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Keep your eyes on Vent. waveform, you might need to change the tube despite theraputic anticoagulation.
Commonly seen in
#COVID19
patients.
#CriticalCare
#Ventilators
#ICU
25
102
233
How to choose your optimal PEEP?
Have a seat, bring your coffee and let’s move on.
N.B: this is not a reference, it is just flashes to what you need to know
#MedTwitter
#CriticalCare
#ventilators
#ICU
#COVID19
#respiratory_therapy
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الحمد لله
الشكر موصول لجميع الأساتذة و الزملاء لثقتهم
أنا أقل الموجودين علما و عملا
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No matter how many times you study it, you need to cheat for 3 a.m consultation 👀.
Done upon suggestion from guidance
@_Abdalrhman
💕
#ICU
#CriticalCare
#MedTwitter
#twittorial
#FOAMed
#medstudenttwitter
#onepager
#foamcc
#respiratory_therapy
#ventilators
1
9
50
For your own peace; perfectionism is non-achievable target. It might be a disorder.
Just calm down and take it easy.
0
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#ARDS
loves high PEEP.
Maybe sometimes"we"love high PEEP😅
A live show of high Vs low PEEP in stiff lung
worsening compliance (see cdyn) worsening Pplatue, worsening driving pressure with no benefit on oxygenation.
#ICU
#CriticalCare
#MedTwitter
#COVID19
#ventilators
2
6
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You know thousands of equations to correct
#hypernatremia
But for lab result just decide to disturb you at 2:30 a.m you need to cheat👀
Done with guidance from
@_Abdalrhman
💕
#ICU
#CriticalCare
#MedTwitter
#twittorial
#FOAMed
#medstudenttwitter
#onepager
#foamcc
#surgerytwitter
1
6
25
#ARDS
. Approach the
#ICU
monster with an organized thought.
#MedTwitter
#CriticalCare
#ventilators
#twittorial
#respiratory_therapy
#COVID
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4
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#hypoxia
is headache inducing topic. Being
#onepager
will make it easy to cheat 👀
Suggested from guidance
@_Abdalrhman
💕
#how_to_become_intinsivist_within_10minutes
#ICU
#CriticalCare
#MedTwitter
#twittorial
#FOAMed
#medstudenttwitter
#foamcc
#respiratory_therapy
#ventilators
0
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تأثير الحزن الشديد عضويا على القلب
و لعله التعبير المجازي المعروف
" قطعت نياط قلبي"💔
و إن كانت العبارة لا تشرح الخلل التشريحي، لكن المعنى واحد
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IV fluid, quick hits you need to keep in mind.
#ICU
#CriticalCare
#MedTwitter
#medstudenttwitter
#surgerytwitter
#twittorial
2
6
21
How to control all medical teams anxiety.
Approved by evidence 😉 👌🏻
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الناس اللي من جد الله لا يحوجك لها 😁
#how_to_become_intinsivist_within_10minutes
#survivor2020
@Tarouty1
@Hussainameer250
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A while ago I was just like a biological weapon 🦠
Now my plasma became more precious than oil barrel 😂😂😂
عموما أفكر أفتح مشروع للي حاب يستثمر
#COVID__19
#survivor2020
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#ECMO
is one of the most advanced life support strategies.
Don't be scared it is really friendly and there we are
#ICU
#CriticalCare
#MedTwitter
#twittorial
#FOAMed
#how_to_become_intinsivist_within_10minutes
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The time you think you are the senior is the time you tear up the team.
It is a team work all the time.
#ICU
#CriticalCare
#respiratory_therapy
#nurse
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If an ARDS patient is still hypoxic, consider proning.
But why in the world sleeping on the belly will improve gas exchange 🤔? Here we are.
#ICU
#CriticalCare
#MedTwitter
#COVID19
#ventilators
#medicine
#respiratory_therapy
#twittorial
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@ArgaizR
Other than the small IVC;
- Pulse pressure variation can be seen in the arterial waveform
- The LV walls were almost collapsing "kissing".
- At the end of the day he improved with antibiotc AND fluid (which is in this case a colloid fluid i.e PRBC)
By all means it nice. Thx👍🏻
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Pt is agitated
Usual approach give sedation
Suggested approach give humanity 🥰.
Hand writing from pt after having nice chat with. Intubated, with open abdomen and multiple trauma.
📝 Allah bless your parents, it is simple
#ICU
#CriticalCare
#MedTwitter
#medstudenttwitter
#FOAMed
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Never lose someone who cares about you
It is so hard to find a truly caring person
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Short
#ICU_story
.
(1/9)
Was called to re-assess the UTI/septic shock pt who was managed with Abx and fluid then was started on norepinephrine/ vasopressin.
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Patient is tachycardic, gasping.
Please,
DO NOT resume sedation.
DO NOT go back to full control.
It is an ineffective trigger due auto-PEEP (one of the most common asynchrone).
Solve it, continue weaning and extubate.
#MedTwitter
#CriticalCare
#ventilators
#ICU
#COVID19
#كورونا
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فجأة صارو كلهم يحبو عمي/خالي موسى 🥴
الكائنات الشريرة 🤍
الكورونا كان حكيم لما اختار يصير mainly adult disease
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@DGlaucomflecken
An extra important step is to give IV fluid bolous, and after a while to give diuretic. This is one of our favorite.
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و في مبسمك البهي آية، بيضاء من غير سوء 🤍
أطال الله في عمرك
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متلازمة من كثر الأشياء اللي لازم أسويها،،
ما راح أسوي شي ☺️
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Stiff lung story.
A story of complications of complicated complex lung.
An air coming in but no gas exchange 🤔
#CriticalCare
#Ventilators
#ICU
#coronavirus
#MedTwitter
#Covid_19
#medstudenttwitter
#twittorial
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شعار المرحلة
Feel no shame to say I don't know.
بالعربي لا تقدح من راسك يا طايح الصبغة 👽
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For those who are interested to know how to figure it out. It is by evaluation of the over all clinical picture but to simplify it:
1- disproportionate increase in peak airway pressure with accepted platue pressure (that's will give you a hint about increase airway resistance..
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Do not start all unstable patient on norepinephrine.
He might benefit from
#echofirst
#pocus
#foamed
#ICU
#criticalcare
#medstudenttwitter
#MedTwitter
#tweetorial
#how_to_become_intinsivist_within_10minutes
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المعنى الحرفي لـ "الدنيا لا تزال بخير" 😍😋
#القطيف
#استوى_اللوز
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Sepsis starts with pneumonia, ends with multi oranges failure.
If you want to imagine that in real life;
ودي سيارتك الورشة 💔☠️
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بذكرك تشرق الكلمات
و يحلو القال و القيلُ
أيـا مستـودع الآيات
زهت فيـــك التراتيلُ
و ما بعـــلاك أبـياتي؟
و دون علاك جــبريلُ!
#رسول_الله
#رسول_السلام
#رسول_الرحمة
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#COVID
ー19 is a good lesson to till how weak we are, how
#Science
is far away behind.
One of the best to teach that the single way is to kneel on the ground and ask Allah for help and
#salvation
.
#كورونا
#survivor2020
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كان اللقاء بها مجرد قهوة
و الحب قد يأتي مع الفنجان
روضت قلبي في حضانة حكمة
ألقى بها بوذا على الرهبان
@sihayijm
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Trust Allah and keep fighting from wherever
- As a health care worker
- As a patient
- or even from your home
#StayHome
#خليك_بالبيت
All at the page and will pass it insha'Allah
D3 of hospitalization, doing good Alhamdulelah 🤲🏻
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Me covering COVID unit after just recovered from COVID.
#فضفضة_طبيب
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Special thanks to dream team who were patient listening my crazy ideas
@mohbedo
@_Abdalrhman
@BaderAZS
#ICU
#CriticalCare
#MedTwitter
#twittorial
#FOAMed
#medstudenttwitter
#foamcc
#how_to_become_intinsivist_within_10minutes
#EmergencyMedicine
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Be careful about your
#heparin
, it might
#HIT
it too hard.
Heparin induced thrombocytopenia what, why, and what to do?
#ICU
#CriticalCare
#MedTwitter
#twittorial
#medstudenttwitter
#surgerytwitter
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كيف تعبر عن مناوبتك في صورة😅
#how_to_become_intinsivist_within_10minutes
Part of discussion with the consultant oncall
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قالت مريضيَ قد أطاح بضغطه
هاتيك عيني دونكvasopressor
قالت أراه محركا متحركا
قلتpropfol تأخر في الأثر
قالت فلِم؟ قلت اسألي وجناتك
عيناك لا يقوى احـتمالهما بشر
فأنا الطبيب تقلصت رئتاي لا
أقوى التنفس دونماspirometer
من كتاب كيف تفاجئ الـconsultant وتصير intensivist خلال ١٠ دقائق😃
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و فجأة و من غير مناسبة
ماما تقولي شغلك منور زي وجهك يا ولدي
🤣🤣🤣
المهم،، السنة و كل سنة
#ناصفة_شعبان #قرقيعان #القطيف
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CPAP/PS is one of the best to get rid of pt ventilator asynchrone.
But still it is not perfect.
Some small changes might help to make your pt extubatable.
#MedTwitter
#CriticalCare
#ventilators
#ICU
#COVID19
5
3
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Hate is too much to be handled. Just spread love and peace 🤍✨
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PEEP to stress index =1
The same concept of inflection point where you ventilate the patient in the area with best recruitment and best compliance.
Here you determine it by pressure to time wave form in volume control mood.
Adjust the PEEP to get the strait pressure line.
1
1
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A nice, to the point review of patient-ventilator asynchrone and waveform analysis.
#MedTwitter
#CriticalCare
#ventilators
#respiratory_therapy
0
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اللَّهُمَّ أدِّ عَنّا حَقَّ ما مَضى مِن شَهرِ رَمَضانَ وَاغفِر لَنا تَقصيرَنا فيهِ، وَتَسَلَّمهُ مِنّا مَقبولاً، وَلا تُؤاخِذنا بِإسرافِنا عَلى أنفُسِنا، وَاجعَلنا مِنَ المَرحومينَ وَلا تَجعَلنا مِنَ المَحرومينَ
0
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أتيت و في نزف المشاعر خاطري
( موسى)، ذبحت إليك ( عجل السامري)
(أخرجتها من جيب قلبي آية)
(بيضاء) تبهر بالمسرة ناظري
أفدي خطاك، إن يكن لي لائم
ما كنت أسأل عن فداكِ عاذري
0
1
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😃 إيش سويت في الإجازة
🙃 كنت مناوب
🤨 يعني؟؟
👽 يعني كنت أصوم زي المسلمين،، و أداوم زي الكفار
3
3
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@Research_Easy
أقرأ أول ساعات الصباح مع شروق الشمس 🌥،، نظام pomodoro في الفواصل البسيطة(٢٥/٥ مثلا) ،، ما أرد على الرسايل/ المكالمات إلا في الاستراحة الطويلة أو بعد ما أخلص
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♥️"و هل الدين إلا الحب" ♥️
🌼"الدين هو الحب، و الحب هو الدين"🌼
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It never gets easier, it's just you become stronger.
From:
How to console yourself if get the second hit, while not yet recovered from the first one.
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PEEP to minimal dead space.
This achieved by adjusting the PEEP to level which gives you the minimal PaCO2-EtCO2 (end tidal CO2)
1
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PEEP/ FiO2
This one can be fiund in table which has been suggested by ARMA trial
2 tables are available, lower PEEP and higher PEEP
1
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Optimal PEEP is the one gives you:
- Best Saturation
- Minimal End expiratory atelectasis
- Minimal End inspiratory overdistension
Please, never put a high PEEP and leave, check the Pplatue (avoid barotrauma) and double check the hemodynamic (significant preload reduction)
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PEEP slightly above the lower inflection point
The lower inflection point is where the alveoli start to open (theoretically keeping PEEP above will prevent atelectasis)
It can be determined (which is not an easy task) by Volume to pressure curve
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A massage from my consultant after spending the whole night with patient mortality up to 90% ❤️
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"كن لما لا ترجو أرجى منك لما ترجو فإنّ موسى بن عمران عليهالسلام خرج يقتبس لأهله ناراً فكلّمه الله عزَّوجلّ فرجع نبياً"
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When you're broken, open up your heart and feel
There's no difference we're all family here 🤍 ✨
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هو: دكتور أنت اللي مغطي الوحدة
أنا: إي نعم
هو: اسمك بالخير؟
أنا: موسى
هو: أوه، أنت موسى positive، الحمد لله على السلامة
أنا: 🙂
هذ آخرتها وياك يالكورونا 🤣
بس عموما الاسم يجيب التفاؤل ♥️✌🏻
#فيروس_كورونا
#فضفضة_طبيب
#بس_اقول
#justsaying
#motivationalquote
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PEEP to best compliance.
Adjust the PEEP and calculate the static lung compliance. The better the compliance the better the PEEP
Compliance is calculated by dividing tidal volume/ driving pressure
1
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5
.. while the lung mechanic is fine)
2- a reduction in the volume at the same time.
3- you might find an abnormal flow wave form just like if the patient is trying to suck more air.
4- a suction catheter that is not passing smoothly through the ETT
1
1
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Be suspicious about your pt condition.
Complications might happen even if procedure was done smoothly and by the Most Expert.
Such an X-ray was found after just a "tube exchange".
#Covid_19
#MedTwitter
#ICU
#CriticalCare
2
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واصل بإصرار..
الآنسة منشن لما أصرت وصلت من قناة عجمان إلى نتفلكس 😁
#بس_اقول
4
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1: Strong recommendation, level A of evidence
2: Should be considered, level B of evidence
3:Strong recommendations, level A of evidence
4:Strong recommendation, level A of evidence
#novels
#goodreads
#رواية
1
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صاحبك اللي تشد الظهر فيه..
اللي إذا عطاك قلم وقت المناوبة، قالك خليه عندك
#فضفضة_طبيب
#بس_اقول
#justsaying
3
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The most common mistake about
#ultrasound
is not to use it
#pocus
#CriticalCare
#how_to_become_intinsivist_within_10minutes
0
0
5
PEEP post recruitment.
After doing a recruitment maneuver, gradually decrease your PEEP till SpO2% drop by more than 2%. Go back, this is your desired PEEP
PHARLAP trial is good to be mentioned here.
1
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POCUS when old is not gold Part IlI
23rd of March 2022
speaker: Dr.Musa AlShabeeb, MD
moderated by: Dr.Bader AlShehri, CCM/POCUS Consultant & Dr. Khaled Maghrabi, ACCM-Consultant.
23rd March 2022.
08:00 P.M
ZOOM :
MeetinID 845 5447 4014
Pass: 738935
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5- some clot particles could be there with the suction
6- unexplained increase FiO2 requirement will the general condition is improving +/- non worsening X-ray infiltrate
1
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When the consultant ask me about equation I don't know even the name,, but still want to discuss
#فضفضة_طبيب
4
1
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The abnormality here is premature cycling so the ventilator ends the inspiratory phase before the patient finished.
Correcting that by increasing the inspiratory time(which is in support mood by adjusting the expiratory sensitivity)
#MedTwitter
#CriticalCare
#ventilators
#ICU
CPAP/PS is one of the best to get rid of pt ventilator asynchrone.
But still it is not perfect.
Some small changes might help to make your pt extubatable.
#MedTwitter
#CriticalCare
#ventilators
#ICU
#COVID19
5
3
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1
1
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God gives His hardest battles to His strongest soldiers.
من كتاب كيف تواسي نفسك بعد ما تعض الأرض في أونكول أمس 😃💔
#فضفضة_طبيب
#motivationalquote
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لما تصحى من النوم يوم post-call الساعة 10 المغرب،
تحاول تتذكر أنت مين
وتبدي تتعرف على نواميس الطبيعة و أسرار الكون
#فضفضة_طبيب
#survivor2020
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@CKsumc
@AlabdulghaniH
دكتور حسن لم يكن زميل عمل
بل كان أخا و معلما و قدوة يحتذى به
أسأل الله عز وجل له التوفيق و النجاح حيثما حل
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