Adam Boulton
@AdamBoulton17
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#NIHR Doctoral Research Fellow with @EPPiC_Warwick Undertaking a PhD in resuscitation. Anaesthetics and intensive care registrar. @TRICNetwork committee.
West Midlands, England
Joined August 2016
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Absolutely delighted to have been awarded an
#NIHR
Doctoral Fellowship! Can't wait to get started in the summer with
@EPPiC_Warwick
@WarwickCTU
@yeung_joyce
@j_p_albuquerque
@perkins_gd
#OHCA
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Anyone else think this is poor taste? I genuinely find critical illness physiology fascinating and caring for very sick patients can be hugely rewarding. But behind every one of these numbers is someone having their worst day. Surely this isn't to be celebrated like some game?
Seen in our ICU! Cannot love it more! Please retweet!
#gitwitter
#surgery
#icu
#meded
#medical
#medschool
#pulmonary
#critcare
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FFICM done ✅ 🎉
Very happy to see the back of postgraduate medical exams!
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@Medic_Russell
100%. And often when we do this I think we're partly seeking empathy/support/reassurance. Not contributing to a morbid public leaderboard
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@lozzlemcfozzle
Thanks for offering an alternative point of view. I would hope it's not in a patient-facing area. Regardless, feels an odd thing to celebrate and describe these people (dead or alive) as hall of famers
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Very excited to get going on my Doctoral Research Fellowship. Complete with OHCAO registry mug
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Nice to hear that our systematic review of prehospital haemostatics is on the reading list for the
@FPHCEd
Diploma in Mountain Medicine.
#DiMM
#prehospitalresearch
@davidnnaumann
@MidwinterMJ
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Lovely to see!
WITH PERMISSION. This is Peter. He’s been with us with
#COVID__19
for 53 days, and was just getting his daily dose of vitamin D, on oxygen via a tracheostomy and with support of our brill nurses. He is well on his way to recovery and home!
#intensivecare
#SocialDistancing
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I did an intercalated clinical sciences BSc at Bham. Was my fav year of medschool! In hindsight, was probably when I first realised I had a passion for research and started looking at clinical-academic training
I suspect disincentivising these programmes will have consequences
After all the news about need for clinical academics, even more depressing news today (
@charlot_summers
)
- Only 7 people applied to do an intercalated BSc after it was taken out of FP scoring
- The below is for surgical SpRs locally for their research comps
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Very powerful story from Paul this morning on
#R4Today
highlighting how prompt CPR and a high quality chain of survival saves lives!
Paul had a cardiac arrest at Stamford Bridge whilst watching Chelsea vs Man City and had CPR for 17 mins
@BBCr4today
@ResusCouncilUK
@ChelseaFC
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Do we really understand the perioperative risk of major surgery in the UK? We have record numbers waiting for surgery and record rates of multi-morbidity. This is important!
@rmoonesinghe
#nihramc23
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@ccpractitioner
Recent ICS guideline on this with decision flowchart. Essentially, if device is manufactured approved for high pressure injection it's simple. I think the green lumen of a vygon CVC is pressure-rated! Still possible with non-rated after correct steps...
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We looked at how COVID-19 was affecting ICU visiting and family communication. The findings are pretty sobering, but perhaps unsurprising to anyone working in hospitals during COVID.
TLDR: Very disrupted, but ICUs adapted
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Martin is a fantastic trainer and an absolutely outstanding College Tutor. He is instrumental in supporting an excellent training environment in anaesthesia at UHCW
@nhsuhcw
This is richly deserved!
Awards!
Warm congratulations to Dr Kariem El-Boghdadly, Dr Martin Minich and The Novice Guide Group whose contribution to the speciality has been recognised by our Nominations committee. 👏
Full details:
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Make sure your public access defibrillator is registered with The Circuit! This will improve access to it in an emergency, as well as better understanding where defibs are located
Today, we launched a social media campaign that could literally save lives!
#LetUsSeeYourAED
is all about ensuring all defibrillators are registered on The Circuit.
By doing so, our control room will know where they are and be able to use them if needed
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There is growing international evidence of health inequalities in out-of-hospital cardiac arrest. These are present not just in the incidence of OHCA, but throughout the chain of survival.
@yeung_joyce
@EPPiC_Warwick
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Moral distress is bad, particularly for intensive care staff.
We investigated moral distress across ICUs using mixed methods. Data collection completed just before the pandemic.
Thread 🧵 1/11
🔓
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@Dr_Done_
Thanks. Perhaps so, certainly that seemed to be the prevailing view of the OP and its engagements. I found myself having a very different hot take, hence the QT. I think many others share this view
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Good stuff as always! Looking forward to the results of
@AIRWAYS_2
May's Papers Podcast out now!
Covering the following;
•RSI in hypovolaemic trauma
•BVM or intubation as 1st line airway management in cardiac arrest
•Video or direct laryngoscopy in emergency intubation
#FOAMed
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International transplant rates. The UK has improved, but there is some way to go
#ICSSOA
@dalecgardiner
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This is why we do research! Anyone uncertain of the value of evidence-based medicine, particularly in emergency care, should read the REBOA story. Unproven therapies may introduce mortality & morbidity and should be robustly evaluated with clinical research!
UK-REBOA results:
REBOA increased mortality at 90 days and at all interim time points.
REBOA increased deaths due to bleeding at 3 hours and 90 days.
REBOA substantially delayed time to definitive haemorrhage control.
💢🎈💢
#ccr23
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Sicker patients account for the weekend mortality effect among adult emergency admissions to a large hospital trust
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@heli_med_james
@TheResusRoom
I'm sure you have tonnes of information, but... our recent systematic review in the EMJ summarises the prehospital evidence for haemostatic dressings in trauma
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This is a very important report highlighting the health inequalities for cardiac arrest patients and how they may be tackled
When somebody has a cardiac arrest,
#EverySecondCounts
, no matter who you are, where you're from or your socio-economic status.
Our new report looks at inequalities in resuscitation and recommends initiatives on how to close the inequality gap:
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Fantastic talk by
@Dunbarian
on vehicle extrication. Lots of myths busted! Very pragmatic and evidence-based approach
#BASICSFPHC
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Wonderful talk on supporting ICU teams with great practical advice from
@DrJulie_H
@Fionafionakel
@SaraCatrinCook
So much of this resonates with our moral distress study findings and the need for a personalised and tiered approach.
@ICS_updates
#SOA23
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"GPICS standards are not aspirational. They are core to safety, outcomes and patient experience. They are vital for staff retention. We must urgently act to reverse this cycle of service decline."
Couldn't be any more clear!
1/4
Our latest position statement on Intensive Care Staffing Standards & the NHS Workforce Crisis ⤵️ .
We stand firm on the need for GPICS staffing standards to be adhered to at all times. Units should not have to struggle with inadequate staffing levels.
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The CT scanner is no longer the doughnut of death. "It's the tube of truth"
@JonesTheBosher
#GATASM17
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Another example of observational and biological evidence not translating into benefit in a well-conducted trial. This is why we test therapies in randomised research!
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@MitoExplorer
@FICMNews
@NIHRresearch
@ICS_updates
Sounds like it's worth linking in with
@TRICNetwork
@_aacw
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Turns out using sweets to teach lumps and bumbs is a good method. Thank you very much!
#MedEd
Adam Boulton is the winner of the award for Teaching Excellence in a Clinical Based Setting
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NEAT-ECHO is a very timely evaluation of UK critical care echo provision in shock. Really pleased to support this via
@TRICNetwork
Data collection will start in March, so get your site signed up soon! See here:
@LukeFlower1
If you’re interested in being involved in the NEAT-ECHO project with the
@TRICNetwork
then we want you to get in touch!
We’re looking for local leads to help us with data collection this March, so head to to find out more.
@LukeFlower1
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Very excited to be back at a conference face-to-face!
Looking forward to speaking about health inequalities in cardiac arrest this afternoon
#RCUKAC22
@ResusCouncilUK
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Trauma Pts don't necessarily need pressors. The microcirc is already heavily constricted. Think about flow, rather than pressure
#GATASM17
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Delighted to have our paper featured in the Resus Room podcast's papers of the month episode. Including words from co-author
@dr_amar_mashru
Give it a listen!
@drrichardlyon
@SJTREM
@TheResusRoom
@EPPiC_Warwick
December 2020 Papers Podcast
•Which prehospital fluids for traumatic brain injury?
•Surgery or antibiotics for appendicitis?
•Which preoxygenation strategies are employed in UK HEMS services?
#FOAMed
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Great interactive session on collaboration and team working. Lots of fun, but we were three short!
@amk762
#nihramc23
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The UK-REBOA trial has been published. The trial was stopped early due to likely harm.
In-hospital REBOA is probably associated with harm, including death at all time points (esp early), death due to bleeding, and time to definitive haemorrhage control.
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A really incredible effort! Thank you to all ICM trainee collaborators
📢 ID-ACCT data collection window finished today.
A huge thank you to all involved!
🤩Data from 1977 patients with 125 sites involved!
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@ThecitizenAID
An important initiative that the public should embrace. Great to hear about it from the horse's mouth today, Tim Hodgetts
#WSMLondon18
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Fantastic opportunity to pick the brains of the GMC's
@drcolinm
at the trainee lunch. Thank you
#WSMLondon18
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I'm sure this practice will be excellent! Potential ACFs should look at signing up
Want some interview practice for ACFs?
Wednesday 15th November 2000-2200 via Microsoft Teams
We will run it as an open session so everyone listens to each other.
The first 9 signing up will be asked questions and then given feedback in front of the rest of the group listening.
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@londonsdrcosmo
@RAMCdoc
@SonoRambler
@J_Stensballe
@LeifRognas
@DrPaulRees
@SJTREM
I guess this is the role of the expert clinician. Applying the evidence base to the individual in front of them and making a personalised decision. Patients don't always fit into nice easy "categories"!
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Very useful and practical motorsport trauma course. Completed ✅
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Extubation should have the same monitoring as intubation. Not half the monitoring disappearing because it's the last case.....
#GATASM17
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Data collection has started! Really excited to have over 90 sites involved. Thank you to everyone taking part, great efforts
📢 📢 📢 Today data collection got underway for ID-ACCT!
Over 90 sites and >400 trainees across the UK are taking part over the next two weeks.
We can't wait to see what the data shows. 📈📊📉
Thanks to all regional reps, site leads & collaborators for their efforts 💪
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Are we increasing the unused opioids entering the community with more rapid discharge and enhanced recovery post surgery. Interesting point...
#WSMLondon18
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My take on this is that the overly confident and certain clinician isn't backed up by strong evidence. The clinical evidence for the best transfusion approach in massive haemorrhage remains uncertain and unconvincing
After spending a lot of time with the literature, I am relatively convinced that the current enthusiasm for balanced transfusion, whether 1:1:1 or 1:1:2, is misguided, and we will use less FFP and platelets in the future
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Great discussion of need for bystander CPR and access to public AEDs
#BASICSFPHC
The
@GoodSamApp
is helping to improve access to this. Spot the conference!
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Last night I wrote GMT or BST next to the time in the notes. Not sure whether to be proud or embarrassed...
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This is really exciting! That's a lot of data in just over a week! 📊🤓
Well done to intensive care trainees across the country
📢ID ACCT update:
>1500 patients from 92 sites included! 🤩
95 sites have answered the national survey!
Thank you to everyone! Keep the data coming in!
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We have a large number of ICUs signed up for ID-ACCT 🎉
Remaining sites please get your involvement form in ASAP
Not long before the data collection window opens for ID ACCT...Get those final involvement forms in today!
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Good luck final year
@warwickmed
student doing mock osces tonight
@nhsuhcw
I will be running a station. Stay calm and you will do well!
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Fantastic news!
(particularly topical given
#Paramedic2
)
“The government’s announcement is the result of years of tireless campaigning” – Our Chief Executive
@simonmgillespie
comments on the news that CPR will be added to the curriculum:
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Great setting in Westminster for a conference (minus the grey British sky...)
@AAGBI
#WSMLondon18
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Don't think I've ever seen the roads so quiet in the morning! Was there a party last night? Is everyone still in bed?!
#iminworkjeremy
#nye
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@AmyOverend
And fix the printer and know where that hard to find guideline/proforma is stored...
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Bystander CPR and early defibrillation remain absolutely key! Community education and training along with initiatives such as
@GoodSamApp
are so important
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@AndrewJD
Ah very good, has shown commitment to lycra. Was worried they might revoke your FRCA
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Back on the train to Edinburgh wielding a poster for another conference. This time for
#Das2018
@DASEdinburgh18
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Learn CPR. Improve access to defibrillators. It really does save lives.
Unfortunately most people who have a cardiac arrest don't do as well as Tom Lockyer.
@ResusCouncilUK
@TheBHF
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@felicitydevere
@RCoANews
This bottleneck is becoming more and more unjustified. Anaesthesia should recruit at ST1.
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Health inequalities continue to worsen in the UK. We can make a difference and we must take action
NHS and the whole of society must act on social determinants of health for a healthier future
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Triclosan-coated sutures reduce the risk of surgical site infection. Largest meta-analysis of RCTs to date
@BMJ_Open
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@ukmat82
@MikailSlater
@dannyjnwong
My experience at 3 centres doesn't match the current negative twitter narrative, in fact it's the opposite. AAs have consistently enriched my training. I hope this survey is valuable and captures a range of experiences
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Great to see the start of the
#BTCC
season! Has to be the best form of motorsport for wheel to wheel action
@itvmotorsport
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@edbarn
@NEJM
@DrCheskes
@EAAARAID
@EastEnglandAmb
@EMDocJB
Certainly nice to see such a large effect size in this population! I do wonder if it's overstated given the number of events and low fragility index.
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Wonderful day in the sun
@donington_hist
Some fantastic cars on display including this driven by a certain J Hunt
#McLaren
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Really interesting and insightful talk tonight around preparedness for paediatric mass casualty events. Thank you
@wmcareteam
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A patient today told me I looked like Father Christmas... Really not sure what to make of it
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