Aaron Heffernan
@Critcare_bear
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Junior doctor, PhD candidate, pharmacist - interested in all things sepsis
Brisbane, Queensland
Joined December 2015
Urine E.coli isolate. Sens to cefalexin, ceftriaxone, meropenem. Resistant piptaz, gent, amox/clav. What is the mechanism of resistance??.
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RT @CRE_RESPOND: CRE RESPOND AMO Seminar Obese Patients - our first speaker, Jack Cross, is currently speaking on "Antibacterial dosing in….
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RT @CRE_RESPOND: Join us tomorrow at AMO Obese Patients seminar to hear about optimising antibacterial & antifungal dosing with Chair, Dr H….
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RT @PulmCrit: Nurses save lives. I see this all the time in the ICU. It's a curious thing - both obvious, yet also frequently overlooked.….
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Such a good book. Many lessons that can be applied in the context of clinical decision making for medicine and patient care.
Thinking in Bets: Zoom AMA February 20th
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Additionally, domain experts are paradoxically more susceptible to the confirmation bias as they can better contort reality to conform to their prior beliefs. An important reminder to appreciate outliers and 'skepticism' - it may just keep you grounded in reality.
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We change our perspective or analysis to suit the outcome or hypothesised outcome. Quite an important consideration when we think about how most research analysis is performed and how morbidity/mortality meetings are conducted.
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RT @SCCM_CPP: #CCPLU Highlights .Continuous enteral nutrition leading to less continuous BMs? This @Crit_Care trial found ↑ risk of constip….
pubmed.ncbi.nlm.nih.gov
The current meta-analysis has not identified any clinically relevant difference in most outcome measures relevant to the care of critically ill patients. However, there is a paucity of high-quality...
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It is a journey that only ends when you stop. One must enjoy the journey and not just the end product (consultancy) - the end product is more training.
Let go of the idea that your training will ever be complete. Let go of the idea that you will ever be “finished.”. Just keep training.
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RT @TheEmergMind: Let go of the idea that your training will ever be complete. Let go of the idea that you will ever be “finished.”. Just….
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RT @RACGPPresident: Just like the Queensland trial, this is a recipe for disaster. I urge the NSW Government in the strongest possible term….
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RT @DoverMarian: #HotTip.The most unwell septic patients do not have a fever. Please don’t wait til they spike one to collect cultures and….
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Junior docs earn (I think) a reasonable wage for their long hours and, in some instances, over 8 years of university study precluding anything more than part time work. Articles in the news make it out that docs all earn >$250 k per year. We certainly don't.
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more complex with multiple comorbidities. The diagnostic/management space is more complex. Lack of support/Allied health staffing. And don't even get me started on weekends where patients are still unwell, but we reduce staffing. Makes little sense to me.
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Difficult to solve. Entire system problem. Limited GP appointments meaning people turn up to ED with GP-type problems. Hospital full with limited nursing/support staff meaning that patient flow in ED is compromised, meaning that patients are ramped/in corridors. Patients are. .
We keep hearing how our healthcare system is collapsing (which it is). But that does nothing to improve our understanding. Let’s use a hypothetical emergency department visit to highlight the disaster that is happening every day around the country. Here’s a thread 🧵:
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For isolates resistant to amox/clav but sensitive to cefazolin, would you ever use cefazolin?? Consider 2 scenarios - simple uti and complicated bacteraemia.
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Will be listening to this on my drive to a rural ED 6 h west of the referral quaternary centre.
EMCrit 324 - Rural Resuscitation - Foundational Stabilization [Primer]. A city cat talking about the game of the country mice -- watch me put my foot in my mouth. Stuff discussed extremely relevant for city slickers too! [members-only]:
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All about having a respectful and mindful discussion. Nurses are a valuable source of knowledge and can be a great set of people to bounce ideas off and discuss a plan moving forward. Sometimes you need to do something different - have the conversation about why.
Had a resident say “we are the doctors. you are the nurses. we put the orders in, you do it. you don’t question it.” .OH. ☺️.She heard an earful. Came up later and apologized.
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RT @DiprivanDarling: Had a resident say “we are the doctors. you are the nurses. we put the orders in, you do it. you don’t question it.”….
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RT @DrKevinSchwartz: “The idea that prolonging therapy somehow prevents resistance by eradicating every last bacterium that could result in….
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