Chris Bishop
@Pipes_n_pumps
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Senior Clinical Research Fellow/PhD in trauma ECMO @QMUL @CommsC4TS @Blizard_Inst ECLS, ECMO, ECPR, lecturer in Resuscitation Science
United Kingdom
Joined September 2011
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Pinned Tweet
In a little over a week I’ll be taking to the high seas to join an international faculty of resuscitation experts, for the once in a lifetime
#RESUSIEM
course where we’ll push the boundaries in resuscitation and trauma management!
@MSC_Cruises_UK
@intubatiem
#ECPR
#REBOA
#Resus
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“When you said CPB, I wasn’t expecting cardio-pumpkin bypass!” Happy Halloween! 🎃👻🧙♀️ 🧛♀️ 💀
#Halloween2023
#Halloween
#SpookySeason
#MedTwitter
#Perfusion
#CPB
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Live demonstration of prehospital ECPR from
@sub30study
team
@drmamoun01
@Simon_Finney
Ben Singer
@nick_sillett
@EuroELSO
@LDNairamb
@Ldn_Ambulance
#EuroELSO22
*This is a simulation*
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Achievement unlocked! Now a full
@ResusCouncilUK
EPALS instructor!
#PedsICU
#PICU
#Resuscitation
🙌 🎉🥳🥂🕺
#MedEd
#ClinEd
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@EmergencyBod
That, unlike our friends across the Atlantic we changed our gun laws after the horrific events of Dunblane, and thankfully it hasn’t happened again.
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Why are bleeding trauma patients still dying? Towards a systems hypothesis of trauma. Where can we intervene?
🩸 CNS-CVS uncoupling
🩸Endothelial glycocalyx injury
🩸Mitochondrial integrity and function
#Trauma
#bleeding
#hemorrhage
0
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@drphiliplee1
Also for his teammates, opposing side and fans who have witnessed an incredibly shocking and traumatic event
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Extracorporeal support could well be a game-changer in our cardiac arrest patients, but let’s not forget the humble AED and it’s place in the chain of survival!
#SystemsSavingLives
#EuroELSO2022
#ECMO
#ECPR
Ling
@proftomquinn
3
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@medicalmodelbri
This ‘experiment’ is beyond parody. I don’t think I ever see this unprofessional behaviour from medical students. As a patient, I’d be utterly horrified to know that an intimate examination would be paraded in this manner for likes!
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What's new in ALS Guidelines 2020 for cardiac arrest - not much(!)
- Adrenaline still in
- Airway interventions dynamic, whatever gets air (and oxygen) in is OK
- IV before IO access
- POCUS usefulness still needs to be established
#Resus20
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@geordie_medic
@DrLindaDykes
It certainly doesn’t help to improve the wider societal understanding that healthcare is delivered not just by doctors and nurses
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Absolutely awesome day on the Specialist Percutaneous Emergency Aortic Resuscitation course
@EastAngliAirAmb
joining like minded colleagues, challenging the status quo and pushing the boundaries in prehospital cardiac arrest management - from basic science to systems redesign
2
5
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Being a perfusionist can sometimes be very scary…..but never been on pump(kin) like this! Happy Halloween! 🎃👻
#CPB
#Perfusion
#halloweenart
0
10
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Proud to ‘earn’ my
#SPEARHEMS
#SPEAR
badge at
@EastAngliAirAmb
as part of the faculty for the Specialist Percutaneous Emergency Aortic Resuscitation course. An incredible vision, now a reality to push the boundaries in OHCA resuscitation!
@EMDocJB
@DrPaulRees
@phemDM
@emccdoc
1
6
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The question “does ECPR for (selected) OHCA work?” has been answered. The next question is “how should we implement it/integrate into our system, and to ensure equity of access?”
#ECPR
#cardiacarrest
#resuscitation
In patients presenting with shockable rhythms, absolute difference (CI) 18.8% (7.6–29.4), p = 0.01 and prolonged CPR, absolute difference (CI) 16.5% (5.9–26.6), p = 0.004. Early invasive ECPR based resuscitation should be strongly considered as a first-line therapy.
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@Mcgrathew33
"End-of-the-bed-o-gram" - that initial first look can give a very useful objective assessment of the patient
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Massive kudos to
@DYannopoulos
and team from Minnesota as their ECMO truck becomes fully operational - revolutionising treatment for refractory out of hospital cardiac arrest!
#ECMO
#ECPR
#ECLS
#Resuscitation
2
9
65
Fantastic two days on the Trauma ECLS
#TECLS
@BartsHospital
Trauma surgeons, anaesthetists, EM docs and perfusionists(!) working and learning together - so we can bring ECMO to our most severely injured patients
@NHSBartsHealth
@Barts_Charity
@karimbrohi
@RLH_TAG
@AnnielondonAA
1
13
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Fantastic day of extracorporeal CPR
#ECPR
teaching and simulation for the
@PHMBSc
iBSc in Prehospital Medicine
@QMULBartsTheLon
. Amazing shared learning, inspiring the resuscitationists of tomorrow!
@gareth_grier
@BairdKat
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8
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The “hybrid-ER” - a potentially exciting development in the management of medical cardiac arrest and trauma haemorrhagic shock - capability to perform CT, angiography/rescue PCI, endovascular-extracorporeal interventions (REBOA, SAAP, ECLS) and surgery - in one room
#SPEAR
0
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Bucket list item ticked off with an awesome visit to the helipad
@LDNairamb
@RoyalLondonHosp
@NHSBartsHealth
this afternoon! A privilege to be shown around by the Charity team and crew
#AdvancedTraumaTeam
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An absolutely awesome two days of cutting edge science, learning and networking
@IofPHC
Resuscitation Science Symposium
@ExploreWellcome
My ‘take homes’:
🫀Carduac arrest is not a diagnosis, it’s lots of different pathologies
🫀No two cardiac arrest patients are the same! (1/n)
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@JonnyHolley
See also all other life support courses. Completely with you on this. Instructors/IP’s are highly experienced clinicians, who have demonstrated exceptional technical, non-technical/HF knowledge and skill, and an aptitude for teaching. This should be paid. I will die on this hill
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London Shock is back! Come to London (or online) for the latest updates in cardiogenic shock
🫀Contemporary mechanisms
🫀Trial updates in circulatory support
🫀Shock Team MDT Network developments
#Cardiogenicshock
#MCS
#ECMO
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Looking forward to calling Whitechapel ‘home’ as of Monday! ☺️
@CommsC4TS
@Barts_Charity
@RoyalLondonHosp
@RLHTraumaTalks
@NHSBartsHealth
@blizard_inst
#WeWorkAtTheLondon
#LondonsLifeline
#Trauma
#ECMO
#ECLS
#MCS
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Always such a great day contributing to the Resuscitation Science module Special Circumstances”
@PHMBSc
@IofPHC
@BairdKat
@gareth_grier
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A “good” ECPR candidate?
✅Witnessed arrest
✅No flow time < 3/5 mins
✅Shockable rhythm/PEA
✅Reversible cause (PE/ACS/overdose/hypothermia)
✅Signs of life during CPR
✅EtCO2 >1.3 KPa
✅Low flow time <60 mins
@ResusMasters
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Incredible to be back at
@NHSBartsHealth
for my
@CommsC4TS
@blizard_inst
Trauma ECMO Fellowship post. The Trust where I learned my craft in clinical perfusion, with amazing people with an awesome “can do” attitude! Ping
@AnnielondonAA
@drmamoun01
@RoyalLondonHosp
@HEMSRLH
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Wow! >120 registrations for tomorrow night’s
@ResusMasters
webinar on trauma shock VA ECMO. Looking forward to it!
@LibbyLilias
@resusdocs
@DrPaulRees
@blizard_inst
@QMUL
@NHSBartsHealth
@RoyalLondonHosp
@ECMOdaily
@ELSOeducation
@FOAMecmo
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In the post-ROSC setting on
@ResusCouncilUK
#ALS
courses, I often find the common instructor prompt “where would you like this patient to go?” unhelpful/of limited value. Shouldn’t we be asking “What are the immediate needs/your next steps?” Words matter. Thoughts
@erc_young
?
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This is a huge step forward for advancing cardiac arrest care. The monumental amount of work to get to this stage cannot be overlooked!
@AnnielondonAA
@drmamoun01
@NHSBartsHealth
@Ldn_Ambulance
@LDNairamb
Today is a big day and thank you to all those involved getting us here. Pre-hospital ECPR training begins for the clinical teams at
@LDNairamb
thanks to all for the support
@NHSBartsHealth
@GetingeGlobal
@Ldn_Ambulance
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Awesome collaboration and joined-up pathways across
@TVAirAmb
@RBandH
@GSTTnhs
to improve survival in out of hospital cardiac arrest with
#ECPR
#ECLS
#ECMO
@ECMOdaily
@FOAMecmo
@EuroELSO
@ResusCouncilUK
@iceman_ex
@GomorraDoc
@edecmo
@JManning_UNC
@ResusOne
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Thank you
@EshtResus
for inviting me to talk on extracorporeal CPR/resuscitative ECMO this afternoon. Fantastic engagement + great questions!
#ECPR
#ECMO
@DrPaulRees
@EMDocJB
@HaldenHB
@FOAMecmo
@MLSCourse
@ECMOdaily
@edecmo
@sub30study
@alice_hutin
@LionelLamhaut
@JManning_UNC
1
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@bambi_858
@ResusCouncilUK
Good EtCO2 trace in ‘well’ ventilated patient, EtCO2 under CPR conditions, Provider tiring, rise in EtCO2 associated with ROSC, persistently low EtCO2 which may be a useful monitoring tool to consider stopping CPR/Resus attempt ☺️
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@drraja_
When you infantilise, disenfranchise and alienate a large workforce of highly educated and skilled professionals what do you expect?
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Looking forward to hearing about the latest developments in resuscitation science and medicine tomorrow
@LDN_TC
#LCAS22
@ZollHospital
🫀Impella
🫀ECPR
🫀REBOA
🫀Cardiac arrest in sport
🫀Goal-directed post-arrest care
🫀OHCA community response
🫀Peri-op arrest
🫀TTM/hypothermia
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A beautiful picture of my “craft” of clinical perfusion 😁
#CPB
#CardiacSurgery
Very biased, but the best healthcare science 😎
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We now have good RCT data from 🇺🇸 and 🇨🇿 on survival benefit of ECPR in OHCA; 43% and 24% respectively in Rx arms. Also circa 30% survival in 🇫🇷 with prehospital ECPR approach. How do we adopt this into our cardiac arrest systems of care?
#ECPR
#ECMO
#cardiacarrest
#ECPR
vs prolonged conventional ACLS only in refractory
#OHCA
⬆️ survival
⬆️ favorable neuro-outcome
secondary analysis of Prague OHCA trial 🇨🇿
⚡️⏳⏱ Better survival if initial shockable rhythm, younger age, shorter
#resuscitation
@Crit_Care
#FOAMcc
🖇️
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A fantastic way to commemorate the 900th Birthday of
@BartsHospital
@NHSBartsHealth
- speaking at the
@The_PCP
Extreme Medicine Conference. After all, this is where it all started for me!
@mdstbarts
3
9
39
Hey
#Emergencymedicine
#ACP
#PA
Twitter - putting together a talk on cardiogenic shock and extracorporeal membrane oxygenation (ECMO) for EM middle grades. As middle grade docs/ACPs/PAs what would you really like to know?!
@RCEMLearning
15
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@karenstacey82
@thefourthcraw
Absolutely incredible. Hyperlacrimation, that’s for sure. What a wonderful window into that most special relationship that transcends professional and patient - the true meaning of humanity.
0
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A wonderful evening
@blizard_inst
celebrating the inaugural lecture of
@TraumaEMC
An incredible trailblazer, innovator and champion of non-physician PhD research. Incredibly privileged to have her as a supervisor. Ping
@CommsC4TS
1
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Didn’t they used to say “go to work on an egg”?! Happy Easter to all those celebrating 😁🐇🍫 🪺 🐑
#Easter2023
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Our next
@erc_young
webinar will be on extracorporeal CPR 27th April 19:00!
▶️ Introduction to the “pipes, pumps and plumbing”
▶️ Who, when and where to consider starting ECPR
▶️ Fascinating insights from perfusion, PHEM, cardiology and critical care!
#ECPR
#ECLS
#ECMO
#Resus
1
12
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Absolutely incredible first day at
@EuroELSO
#EuroELSO2022
Discussing cutting edge
#ECLS
science and latest outcomes and finally got to meet Dr. Bob Bartlett who started it all! Privileged to stand shoulder to shoulder with a true giant and gentleman.
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Looking forward to contributing to the upcoming Specialist Percutaneous Emergency Aortic Resuscitation
#SPEAR
course
@EastAngliAirAmb
- joined by some incredible and forward thinking clinicians
@DrPaulRees
@emccdoc
@phemDM
@GreenhalghRob
as we strive to push boundaries in OHCA 💪
5
2
35
A truly unforgettable week of sun, sea and resuscitation science!
#ResusIEMCruise
@airwayGladiator
@intubatiem
@ROScorvalhala
@PrehospitalCC
@Acfletch1984
#BeyondALS
#CPR
#ECMO
#ECPR
#REBOA
#trauma
#airway
☀️🏖️🚢 🍹 🍸 🏥 🚁
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Stopped in the corridor by consultant surgeon I worked with yesterday. Thanked me for my help with the list, and happily relayed that both patients were doing well. I wish this happened more!
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Early advanced vascular access for medical cardiac arrest
🫀Physiologically targeted ALS
🫀Early recognition of ROSC
🫀Arterial waveform morphology assessment for aetiology?
#SPEAR
@DrPaulRees
@EAAARAID
@EastAngliAirAmb
1
7
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@SamuelBS85
There are a few, but referring to a coronary artery bypass graft as a “CABG” did not go down particularly well with a consultant anaesthetist. “A CABG is a bloody vegetable, not a life-changing cardiac operation - Jesus Christ!” 😂
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Indeed!!
#ALS
and the ‘fancy stuff’ - ECPR/REBOA/SAAP won’t yield survivors if we can’t get our citizens (relatives, friends, neighbours, bystanders) to recognise cardiac arrest, call for help and start immediate CPR
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No universally agreed consensus on eligibility for ECPR in refractory arrest, however ‘signals’ associated with better outcomes:
- Witnessed arrest
-Early CPR
-Shockable/PEA
-Signs of life during CPR
-EtCO2 >1.3KPa
-Reversible cause
-Low flow time (<60’)
#Resus21
1
8
31
A day late, but really looking forward to this Easter treat later 🐣 🪺 🐑
1
0
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Awesome talk from
@DrPaulRees
on ‘Advanced Resuscitation - the near future’ - physiology driven CPR, endovascular-extracorporeal resuscitation and the prospect of suspended animation/emergency preservation and resuscitation!
@ResusMasters
@resusdocs
2
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Up now on our
#SPEAR
course
@HaldenHB
on vascular access tips and tricks!
@EastAngliAirAmb
@EAAARAID
0
7
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So happy to be back helping
@BartsResusTeam
@NHSBartsHealth
@RoyalLondonHosp
for their
@ResusCouncilUK
#ILS
course today; naturally sporting my
@MedLoops
lanyard 😉
3
0
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Just over a week now until
#EuroELSO2022
@EuroELSO
! Looking forward to cutting edge science and latest clinical outcomes related to adult, neonatal paediatric
#ECMO
#ECLS
and
#ECPR
, and meeting old and new friends face to face again! 🫀🫁🔄
1
9
30
Tip of the
#SPEAR
! Great to be speaking alongside
@DrPaulRees
on pushing the boundaries in resuscitation
@zollemsfire
@ZollHospital
EMS Resuscitation Masterclass
@CavendishUK
1
2
29
Arguably the most important person (aside from the patient of course), is that first responder who is the vital first 2-3 links in the chain of survival
ECMO, alternative drug therapies, double sequential defibrillation, intubation, video laryngoscopes for patients in cardiac arrest.
What remains clear is that none are effective without high-quality CPR and team work
#Basics
#Paramedic
0
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It is almost time for
#SPEAR
! Looking forward to heading to
@EastAngliAirAmb
and welcoming colleagues from the U.K. and further afield. We’ll take a deep dive into cardiac arrest and the novel endovascular-extracorporeal approach!
@DrPaulRees
@EMDocJB
@HaldenHB
@emccdoc
@phemDM
3
6
29
Great day at the Defence Endovascular Resuscitation (DefER) REBOA course at
@BH__Academy
@RoyalLondonHosp
Privilege to meet and learn from military medical personnel and thanks to
@DrPaulRees
for letting me have a ‘hands on’ play with the kit!
#REBOA
#AccessFirst
0
2
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@Jopo_dr
"I'm telling you doctor, it's not hypochondria; alas it's my dysfunctional mitochondria"
1
0
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Thoughts and prayers for
#Eriksen
and his family. Really hoping for a good outcome. Kudos to the on-site medical teams and emergency responders who will be in this fight for life
2
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Fantastic thanks for sharing! Many of us working in critical care and ECMO centres appreciate what a monumental MDT collaboration, and human factors task this is
A multidisciplinary team proning a COVID-19 patient and adding an extra oxygenator to the ECMO machine, in an attempt to improve their blood oxygen levels.
One year ago
@lynseyaddario
captured these striking photos for the
@nytimes
from our critical care unit.
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Calling
#Echocardiography
#POCUS
peeps - I need a basic/introductory textbook on echocardiography, hit me up with recommendations!
@iceman_ex
@EchoSoliman
@nat_echo
5
5
28
@c3convertase
Is there any vetting? Rigorous selection process? I’m skeptical given the course has a 100% pass rate, and this the behaviour that these individuals consider appropriate
5
2
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@thefourthcraw
Thank you for sharing this incredible story of true professionalism, friendship and humanity.
0
1
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Awesome first day at
#ParisRescue
! Inspiring talks from leading experts, hands on skills workshops and just great, passionate people coming together to share experience and learning in
#ECMO
and
#ECPR
1
1
27
@DrPaulRees
diving deep into revisiting resuscitation science. Maximising coronary perfusion is key to ROSC. “Advanced” resuscitation looks to bespoke physiological measures and targeted Rx using
#SPEAR
@EastAngliAirAmb
@EAAARAID
as a path to endovascular-extracorporeal CPR
2
2
26
Awesome “Beyond the Beat” advanced resuscitation event from
@ACParamedicine
and
@SydneyHEMS
Drilling into the basic physiology of cardiac arrest and CPR, and how
@GoodSamApp
and ECLS can be integrated to push the needle of survival
@HawkmoonHEMS
@nattiejpk
@cliffreid
2
5
27
Great third
#SPEAR
course
@EastAngliAirAmb
Pleasure to join
@DrPaulRees
@EMDocJB
@HaldenHB
as we shared our experience and expertise to take OHCA resuscitation to the next level!
2
4
26
@DrKeeble
Opening the regional OHCA meeting at
@AngliaRuskin
@FHEMS_ARU
with a call to arms. It’s been 6 years since “Resuscitation to Recovery”; recommendations need to be properly implemented - how are we going to do it?
#OHCA
#Resuscitation
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