Jakob Mathiszig-Lee
@willtube4food
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Prince of Propofol, Gooner, Pythonista and Health Informatician. Sometimes build ventilators too. Love bikes, wine and chess
London
Joined January 2010
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LOVTITUDE FANMEETING
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FB MADE YOU BLUSH
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Xavi
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#それスノ
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#原神予告番組
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クロリンデ
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シグウィン
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#한성수_방시혁이랑_손잡고_한강가
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Hansi Flick
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Laporta
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ノーヒットノーラン
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ジェシー
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LEAVE SEVENTEEN ALONE
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アルハイゼン
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戸郷投手
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ショートアニメ
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Pinned Tweet
These now available in rose/yellow gold + rhodium to anyone who wants to be as cool as me
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Amongst all the doom and gloom this little man arrived yesterday evening 🥰
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It is phenomenally exciting that since I started medical school vaccines have slashed the rates of cervical cancer and now there's the potential for the same with multiple sclerosis.
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All hospital crime is legal! Write in whatever colour pen you like! White coats are back baby it's purge time.
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For Halloween I scared some doctors working in North America by showing them a UK consultants payslip
#payrestoration
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As a frontline NHS worker I need to get to work *fast*.
@Ferrari
how about showing some support?
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@GaryLineker
@GarethBale11
Agree ok not a fan of the new rules but he literally controlled it with his arm bud
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I think one of the saddest things about recent events in UK medical training is how badly foundation doctors are thought of by many decision makers.
These are highly qualified physicians who are monsters of general medical knowledge. My breadth of understanding of medicine and
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The evidence for the nocebo effect is well and truly clear at this point. Please, please, stop saying "sharp scratch" when cannulating or, when about to inject propofol, "this might sting".
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On Sunday I sent an email to a couple of engineers at imperial college to look at potentially prototyping a pandemic vent. Long shot but some people showed some interest. Yesterday the amazing Joseph Sherwood got a first draft working
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This remains one of my favourite tricks in anaesthesia. I was shown it as an FY1 and have used it almost every week in theatre since.
Switch the sweep speed on your arterial line or sats trace to 6.25mm/s and any pulse pressure variation becomes much more obvious.
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POCUS threads be like "great save! After 4 hours of advanced ultrasound we discovered the patient needed a bit of fluid and then they got better"
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Well in contrast to the queen he can only move one square at a time
The queen’s coronation procession route vs King Charles’.
Massive decline.
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@HustleChillson
@geekylonglegs
What's a hundred complaints to a K*ren like me can ya please remind me?
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One of the reasons I like doing arterial lines in plane is you know the exact direction of the vessel and can watch the catheter/wire slide in.
Maybe a little slower than landmark for easy ones but overall I'm faster and, importantly, lines are much more reliable in long cases.
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It is absolutely unacceptable for a senior NHS consultant to be endorsing ridiculous claims like these
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Bookings now open for my teicoplanin mixing workshop.
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@BryanGlezerson
@traependergrast
It's super easy to remember. Last letter is the first letter of the next factor
TwelvE
EleveN
NinE
EighT
Ten
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POCUS people will not stop until every procedure takes at least 6 hours.
Do you check for lung sliding using POCUS before & after placing a CVC?
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This is an absolute crisis. Soon we'll be left with Birmingham grads adorable yet useless crayon entries in the notes or Manchester grads flailing around without someone to facilitate their discussions
I know medics trained at Cambridge and top London unis who have walked away from medicine this year, after gruelling months on Covid wards.
The NHS is already losing some of the best doctors in the world. Without more support, it looks like this will only continue in 2021.
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Every single one of these syringes had a label on.
I don't understand how anyone with an above room temperature IQ thinks vertical labels are sensible.
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Small gesture but I placed some sunflowers in the railings opposite the Russian embassy.
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The bit of the Nightshift where the alarm you optimistically set for the morning goes off while you're in resus/theatre/IR is my fave.
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@dieworkwear
How can you "enjoy walking" without spending countless hours reading about walking online and getting into increasingly bitter arguments on the walking enjoyers forum?
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Day 10 post vaccine. Time to go test this bad boy out and lick a tube escalator hand rail
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@KirstyChallen
@ShaunLintern
One of the key things in the
#BawaGarba
case seems to be that the precipitating event for Jack's arrest is that he was given his ACE-i by a parent unprescribed. How was she supposed to prevent that?
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100% behind all my nursing colleagues striking tomorrow. They're only asking to be paid the same as they were a few years ago, an absolute bargain in my eyes.
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Having a lucid conversation with a patient as you leave theatre after a 10+ hour complex procedure never gets old. TIVA is the absolute best and I'm never going back.
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Good chat with one of my bffs tonight who's a surgeon. He felt (and I agree) that there's a big underappreciation from anaesthetists about just how precious operating time is for surgical trainees. We get every day in theatre but they might get one list a week.
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I'm super proud of the paper myself and
@FinnCatling
co-first authored along with excellent supervision from
@rmoonesinghe
and Professor Stephen Brett.
Over 127,000 patients from
@NELANews
used to create a novel mortality risk calculator. Open Access.
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@MHA_92_
Lmao.
This is like when a hospital in London wondered why no one was taking up the locum shift on a very busy labour ward for the 'capped' rate ON CHRISTMAS DAY
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Drs begging for freebies on twitter when they earn a stable, decent, income whilst the service industry is melting down is a little unsavoury imo.
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Fellow consultants, worth refreshing your knowledge of the BMA rate card for additional night working.
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Well I did say I'd like to come back and am delighted to have been offered a locum consultant post by
@RMHCancerPeriop
. It's an extraordinary place to work and am so excited to become a member of such a wonderful department. One last ARCP to go!
Sometimes difficult to get a lot out of short rotations but I've had a really fantastic 3 months at the Marsden.
If you're at all interested in TIVA, major surgery or peri-operative medicine I'd really, really, recommend spending time here.
Hopefully get to return in the future
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I don't think the government understand that this has been simmering since 2016. Such is the length of UK training many people will have taken in both sets of strikes and have only seen conditions get worse.
I don't see the BMA backing down and nor should they.
New in from Downing Street on
#JuniorDoctorsStrike
- no talks unless BMA drop 35% pay rise ask.
Ok, but where is the counter offer from Govt?
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Given today's depressing headlines it's really good to see
@TwitterUK
signposting people to proper information.
#measles
#vaccines
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@alastairmiller3
Do you come in on Christmas day to supplement the staffing given how upset you are at that level of cover?
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Charging myself £50 to get in my own house then £10 a can for that authentic NYE experience
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Sending out the Christmas rota and immediately turning on out of office notifications
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Idea: compulsory military service as part of the foundation program to fix everyone's terrible work ethic.
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One of my chief motivations for getting into medical devices is to end sights like this.
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Attn
@hansmollman
i cycled round wembley and spotted the car practising for it's big day on sunday
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Working on labour ward tonight. Anyone who requests an epidural is getting some hay sprinkled on the floor and told to get on with it.
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@startle65
@DraegerNews
@AAGBI
@RCoANews
@Anaesthesia_AGB
The definitive piece on comparisons between flying and anaesthetics
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Night time as a new father seems to consist of either trying to get them to sleep or lying awake wondering if they're quiet because they're dead.
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Hospitals around London are in absolute free fall with massive amounts of cancer and other life saving operations simply unable to be carried out due to the burden from covid. Meanwhile Ron yet again puts his hat in the ring with the other charlatans downplaying the pandemic.
As of yesterday, there were 2,228 patient with COVID-19 in Intensive Care Units in England, Wales and NI. Back in April there were nearly 4,000
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Time to bin metaraminol infusions? 5 extravasations in nearly 15,000 cases using peripheral noradrenaline (20ug/ml), none that needed treatment.
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@gmcuk
GMP states very clearly that making misleading statements harms the image of the profession.
Why have some doctors denying COVID and making false claims been investigated and others not?
Your delays in acting have undermined the public's perception of the profession.
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F to the R to the C to the MOTHER FUCKING A!!!!!!!!!!!!!!!!
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3 registrar's and no SHO on the unit overnight. Very proud to say we have completed all the discharge summaries and drug charts for patients stepping down to the ward and have even managed to get the list printed properly.
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HOW IS IT ALWAYS THE SAME TRUST!!?
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There are deadlines and there's being given a 3hrs for a presentation to the cabinet office 😱
Managed to get through it relatively smoothly even with one computer freezing mid presentation
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Probably going to of limited use to my followers but who knows, med students like to have fun too.
PSA: if you are out please, please, be careful with pills at the moment. Blue Tesla's have put multiple in hospital and absolutely don't double drop if it's your first time out.
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As per current guidelines, unless it's life or limb saving:
: Don't send after 10pm
: Don't do something that'll finish after midnight
: Don't get pressured into doing something dumb "because it'll be nice to clear the board"
*News* Patients operated on at night 'at greater risk of complications or dying'
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@FIAclowns
@TonyYates
@LaureusSport
@Max33Verstappen
@redbullracing
You'd like him to be banned from F1 because he crashed into someone in a computer game?
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For the avoidance of doubt i'm well aware of what my salary is compared to most staff and the UK median but these reactions illustrate just how big the discount NHS staff are working for is
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Can't wait for a week where more patients on my side of the unit get better so I can get published in NEJM
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SALBUTAMOL 👏 NEBS 👏 DONT 👏 HELP 👏 WHEN 👏 THE 👏 PROBLEM 👏 IS 👏 AN 👏 OBSTRUCTED 👏 AIRWAY
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A little Saturday morning thread on Anaesthesia and the environment.
This is something of a hot topic at the moment and it is frequently claimed that Anaesthetic gasses make up 5% of NHS emissions.
The problem? That isn't true
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@edcole04
@AngloCatholica
@SellAuba
No because at least it's clear at that point. The frame rate of cameras means there's already a significant margin of error that isn't accounted for.
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@HKalodimos
One trick to managing difficult libertarians is to calm them down by quizzing them on the age of consent in various jurisdictions
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This will happen in the UK. Don't get conned into training your replacements
“Physicians aren’t being replaced by CRNAs/NPs/PAs”
Exhibit A
Optimal patient care and safety is accomplished when physician led teams take care of patients
This is why I support Physicians for Patient Protection
@pppforpatients
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They grow up so fast 😢
Hard to believe the email I sent that kicked this off was 3 weeks ago. Amazed at the performance we're getting out of such simple parts and it's getting better every day.
If anyone has contacts at the FDA/MHRA/TGA please hit me up.
#Covid19
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There's rightly been talk about the role of regional anaesthesia in restarting elective work
Important to keep in mind the pillars of a quality regional service:
- Patient selection
- Surgical buy in
- Moving your needle entry point by 2 cm and writing it up as a novel block
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@PompeyCyclist
@finishmetea
That's the point. The helmet takes the impact and reduces the energy transmitted to your skull and, most importantly, your brain
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@BenjiNaesen
Meme attack on cipressa that causes wout to burn energy to follow after which he calmly climbs off his bike
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@edzitron
@LanaDelRaytheon
He probably called the pizza place to complain the box was slightly wet too
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The saddest message to get on your Anaesthetic machine when doing an elective case.
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@ClientJournoExp
The contrast between these and CNN is ridiculous
Like in the first wave, the UK government has been slow to respond to rising case and death numbers with restrictions. It has failed to get an adequate contact-tracing and isolation system running.
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6 years ago today a truly legendary party was about to begin. Happy anniversary to my incredible wife.
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Good luck to everyone sitting the primary FRCA tomorrow. Treat yourself to something nice for dinner, have a large glass of wine and take the evening off.
Cramming tonight won't make any difference but a poor night's sleep will.
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People documenting Cormack-Lehane scores for video laryngoscopy drives me up the wall. It gives you no useful information.
Huge fan of this scoring system since I first came across it and here's a nice explanatory video.
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So here's a problem I come across a lot and am curious to hear other people's thoughts. Elderly patient, running v low TCI numbers and a v low power ECG with a high BIS but little activity on EEG.
- Increase Propofol?
- Decrease Propofol?
- Hold nerve and do nothing?
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Finished my last shift as a reg today. Feels like yesterday I was smashing pints at sports night and now I'm about to become a consultant.
Celebrating with this delightful bottle and packing for
@LatitudeFest
where I spent most of my summers at uni as site crew.
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Future multiple grand tour winner already getting started on bike maintenance
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@AleziaP
@AnaesthesiaABC
Not allowing people to have ITU signed off during covid is an absolute outrage.
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