Profile avatar
benmillette.bsky.social
Consultant in Intensive Care and Anaesthesia. POCUS, Antibiotic stewardship, MedEd and Mexican food
88 posts 212 followers 136 following
Regular Contributor
Active Commenter
Posts 20 Comments 30

What do people think about some sort of "POCUS on call" service? I'm thinking a practitioner with advanced multimodality skills who could respond to requests for POCUS from multiple hospital departments. Anyone know of anything like this that exists?

submitted 1 day ago • 10 comments

I'm pretty hard to shock but this is appalling BBC News - Kidney trade: Myanmar villagers fly to India to sell organs illegally - BBC News www.bbc.co.uk/news/article...

submitted 2 days ago • 0 comments

A quick #VEXUS thread 🧵- 3 reasons why the portal vein is the most useful single venous doppler waveform 🥇 (if you're only going to do ONE site to look for venous congestion, this is probably the most useful one!) #emimcc

submitted 3 days ago • 3 comments

Requesting a contrast enhanced scan for a patient with a creatinine of well over a thousand and seeing the conniptions this generated in radiology

submitted 21 days ago • 0 comments

Doppler ultrasound for venous congestion - #VEXUS - has truly been game-changing in my clinical #POCUS practice. Here's the TL;DR on the concept of #VEXUS - 🧵 #emimcc

submitted 25 days ago • 2 comments

Hey psych people, what's the opinion on this paper, if you've seen it? www.frontiersin.org/journals/psy... Seems to pretty convincingly debunk the Dunning-Kruger effect, which would be quite funny! Here's the logic, if I have it right:

submitted 26 days ago • 21 comments

Life moves pretty fast...

submitted 28 days ago • 0 comments

Confession: I LOVE hyponatremia 🤓 (I know, I know. What can I say, I'm a true internist!) HypoNa is often feared, maligned, and misunderstood - but I promise it doesn't have to be scary! Here are my top 10 hyponatremia tips and tricks - a 🧵 #emimcc

submitted 35 days ago • 12 comments

vasopressin challenge: this group evaluated 1U bolus of vasopressin to evaluate patient responsiveness I love this for a few reasons: [1] allows vaso to have rapid onset (rather than taking 30-60 min to build up) [2] we can get a sense of whether the vaso is helping 🧵 1/5 #EMIMCC

submitted 35 days ago • 7 comments

If a picture’s worth 1000 words then this cine loop’s a damn novella dedicated to the pathogenesis of hepatic hydrothorax 😍 #EMIMCC #pocus

submitted 37 days ago • 1 comment

A great study on using procalcitonin in children on IVABx- no difference in antibiotic duration between the groups. However median ABx duration was only 4 days so probably not much scope for reduction. www.thelancet.com/journals/lan...

submitted 43 days ago • 1 comment

The Scaling Paradox: AI capabilities have improved remarkably quickly, fuelled by the explosive scale-up of resources being used to train the leading models. But the scaling laws that inspired this rush actually show very poor returns to scale. What’s going on? 1/ www.tobyord.com/writing/the-...

submitted 46 days ago • 2 comments

Suggested New Year's Resolution: more mindful prescribing of IV fluids 🫧 Far too often I see IV fluids thrown around with minimal consideration; meanwhile, we'll deliberate for hours about a dose of lasix 🤦‍♀️ Here are the 10 most common fluid prescription mistakes I see 🧵 #emimcc

submitted 50 days ago • 3 comments

While focussed ECHO and POCUS clearly have utility, I’m increasingly seeing them prioritised in emergency situations while the basics get forgotten about. And I don’t see it change management all that often 🤷

submitted 56 days ago • 9 comments

Considering we see lots of severe flu every year (and have had pandemics of it!), it's astounding that we know so little about evidence-based treatments for it. The comparison with COVID is quite stark

submitted 56 days ago • 0 comments

It's that time of year again. Here are my top 10 ID papers of 2024 1. My opinion 2. Practice changing, paradigm-shifting or dogma challenging 3. Not COVID 4. Alphabetical order by first author 5. CoI for 4 and 5 (I am an author) Summary slide here, details in thread #IDSky #Top10IDpapers

submitted 67 days ago • 12 comments

The final TRIC Network NEAT-ECHO paper has been published! A summary: 🏥 179 ICUs 📡 96% of teams had an echo accredited clinician 👩‍🏫 89% had an approved mentor ✅ 95% felt positively about echo in ICU 🖥️ 33% had imagine storage systems 🫀15% had 24/7 echo access link.springer.com/article/10.1...

submitted 67 days ago • 0 comments

100% agree. The only time to site a Femoral CVC is in situational extremis when access elsewhere is limited… I.e outside of spacious environs or/and if all other access points failed or thrombosed. That fem CVC sited should be changed ASAP for one sited in a more visible part of the anatomy. 1/2

submitted 70 days ago • 1 comment

Subclavian Mafia coming in hot now 😉 1) It's a dirty line when there's cleaner available 2) Awake patients tolerate subclav v well 3) Subclav PTX rate is the same as IJ if you use US pubmed.ncbi.nlm.nih.gov/31143996/ 4) Radial art is fine in 99% but femoral is the go-to in the 1% w/ severe shock

submitted 71 days ago • 4 comments

Important study which adds to a growing literature associating worse outcomes with “renally adjusted” beta-lactam dosing. Major confounder is that renal failure itself is associated with increased mortality. Reality is, however, we are really bad at predicting plasma drug levels in patients.

submitted 71 days ago • 2 comments