Had so much fun at the Cardiopulmonary Skills for the Modern ICU: Game On session! Lots of great physiology and teaching, plus our team won shirts!

Great early morning run and ECMO chat today at #CHEST2026

If you are at #CHEST2026 on Tuesday be sure to catch our TWO @CritCareTime events: - PE Pressure Cooker (226A 8am on 10/20) - Case based Cardiogenic Shock (227C 11:15am on 10/20)

Recorded a great conversation on clinical teaching w @PaulBerglMD One interesting sidebar: a common characteristic of master clinicians is they spent many years doing busy clinical shifts. Another way to put this: you’ll never become a great clinician watching interns do admits

I often see a false dichotomy between physical examination & POCUS. Do you draw a distinction between the cardiac exam & auscultation because it involves a stethoscope? Between the neurological exam & reflexes because it uses a hammer? In 2026, physical exam requires POCUS.

When someone really needs volume off, *THIS* is how you do it. Aggressive diuresis potentially makes the difference between someone being intubated for a day and for a week.

We made a 2 min mini-episode of @CritCareTime demonstrating the steps for an emergency front of neck airway (eFONA). Let us know what you think and if you want more of this content! Thx to the @TheAirwaySite for letting us film at the difficult airway course!

What’s the correct heart rate in the image above?

Whenever you see different heart rate values for ECG (🟩) and pulse ox (🟦) You need to look closely at the ECG and pleth to figure out which is accurate. An art line can help too. In this case the ECG is over counting by 3:1.

Being able to accurately interpret an ICU monitor like this is an essential skill. Let’s start with a basic question: what’s the HR?

As a mentor, nothing makes me happier than getting a quick update email/text out of the blue. It doesn't have to be epic. It could be as simple as "passed step 1" or "loving my surgery rotation" or "applying in cards." It's great hearing from people you've helped along the way!

Every summer the same warning makes the rounds: "don't get sick in July." That's when the newly minted doctors arrive, interns six weeks out of med school, senior residents in roles they've never held, entire teams reshuffled overnight. In the US we call it the "July Effect." In Britain, more luridly, the "killing season." New people make more errors, and more errors must mean more dead patients. Right? The "July Effect" feels true, but like many intuitive facts in medicine, it's a myth. 🧵 1/

Exciting news: @CritCareTime just crossed 1 million downloads! If you’d told me 3 years ago that 1000 people a day *every* day would want to listen to me & @Askins_Razor teach about niche topics in critical care medicine I wouldn’t have believed you! 1M is admittedly an arbitrary number but I’m very excited that we have an audience who are eager to listen. I guess we’ll have keep going!

Hot Tub Hype Machine: Midjourney wants to put 50,000 of these Ultrasound scanners in "med spas". The physics, the economics, and the evidence all say not so fast open.substack.com/pub/nickma…

Excited to share a 🆕 @CritCareTime: a Ventricular Tachycardia Masterclass with guest Dr Sara Crager @SaraCrager. We cover recognizing VT (monomorphic vs polymorphic), identifying the cause, & treatment. If you care for people with VT you NEED to listen to this episode! 1/

Getting ready to record a @CritCareTime podcast on arterial lines. Other than this meme, what do y’all want us to discuss?