Turning the Tide
@Turningthe_Tide
We are a registered charity promoting education, communication and the sharing of knowledge to ensure safer IV fluid prescribing.
1/ You might think: "Why give NaCl to someone overloaded with salt and water? Shouldn’t we be pulling sodium out, not putting it in?" 🧂💧 It feels wrong — but correcting chloride can unlock natriuresis. Let’s break the paradox. 🧵
(1/x) Septic shock is the leading cause of death in most ICUs worldwide. Unfortunately, the hemodynamics of sepsis are still often taught incorrectly in medical school. A 🧵
Right here. And that clinician is truly misled by the fact that there was a brief positive response to the fluids. “They really needed it, they just need a bit more and everything will be ok.” Its well-meaning but cam be fatal.
3/3 followed by a clinician brainstem reflex to continue a prescription of more fluids that temporarily improve MAP at the expense of further uncoupling of the circulation and worsening tissue perfusion. Rinse, repeat. Patient dies despite “we did everything we could”.
Back to basics! I am starting a new series of videos focusing on mastering basic #POCUS concepts. Starting off with honing your ability to obtain the 4 basic cardiac views and steps on how to obtain additional/advanced views. Please give it a watch: youtube.com/watch?v=kX2s_2…
Fractional longitudinal LV shortening. An alternative to LV GLS