Segun Olusanya
@drfreeze.bsky.social
Aka iceman_ex. Husband, Intensivist, Ultrascoundrel. @ics-updates.bsky.social council member. All about the #medsky, #foamed and #foamcc. Meme: papers ratio over 9000
Reposted by Segun Olusanya
treatment of severe/refractory hypoglycemia (IBCC update)
commonly messed up in practice & literature 🤦♂️
key points:
🧃 IV dextrose gtts are good but not super effective
🧃 PO carbs are more effective
🧃 IV steroid for refractory dz
🧃 structured escalation
🧃 rarely needs ICU admit #EMIMCC
commonly messed up in practice & literature 🤦♂️
key points:
🧃 IV dextrose gtts are good but not super effective
🧃 PO carbs are more effective
🧃 IV steroid for refractory dz
🧃 structured escalation
🧃 rarely needs ICU admit #EMIMCC
November 30, 2025 at 5:18 PM
treatment of severe/refractory hypoglycemia (IBCC update)
commonly messed up in practice & literature 🤦♂️
key points:
🧃 IV dextrose gtts are good but not super effective
🧃 PO carbs are more effective
🧃 IV steroid for refractory dz
🧃 structured escalation
🧃 rarely needs ICU admit #EMIMCC
commonly messed up in practice & literature 🤦♂️
key points:
🧃 IV dextrose gtts are good but not super effective
🧃 PO carbs are more effective
🧃 IV steroid for refractory dz
🧃 structured escalation
🧃 rarely needs ICU admit #EMIMCC
Reposted by Segun Olusanya
Apropos someone asking why it was a .gif in the replies:
Next year the .gif format will be as old as the last spitfire made was when the .gif format was released.
Next year the .gif format will be as old as the last spitfire made was when the .gif format was released.
Academia tends towards the spitfire_survivorship_bias.gif meme on multiple levels (not throwing shade here, lots of institutions are like this!), along with more senior types forgetting that lots of high flyers were so-so students once upon a time
November 29, 2025 at 8:13 PM
Apropos someone asking why it was a .gif in the replies:
Next year the .gif format will be as old as the last spitfire made was when the .gif format was released.
Next year the .gif format will be as old as the last spitfire made was when the .gif format was released.
Reposted by Segun Olusanya
👏👏Congratulations to all of our Fellowship 2025 recipients! We're proud of your achievements in echocardiography and your representation of our expert workforce
November 29, 2025 at 4:30 PM
👏👏Congratulations to all of our Fellowship 2025 recipients! We're proud of your achievements in echocardiography and your representation of our expert workforce
Reposted by Segun Olusanya
The #PedsICU community did a fantastic job raising concerns early about MIS-C early during the COVID epidemic. Trust me, it would have done the same if suddenly we had seen a lot of vaccine related complications, and wouldn’t have hesitated to advocate for intervention.
November 29, 2025 at 6:29 PM
The #PedsICU community did a fantastic job raising concerns early about MIS-C early during the COVID epidemic. Trust me, it would have done the same if suddenly we had seen a lot of vaccine related complications, and wouldn’t have hesitated to advocate for intervention.
“Factor Fexcectorn” is my new spirit animal
November 29, 2025 at 3:24 PM
“Factor Fexcectorn” is my new spirit animal
Hey guys- check this out
@bsecho.bsky.social have launched a new Level 1 library🚀
Can't wait to explore these real-world Level 1 echo cases developed by a team including legends Jen Gosling and Richard Fisher.
The first 30 cases are FREE!
Find out more: bsecho.org/Public/News/...
@bsecho.bsky.social have launched a new Level 1 library🚀
Can't wait to explore these real-world Level 1 echo cases developed by a team including legends Jen Gosling and Richard Fisher.
The first 30 cases are FREE!
Find out more: bsecho.org/Public/News/...
BSE launches groundbreaking emergency echo educational resource
Level 1 Library now available
bsecho.org
November 28, 2025 at 2:19 PM
Hey guys- check this out
@bsecho.bsky.social have launched a new Level 1 library🚀
Can't wait to explore these real-world Level 1 echo cases developed by a team including legends Jen Gosling and Richard Fisher.
The first 30 cases are FREE!
Find out more: bsecho.org/Public/News/...
@bsecho.bsky.social have launched a new Level 1 library🚀
Can't wait to explore these real-world Level 1 echo cases developed by a team including legends Jen Gosling and Richard Fisher.
The first 30 cases are FREE!
Find out more: bsecho.org/Public/News/...
Underrated post
I think it’s better to imagine the RSI as the Ship of Theseus.
None of the components are the same any more, the name stubbornly remains unchanged and discussing the meaning of it is only really interesting to the inanely academic.
None of the components are the same any more, the name stubbornly remains unchanged and discussing the meaning of it is only really interesting to the inanely academic.
November 27, 2025 at 10:32 PM
Underrated post
Reposted by Segun Olusanya
Patient with cirrhosis and INR of 3 needs a procedure
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
November 27, 2025 at 1:06 PM
Patient with cirrhosis and INR of 3 needs a procedure
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
Reposted by Segun Olusanya
Influenza has come early this year, and with the H3N2 being especially virulent amongst older people, hospitals and ICUs are under pressure. Join us tomorrow (27th November) to learn about flu in ICU this winter. With @ics-updates.bsky.social @rajlaz.bsky.social @shond.bsky.social and Brij Patel
H3N2: Rapid clinical update and implications for this Winter
Preparing intensive care for Winter 2025.
ics.ac.uk
November 26, 2025 at 9:30 PM
Influenza has come early this year, and with the H3N2 being especially virulent amongst older people, hospitals and ICUs are under pressure. Join us tomorrow (27th November) to learn about flu in ICU this winter. With @ics-updates.bsky.social @rajlaz.bsky.social @shond.bsky.social and Brij Patel
Reposted by Segun Olusanya
4/ Meanwhile, an expose in the BMJ brought the experiences of these locally-employed doctors, in short-term, non-standard "gig economy" contracts, into sharp focus.
You can read that one here:
www.bmj.com/content/391/...
You can read that one here:
www.bmj.com/content/391/...
Revealed: Thousands of NHS doctors are trapped in insecure “gig economy” contracts
Thousands of locally employed doctors—many of them international graduates and from ethnic minorities—are trapped in insecure NHS contracts with no access to training, career progression, or national ...
www.bmj.com
November 22, 2025 at 8:22 AM
4/ Meanwhile, an expose in the BMJ brought the experiences of these locally-employed doctors, in short-term, non-standard "gig economy" contracts, into sharp focus.
You can read that one here:
www.bmj.com/content/391/...
You can read that one here:
www.bmj.com/content/391/...
Reposted by Segun Olusanya
1/ The medical workforce and the #SASsix, a Saturday morning thread...
The eagle-eyed among you may have spotted two related publications relating to workforce this week. Taken together, they paint a stark picture of the current medical workforce.
The eagle-eyed among you may have spotted two related publications relating to workforce this week. Taken together, they paint a stark picture of the current medical workforce.
November 22, 2025 at 8:22 AM
1/ The medical workforce and the #SASsix, a Saturday morning thread...
The eagle-eyed among you may have spotted two related publications relating to workforce this week. Taken together, they paint a stark picture of the current medical workforce.
The eagle-eyed among you may have spotted two related publications relating to workforce this week. Taken together, they paint a stark picture of the current medical workforce.
Reposted by Segun Olusanya
I wish I didn’t have to share this. But the BBC has decided to censor my first Reith Lecture.
They deleted the line in which I describe Donald Trump as “the most openly corrupt president in American history.” /1
They deleted the line in which I describe Donald Trump as “the most openly corrupt president in American history.” /1
November 25, 2025 at 9:26 AM
I wish I didn’t have to share this. But the BBC has decided to censor my first Reith Lecture.
They deleted the line in which I describe Donald Trump as “the most openly corrupt president in American history.” /1
They deleted the line in which I describe Donald Trump as “the most openly corrupt president in American history.” /1
November 25, 2025 at 12:28 PM
Reposted by Segun Olusanya
EchoPrime, an AI-based model, seems to increase workflow efficiency and provide a more comprehensive interpretation of echocardiograms after being trained on more than 12 million videos and paired text reports. www.tctmd.com/news/largest...
Largest AI-Echo Model Shows Promise for Increasing Workflow Efficiency
EchoPrime was trained on more than 12 million videos; it’s now being tested clinically, with more data expected next year.
www.tctmd.com
November 24, 2025 at 9:02 PM
EchoPrime, an AI-based model, seems to increase workflow efficiency and provide a more comprehensive interpretation of echocardiograms after being trained on more than 12 million videos and paired text reports. www.tctmd.com/news/largest...
Reposted by Segun Olusanya
Trimethoprim-sulfamethoxazole carries a very low (but real) risk of causing ARDS.
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
November 24, 2025 at 8:48 PM
Trimethoprim-sulfamethoxazole carries a very low (but real) risk of causing ARDS.
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
Duration of therapy is a risk factor (>7 days).
Could likely be minimized by avoiding unnecessarily long courses.
TMP-SMX is usually well tolerated, but can wreak havok (SJS, ARDS, drug-induced meningitis). #EMIMCC
@kamranabbasi.bsky.social shines with this scathing editorial on the mess that has been made with locally employed Doctors (LEDs) in the U.K.
www.bmj.com/content/391/...
www.bmj.com/content/391/...
NHS 2025: a wobbly triadic stool and a gig economy
The NHS sits seventh on the list of the world’s largest employers, rubbing shoulders with the armies of China, India, and the US, as well as mega-corporations.1 It’s also part of the “gig economy.” Th...
www.bmj.com
November 24, 2025 at 8:58 PM
@kamranabbasi.bsky.social shines with this scathing editorial on the mess that has been made with locally employed Doctors (LEDs) in the U.K.
www.bmj.com/content/391/...
www.bmj.com/content/391/...
Reposted by Segun Olusanya
Sorry Josh, my question was rhetorical, which isn't very fair. We worked on this years ago, as you can see. At that time, our team used adrenaline a lot after dopamine failed. Obviously, like everyone else, we prescribe noradrenaline as a first-line treatment, which
November 22, 2025 at 11:27 AM
Sorry Josh, my question was rhetorical, which isn't very fair. We worked on this years ago, as you can see. At that time, our team used adrenaline a lot after dopamine failed. Obviously, like everyone else, we prescribe noradrenaline as a first-line treatment, which
Reposted by Segun Olusanya
Finished updating the IBCC chapter on septic shock
This algorithm is where I ended up 👇
Therapies should be based on several factors (not solely whether CRT is <3; CRT isn't precise so this dichotomy is problematic)
Beware of vasopressin; it may depress digital perfusion & block the goal #EMIMCC
This algorithm is where I ended up 👇
Therapies should be based on several factors (not solely whether CRT is <3; CRT isn't precise so this dichotomy is problematic)
Beware of vasopressin; it may depress digital perfusion & block the goal #EMIMCC
November 19, 2025 at 2:01 PM
Finished updating the IBCC chapter on septic shock
This algorithm is where I ended up 👇
Therapies should be based on several factors (not solely whether CRT is <3; CRT isn't precise so this dichotomy is problematic)
Beware of vasopressin; it may depress digital perfusion & block the goal #EMIMCC
This algorithm is where I ended up 👇
Therapies should be based on several factors (not solely whether CRT is <3; CRT isn't precise so this dichotomy is problematic)
Beware of vasopressin; it may depress digital perfusion & block the goal #EMIMCC
Reposted by Segun Olusanya
new trolley problem just dropped: Elon vs. 10^58 randomly chosen people. let's see what Grok has to say
November 21, 2025 at 3:43 PM
new trolley problem just dropped: Elon vs. 10^58 randomly chosen people. let's see what Grok has to say
@avkwong.bsky.social finishing off the advanced CACU course with a talk on POCUS in AI.
This is an incredible growth area.
This is an incredible growth area.
November 21, 2025 at 3:53 PM
@avkwong.bsky.social finishing off the advanced CACU course with a talk on POCUS in AI.
This is an incredible growth area.
This is an incredible growth area.
Reposted by Segun Olusanya
'He'?
That tells me the level of bias underlying this uninformed post.
Surgical training is so rigorous that the surgeons '20 years from now' are already at med school, and I can tell you from direct experience they are brilliant, innovative, and better communicators than their forebears.
#MedSky
That tells me the level of bias underlying this uninformed post.
Surgical training is so rigorous that the surgeons '20 years from now' are already at med school, and I can tell you from direct experience they are brilliant, innovative, and better communicators than their forebears.
#MedSky
It’s fun to think about the surgeon who will botch your surgery 20 years from now and what he’s doing at this moment. He just ran all his homework through ChatGPT. He just read that article about vaccines and autism at the CDC website. He just watched an Instagram video about the moon landing hoax.
November 21, 2025 at 11:04 AM
'He'?
That tells me the level of bias underlying this uninformed post.
Surgical training is so rigorous that the surgeons '20 years from now' are already at med school, and I can tell you from direct experience they are brilliant, innovative, and better communicators than their forebears.
#MedSky
That tells me the level of bias underlying this uninformed post.
Surgical training is so rigorous that the surgeons '20 years from now' are already at med school, and I can tell you from direct experience they are brilliant, innovative, and better communicators than their forebears.
#MedSky
Reposted by Segun Olusanya
Doctors need to decide if they want to be liked or if they want to be paid more. Tube drivers are paid a lot because they don't care who likes them.
It’s hard to read this stuff from doctors without cringing at how wildly out of touch it sounds (and how little self-awareness). £100k+ income is, to most of the public, beyond our dreams. Entitlement and class privilege is not the best way to win people over to your cause!
November 20, 2025 at 7:59 PM
Doctors need to decide if they want to be liked or if they want to be paid more. Tube drivers are paid a lot because they don't care who likes them.
Amazing
November 20, 2025 at 2:38 PM
Amazing
Reposted by Segun Olusanya
A new #BMJInvestigation finds that thousands of locally employed doctors are trapped in insecure NHS contracts with no access to training, career progression, or national safeguards.
Experts warn that the NHS is effectively “behaving like a gig economy employer”
www.bmj.com/content/391/...
Experts warn that the NHS is effectively “behaving like a gig economy employer”
www.bmj.com/content/391/...
November 20, 2025 at 12:18 PM
A new #BMJInvestigation finds that thousands of locally employed doctors are trapped in insecure NHS contracts with no access to training, career progression, or national safeguards.
Experts warn that the NHS is effectively “behaving like a gig economy employer”
www.bmj.com/content/391/...
Experts warn that the NHS is effectively “behaving like a gig economy employer”
www.bmj.com/content/391/...
@manumalbrain.bsky.social dropping knowledge bombs at the advanced Critical and Acute Care Ultrasound course in Watford.
Great to hang out with him and @avkwong.bsky.social
And join the Fluid Academy- www.fluidacademy.org
Great to hang out with him and @avkwong.bsky.social
And join the Fluid Academy- www.fluidacademy.org
November 20, 2025 at 10:19 AM
@manumalbrain.bsky.social dropping knowledge bombs at the advanced Critical and Acute Care Ultrasound course in Watford.
Great to hang out with him and @avkwong.bsky.social
And join the Fluid Academy- www.fluidacademy.org
Great to hang out with him and @avkwong.bsky.social
And join the Fluid Academy- www.fluidacademy.org