Kristian Strand
@docstrand.bsky.social
Intensivist in Stavanger, Norway. Jack of all trades, master of none. Sometimes I do research.
Amen to that
One of my strong pet peeves: never start vasopressin based on a fixed cutoff for noradrenaline and never without an echo. I strongly oppose the algorithm proposed here #emimcc #cccsky
Mastering vasopressin in septic shock, pragmatic bedside guidance on its optimal use, emphasizing real-world constraints & evidence gaps:
💉 clinical pharmacology
⚖️ dosing
⏱️ timing
🩺 practical considerations
#FOAMcc @intenscaremed.bsky.social
🔓 rdcu.be/ePAno
💉 clinical pharmacology
⚖️ dosing
⏱️ timing
🩺 practical considerations
#FOAMcc @intenscaremed.bsky.social
🔓 rdcu.be/ePAno
November 14, 2025 at 9:18 PM
Amen to that
Vurderer å se Koke Bjørn, men usikker på om tobakkskildringene blir for meget for meg
October 19, 2025 at 8:38 PM
Vurderer å se Koke Bjørn, men usikker på om tobakkskildringene blir for meget for meg
So true. Sometimes it feels like the patient with a unifying diagnosis is so rare that you want to write a case report when you finally encounter one.
This is something I say a lot too. People (not the author) seem to think the only thing doctors do is diagnose. In reality, that's a tiny part of a modern doctor's job in the real world. A fancy AI offering diagnostic powers would help me only quite occasionally. Real life is not like House.
October 17, 2025 at 2:42 PM
So true. Sometimes it feels like the patient with a unifying diagnosis is so rare that you want to write a case report when you finally encounter one.
Reposted by Kristian Strand
Lederlønningene i helsevesenet er umusikalske, trolig unødvendige og de skaper veldig mye støy. Men samtidig er dette en avsporing. Utfordringene i helse har ingenting med disse lønningene å gjøre. >> www.nrk.no/nordland/rod...
Full krangel om lederlønn i Helse-Norge: – Føles som et slag i magen
www.nrk.no
October 14, 2025 at 4:41 PM
Lederlønningene i helsevesenet er umusikalske, trolig unødvendige og de skaper veldig mye støy. Men samtidig er dette en avsporing. Utfordringene i helse har ingenting med disse lønningene å gjøre. >> www.nrk.no/nordland/rod...
Aslak Sira Myhre treffer spikeren på hodet. www.aftenbladet.no/meninger/kom...
September 20, 2025 at 8:58 AM
Aslak Sira Myhre treffer spikeren på hodet. www.aftenbladet.no/meninger/kom...
I have a hard time finding a reason for not providing BVM (add PEEP valve) or NIV between induction and intubation in critical care unless you enjoy the thrill of a rapidly desaturating patient.
ICU Practice - Return to Basics:
For the average rapid sequence intubation (no cardiac arrest, no active emesis), do you provide bag-mask ventilation between induction and laryngoscopy (I & L)?
Yes?
No?
No, and the reason is...
For the average rapid sequence intubation (no cardiac arrest, no active emesis), do you provide bag-mask ventilation between induction and laryngoscopy (I & L)?
Yes?
No?
No, and the reason is...
August 30, 2025 at 9:42 PM
I have a hard time finding a reason for not providing BVM (add PEEP valve) or NIV between induction and intubation in critical care unless you enjoy the thrill of a rapidly desaturating patient.
Og det hjalp ikke akkurat når en forsker fra FHI løp til mediene og erklærte at hvert sparte menneskeliv kostet 133 mill kr. Noe som selvsagt var 100% vrøvl.
Dette er problemet med hele evalueringa av Norges håndtering av pandemien sammenlignet med Sverige. Det blir helt feil å kun se på antall døde og ikke på antallet som ble innlagt, kritisk syke og/eller fikk mer eller mindre varige mén. Her synes jeg FHI har sviktet.
Also, evaluation papers need to move away from this narrow focus on deaths as the only COVID harm worth considering - vaccines also prevented a LOT of hospital and ICU admissions, many of which would have had life altering consequences.
July 29, 2025 at 12:08 PM
Og det hjalp ikke akkurat når en forsker fra FHI løp til mediene og erklærte at hvert sparte menneskeliv kostet 133 mill kr. Noe som selvsagt var 100% vrøvl.
Reposted by Kristian Strand
En av vår tids største forbrytelser. Alle som snakker varmt om «vestlige verdier» i årene framover må svare på hvordan vi tillot dette. www.vg.no/nyheter/i/ny...
Bildene av Muhammed (1) ryster en hel verden
Til VG forteller fotografen hva opplevelsen har gjort med ham.
www.vg.no
July 25, 2025 at 12:06 PM
En av vår tids største forbrytelser. Alle som snakker varmt om «vestlige verdier» i årene framover må svare på hvordan vi tillot dette. www.vg.no/nyheter/i/ny...
IMHO Trump seems to be slightly underperforming with regard to the promised dealmaking with foreign countries.
June 15, 2025 at 3:05 PM
IMHO Trump seems to be slightly underperforming with regard to the promised dealmaking with foreign countries.
This.
That said, I still think its bad for the site in the long-run if its reputation becomes a site where anyone vaguely centrist gets yelled it
June 4, 2025 at 8:24 PM
This.
Reposted by Kristian Strand
Procalcitonin- the more we learn, the less we love it 💔
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
Procalcitonin levels in septic and nonseptic subjects with AKI and ESKD prior to and during continuous kidney replacement therapy (CKRT) - Critical Care
Background Procalcitonin is a 14.5 kDa protein used clinically as a marker of sepsis and therapeutic response to antibiotic therapy. However, its utility in critically ill patients with either acute k...
ccforum.biomedcentral.com
May 8, 2025 at 3:26 PM
Procalcitonin- the more we learn, the less we love it 💔
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
▪️94% of non-septic AKI pts had a Pct >0.5 prior to commencing CRRT
▪️Even using a threshold of >3.2 the specificity was only 38% 🗑️
“Pct in pts with AKI/ESRD should not be measured”
#EMIMCC
ccforum.biomedcentral.com/articles/10....
Reposted by Kristian Strand
Agreed. If "comprehensive" and "multidisciplinary" critical care means the outsourcing of every core task, there's not much of a discipline left.
April 20, 2025 at 3:06 PM
Agreed. If "comprehensive" and "multidisciplinary" critical care means the outsourcing of every core task, there's not much of a discipline left.
Also applies to US vs Scandinavian practice.
I’ve missed the clashes of US vs UK medicine that used to happen on twitter. Someone sent me this one today and oh boy does it demonstrate one of the many reasons I’m glad I won’t need to rely on American healthcare when sick. A “wild” cardiac arrest being posted online
March 3, 2025 at 11:27 PM
Also applies to US vs Scandinavian practice.
Reposted by Kristian Strand
In the discussion of how 'America First' might affect US-Norwegian defence cooperation along NATO's northern flank moving forward, a credible threat assessment is an absolute minimum. Instead, overly simplified evaluations of the nature and character of the Russian threat dominate discourse 🧵
March 3, 2025 at 9:20 AM
In the discussion of how 'America First' might affect US-Norwegian defence cooperation along NATO's northern flank moving forward, a credible threat assessment is an absolute minimum. Instead, overly simplified evaluations of the nature and character of the Russian threat dominate discourse 🧵
Reposted by Kristian Strand
As I tell my residents, in the unconscious, undifferentiated patient with shock, the only safe crystaloid is saline.
January 6, 2025 at 8:55 PM
As I tell my residents, in the unconscious, undifferentiated patient with shock, the only safe crystaloid is saline.
Reposted by Kristian Strand
The Christmas cocktail no one wants:
22 Dec: Piperacillin/Tazobactam
26 Dec: Meropenem+Linezolid
28 Dec: Negative cultures→ Meropenem+Soltrim +Fluconazole
A nightmare—we need faster & better #diagnostics
#AMR #fungi #bacteria #fungalinfections #science #GlobalHealth #SciComm #MedSky #publichealth
22 Dec: Piperacillin/Tazobactam
26 Dec: Meropenem+Linezolid
28 Dec: Negative cultures→ Meropenem+Soltrim +Fluconazole
A nightmare—we need faster & better #diagnostics
#AMR #fungi #bacteria #fungalinfections #science #GlobalHealth #SciComm #MedSky #publichealth
December 30, 2024 at 2:55 PM
The Christmas cocktail no one wants:
22 Dec: Piperacillin/Tazobactam
26 Dec: Meropenem+Linezolid
28 Dec: Negative cultures→ Meropenem+Soltrim +Fluconazole
A nightmare—we need faster & better #diagnostics
#AMR #fungi #bacteria #fungalinfections #science #GlobalHealth #SciComm #MedSky #publichealth
22 Dec: Piperacillin/Tazobactam
26 Dec: Meropenem+Linezolid
28 Dec: Negative cultures→ Meropenem+Soltrim +Fluconazole
A nightmare—we need faster & better #diagnostics
#AMR #fungi #bacteria #fungalinfections #science #GlobalHealth #SciComm #MedSky #publichealth
Reposted by Kristian Strand
I might have more to say later, but all the reviews of Carter's presidency emphasize his character, his success in the Mideast, and inflation/gas prices.
But left out of all that: His Cold War policies were abject failures and left America in a precarious situation by 1980. /1
But left out of all that: His Cold War policies were abject failures and left America in a precarious situation by 1980. /1
December 30, 2024 at 7:22 PM
I might have more to say later, but all the reviews of Carter's presidency emphasize his character, his success in the Mideast, and inflation/gas prices.
But left out of all that: His Cold War policies were abject failures and left America in a precarious situation by 1980. /1
But left out of all that: His Cold War policies were abject failures and left America in a precarious situation by 1980. /1
Call me a nazi, but this may not be the way we should interact
www.dailydot.com/debug/jesse-...
www.dailydot.com/debug/jesse-...
Bluesky suffered a full-on meltdown after a journalist users don't like joined
Was the 'safe' alternative to X violated? Or did Bluesky users reveal their true colors?
www.dailydot.com
December 16, 2024 at 11:08 PM
Call me a nazi, but this may not be the way we should interact
www.dailydot.com/debug/jesse-...
www.dailydot.com/debug/jesse-...
Depressing.
It’s so funny that half of Bluesky was like “yes we must kill all the CEOs and then dance in their blood” but Jesse Singal’s mere presence is what led to the dumb company actually having to be like “let’s discuss moderation”
December 14, 2024 at 1:39 PM
Depressing.
Remind me again, why we left X...
“Dear Michael Kruse. Why don’t you go and fuck yourself in the ass with a running chainsaw? Yes, shove it all the way up your ass while it is running. That is the best thing you could possibly do to make the United States a better place.”
New this morning for @politico.com.
December 13, 2024 at 12:17 PM
Remind me again, why we left X...
Sånn er det med den saken
December 7, 2024 at 2:10 PM
Sånn er det med den saken
Reposted by Kristian Strand
One of my favourite reads, and a wonderfull quote: "The worse the hypothesis, the more complicated the statistical analysis"
Prof. Vincent never got it right.
With all due respect to Prof Vincent, our problem is not the randomized clinical trial.
thethoughtfulintensivist.substack.com
November 30, 2024 at 11:15 AM
One of my favourite reads, and a wonderfull quote: "The worse the hypothesis, the more complicated the statistical analysis"
Reposted by Kristian Strand
Actually, the pretty normal TAPSE is a kind of artefact. If you had an apical view, you would see the apex rocking, the lateral LV wall dragging the limp dilated RV. If you measured the relative RV free wall shortening wrt apex, it would be low.
November 15, 2024 at 9:26 PM
Actually, the pretty normal TAPSE is a kind of artefact. If you had an apical view, you would see the apex rocking, the lateral LV wall dragging the limp dilated RV. If you measured the relative RV free wall shortening wrt apex, it would be low.
Reposted by Kristian Strand
Høstens første hvite nedbør kom i dag, men dessverre i form av ubrukelig hagl.
Engelskmenn er eksperter på å få i gang en prat, med å starte helt uskyldig om været.
«Oh, isn’t it cold today?»
«Yes, but you are so clever wearing that fancy hat!»
«Oooh, thanks!»
Følg meg for denne type innsikter.
Engelskmenn er eksperter på å få i gang en prat, med å starte helt uskyldig om været.
«Oh, isn’t it cold today?»
«Yes, but you are so clever wearing that fancy hat!»
«Oooh, thanks!»
Følg meg for denne type innsikter.
November 16, 2024 at 1:09 PM
Høstens første hvite nedbør kom i dag, men dessverre i form av ubrukelig hagl.
Engelskmenn er eksperter på å få i gang en prat, med å starte helt uskyldig om været.
«Oh, isn’t it cold today?»
«Yes, but you are so clever wearing that fancy hat!»
«Oooh, thanks!»
Følg meg for denne type innsikter.
Engelskmenn er eksperter på å få i gang en prat, med å starte helt uskyldig om været.
«Oh, isn’t it cold today?»
«Yes, but you are so clever wearing that fancy hat!»
«Oooh, thanks!»
Følg meg for denne type innsikter.