Segun Olusanya
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drfreeze.bsky.social
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
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/...
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
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.
November 22, 2025 at 8:22 AM
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
November 25, 2025 at 9:26 AM
#emimcc types:

Anyone seeing bad H3N2 yet?
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
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
November 24, 2025 at 8:48 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/...
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
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
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
November 19, 2025 at 2:01 PM
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
@avkwong.bsky.social finishing off the advanced CACU course with a talk on POCUS in AI.

This is an incredible growth area.
November 21, 2025 at 3:53 PM
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
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
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
Amazing
Just ask - "Could it be Caffeine?" #AnaesthesiaSky
November 20, 2025 at 2:38 PM
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/...
November 20, 2025 at 12:18 PM
@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
November 20, 2025 at 10:19 AM
Reposted by Segun Olusanya
#ICM-Quizz #MedEd Pulmonary artery pulse pressure and an EtCO₂ waveform of 17 mmHg indicate that atrial activity sustains transpulmonary flow and pulmonary venous return. In VA-ECMO without native ejection, EtCO₂ tends to fall below 10 mmHg. zurl.co/5XREe
November 20, 2025 at 9:00 AM
Reposted by Segun Olusanya
What if dog was one of us
October 15, 2025 at 3:01 AM
Reposted by Segun Olusanya
#ICM-Quizz #MedEd A 60-year-old man on VA-ECMO and Impella CP for refractory ventricular fibrillation showed unusual hemodynamic values under sedation, paralysis, hypothermia, and ventilation. What's your diagnosis?
November 19, 2025 at 5:00 PM
Reposted by Segun Olusanya
A country where Sadiq Khan can lead London, Humza Yousaf can lead Scotland, and Rishi Sunak can lead Britain is a country where the racists had *lost*. So much of this vicious bile has come directly after that and almost no one seems to draw the connection
November 19, 2025 at 2:58 PM
Reposted by Segun Olusanya
I joined Roon but it doesnt look good, doubt I will use it much.

I think you may need to be a USA physician to join ???

A major strength of MedSky is multidisiplinary discussions… so excluding RNs, PAs, pharmacists, RTs etc destroys that.

TBH we just need more people here, this place is nice
discussions.so
November 19, 2025 at 1:38 PM
Reposted by Segun Olusanya
And...septic cardiac dysfunction heals on its own within 72 hours...
November 18, 2025 at 6:44 AM
Reposted by Segun Olusanya
Most studies are unable to seperate preexisting cardiac dysfunction, iatrogenic card dysf and simply abnormal load conditions causing abnormal echo parameters from true sepsis induced cardiac dysfunction. #emimcc #cardiosky
November 17, 2025 at 7:52 PM
There’s been 13 strikes?

They snuck up on me like fast and the furious sequels
November 14, 2025 at 7:32 AM