Steven Ilko 🏥 🚁💨
@zentensivistilko.bsky.social
EM/ACCM/E-AEC Zen-tensivist. Humanist. Philosophizer/Belly-Button Starer. Med interests: MCS, HEMS-CC, de-prescribing, and communication. My opinions are my own, not of my employer(s).
It was our local practice pattern to ace wrap the snot out of it and send them with reliable parents. No pressors, no oxygen, no limb/organ threat? No problem.
November 25, 2025 at 3:49 PM
It was our local practice pattern to ace wrap the snot out of it and send them with reliable parents. No pressors, no oxygen, no limb/organ threat? No problem.
It's nice to listen how others articulate their practice patterns and acknowledge the limitations of real world application
November 24, 2025 at 3:11 PM
It's nice to listen how others articulate their practice patterns and acknowledge the limitations of real world application
How is that helpful for the vast majority of travelers who don't have access to airport lounges? Your clever advice may as well read: don't be poor
November 24, 2025 at 1:30 PM
How is that helpful for the vast majority of travelers who don't have access to airport lounges? Your clever advice may as well read: don't be poor
As a lukewarm bicarb aficionado, a 1 point difference out of 10 in an obscure measure of vertigo symptoms is probably unlikely to be a robust patient centered outcome.
November 20, 2025 at 7:37 AM
As a lukewarm bicarb aficionado, a 1 point difference out of 10 in an obscure measure of vertigo symptoms is probably unlikely to be a robust patient centered outcome.
Pretty sure that was just nature attempting to course correct
a man says " and i will strike down upon thee " in yellow letters
ALT: a man says " and i will strike down upon thee " in yellow letters
media.tenor.com
November 13, 2025 at 9:23 PM
Pretty sure that was just nature attempting to course correct
Long story short: if history is our guide, we're pretty f*cked.
a cartoon of perry the platypus wearing a hat and belt
ALT: a cartoon of perry the platypus wearing a hat and belt
media.tenor.com
November 10, 2025 at 5:50 PM
Long story short: if history is our guide, we're pretty f*cked.
The DNC belief that institutions protect us, fight wrongs and bend towards equality are symptomatic of the Democratic Nationalism poisoning our society and fails to help anyone but those who benefit from power. Those who will lead us out prioritize people above institutions, humanity over profits.
November 10, 2025 at 5:50 PM
The DNC belief that institutions protect us, fight wrongs and bend towards equality are symptomatic of the Democratic Nationalism poisoning our society and fails to help anyone but those who benefit from power. Those who will lead us out prioritize people above institutions, humanity over profits.
Those fighting to keep these institutions open fail to recognize how it's their blind devotion to institutions themselves, their false belief in the institutions to correct these problems, that are fueling the greatest injury. They're complicit in the harms that will follow. History shows this.
November 10, 2025 at 5:50 PM
Those fighting to keep these institutions open fail to recognize how it's their blind devotion to institutions themselves, their false belief in the institutions to correct these problems, that are fueling the greatest injury. They're complicit in the harms that will follow. History shows this.
Seems to be dose dependent if you're administering hydrochloric acid to your patients. So don't do that. pubmed.ncbi.nlm.nih.gov/16966998/
Acidosis impairs the coagulation: A thromboelastographic study - PubMed
Acidosis causes a strong impairment of the coagulation as measured with thromboelastography. The impairment found when lowering pH from 7.4 to 7.15 was almost identical to the impairment seen in another study by Kettner et al. when the temperature was lowered from 36 degrees C to 32 degrees C.
pubmed.ncbi.nlm.nih.gov
November 7, 2025 at 2:52 PM
Seems to be dose dependent if you're administering hydrochloric acid to your patients. So don't do that. pubmed.ncbi.nlm.nih.gov/16966998/
I low key love it. I order it. It's given. Intervention complete.
a bald man with blue eyes is wearing a gray shirt
ALT: a bald man with blue eyes is wearing a gray shirt
media.tenor.com
November 4, 2025 at 12:32 PM
I low key love it. I order it. It's given. Intervention complete.
I still get hepatology hold outs who futz at me for having given steroids for alcoholic hepatitis...
"They don't have great follow up"
... They have even worse follow up when they're dead...
"They don't have great follow up"
... They have even worse follow up when they're dead...
October 31, 2025 at 12:53 AM
I still get hepatology hold outs who futz at me for having given steroids for alcoholic hepatitis...
"They don't have great follow up"
... They have even worse follow up when they're dead...
"They don't have great follow up"
... They have even worse follow up when they're dead...
They definitely lost me at dextran/hetastarch 😂
You can model all you want, but the evidence is clear that these have no purpose. Albumin... Meh. I like it in refractory burn resuscitation which this seems to support. Certainly not a sepsis/ICU panacea.
You can model all you want, but the evidence is clear that these have no purpose. Albumin... Meh. I like it in refractory burn resuscitation which this seems to support. Certainly not a sepsis/ICU panacea.
October 20, 2025 at 11:44 AM
They definitely lost me at dextran/hetastarch 😂
You can model all you want, but the evidence is clear that these have no purpose. Albumin... Meh. I like it in refractory burn resuscitation which this seems to support. Certainly not a sepsis/ICU panacea.
You can model all you want, but the evidence is clear that these have no purpose. Albumin... Meh. I like it in refractory burn resuscitation which this seems to support. Certainly not a sepsis/ICU panacea.
I'm somewhat curious how this is eminence based... They have created models that seem to be decently reflective of reality. I would consider it eminence based if they just claimed "believe me, it's in the third space" and provided no real support. Seems to me they brought the receipts.
October 20, 2025 at 4:35 AM
I'm somewhat curious how this is eminence based... They have created models that seem to be decently reflective of reality. I would consider it eminence based if they just claimed "believe me, it's in the third space" and provided no real support. Seems to me they brought the receipts.
Finally some public support of push dose dilt for svt. No one appreciates the adenosine doom
October 11, 2025 at 10:07 PM
Finally some public support of push dose dilt for svt. No one appreciates the adenosine doom
A lot more methin around these days. It's been interesting watching the arc of substance use trends with the rise of the opioid epidemic to the combo stimulants/fentanyl speedballs towards the dominance of stimulants.
October 3, 2025 at 5:08 PM
A lot more methin around these days. It's been interesting watching the arc of substance use trends with the rise of the opioid epidemic to the combo stimulants/fentanyl speedballs towards the dominance of stimulants.