iiinova — where your digital self keeps evolving

Daniel Jolley @djoll.bsky.social · 01/08/2026

Anaesthetics have a certain rhythm. At the beginning, the anaesthetist sets that rhythm. 🎶 But as the anaesthetic evolves, particularly late in a case, you risk the rhythm being defined by things outside your control… #Anesthesiology

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Daniel Jolley @djoll.bsky.social · 09/07/2026

Perhaps I’ll see real-time clinical propofol monitoring in my career… would be pretty awesome!

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★ metajournal @metajournal.bsky.social · 29/06/2026

Dreaming while under general anaesthesia is common and predominately positive, and is not associated with intraoperative awareness. #Review — Dreaming during anaesthesia: a scoping review. Br J Anaesth. 2026 Jun 11 metajournal.com/42270528

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★ metajournal @metajournal.bsky.social · 05/06/2026

After 18 months of coding, the new metajournal is now live. Faster and with better article suggestions than before, come and check it out → metajournal.com

metajournal.com

metajournal

Your personalized medical journal

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Daniel Jolley @djoll.bsky.social · 01/04/2026

One of anaesthesia's superpowers is being an aggressively introspective specialty (occasionally too much so, leading to neurotic, double-guessing & nervous anaesthetists). Reading legendary tech-VC Marc Andreeson's "I try to be as minimally introspective as possible" comment is a perplexing,… 1/2

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Daniel Jolley @djoll.bsky.social · 26/09/2025

I wrote about the anti-acetaminophen advice: Tylenol, Tyranny, and Misogyny “This is a broader project of bad science weaponised to undermine trust and weaken institutions … science is being twisted for ideological goals, to reinforce sexism & inequity.” → www.metajournal.com/blog/118/tyl...

metajournal.com

Tylenol Tyranny And Misogyny « metajournal.com

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ANZCA @anzca.bsky.social · 23/09/2025

ANZCA and FPM STATEMENT Paracetamol use in pregnancy We are aware of recent claims from the US questioning the safety of paracetamol use in pregnancy. These claims are not based on new evidence. Our full statement is here: tinyurl.com/5yye2npu

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Daniel Jolley @djoll.bsky.social · 24/09/2025

I collected the main evidence investigating #acetaminophen / #paracetamol use in pregnancy & possible neuro development effects here: www.metajournal.com/collections/... Ahlqvist’s 2024, 2.5 million subject sibling-controlled cohort study is the most reassuring. Advice remains unchg’d outside US!

metajournal.com

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Prof Brendan Crabb AC @brendancrabb.bsky.social · 29/03/2025

An important long read. Key elements of highly pathogenic H5N1 incl: 1. It’s already a major ‘pandemic’ of birds with big impact, (2) it’s adapting to mammals, (3) it’s not yet in Oz, (4) we need robust pandemic preparedness, including clean indoor air strategies. www.abc.net.au/news/2025-03...

abc.net.au

This flu virus is spreading and scientists say it has pandemic potential

Since 1959 the avian flu virus H5N1 has been popping up around the globe. Now scientists believe it could spark the next pandemic.

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Daniel Jolley @djoll.bsky.social · 02/03/2025

Make Cavities Great Again? 🦷🤦‍♂️ “Utah Could Become America's First State To Ban Fluoride In Public Water” NB: recent Australian study found no sig difference in childhood IQ from fluoridated water. → journals.sagepub.com/doi/full/10.... yro.slashdot.org/story/25/03/... #idiocracy

yro.slashdot.org

Utah Could Become America's First State To Ban Fluoride In Public Water - Slashdot

NBC News reports that Utah could make history as America's first state to ban fluoride in public water systems — even though major medical associations supporting water fluoridation: If signed...

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Daniel Jolley @djoll.bsky.social · 24/02/2025

Why do experts seem less certain than everyone else? (Why is there surging expertise-rejection?) In anaesthesia, embracing uncertainty means knowing what you don't know. True expertise means being comfortable with complexity and change: www.metajournal.com/blog/115/exp... #expertise #uncertainty

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Daniel Jolley @djoll.bsky.social · 24/02/2025

(Via @AaronDavid@mastodon.world)

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Daniel Jolley @djoll.bsky.social · 30/12/2024

The Unseen Anaesthetist: Trust is the foundation of anaesthetic care ➡️ www.metajournal.com/blog/114/the...

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Walter Crittenden, MD 🩺 @propofolmonkey.medsky.social · 10/12/2024

“If I had eight hours to chop down a tree, I'd spend the first six hours sharpening my axe.” - Abraham Lincoln, alluding to preoxygenation and positioning on a potentially problematic patient (probably) #ansky #medsky

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Andrea Love, PhD | Biomedical Scientist @drandrealove.bsky.social · 09/12/2024

Do you say raw milk tastes better than pasteurized? It’s fat. Milk undergoes quality control before sale. On top of pasteurization, that involves skimming fat. Unprocessed milk? 3.5 - 5% fat. Whole milk? 3.25% fat. 2%? Duh, 2%. 1%? Yup. Skim? <0.5%. You like the taste of fat. 1/

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Daniel Jolley @djoll.bsky.social · 10/12/2024

Cory Doctorow’s critique of Bluesky as refuge from Twitter is mandatory reading for all of #MedSky & #AnSky as we (re)build a med SoMe community here (perhaps wandering through the garden of Mastodon on the way…) #enshittification doctorow.medium.com/https-plural...

doctorow.medium.com

Bluesky and enshittification

No one is the enshittifier of their own story.

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Anaesthesia @anaesjournal.bsky.social · 04/12/2024

Does your role (eg consultant, resident, nurse etc) affect how quickly you learn to use HAVL if you already know how to use DL? No. 12 tracheal intubations were needed to reach proficiency across all clinician groups. #AnSky #MedSky #AirwaySky buff.ly/3CVoXIZ

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Daniel Jolley @djoll.bsky.social · 03/12/2024

This is a pretty incredible move by India: US$715 million deal with 30 global academic publishers for nationwide access to 13,000 journals. (And because this also covers some Open Access journals, the rest of the world benefits from Indian's published research.) www.science.org/content/arti...

science.org

India takes out giant nationwide subscription to 13,000 journals

Deal allows scholars to read paywalled articles for free and will cover open-access fees

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Daniel Jolley @djoll.bsky.social · 02/12/2024

In Australia, most of us have never seen or used etomidate, unless in the UK or NZ. It’s never felt like we’re missing out! 🤣

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Brian Hughes @bmhughes.bsky.social · 28/11/2024

A new BMJ review claims that #LongCovid can be treated using CBT and physical exercise As ever, the devil is in the detail TL; DR the authors' own risk-of-bias analyses show that their own conclusion is unwarranted (Too bad they hid the crucial deets in an online supplement!) cc #pwME #MECFS

thesciencebit.net

That BMJ review of Long Covid therapies does not show what it says it does

The BMJ have published a “living systematic review” of interventions for the management of Long Covid. It sets out to gather all relevant studies, and to comb their findings in order to see what works...

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Andy Conway Morris @andymoz78.bsky.social · 24/11/2024

Talking of Bier, @orthopodreg.bsky.social the story of how he developed spinal anaesthesia is pretty wild A story of cocaine, cigars, and German army helmets. #AnSky #MedSky #HistoryMedSky

media.tenor.com

a baby rhino is playing with snow in a zoo enclosure .

Alt: a baby rhino is playing with snow in a zoo enclosure .

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Daniel Jolley @djoll.bsky.social · 25/11/2024

We’re getting better! PORC of 2.2% in this single center study (vs 10-15% in past). More routine NM monitoring & more common sugammadex use? #AnSky

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Kevin Fong @drkevinfong.bsky.social · 24/11/2024

editorial from @bmj.com and paper: Poor staff retention is associated with higher patient mortality. Have said it before & I’ll say it again. If you don’t care for the carers, they cannot care for their patients. www.bmj.com/content/387/...

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Daniel Jolley @djoll.bsky.social · 24/11/2024

Interesting 2022 follow-up study from the same researcher, Dr George Zhong - shows the nuance inherent in many environmental/GWP trade-off decisions. Great that this work is being done. 👏

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George Zhong @propofoldreams.bsky.social · 24/11/2024

The original study was benchtop using a test lung. We then did a lesser cited follow up clinical study. Long story short, FGF 2 suffice for non laparoscopic surgeries. FGF 4-6 for laparoscopic surgeries. High FiO2 negates any potential environmental benefits. www.bjanaesthesia.org/article/S000...

bjanaesthesia.org

DEFINE_ME

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Paul Southall @pjsouthall.bsky.social · 24/11/2024

The updated version does state that increased flows have an increased environmental impact This was one of the articles considered when the updated Green Theatre Checklist was being written (which will be released very soon!) www.bjanaesthesia.org/article/S000...

bjanaesthesia.org

DEFINE_ME

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Daniel Jolley @djoll.bsky.social · 24/11/2024

💯 agree / The value of a "rescuer" arriving is more than just a 2nd pair of hands, its the new, fresh eyes brought to reset fixation in the room. Still sometimes VERY hard not to jump in before establishing your own situational awareness: Endsley's Perception/Comprehension/Projection hierarchy

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Daniel Jolley @djoll.bsky.social · 24/11/2024

This great lab study from 2020 surprised me at the time - challenging our assumptions about fresh gas flow rates and economic/environmental costs. #AnSky [ Higher FGF (~6L/min) during TIVA reduces costs without sig environmental impact. ] Summary → www.metajournal.com/articles/103...

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Walter Crittenden, MD 🩺 @propofolmonkey.medsky.social · 20/11/2024

Here’s my pre-induction timeout routine, spoken aloud to the room: “This is <patient>, DOB, here for <procedure>. Pulse ox is on and working. BP cuff is cycling. Monitor shows <rhythm> and the alarms are on. Suction is working. Airway equip is here. Abx are here. 1/

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Daniel Jolley @djoll.bsky.social · 20/11/2024

Interesting medical LLM study in JAMA Open showing that even when LLMs have superior diagnostic skills, just providing doctors with access does not improve diagnosis. (summarised on MJ). #ai #LLMs #medicine #MedSky → www.metajournal.com/articles/177...

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Daniel Jolley @djoll.bsky.social · 18/11/2024

This is a great example of BIS/Entropy interference from 50/60Hz mains. I often see similar pEEG jumps from the forced-air warmer / Bair Hugger. #AnSky #anaesthesia

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Daniel Jolley @djoll.bsky.social · 18/11/2024

Welcome @anzca.bsky.social ! 👏 Now we just need to get some of the other ANZ medical colleges over here too.

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Daniel Jolley @djoll.bsky.social · 18/11/2024

This is unsettling… forever immortalised in plastic, never able to consent.

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Shaheed @sr23.bsky.social · 17/11/2024

I’m here for it My uncle used to say "The first rule of theatre is to always leave them wanting more" Great bloke... Terrible anaesthetist...

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Scott Gottlieb, MD @scottgottliebmd.bsky.social · 17/11/2024

The migration of MedTwitter, along with a large cohort of science journalists, to BlueSky is striking in its scale and rapidity. In a short time, this shift has effectively transformed BlueSky into the essential hub for breaking medical news and vibrant scientific discourse.

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Dr. Rachel Zoffness @drzoffness.bsky.social · 17/11/2024

❌ There is no "pain center" in the brain. 🧠 Rather, pain is a diffuse neurological process involving MANY brain sites, including PFC (attention), cerebral cortex (thoughts) + limbic system, critical parts of our emotion circuitry💥 📣 Pain is *both* physical and emotional ALWAYS 👏🏼 #MedSky #psyscisky

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Yorkshire Society of Obstetric Anaesthetists @obsanaes.bsky.social · 16/11/2024

go.bsky.app/LSCVjhi Link would help wouldn’t it!!! Sorry!!

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Sethina Watson @sethina.bsky.social · 15/11/2024

Just arrived and looking for some anaesthetic or critical care content? I've collated 150 accounts to follow in Pack 1. Plus another 100. Some familiar names & faces. International conversations. #MedSky #AnSky #Anaesthesia #Anaesthetist #ICM #ICU #CriticalCare #Intensivist #Anaesthesiologist

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Daniel Jolley @djoll.bsky.social · 15/11/2024

Looked at three interesting articles this week… a couple of meta-analyses: one on opioid-free anaesthesia, another on anaesth techniques for AF ablations; and then an RCT on atelectasis benefits of LMAs (😳) #AnSky www.metajournal.com/blog/113/opi...

metajournal.com

Opioid-free, AF anaesthesia and LMA atelectasis

Three interesting recent studies looking at specific choices around anaesthetic technique. In the Canadian Journal of Anesthesia, da Silveira reviews the benefits of opioid-free laparoscopic surgery (...

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Daniel Jolley @djoll.bsky.social · 15/11/2024

Hmmm. Well this is interesting… seems Med Twitter has finally migrated en masse. 😃 I have a bit of coding to do to setup metajournal.com over here as well … though already exists (imperfectly) on mastodon: med-mastodon.com/@metajournal Always good to have another project! 😝

metajournal.com

metajournal.com - stay up to date!

Using machine learning to find the most significant, interesting and personally relevant articles – just for you.

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