iiinova — where your digital self keeps evolving

Mark Borthwick @markborthwick.bsky.social · 08/06/2026

41% of ventilated patients receive a mucoactive agent If you exclude (prescribed) NaCl 0.9%, it’s 27% of all ventilated patients pmc.ncbi.nlm.nih.gov/articles/PMC... MARCH will change practice whichever way it goes

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Mark Borthwick @markborthwick.bsky.social · 17/06/2025

Looking for help…! #CriticalCarePharmacist #Oxford www.jobs.nhs.uk/candidate/jo...

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Mark Borthwick @markborthwick.bsky.social · 06/06/2025

Whole day was great UKCPA Critical Care Symposium @ukcpa.bsky.social

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Mark Borthwick @markborthwick.bsky.social · 24/05/2025

#COVID5years Quotes that made us laugh in the moment are added to a whiteboard My niece asks pertinent questions for a school project

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Mark Borthwick @markborthwick.bsky.social · 18/05/2025

#COVID5years Impromptu hugs between nursing staff before a shift in the critical care covid bays

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Mark Borthwick @markborthwick.bsky.social · 03/05/2025

#COVID5years A little ‘thank you’ light show is projected onto the hospital Parallels are made between the Nightingale facility nearing completion, and pandemic flu facilities 100years earlier We start collecting handprints from our ICU workers

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Mark Borthwick @markborthwick.bsky.social · 23/04/2025

#COVID5years PIPA going strong Clinical trials aseptic unit making hundreds of propofol and NMB syringes each day Clinical pharmacy services to crit care now 7 days a week, 12hours a day

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Mark Borthwick @markborthwick.bsky.social · 15/04/2025

#COVID5years Renal replacement fluid supplies now under pressure, and start to be micromanaged Regular counts commence to report back to NHS central, we write on anything handy

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Mark Borthwick @markborthwick.bsky.social · 14/04/2025

#COVID5years Neuro ICU takes all general ICU work, other expanded/specialist units take covid patients PIPA in full flow Clinical trials mass produce propofol and atracurium syringes Nationally: Propofol supply begins to wobble Epoprostenol demand surges and detabilises supply

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Mark Borthwick @markborthwick.bsky.social · 11/04/2025

#COVID5years A more robust near patient IV prep area is developed - Pharmacy Intravenous Preparation Area (*PIPA*) Staff trained in IV making and ANTT in a medical school facility Nurses, medical students, pharmacy technicians, pharmacists collaborate Critical care surges into cardiothoracics

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Mark Borthwick @markborthwick.bsky.social · 09/04/2025

#COVID5years After the IV making service falls over, a new collaboration gets it on its feet again Outpatient areas are earmarked for an expanded service, shielding nurses and medical students are added to the initiative More critical care areas are converted to covid bays

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Mark Borthwick @markborthwick.bsky.social · 05/04/2025

#COVID5years The near patient IV making service falls over: new staff supporting the weekend are not trained in time, the weekday staff are exhausted Clinical trials aseptics unit start production of prefilled syringes of propofol and atracurium Home haircuts begin

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Mark Borthwick @markborthwick.bsky.social · 03/04/2025

#COVID5years Paediatric ICU empties and hands over the space to adult critical care to make ready for further influx The near patient IV medicines making area is pushed out of ICU as bays fill up with COVID, putting it in the “PPE only area” New spaces are eyed up to locate the service to

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Mark Borthwick @markborthwick.bsky.social · 31/03/2025

#COVID5years Urgent planning for national medicines in critical care is underway Nightingale hospitals soak up infusion pump supplies (amongst other equipment and resources) “Making service” commences at OUH (this will morph into PIPA over time “Pharmacy Intravenous Prep Area”)

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Mark Borthwick @markborthwick.bsky.social · 26/03/2025

#COVID5years Pharmacist upskilling webinars by UKCPA and RPS experience high demand (each event ran at least twice) Businesses begin supporting NHS staff with care packages

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Mark Borthwick @markborthwick.bsky.social · 25/03/2025

#COVID5years The redeployment of pharmacists to critical care requires rapid upskilling at scale The UKCPA and RPS pull together webinars and resources to quickly address the need

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Mark Borthwick @markborthwick.bsky.social · 24/03/2025

#COVID5years PPE training for pharmacists newly deployed to critical care Atracurium supply comes under strain, initial plans to consider cisatracurium Begin looking at 7day rosters

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Mark Borthwick @markborthwick.bsky.social · 23/03/2025

#COVID5years Inside, urgent planning occurred Lightening nursing workload a key aim: -Simplify CD process -Prefilled syringes made in aseptics -Individual patient doses made nearby -COVID order sets simplify prescribing and administration timing Outside, it was beautiful

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Mark Borthwick @markborthwick.bsky.social · 21/03/2025

#COVID5years Planning continues in the pharmacy critical care corner Rest of department swings in to support Outside, Spring gets underway

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Mark Borthwick @markborthwick.bsky.social · 16/01/2025

We appear to be past the peak of #Flu in UK 🙌

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Mark Borthwick @markborthwick.bsky.social · 05/01/2025

#Flu UKHSA report 3rd Jan www.gov.uk/government/s...

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Mark Borthwick @markborthwick.bsky.social · 12/12/2024

#Flu Increasing hospital and ICU admission rate Dominant strain H1N1: In severe immunosuppression*, it’s Zanamivir rather than the usual Oseltamivir first line *severe immunosuppression is defined in UKHSA guidance www.gov.uk/government/p...

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Mark Borthwick @markborthwick.bsky.social · 05/12/2024

#Flu ▪️Hospital admissions low but rising ▪️Crit care admissions low ▪️When subtyped, almost all are found to be A(H1N1) ▪️H1N1 has higher risk of antiviral resistance ▪️No resistance seen so far ▪️Historically, H1N1 hits NHS system less hard, but unfortunately hits the ICU system hard

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