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Mark Borthwick

@markborthwick.bsky.social
79 followers 78 following 44 posts

Critical care pharmacist; what’s your poison….?

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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 · 14/11/2025
Awesome conference, so much good stuff :-)
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Mark Borthwick @markborthwick.bsky.social · 29/08/2025
I get why people resign from positions of authority when organisation/leadership goes down the wrong path (yes, looking at the RFK vaccine nonsense) BUT Who do you think replaces the leavers? A similarly minded person, or someone more allied to those views? We give way, and so facilitate
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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
😘
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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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Cathrine McKenzie FRPharmS @cathymac40.bsky.social · 06/06/2025
Jonathan presents the UK respiratory metagenomics implementation, route to routine. @ukcpa.bsky.social was great 👍
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David McWilliams @david-mcwilliams.bsky.social · 06/06/2025
Just a week to go until the launch of the NCEPOD report Recovery Beyond Survival - a review of the quality of rehabilitation care provided to patients following an admission to an ICU. Register now to for the lunchtime webinar on 12 June👇 bit.ly/NCEPODwebinar
bit.ly
Microsoft Virtual Events Powered by Teams
Microsoft Virtual Events Powered by Teams
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
My sincere thanks to all my critical care pharmacy colleagues for contributing data, and to UKCPA for the use of resources to make the study happen
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
Overall we found the UK has moved over to using PPIs for SUP, there is some blanket prescribing going on, enteral feeding is commonly used as stopping criteria, though SUP is not stopped in some locations meaning deprescribing processes are needed
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
Stopping criteria were dominated by “patient fed” (65% of units) In three quarters of those, that meant “full enteral feed”, in the remaining quarter that largely meant “any enteral feed”. Neither SUP-ICU, nor REVISE used enteral feeding as stopping criteria
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
About a fifth of units reported they administered SUP to all patients, contrary to guidelines that advocate only giving SUP to critically ill patients with risk factors
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
Overall, we gathered information from over two thirds of UK critical care units, twice Unsurprisingly, there was a large shift towards the use of PPIs for SUP between 2020 and 2024
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
We gathered SUP practices again in 2024, just prior to the publication of REVISE (which had the potential to change practice again) www.nejm.org/doi/abs/10.1...
nejm.org
Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation | NEJM
Whether proton-pump inhibitors are beneficial or harmful for stress ulcer prophylaxis in critically ill patients undergoing invasive ventilation is unclear. In this international, randomized trial,...
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
However, the appearance of COVID and the withdrawal of ranitidine somewhat ruined the experimental conditions
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
We aimed to more completely characterise UK practice before the publication of PEPTIC (H2RA as first line SUP agent, or PPI as first line SUP agent) We then wanted to see how or if practice would change after the publication of PEPTIC jamanetwork.com/journals/jam...
jamanetwork.com
Effect of Stress Ulcer Prophylaxis With PPIs vs H2RBs on ICU Mortality
This cluster randomized trial compares the effects of proton pump inhibitors (PPIs) vs histamine-2 receptor blockers (H2RBs) on 90-day mortality among patients requiring invasive mechanical ventilatio...
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
In the work up to SUP-ICU, an observational study recorded SUP practices across several countries This revealed that unlike other countries, UK practice was divided between H2RA and PPIs onlinelibrary.wiley.com/doi/abs/10.1...
onlinelibrary.wiley.com
Stress ulcer prophylaxis in the intensive care unit: an international survey of 97 units in 11 countries
Background Stress ulcer prophylaxis (SUP) may decrease the incidence of gastrointestinal bleeding in patients in the intensive care unit (ICU), but the risk of infection may be increased. In this st...
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Mark Borthwick @markborthwick.bsky.social · 27/05/2025
Have stress ulcer prophylaxis practices changed in the UK since the publication of PEPTIC? Yes, but highly likely nothing to do with PEPTIC journals.sagepub.com/doi/10.1177/...
journals.sagepub.com
Stress ulcer prophylaxis practice in UK critical care units: A comparison of cross-sectional surveys between 2020 and 2024 - Mark Borthwick, Greg Barton, Emma Boxall, John P Dade, Odran Farrell, Ruth ...
Background: Critically ill patients are at risk of bleeding from stress ulcers. Comprehensive information regarding United Kingdom stress ulcer prophylaxis (SUP...
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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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Cathrine McKenzie FRPharmS @cathymac40.bsky.social · 21/05/2025
Dear ICU pharmacist colleague. Please complete our brief clinical pharmacysurvey for adult ICU. @rsbournie.bsky.social @markborthwick.bsky.social @chrisremmington.bsky.social @esicm.bsky.social @sccmcriticalcare.bsky.social @ukcpa.bsky.social #together #weareICU docs.google.com/forms/d/e/1F...
docs.google.com
A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study
Dear colleagues, We invite you to participate in our survey, "A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study," conducted by researchers fr...
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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 · 04/05/2025
www.thelancet.com/journals/lan...
thelancet.com
Supporting medical science in the USA
The pursuit of rigorous medical science is not compatible with capitulation to government demands aimed at weaponising and eroding science. On April 14, Edwin R Martin Jr, the Trump-appointed interim ...
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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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Cathrine McKenzie FRPharmS @cathymac40.bsky.social · 02/05/2025
docs.google.com/forms/d/e/1F... Dear Intensive pharmacist, please complete our short international survey . This one for pharmacists, more coming for pharmacy team, including pharmacy technicians #bepartofresearch @markborthwick.bsky.social @chrisremmington.bsky.social and team
docs.google.com
A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study
Dear colleagues, We invite you to participate in our survey, "A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study," conducted by researchers fr...
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Mark Borthwick @markborthwick.bsky.social · 29/04/2025
Really interesting thread Segun Balancing sufficient assurance of knowledge, skills, behaviours and experience vs overburdening is difficult, and key We all -public, payers, colleagues- need some form of objective assurance of competence, not none (in medicine, nursing, pharmacy, physio, etc)
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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 · 28/03/2025
This is great, proper multi professional team with patient representation
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Reposted by Mark Borthwick
David McWilliams @david-mcwilliams.bsky.social · 28/03/2025
The protocol for our PHOENIX trial has been published today, evaluating the feasibility of optimised nutrition and enhanced Physiotherapy for survivors of critical illness #ICURehab bmjopen.bmj.com/content/15/3...
bmjopen.bmj.com
Physiotherapy and Optimised Enteral Nutrition In the post-acute phase of critical illness (PHOENIX): protocol for a mixed methods feasibility randomised controlled trial
Introduction Each year in the UK, 140 000 patients are discharged from intensive care units (ICUs) to general hospital wards, almost all with complex rehabilitation needs. 84% of patients still requir...
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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 · 26/03/2025
“We at Oxford” are well prepared due to critical care clerkship aspect of clinical diploma “We in England” have probably not maintained a basic exposure to critical care as part of training Training pathways and specialised credentialling available for those who wish to make crit care their career
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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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Louise Gallie @rehablegendlou.bsky.social · 12/03/2025
It's World Delirium Awareness Day. This year, the theme is 'Raising Awareness', so let's start by sharing this animation of my #PatientExperience #WDAD2025 youtu.be/JrK5zZC1rbw?si…
youtu.be
'What's it like to have Delirium'?
YouTube video by From Delirium To Reality
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Mark Borthwick @markborthwick.bsky.social · 16/02/2025
Nice chapter: medical models ✅ Nice chapter: nursing workforce✅ One sentence for pharmacists 🙄 Maybe add some key points from this in your guidance to ensure translation on the ground pubmed.ncbi.nlm.nih.gov/32826496/
pubmed.ncbi.nlm.nih.gov
Position Paper on Critical Care Pharmacy Services: 2020 Update - PubMed
Critical care pharmacists are essential members of the multiprofessional critical care team. The statements recommended by this taskforce delineate the activities of a critical care pharmacist and the...
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Guild of Healthcare Pharmacists @guildofhp.bsky.social · 07/02/2025
National campaign launch - 10% minimum of pharmacist time must be dedicated for Supporting Professional Activities (SPAs). Demands on pharmacists are rapidly reaching untenable levels. Read more: www.ghp.org.uk/protected-ti...
ghp.org.uk
Protected Time for Supporting Professional Activities (SPA) – National Campaign – Guild of Healthcare Pharmacists
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The Pharmaceutical Journal @pharmaj.bsky.social · 22/01/2025
A 'Prevention of future deaths' report has highlighted the problem of pharmacists not being permitted to issue different strengths of medicines without an amended prescription following the death of a toddler #ukpharmacy #prescribing
buff.ly
Coroner raises concerns over pharmacists being unable to amend prescriptions following death of toddler
A coroner has expressed concern that pharmacists are not permitted to provide differing strengths of the same medicines without an amended prescription, following the death of two-year-old Ava Grace…
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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 · 06/01/2025
Yes Add to the news about spread in cattle and cats, and this little bomb is on its final few ticks
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Mark Borthwick @markborthwick.bsky.social · 05/01/2025
Does enteral nutrition protect against stress ulceration in the critically ill? Probably, but little in the way of direct robust evidence journals.lww.com/co-clinicaln...
journals.lww.com
Does enteral nutrition protect against stress ulceration in ... : Current Opinion in Clinical Nutrition & Metabolic Care
summarizes available evidence regarding EN effects on GIB Recent findings There are few data available to directly compare the effect of EN on GIB. Direct comparison in animal models generally indi...
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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 · 22/12/2024
#Flu
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