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Matthew Snowsill

@mattsnowsill.bsky.social
2.3K followers 624 following 65 posts

🏥 London EM Consultant 🚑 ACCESS London Retrieval Consultant 🚁 Former London HEMS 🧑‍🎓 QMUL Resus MSc grad 🚑 Founder & Lead: PHEMfeedback.bsky.social 💚 🤔 #ResusSky #MedSky #MedTwitter #FOAMed #POCUS #PHEM #HumanFactors #PrehospitalFeedback #Resus #emimcc

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Reposted by Matthew Snowsill
josh farkas 💊 @pulmcrit.bsky.social · 29/10/2025
The BICAR-ICU-2 trial just dropped! RCT involving IV bicarb in metabolic acidosis among patients with mod-severe AKI Bicarb didn't affect mortality but it reduced the need for dialysis & risk of bacteremia VERY similar conclusions to BICAR-ICU-1 🧵 #1/ jamanetwork.com/journals/jam... #EMIMCC
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Jack Iwashyna @iwashyna.bsky.social · 29/10/2025
"One intangible advantage of capillary refill time is that performing it brings the clinician back to the bedside to reassess the patient. This act may be itself the holy grail of early sepsis management." great piece on #sepsis
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Segun Olusanya (He/Him) @drfreeze.bsky.social · 18/10/2025
I would normally not have batted an eye at this paper But it’s by Robert Hahn, and is a nice overview of everything we know about fluid redistribution in the critically unwell- including gel phase, some glycocalyx stuff, 3 compartment models, and albumin escape rates #foamed
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Matthew Snowsill @mattsnowsill.bsky.social · 13/10/2025
actacc.org/education/meet… Webinar by the WITCA (Women in Cardiothoracic Anaesthesia) group For those who might be interested 😊 #emimcc #medsky
actacc.org
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josh farkas 💊 @pulmcrit.bsky.social · 08/10/2025
normal mentation *doesn't* indicate adequate systemic perfusion especially in cardiogenic shock, people can mentate well despite terrible CO & systemic perfusion poor mentation is sometimes an early sign of *septic* shock, but often a very late indicator of other shock states #EMIMCC
media.tenor.com
Sad Sad Bean GIF
ALT: Sad Sad Bean GIF
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Bluesky @bsky.app · 08/09/2025
v1.108 is rolling out today 🚚 Now live, at long last: Bookmarks, aka Saved Posts. For all those posts you'll definitely plan to come back to! Update the app and give it a try. The button is right down there 👇
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Matthew Snowsill @mattsnowsill.bsky.social · 28/08/2025
x.com/ACCESS_Londo... For those near London interested in #resus, #emimcc Maternal critical care transfers is the theme of this Clinical Development Day (in person only). Sorry it's a link to the other place....
x.com
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Dr Thomas Shanahan MRCEM @tshanahan0584.bsky.social · 03/06/2025
Very pleased to share short report just published in #EMAJournal @emajournal.bsky.social Case Series of Resuscitative Hysterotomy in Pregnant Trauma Patients Performed in the Emergency Department of a Level One Major Trauma Service onlinelibrary.wiley.com/share/author...
onlinelibrary.wiley.com
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josh farkas 💊 @pulmcrit.bsky.social · 26/05/2025
minor updates to the antiemetic chapter 🤢 inhaled isopropyl alcohol pads are safe, fast, and underutilized 🤢 ondansetron is often a front-line drug due to favorable safety profile 🤢 olanzapine is a highly effective, broad-spectrum agent that is underutilized (emcrit.org/ibcc/antieme...) #EMIMCC
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Robbie Lloyd @robbielloyd.bsky.social · 21/05/2025
My take on sepsis, circulation management in septic shock, peripheral noradrenaline #EmergencyMedicine #EM #Sepsis #MedSky #EMedSky #MedEd #EMSky
open.substack.com
UK EM Field Notes #8
My take on sepsis, circulation management in septic shock, peripheral noradrenaline
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@IM_Crit_ @imcrit.bsky.social · 07/05/2025
Sad news: Another giant in Critical Care, Professor Rinaldo Bellomo, passed away this morning. He was born in Reggio Emilia, Italy & emigrated to Australia in the 1980s receiving his medical degree from Monash Medical School in Melbourne He completed fellowships in nephrology,
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Nick Mark, MD @nickmark.bsky.social · 02/05/2025
I work with the best team! Love this battle of the inotrope education: milrinone vs dobutamine. Blue 🔵 or 🔴?
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Lars Mølgaard Saxhaug @load-dependent.eurosky.social · 01/05/2025
I’m obviously a bit biased, but I believe there is greater danger in misclassification of non-septic shock (especially cardiogenic) as septic shock than from delayed recognition of septic shock. #emimcc #cccsky
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Royal College of Emergency Medicine @rcem.ac.uk · 21/04/2025
🚨 New: Best Practice Guidelines with the National Poisons Information Service (NPIS) - Management of Patients with Suspected but Unidentified Poisoning in the Emergency Department. ⬇️ Download it 🔄 share it ▶️ practice it. 🔗 Link: rcem.ac.uk/clinical-...
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Dr Stevan Bruijns 🏥🚑🤕🌍🏳️‍🌈 @codingbrown.bsky.social · 17/01/2025
Relationship between ⌚ spent in A&E & odds of 30-day, post-discharge, all-cause mortality: Compared with patients who spent 2h in A&E, the odds of post-discharge death were: 🕒 1.1 x ☝️ if spent 3h 🕕 1.6 x ☝️ if spent 6h 🕘 1.9 x ☝️ if spent 9h & 🕛 2.1 x ☝️ if spent 12h #EMedsky 🔗 shorturl.at/Tvw9e
shorturl.at
Association between time spent in emergency care and 30-day post-discharge mortality, England - Office for National Statistics
Relationship between time spent in A&E and the odds of 30-day, post-discharge, all-cause mortality, controlling for other factors.
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Segun Olusanya (He/Him) @drfreeze.bsky.social · 08/12/2024
The Barts/London prehospital experience has just been published www.resuscitationjournal.com/article/S030... Excellent work by my friends and colleagues.
resuscitationjournal.com
Sub30: Feasibility study of a pre-hospital extracorporeal membrane oxygenation (ECMO) in patients with refractory out-of-hospital cardiac arrest in London, United Kingdom
Out-of-hospital cardiac arrest (OHCA) carries a significantly poor prognosis with fewer than one in ten patients (∼9%) surviving to hospital discharge with some evidence suggesting that survival rates may even be decreasing to 7.8 %1–2 Survival is inversely correlated to the time taken to restore a spontaneous circulation, and cardiac arrests refractory to initial resuscitation attempts lead to very low neurologically intact survival rates.3 Extracorporeal cardiopulmonary resuscitation (ECPR) describes the implementation of extra-corporeal membrane oxygenation (ECMO) during ongoing resuscitation and is emerging as a treatment to improve outcomes for patients in refractory cardiac arrest.
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Katie Wiskar @katiewiskar.bsky.social · 03/12/2024
1/ I love love LOVE scanning the heart 😍, but when it comes to bang for your buck for ultrasound novices, lung ultrasound is such a winner 🏆 It's time for another #POCUS basics #skeetorial 🧵 Let's talk about common pitfalls in #LungUltrasound and how to correct these ✔️ #emimcc
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Matthew Snowsill @mattsnowsill.bsky.social · 01/12/2024
Beautifully articulated as always It's not just about rate of patients seen. *Emergency* Medicine needs time and space to train, reflect, innovate, discuss and enjoy the unique challenges it faces. These aspects are still work and service. They've been devalued but they're more important than ever
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Brian Elliott @brianelliottmd.bsky.social · 01/12/2024
Since we’re entering the last month of 2024, here is a non-systematic review of #pulmcrit trials published this year that I found particularly noteworthy. Not comprehensive, so please include any that I may have missed! (🧵1/11) #emimcc #critcare #pulmsky #medsky
media.tenor.com
a man in a blue shirt and tie is standing in front of a bulletin board with papers on it .
ALT: a man in a blue shirt and tie is standing in front of a bulletin board with papers on it .
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Clare Eliza @clare-eliza.bsky.social · 25/11/2024
I built and lead a HIU programme and if your unit hasn’t got one, you need one - benefits the patient, benefits the unit, benefits the finances, and can be extremely interesting work
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Rachel Edwards @drracheledwards.bsky.social · 28/11/2024
Interesting article. A lot of what we label as refractory VF isn’t refractory at all. It’s actually recurrent. Is there a way in which we could change defibrillation strategies or antiarrhythmic drug administration to better address this? academic.oup.com/eurheartj/ad...
academic.oup.com
Defibrillation and refractory ventricular fibrillation
Of patients with out-of-hospital cardiac arrest (OHCA) presenting in ventricular fibrillation (VF), the majority require multiple shocks.1 Guidelines recom
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Anaesthesia @anaesjournal.bsky.social · 28/11/2024
Face mask ventilation vs high-flow nasal oxygenation Comparison of end-tidal oxygen concentration and the lowest SpO2 after tracheal intubation between parturients. #AnSky #MedSky buff.ly/4fMvK6u
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josh farkas 💊 @pulmcrit.bsky.social · 27/11/2024
Skytorial: Five pearls on olanzapine 😁 Between agitation and nausea/vomiting, olanzapine has a wide range of use. Olanzapine is generally not a front-line agent (e.g., haloperidol or ondansetron often are). But sometimes, it really comes in clutch....
media.tenor.com
a man in a plaid shirt sits at a picnic table with the words " settle down " on the bottom
ALT: a man in a plaid shirt sits at a picnic table with the words " settle down " on the bottom
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Matthew Snowsill @mattsnowsill.bsky.social · 26/11/2024
Nipped back to the other place briefly. 8 bot followers waiting for me, not much else since I came across. Not really missing it loads but will check in from time to time while the communities build here.
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Matthew Snowsill @mattsnowsill.bsky.social · 26/11/2024
For those professionals interested in improving the standard of care provided to patients with learning disabilities: The Medical Practice in Adult Learning Disability postgraduate certificate (PGCert) www.edgehill.ac.uk/course/medic... www.rcp.ac.uk/events-and-e... #medsky #emimcc
edgehill.ac
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Matthew Snowsill @mattsnowsill.bsky.social · 25/11/2024
Will happily take a work-provided smart phone with the same capabilities as my personal one which currently offsets a huge amount of inadequate IT... This is a systems issue that needs a solution. That solution needs to make it easy not to need to use a personal device (as well as appropriate IG)
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Tom Quinn @proftomquinn.bsky.social · 25/11/2024
They produced another very insightful report on inequalities and ED use a couple of years back www.redcross.org.uk/about-us/wha...
redcross.org.uk
Exploring high-intensity use of Accident and Emergency
The Nowhere else to turn: exploring high-intensity use of accident and emergency services reports shows explores the use of A&E in deprived areas.
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Matthew Snowsill @mattsnowsill.bsky.social · 25/11/2024
Critical fundamentals #emimcc #resussky
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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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Cliff Reid @cliffreid.bsky.social · 23/11/2024
Want to improve your Basic Bag-Valve-Mask Ventilation skills? Here's a VERY short course I made that's free and will only take 5-10 minutes. tinyurl.com/BMVCourse
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Nick Mark, MD @nickmark.bsky.social · 23/11/2024
Why do people wear shoe covers in the operating room? 💥 The reason may surprise you! A 🧵 about the #HistoryOfMedicine and the dangers of blindly following traditions. onepagericu.com/blog/cx1l66q... 1/
onepagericu.com
Dissipating The Myth of Shoe Covers — ICU One Pager
If you work in a hospital chances are you've put on shoes covers. This is a well intentioned practice largely predicated on a misunderstanding about the history of medicine. Originally, shoe covers we...
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Matthew Snowsill @mattsnowsill.bsky.social · 23/11/2024
"Your scientists were so preoccupied with whether or not they could, they didn't stop to think if they should"
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Matthew Snowsill @mattsnowsill.bsky.social · 23/11/2024
Important skill for EM folks #emesky #resussky #emimcc For those in London (UK), the folks at Homerton do good #pocus teaching on this
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Jace Mullen @jacemullen.bsky.social · 19/11/2024
Tell your friends! Prehospital Sky as a feed is up and running! If you see things relevant to EMS please tag them #EMSsky for them to be cataloged! Everyone is welcome, I hope this ends up high yield! bsky.app/profile/did:...
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Tharusha Gunawardena (he/him) @tharusha.bsky.social · 22/11/2024
Have yall heard of “Wellen’s Syndrome”? It describes a characteristic ECG appearance (biphasic anterior ST segments)- associated with a critical LAD lesion. in cases of ongoing discomfort- it should be considered like an Anterior STEMI because it can progress to one should the LAD fully occlude
ecg with wellens syndrome
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Royal College of Emergency Medicine @rcem.ac.uk · 21/11/2024
“Patients are suffering the consequences of a system that is in crisis, while staff continue to shoulder the burden of delivering effective and safe care in these conditions." RCEM's President responds to CQC's Urgent and Emergency Care survey. Read more here - tinyurl.com/3ypeesvh
tinyurl.com
‘Patients are suffering the consequences of a system that is in crisis’ - RCEM responds to CQC’s UEC patient survey
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Caroline Dew @caro-icu.bsky.social · 22/11/2024
“Learning CPR on manikins without breasts puts women’s lives at risk, study finds” Dr Rebecca Szabo et al @inquisitivegyn.bsky.social Research 🔗: academic.oup.com/heapro/artic... #ResusSky
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Stu Marshall @hypoxicchicken.medsky.social · 21/11/2024
It’s likely that experts gain less in terms of reduction of physical stress due to awkward body posture than novices as they have refined technique over time. Maybe though, training of DL & VL both need to emphasise body posture and physical ergonomics of intubation? #AnSky #MedSky #HFESky
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Patient Safety Learning @patientsafetylearning.org · 21/11/2024
New to Bluesky? Check out our #patientsafety starter pack go.bsky.app/Jhnn8Yb
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Natalie May @nmay.bsky.social · 19/11/2024
The latest from @stemlyns.bsky.social - what dose of TXA in traumatic brain injury? #FOAMed #MedSky #EMedSky www.stemlynsblog.org/dose-txa-in-...
stemlynsblog.org
2g or 1+1g Tranexamic Acid (TXA) in traumatic brain injury?
Explore the use of TXA in traumatic brain injury and its impact on mortality and long-term neurological outcomes.
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Jace Mullen @jacemullen.bsky.social · 19/11/2024
You're in luck! I just made the Prehospital Sky feed! bsky.app/profile/did:...
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Steven Mathern @stevenmathern.bsky.social · 19/11/2024
shortcomings of the STEMI NSTEMI paradigm, resulting patient harm, and why we need to add on the 'OMI paradigm' which i will post next #CardioSky #EmImCc #12lead #ekg #STEMI #pci #OMI heart.bmj.com/content/110/...
heart.bmj.com
No false negative paradox in STEMI-NSTEMI diagnosis
ST-segment elevation myocardial infarction (STEMI) diagnosis is based on a clinical presentation and ST-segment elevation (STE) in at least two consecutive leads. Despite being deeply rooted in both t...
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M Velia Antonini @foamecmo.bsky.social · 16/11/2024
Pediatric #ECPR: where next?? EuroELSO webinar 🗓️ Nov 27, 17:00 CET 🎙 speakers: M Davidson, M O’Callaghan, A Desai, J Brandt 🎙 moderator: P Roeleveld 🎙 chairs: M Mendonca, U Pollak, T Thiruchelvam 🖋 www.euroelso.net/webinars/! 🎥 all previous webinars available at 🔓 bit.ly/EuroELSOyout... #PedsICU
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Eric Widera, MD @ewidera.bsky.social · 18/11/2024
Medicine focuses a lot on the question “will this help my patient” but not on the question “when will it help my patient.” The latter becomes important as we age. We’ve developed a “time-to-benefit” tool on eprognosis.ucsf.edu to help answer this question. Here is a snapshot #MedSky #FOAMed #meded
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Matthew Snowsill @mattsnowsill.bsky.social · 19/11/2024
Also relates to: 🛑 ED crowding 🛑 Corridor care 🛑 Ambulance offload delays Among others... If it's enough of an issue to hammer front line staff, it's enough of an issue to need systemic solutions #emedsky #emimcc #resussky #EMSsky #paramedicinesky [😡 & monitor alarms which are not acted upon 🤯]
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Resuscitology @resuscitology.bsky.social · 19/11/2024
Physiologically challenging airway? Watch out for SHARK KILLERS 🦈 (H/T @cliffreid.bsky.social) #Resuscitology15 #FOAMed #MedSky #EMedSky
Shock, hypoxia, acidosis, RV failure complicate airway management
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Dr Stevan Bruijns 🏥🚑🤕🌍🏳️‍🌈 @codingbrown.bsky.social · 19/11/2024
With multiple front doors into urgent and emergency care (UEC), why don't we measure performance at each? 🩼 & 🚑 = 👌🕓 / 💺 = 👎 #Medsky #EMedsky .../1
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Shockwaves.icu @shockwavesicu.bsky.social · 18/11/2024
Hello all! On behalf of the editors, @maxhockstein.bsky.social and @zentensivist.bsky.social, we’d like to announce the launch of our living textbook for hemodynamics, shockwaves.icu! #emimcc
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Tyne Lunn @tyneriver.bsky.social · 16/11/2024
#ParamedicineSky - let’s regrow the community 💛 pls tag more to help us find each other 👇🏼 go.bsky.app/BZpAcQN
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