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Tom Fisher

@tomfisher.bsky.social
639 followers 238 following 97 posts

CT2 anaesthetics, critical care echo-head, NIHR academic clinical fellow @ Univ of Birmingham

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Reposted by Tom Fisher
Jocalyn Clark @jocalynclark.bsky.social · 12/06/2026
#OMB Another consequence of the “no foreign research” federal rule is to pull US science further backwards, making more way for China's ascension as a research powerhouse and leading global collaborator. 🇺🇸🇨🇳🌐 How & why? NEW piece👇 www.bmj.com/content/393/...
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Tom Fisher @tomfisher.bsky.social · 15/01/2026
🫀 Delighted to see the publication of our narrative review examining diastolic dysfunction in critical illness This is fascinating area of pathophysiology. Whether it represents an epiphenomenon or a treatable trait and its influence on long‑term outcomes is a key question for future work. 1/2
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MIke Ambler @mike-ambler.bsky.social · 19/03/2025
Very excited to post this preprint... making a species that doesn't hibernate do something a lot like it, AND showing it is cardioprotective. www.biorxiv.org/content/10.1...
biorxiv.org
Synthetic torpor in the rat recapitulates key features of natural torpor and is cardioprotective
During hibernation, animals enter torpor, a reversible physiological state typically characterised by reductions in core temperature, heart rate and oxygen consumption. Species that enter this hypothe...
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Segun Olusanya (He/Him) @drfreeze.bsky.social · 27/02/2025
I had the pleasure of teaching lung #pocus at a “train the trainers” course, with the ever excellent @avkwong.bsky.social and Cian McDermott as faculty Some reflections from the day: (1/n)
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Jerry W. Jones, MD FACEP FAAEM @ecgprof.bsky.social · 14/02/2025
For all my ECG nerds friends: What to consider when you see one or more PVCs: medicusofhouston.com NEVER a tariff on MY classes! #ECGNerds #ECGSky #MedSky #CardioSky #Cardiology #YaleEM #EMedSky #nursesky #MedEd #EMSky #BlueSky #MedEducation #emimcc #EUSEM #ACEP #AAEM #ESEM #ASEM #ACEM
"A Few Words About Premature Ventricular Complexes (PVC)" - Page 1

Come join us in Halifax, Nova Scotia April 21 - 24, 2025 for a TARIFF-FREE great time in The Masterclass in Advanced Electrocardiography! Earn AMA PRA Category 1 Credit and benefit from the only live, in-person interactive course in advanced ECG interpretation!"A Few Words About Premature Ventricular Complexes (PVC)" - Page 2

Come join us in Halifax, Nova Scotia April 21 - 24, 2025 for a TARIFF-FREE great time in The Masterclass in Advanced Electrocardiography! Earn AMA PRA Category 1 Credit and benefit from the only live, in-person interactive course in advanced ECG interpretation!"A Few Words About Premature Ventricular Complexes (PVC)" - Page 3

Come join us in Halifax, Nova Scotia April 21 - 24, 2025 for a TARIFF-FREE great time in The Masterclass in Advanced Electrocardiography! Earn AMA PRA Category 1 Credit and benefit from the only live, in-person interactive course in advanced ECG interpretation!"A Few Words About Premature Ventricular Complexes (PVC)" - Page 4

Come join us in Halifax, Nova Scotia April 21 - 24, 2025 for a TARIFF-FREE great time in The Masterclass in Advanced Electrocardiography! Earn AMA PRA Category 1 Credit and benefit from the only live, in-person interactive course in advanced ECG interpretation!
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Reposted by Tom Fisher
Segun Olusanya (He/Him) @drfreeze.bsky.social · 08/02/2025
Delighted to share the Barts echo team’s latest article “Examining the Relationship Between Pulmonary Artery Acceleration Time and Pulmonary Artery Pressures in Patients with Ischemic Cardiogenic Shock” Free to read for 50 days on the following link www.sciencedirect.com/science/auth...
sciencedirect.com
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Segun Olusanya (He/Him) @drfreeze.bsky.social · 06/02/2025
Really nice article on TAPSE/TRVmax as a potential prognostic marker From the team at Nepean ICU, led by Emma Bowcock annalsofintensivecare.springeropen.com/articles/10....
annalsofintensivecare.springeropen.com
The value of right ventricular to pulmonary arterial coupling in the critically ill: a National Echocardiography Database of Australia (NEDA) substudy - Annals of Intensive Care
Background Right ventricular (RV) function is tightly coupled to afterload, yet echocardiographic indices of RV function are frequently assessed in isolation. Normalizing RV function for afterload (RV...
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Damien BARRAUD @damienbarraudmd.bsky.social · 02/02/2025
My pov : patients with good outcomes after OHCA associated with hanging...were probably not in OHCA...
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@IM_Crit_ @imcrit.bsky.social · 01/02/2025
ICU Mini-Stories: Middle-age pt presented to ED at 8:00 am with cough/dyspnea/weakness x 2 weeks. Poor appetite/could walk only a few feet due to dyspnea/dizziness. Vitals: HBP 79/60, HR 80, afebrile, O2 sat 96% on 2 l/m. Physical exam: ill-appearing, dry mucous membranes. Labs:
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Tom Fisher @tomfisher.bsky.social · 01/02/2025
🔬 Pleased to share our new scoping review on cardiac arrest after hanging- sadly not an uncommon cause of cardiac arrest which has previously lacked a good quality synthesis of evidence Link: authors.elsevier.com/a/1kXSi_6ryq... 🧵1/6
Screenshot of an abstract for cardiac arrest after hanging: a scoping review

Abstract
Background
Hanging is a common cause of suicide and asphyxial cardiac arrest. There are few data to inform the treatment of cardiac arrest after hanging. We designed a scoping review to describe evidence relating to interventions and outcomes in patients with and without cardiac arrest after hanging.
Methods
Medline, Embase and Cochrane were searched from inception to 05/12/2024. Titles and abstracts were screened, and duplicates were removed. Articles were eligible for inclusion if they studied non-judicial hanging in adults or children, included cardiac arrest patients and provided functional or survival outcomes.
Results
The search retrieved 855 articles. One hundred and nineteen references underwent full-text review. Forty-five studies were included in the review. Studies were mainly from high-income countries and were all observational. There was variation in the terminology for hanging and in the outcomes reported. Survival with favourable functional outcome was rare in patients with cardiac arrest after hanging but was very common in patients without cardiac arrest. Cervical spine, airway and vascular injuries were rare. No studies identified interventions that were associated with improved survival following return of spontaneous circulation.
Conclusion
There are few data to inform treatment of patients with cardiac arrest after hanging. The available data suggest that cardiac arrest is a critical determinant of poor outcome following hanging. Further research should uniformly report outcomes of patients with cardiac arrest after hanging based on the Utstein template.
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Reposted by Tom Fisher
Tim Norfolk @icmtim.bsky.social · 22/01/2025
If a picture’s worth 1000 words then this cine loop’s a damn novella dedicated to the pathogenesis of hepatic hydrothorax 😍 #EMIMCC #pocus
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Ed Palmer @doced.bsky.social · 16/01/2025
xkcd.com/882/
xkcd.com
Significant
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Tom Fisher @tomfisher.bsky.social · 02/01/2025
When following a left atrial pressure algorithm that uses 2.8m/s as a binary cutoff, do people give a bit of leeway if it's *almost* 2.8 with severe TR/wide vena contracta?
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Tom Fisher @tomfisher.bsky.social · 31/12/2024
Does anyone know where I can find a manual/user guide for Phillips 5500CV or other similar Phillips device? Only get Phillips espresso machines when I Google for the manual and it's slow mastering the knobology incrementally just while scanning! #cardiosky #echofirst #echosky
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Tom Fisher @tomfisher.bsky.social · 24/12/2024
Instructive case in my ongoing FUSIC HD journey- pt with dyspnoea, leg/groin/abdo swelling
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Tom Fisher @tomfisher.bsky.social · 06/12/2024
Was somewhat surprised by moderate-severe AR (prev trivial) when looking to assess a prev moderately stenotic AV in a FUSIC HD training scan recently. FUSIC HD limits AV assessment to colour and dimensionless index. Is the DI still useful in these mixed valve disease cases? #echosky #cardiosky
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Ben Millette @benmillette.bsky.social · 03/12/2024
There's not enough #POCUSky so let's get the ball rolling. What is the similarity between the following two thoracic ultrasounds? Clip 1: #emimcc #medsky
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Ed Palmer @doced.bsky.social · 03/12/2024
People often talk about the time critical nature of sepsis. But it may surprise you to hear that the evidence to support “early” antibiotics actually isn't a settled debate. Why is that? The key question is “early in relation to what”? 🧵 1/n
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Aoife Abbey 📟 🩺 ⚕️ @whistlingdixie.bsky.social · 02/12/2024
A sad day for critical care - and what a phenomenal legacy he has left us. RIP Prof Gattinoni, a Giant ⚕️📟 www.esicm.org/obituary-luc...
esicm.org
Obituary: Luciano Gattinoni - ESICM
In Memory of Professor Luciano Gattinoni
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Lars Mølgaard Saxhaug @load-dependent.eurosky.social · 30/11/2024
If the LV of the patient with sepsis is «hyperdynamic» when on noradrenaline, then EF dropps and the LV looks poorly when vasopressin is added, but recovers to normal with dobutamine, you likely haven’t «uncovered hidden LV dysfunction» or septic cardiomyopathy. #emimcc #pocus #echofirst 1/
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Tom Fisher @tomfisher.bsky.social · 29/11/2024
Why do so many (UK) favour a sternal cap refill rather than peripheral in adult patients? Many claim this is superior by way of anecdote and "their hands will be cold anyway" but I've never been able to find ANYTHING to support this (certainly no andromeda equivalent!) #emimcc
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Critical Care Reviews @criticalcarereviews.com · 28/11/2024
Acute Decompensated Valvular Disease in the Intensive Care Unit CCR Journal Watch criticalcarereviews.com/latest-evide... Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...
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Tom Fisher @tomfisher.bsky.social · 28/11/2024
30ml/kg first-line for allcomers with sepsis (no nuance added in discussion beside implying CLOVERS & CLASSIC & sepsis pathophysiology support this) What could go wrong??!?
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Dilip Jayasimhan @dilipj1.bsky.social · 27/11/2024
A thread 🧵 on trials I think have changed or will change ICU practice (at least my own). #emimcc
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Lars Mølgaard Saxhaug @load-dependent.eurosky.social · 07/03/2018
1w cough and increasing dyspnea. Upon pickup by paramedics sat70%, hypotensive. ⬆️CRP/WBC. Pneumonia/septic shock assumed, abx and bolus fluids initiated, intubated in the ER. Hypotensive despite high dose pressor, #Echo follows #FOAMed #FOAMcc
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Katie Wiskar @katiewiskar.bsky.social · 26/11/2024
1/ Back to the basics today: let's talk about common pitfalls in obtaining cardiac #POCUS images ❤️ Here are some very common image acquisition errors in basic views, as well as the simple moves to correct them ✅ 🧵 #emimcc #POCUSky #echosky #MedSky
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Ben Morton @benmorton.bsky.social · 25/11/2024
Rant #5 Please don't tell me what the PaO2 is... Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings. What is the SpO2 I genially ask? In our target range? Well that's fine then. Staff member shifting uneasily, "but the PaO2..." Here we go...
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Tom Fisher @tomfisher.bsky.social · 25/11/2024
Basic FICE training scan in a stable post-op elderly patient with no cardiac hx other than systolic murmur & pre-op echo demonstrating SAM of the MV, pending workup. Have always thought it must be amyloid? #cardiosky #emimcc #pocus
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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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Tom Fisher @tomfisher.bsky.social · 23/11/2024
Does anyone do and advocate for the oblique technique? Have never seen it done
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Greg Bryson @glbryson.bsky.social · 21/11/2024
Print this and place it beside every phone and Epic terminal in the hospital. “the current state of evidence suggests that treating asymptomatic elevated inpatient BP should generally be the exception, not the rule.” www.ahajournals.org/doi/10.1161/...
ahajournals.org
The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association | Hypertension
Over the past 3 decades, a substantial body of high-quality evidence has guided the diagnosis and management of elevated blood pressure (BP) in the outpatient setting. In contrast, there is a lack of ...
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Katie Wiskar @katiewiskar.bsky.social · 18/11/2024
This is a really interesting study on #LungUltrasound for pneumothorax. TLDR: LUS significantly underperformed CXR for detection of traumatic PTX, with high specificity (99%) but very low sensitivity (27%). I have a few thoughts 🧵 -
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Tom Fisher @tomfisher.bsky.social · 15/11/2024
Difficult parasternal & apical windows but certainly not subtle! Hugely dilated RVOT with preserved longitudinal function but severely impaired radial function. 🧵
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Tom Fisher @tomfisher.bsky.social · 14/11/2024
Mild hypoxaemia & collapse at home Any thoughts purely based on still images? The moving ones are less subtle! #pocus #emimcc #cardiosky #fusic
RVOT PW dopplerPW TDI at tricuspid annulusTAPSEHepatic vein PW
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Segun Olusanya (He/Him) @drfreeze.bsky.social · 13/11/2024
New paper from the Barts Critical Care Echo Research Group just dropped 50 day free link below 👇🏼 #foamed #foamcc #medsky www.sciencedirect.com/science/auth...
sciencedirect.com
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Tom Fisher @tomfisher.bsky.social · 13/11/2024
New platform, re-sharing our recent sex differences in cardiogenic shock SRMA: -Women are ⬆️ likely to die than men (35% unadjusted, 10% adjusted for comorbidities) -Women ⬇️ less likely to recieve mechanical support Urgent need to understand these differences & enroll more women in CS RCTs!
ccforum.biomedcentral.com
Sex differences in treatments and outcomes of patients with cardiogenic shock: a systematic review and epidemiological meta-analysis - Critical Care
Background Women are at higher risk of mortality from many acute cardiovascular conditions, but studies have demonstrated differing findings regarding the mortality of cardiogenic shock in women and m...
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Tom Fisher @tomfisher.bsky.social · 12/11/2024
This patient had been initiated on peritoneal dialysis for ckd secondary to polycystic kidney disease. Right PLAPS point US demonstrates anechoic pleural fluid above the diaphragm, cystic appearance of liver below the diaphragm. No left-sided effusion. 🧵 #pocus #fusic #emimcc
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Tom Fisher @tomfisher.bsky.social · 11/11/2024
Not enough #pocus on bluesky! What's the cause of this peritoneal dialysis patient's dyspnoea?
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