ICM Consultant at Liverpool University Hospitals NHS FT. All views my own.

Liverpool, England
Joined December 2014
A pretty reassuring thread!
The study we've all been waiting for Using data from >50,000 #COVID19 contacts, vaccinated people are less infectious EVEN with Delta, and EVEN if CT count is the same Also, kids appear less infectious and less susceptible, including with Delta 1/ medrxiv.org/content/10.1101/…
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Hanging out in the ICU
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Just finished a run of ITU shifts and really sad to say COVID is very much not going away. Half our ITU beds filled with COVID patients which is having a serious impact on our ability to deliver other services. Majority coming to ITU aren’t vaccinated. Please #GetVaccinated
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This paper really is rather excellent, & certainly worth a read in full: COVID-19 false dichotomies & a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, & reinfection bmcinfectdis.biomedcentral.c…
One of the most important papers to emerge during the pandemic, in my opinion. Well worth a read. A good reminder to address our preconceptions, biases & polarised viewpoints, and not take all we are told at face value. Embrace the shades of grey! bmcinfectdis.biomedcentral.c…
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🇩🇰🙏🏾
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Alex is one of our incredible ACCPs that I have the pleasure of working alongside. Sure this will be a great listen.
This Thursday the #FICMLearning Podcast will have the brilliant Alex Scott! An #ACCP working at the Liverpool University Hospitals NHS Foundation Trust 🟠Here's a sneak peek of the latest episode with Alex. 🟠Full episode available on Thursday! #FOAMed #ACCPs
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Tim Astles retweeted
Cracking first session of the 2nd year of the Liverpool Trauma Seminars. MDT discussion of a code red polytrauma from roadside to ICU. More to follow, watch this space... @simonjudemercer @PaulMay11 @EmergentAcademy @TraumaLiverpool @AintreeMTC
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This is an excellent, clear and honest infographic....
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Would be nice if this was the end of “we’ll do the contrast scan but only if ITU promise to provide RRT afterwards”
Our new paper in @JAMAInternalMed: is IV contrast nephrotoxic? Lots of studies say no, but have ⬆️risk of confounding: people who get contrast ≠ people who don't get it. We used a natural experiment to try to overcome this bias jamanetwork.com/journals/jam… 1/5
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Proud to present our meta-analysis of a highly-debated topic! The synthesized evidence of almost 9000 critically ill patients with #COVID_19 suggests that #early_intubation, as suggested by several #guidelines, may not be justified. @crit_care 📌rdcu.be/chBag
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Tim Astles retweeted
Post #resuscitation @ERC_resus @ESICM guidelines #resus21 🫀diagnosis & reperfusion 🫀post CA syndrome 🫀hemodynamics 🫁oxygenation/ventilation 🧠general #ICU approach 🧠seizures control 🌡️TTM 🧠prognosis & outcome 💪#ICUrehab 🫁organ donation 🏥CA centers bit.ly/39ceAz2
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Tim Astles retweeted
RECOVERY: 1 year old today 1 trial 1 year 10 drugs studied 6 clear answers to date: - 2 treatments that save lives - 4 that do not - all against many people's prior beliefs How to describe the experience? - extraordinary - hugely rewarding - humbling - a privilege to be part of
1️⃣ year ago, the first patients were recruited to the #RECOVERYtrial Since then, the trial has found two effective treatments for severe #COVID19 and saved many lives worldwide 🌍 THANK YOU to everyone involved 👏 🌐 recoverytrial.net/ @NIHRresearch @The_MRC #NHS
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Today we closed our overflow ITU @LivHospitals Aintree as the 3rd COVID wave finally settles. It’s been a really tough year for anyone working in ITU but I’m lucky to have been part of an incredible team that have had each others backs through all of this. 🤞for no 4th wave.
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Great infographic from @ICS_updates highlighting just what we’ve been up against in the ITU world in the last year.
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Tim Astles retweeted
The interleukin-6 receptor blockers tocilizumab and sarilumab were tested against standard care in a randomized trial involving patients newly admitted to the intensive care unit and requiring respiratory or blood-pressure support. #COVID19 #IDTwitter
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Bit of bedtime reading...
Main early papers on #COVID19 & their findings, an overview: ➡️ manifestations of severe disease ➡️ pharmacological therapy ➡️ ventilatory support in pts with #SARSCoV2 related #ARDS ➡️ healthcare organization & healthcare worker stress #FOAMcc #COVIDFOAM rdcu.be/cc1ll
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Eugh. Happy 2021!
The Imperial report on the new UK B117 strain is out. Very concerning findings, that highlight why we need to act on this *now*. These findings suggest that the situation within the UK is likely to get much worse than it is now. Here's why- Thread.
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Tim Astles retweeted
On the recommendation of the Data Safety and Monitoring Board, #REMAPCAP has paused randomization to therapeutic #anticoagulation among critically ill patients with #COVID19 for futility.
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Tim Astles retweeted
There are several reasons to think that the new UK #SARSCoV2 variant is an important one as it might be more contagious than other variants, but there are also some uncertainties. So much misinformation is being circulated, so this thread brings key data together. 🧵
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