Shailesh Shah

@[email protected]
46 Followers
74 Following
51 Posts
Critical Care and Acute Medicine Consultant.
Invested in Critical Care Outreach and early recognition of the deteriorating patient.
Teacher of POCUS and it’s integration into clinical assessment
Dad, husband and inconsistent hockey goalkeeper.
Show threadShailesh ShahDec 11, 2023

@jopo_dr @gpollara

Source:
https://www.researchgate.net/profile/David-Adamson-9/publication/237461231_Living_well_at_the_end_of_life_Adapting_health_care_to_serious_chronic_illness_in_old_age/links/00b49528ce21f135ff000000/Living-well-at-the-end-of-life-Adapting-health-care-to-serious-chronic-illness-in-old-age.pdf?origin=publication_detail&_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6Il9kaXJlY3QiLCJwYWdlIjoicHVibGljYXRpb25Eb3dubG9hZCIsInByZXZpb3VzUGFnZSI6InB1YmxpY2F0aW9uIn19

Show threadShailesh ShahDec 11, 2023
@jopo_dr
She is just awesome!
Show threadShailesh ShahDec 10, 2023
@macesari
Yes - I suspect it works both ways too.
Delirium leads to prolonged LoS, risk of secondary events and recovery time.
Show threadShailesh ShahDec 9, 2023
@jopo_dr
Meet Scout
Show threadShailesh ShahDec 9, 2023
@gpollara @jopo_dr
Agree Gabriele.
Well established concept in OPM/GIM
I often draw a similar time/illness-frailty model for patients/loved ones I encounter.
Show threadShailesh ShahOct 20, 2023

@Watergypsy

I am in no doubt that catheter directed therapies have a role in PE. Lots of issues around service development and deliver, but this is a different argument.

The biggest thing about this study was the outing of inherent racism in its non-randomised patient selection.

Shailesh ShahOct 18, 2023

Ongoing discussion re best approach to intermediate-high/high risk PE.

What options do we have?
Anti-coag
Systemic Thrombolysis 100%, 50%, 25%
IR guided (embolectomy/CDT)
Fluid
Furosemide

The evidence is certainly in favour of IR guided therapies

However, in the spiralling obstructive shock patient, would you reach for the diuretic??

https://academic.oup.com/ehjacc/article/11/1/2/6386419

https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-13-0404/_pdf/-char/ja

https://www.jacc.org/doi/10.1016/S0735-1097%2817%2935282-8

Diuretic vs. placebo in intermediate-risk acute pulmonary embolism: a randomized clinical trial

AbstractAims. The role of diuretics in patients with intermediate-risk pulmonary embolism (PE) is controversial. In this multicentre, double-blind trial, we ran

OUP Academic
Show threadShailesh ShahOct 16, 2023
@jopo_dr
Sound advice. Though I do love a friendly jumpy pooch.
Show threadShailesh ShahOct 15, 2023

@jopo_dr do you have any advice or recommendations for books on pups…

We may well be expanding the family!!

Show threadShailesh ShahOct 15, 2023
More dilution needed….