Raj LB

@rajlb

Vainly trying to get people to design slides properly Knock people out for a living #AnSky #CritCareSky 🇬🇧 🏴󠁧󠁢󠁥󠁮󠁧󠁿

1600 Siguiendo1541 Seguidores9684 Publicaciones

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Raj LB@rajlb· 20d

ALL HAIL LAWRENCE DOWNING STREET

A bunch of photographers kneeling to the right to photograph a mouse that had been killed.

On the left Larry the Cat, sat with body facing the photographers but head turned to the camera

Raj LB@rajlb· 21d

Asked a question about whether an MSP could be a Lord (of the back of Sarwar moving to the Lords). Got answers to the question. Inevitably also got this very helpful response.

Bluesky screenshot. Post with four image thumbnails about Anas Sarwar (none of thumbnails are expanded so I've not include alt descriptions)

angus-indy-lady.bsk... @angus... 46m

A Failed Unelected Leader in

Scotland.

Lording it up.

It was his only goal, like many before him.

Liebour wonder why they have become unelectable.

Raj LB@rajlb· 22d

I hope we get to keep the meme

Three panels of Keir Starmer giving a speech in front of a red back ground. Each panel has yellow text.

Panel 1 text: using a meme from a forgotten PM

Panel 2 text: because it was their most significant achievement

Panel 3 text: That's real Britain.

Raj LB@rajlb· 26d

Raj LB@rajlb· 26d

Everybody absolutely knew who those 3 people were.

Wikipedia screenshot.

Table.

Title: 2013 Falkland Islands sovereignty referendum

10-11 March 2013

Do you wish the Falkland Islands to retain their current political status as an Overseas Territory of the United Kingdom?

Results

Headings: Choice Votes %

Yes

1.513

99.80%

No

3

0.20%

Valid votes

1,516

99.87%

Invalid or blank votes

2

0.13%

Total votes

1,518

100.00%

Registered voters/turnout

1,650

92%

Raj LB@rajlb· Jul 13

"I need the SUV for practicality" OK mate

A diagram comparing the width of a BMW iX (an SUV) at 1970mm and the Kia PV5 (a minivan that is not very mini) at 1895mm.

Same cars comparing length BMW 4965mm Kia 4695mm

Raj LB@rajlb· Jul 12

Took this some time back. An IKEA meat tenderiser where I guess you could be use either end to make things more tender.

A black meat tenderiser, shaped like hammer. The hammerhead is symmetrical and shaped like cylinder but tapers towards the middle. The other end is shaped like a butt plug.

Raj LB@rajlb· Jul 11

One would think you'd have a sophisticated enough to know that I don't care.

Screenshot of Microsoft word. The Copilot icon is in the bottom left and above it are four messages. On the left, you can see a small amount of the text from the document I had open but not enough for it to be conmprehensible.

Copilot has moved
Find it here when you need it

Summarise this document

Ask a question about this document

Suggest ways to improve this document

Raj LB@rajlb· Jun 26

My possibly minority of one opinion (as a non-obstetric anaesthetist) is that scientific inquiry should be working towards pain-free labour. I find it baffling we accept pain in obstetrics in a way we just would not accept in any other sphere of healthcare.

General anaesthesia should be discussed as a primary alternative to neuraxial anaesthesia, not a last resort [4, 22]

Raj LB@rajlb· Jun 24

I was a deeply concerned that only a few years after getting FFICM, that I got it from the Faculty would single me out as an "old" but according to @ficm.bsky.social I'm to change them which is nice.

From Day One, your post-nominals will change. An easy one, the F changes to C so FFICM becomes FCICM, AFICM becomes ACICM and MFICM becomes MCICM. Please note that you may still see FICM or FFICM referenced on some communications as internal systems update.

Raj LB@rajlb· Jun 21

It's always interesting hearing about US/other practices working practices. Variably enforced, British residents are supposed to only work a 48hr/wk, 56 if they opt out of the working time directive. Since 2016, residents can get extra leave and trusts fined if they're in breach of the hours.

3.1 What are the working hours and patterns a doctor can work?
In addition to the protections offered by the working time regulations (WTR), the contract provides the following safeguards on working hours and patterns which will be reflected in work schedules:

Maximum average 48-hour working week with doctors who opt out of the WTR capped at maximum average of 56 working hours per week.
Maximum 72 hours’ work in any consecutive 168 hour period.
Maximum shift length of 13 hours.
Maximum of four consecutive long (>10 hours) shifts* with a minimum of 48 hours rest rostered immediately following the conclusion of the fourth such shift.
Maximum of four consecutive night shifts with minimum 46 hours rest after a run of either three or four consecutive night shifts.
All reasonable steps should be taken to avoid rostering doctors to work at the weekend at a frequency of greater than one in three weekends.
Maximum seven consecutive shifts* (apart from low-intensity non-resident on-call rotas, for which a 12-day maximum applies), there must be a minimum 48hours’ rest rostered immediately following the conclusion of the seventh shift.
No more than three rostered on-calls in seven days except by agreement, with guaranteed rest arrangements where overnight rest is disturbed.
Maximum 24-hour period for on call which cannot be worked consecutively except at weekends or by agreement that it is safe to do so.
Work rostered following on-call cannot exceed 10 hours, or 5 hours if rest provisions are expected to be breached.

Raj LB@rajlb· Jun 20

Facebook is weird: Exhibit number 452 During my occasional Facebook visits, I get a terrible anaesthesia education page in my feed. The answer is of course A, C, D, and E.

Image of a multiple choice question.

Text:

CLINICAL QUESTION

ANAESTHESIA PHARMACOLOGY

SCENARIO

During anaesthesia, a patient with Parkinson's disease treated with levodopa should not receive.

SELECT THE CORRECT OPTION (A-E) MULTIPLE CHOICE

A

Enflurane

B

Fentanyl

C

Morphine

D Droperidol

E

Nitrous oxide

Raj LB@rajlb· Jun 20

I don't want anybody to pile-on this guy (use Bluesky how you like) but for example this profile posts hourly about translational medicine and never seems to have replied to anybody. One assumes it's automated. Don't think it's that helpful for growing a social media community at #MedSky.

Raj LB@rajlb· Jun 20

On which, it's hilarious how many people look at me gone out when I say "use local for an ABG". The evidence is grade A! It's also really old now! It's from the 1990s! We didn't even have smartphones! We hadn't even invented electricity! www.brit-thoracic.org.uk/clinical-res...

A highlighted block of text which says: C2: Local anaesthesia should be used for all ABG specimens except in emergencies (grade A).

Text in full:

Recommendations for use of ABGs and arterialised capillary blood gases

C1: For critically ill patients or those with shock or hypoten- sion (systolic blood pressure <90 mm Hg), the initial blood gas measurement should be obtained from an arterial sample. For most patients who require blood gas sampling, either ABGs or arterialised earlobe blood gases may be used to obtain an accur- ate measure of pH and PCO2. However, the PO2 is less accurate in earlobe blood gas samples (it underestimates the PO2 by 0.5- 1 kPa) so oximetry should be monitored carefully if earlobe blood gas specimens are used and a repeat arterial specimen should be taken if there is any concern about the accuracy of a capillary sample (grade D).

C2: Local anaesthesia should be used for all ABG specimens except in emergencies (grade A).

7.1.4 Transcutaneous oxygen assessments

Transcutaneous oxygen devices give different information from pulse oximetry. They are more sensitive to reduced perfusion and may be used to monitor tissue oxygenation in in trauma

202 Lightowler JV, Elliott MW. Local anaesthetic infiltration prior to arterial puncture for blood gas analysis: a survey of current practice and a randomised double blind placebo controlled trial. J R Coll Physicians Lond 1997;31:645-6.

203 Giner J, Casan P, Belda J, et al. Pain during arterial puncture. Chest

1996:110:1443-5.

204 Ibrahim I, Yau YW, Ong L, et al. Arterial puncture using insulin needle is less painful than with standard needle: a randomized crossover study. Acad Emerg Med 2015:22:315-20.

Raj LB@rajlb· May 25

Pick a Bond villain from the photos you already have on your phone.

Image of a white man with a beard in a military green jacket.

Robert Kenyon, the Reform parliamentary candidate for the Makerfield by-election

Raj LB@rajlb· May 25

This must be the lamest thing ever purchased with the proceeds of crime

White-on-black text

Murrell's first major purchase, a £33,000 Volkswagen Golf, was made in early 2016 using £16,489 of SNP money

Raj LB@rajlb· May 22

It's because the scale has been removed. Portions are much bigger in the US. I've added the scale back in.

Same as the picture in the op except with scale adding suggesting two of the sandwiches together have a width of 1 metre

Raj LB@rajlb· May 22

Ah, memories. Mostly bad.

Picture of a faded white mechanical pencil with "The Royal College of Anaesthetists" written in blue in a serif font

Raj LB@rajlb· May 21

Keir Starmer speaking behind a podium with Renew Britain written on it.

Caption: that's real Britain

Raj LB@rajlb· May 19

New treatment for postop nausea and vomiting just dropped

Bluesky screenshot

8h

rktecture @rktecture.bsky.social

It is also to remember that being against Israel in 2026 is not antiemetic, though obviously the media seems mostly happy to conflate that.

Raj LB@rajlb· May 19

Raj LB@rajlb· May 18

I think I'm a hawk because I'm like "give Ukraine all of the guns and tax me for it"

Screenshot of a political quiz with bars representing different political dimensions.

Social Democrat

Centre-left on economics, cosmopolitan and pro-European, with a belief in strong public services and a broadly Atlanticist foreign policy.

Difficult to describe the entire picture but this was the other summary the site gave.

My result: Social Democrat

Economic: leaning collectivist
Social: progressive
Sovereignty: strongly cosmopolitan
Military: strongly hawkish
Authority: libertarian
Constitutional: leaning reformist

Raj LB@rajlb· May 18

You guys are so useless at naming things. You keep referring to London Bridge as "Tower Bridge". What the hell is Tower Bridge? As Google states, the correct name is London Bridge, that's what the whole world calls it and I really think Londoners need to move on.

Google Images search for London Bridge showing many, many pictures of a bridge London with two large towers

Raj LB@rajlb· May 16

Yes, it is racist to lay the responsibility of Israel's actions at the feet of Jews, just like it's racist to blame your local Indian restaurant owner for the actions of Narendra Modi.

Raj LB@rajlb· May 15

And that red hand was Andy Burnham's

Screenshot of a Wikipedia article with a image of Andy Burnham at the top

J Spurling Ltd v Bradshaw

+

ADD ARTICLE DESCRIPTION

J Spurling Ltd v Bradshaw [1956] EWCA Civ 3 is an English contract law and English property law case on exclusion clauses and bailment. It is best known for Denning LJ's "red hand rule" comment, where he said,

I quite agree that the more unreasonable a

clause is, the greater the notice which must be given of it. Some clauses which I have seen would need to be printed in red ink on the face of the document with a red hand pointing to it before the notice could be

held to be sufficient.

Raj LB@rajlb· May 14

I really have to keep reminding myself of this.

Simpsons meme where Bart is writing lines on a blackboard.

The line "Ant Middleton is not the one from Ant and Dec"

Raj LB@rajlb· May 14

um, can you play a song with a fucking beat? (Hit it like) hit it like rom-pom-pom-pom (Get it hot) get it hot like Papa John (Make a bitch) make a bitch go on and on (It's a fem) it's a femininomenon

The Pope singing(?) into a microphone with a cardinal behind him And members of the press.

Raj LB@rajlb· May 13

With Miliband? Please?

Screenshot of a BBC News thumbnail

Image: from left to right, David Lammy, Keir Starmer and Rachel Reeves on the front bench in the Commons.

Headline: Starmer warns leadership contest would 'plunge us into chaos' in pleas to ministers and MPs

Subheadline: Sir Keir battles to save his job, as Health Secretary Wes Streeting is thought to be plotting a leadership challenge potentially as early as Thursday.

Raj LB@rajlb· May 11

Best Star Trek crew. Wrong answers only.

Keir Starmer plus cabinet in a photo on a rooftop where everybody is smiling

Raj LB@rajlb· May 11

I think he looks more like a guy who's about to start a fight outside a pub