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Mark Borthwick

@markborthwick

Critical care pharmacist; what’s your poison….?

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10.11.2024
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Latest posts by Mark Borthwick @markborthwick

Awesome conference, so much good stuff :-)

14.11.2025 20:42 👍 2 🔁 0 💬 0 📌 0

I get why people resign from positions of authority when organisation/leadership goes down the wrong path (yes, looking at the RFK vaccine nonsense)

BUT

Who do you think replaces the leavers? A similarly minded person, or someone more allied to those views?

We give way, and so facilitate

29.08.2025 08:03 👍 0 🔁 0 💬 0 📌 0
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Looking for help…!

#CriticalCarePharmacist
#Oxford

www.jobs.nhs.uk/candidate/jo...

17.06.2025 11:30 👍 0 🔁 0 💬 0 📌 0

😘

06.06.2025 22:53 👍 1 🔁 0 💬 0 📌 0
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Whole day was great
UKCPA Critical Care Symposium
@ukcpa.bsky.social

06.06.2025 20:08 👍 1 🔁 0 💬 0 📌 0
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Jonathan presents the UK respiratory metagenomics implementation, route to routine. @ukcpa.bsky.social was great 👍

06.06.2025 17:30 👍 2 🔁 1 💬 0 📌 0
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Microsoft Virtual Events Powered by Teams Microsoft Virtual Events Powered by Teams

Just a week to go until the launch of the NCEPOD report Recovery Beyond Survival - a review of the quality of rehabilitation care provided to patients following an admission to an ICU.

Register now to for the lunchtime webinar on 12 June👇

bit.ly/NCEPODwebinar

06.06.2025 19:54 👍 4 🔁 4 💬 0 📌 0

My sincere thanks to all my critical care pharmacy colleagues for contributing data, and to UKCPA for the use of resources to make the study happen

27.05.2025 19:30 👍 0 🔁 0 💬 0 📌 0

Overall we found the UK has moved over to using PPIs for SUP, there is some blanket prescribing going on, enteral feeding is commonly used as stopping criteria, though SUP is not stopped in some locations meaning deprescribing processes are needed

27.05.2025 19:30 👍 0 🔁 0 💬 1 📌 0

Stopping criteria were dominated by “patient fed” (65% of units)

In three quarters of those, that meant “full enteral feed”, in the remaining quarter that largely meant “any enteral feed”.

Neither SUP-ICU, nor REVISE used enteral feeding as stopping criteria

27.05.2025 19:30 👍 0 🔁 0 💬 1 📌 0

About a fifth of units reported they administered SUP to all patients, contrary to guidelines that advocate only giving SUP to critically ill patients with risk factors

27.05.2025 19:30 👍 0 🔁 0 💬 1 📌 0

Overall, we gathered information from over two thirds of UK critical care units, twice

Unsurprisingly, there was a large shift towards the use of PPIs for SUP between 2020 and 2024

27.05.2025 19:30 👍 0 🔁 0 💬 1 📌 0
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Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation | NEJM Whether proton-pump inhibitors are beneficial or harmful for stress ulcer prophylaxis in critically ill patients undergoing invasive ventilation is unclear. In this international, randomized trial,...

We gathered SUP practices again in 2024, just prior to the publication of REVISE (which had the potential to change practice again)

www.nejm.org/doi/abs/10.1...

27.05.2025 19:30 👍 0 🔁 0 💬 1 📌 0

However, the appearance of COVID and the withdrawal of ranitidine somewhat ruined the experimental conditions

27.05.2025 19:30 👍 0 🔁 0 💬 1 📌 0
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Effect of Stress Ulcer Prophylaxis With PPIs vs H2RBs on ICU Mortality This cluster randomized trial compares the effects of proton pump inhibitors (PPIs) vs histamine-2 receptor blockers (H2RBs) on 90-day mortality among patients requiring invasive mechanical ventilatio...

We aimed to more completely characterise UK practice before the publication of PEPTIC (H2RA as first line SUP agent, or PPI as first line SUP agent)

We then wanted to see how or if practice would change after the publication of PEPTIC

jamanetwork.com/journals/jam...

27.05.2025 19:30 👍 0 🔁 0 💬 1 📌 0
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Stress ulcer prophylaxis in the intensive care unit: an international survey of 97 units in 11 countries Background Stress ulcer prophylaxis (SUP) may decrease the incidence of gastrointestinal bleeding in patients in the intensive care unit (ICU), but the risk of infection may be increased. In this st...

In the work up to SUP-ICU, an observational study recorded SUP practices across several countries

This revealed that unlike other countries, UK practice was divided between H2RA and PPIs

onlinelibrary.wiley.com/doi/abs/10.1...

27.05.2025 19:30 👍 1 🔁 0 💬 1 📌 0
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Stress ulcer prophylaxis practice in UK critical care units: A comparison of cross-sectional surveys between 2020 and 2024 - Mark Borthwick, Greg Barton, Emma Boxall, John P Dade, Odran Farrell, Ruth ... Background: Critically ill patients are at risk of bleeding from stress ulcers. Comprehensive information regarding United Kingdom stress ulcer prophylaxis (SUP...

Have stress ulcer prophylaxis practices changed in the UK since the publication of PEPTIC?

Yes, but highly likely nothing to do with PEPTIC

journals.sagepub.com/doi/10.1177/...

27.05.2025 19:30 👍 1 🔁 6 💬 2 📌 0
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#COVID5years

Quotes that made us laugh in the moment are added to a whiteboard

My niece asks pertinent questions for a school project

24.05.2025 13:32 👍 1 🔁 1 💬 0 📌 0
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A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study Dear colleagues, We invite you to participate in our survey, "A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study," conducted by researchers fr...

Dear ICU pharmacist colleague. Please complete our brief clinical pharmacysurvey for adult ICU. @rsbournie.bsky.social @markborthwick.bsky.social @chrisremmington.bsky.social

@esicm.bsky.social @sccmcriticalcare.bsky.social @ukcpa.bsky.social
#together
#weareICU

docs.google.com/forms/d/e/1F...

21.05.2025 12:20 👍 8 🔁 10 💬 1 📌 0
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#COVID5years
Impromptu hugs between nursing staff before a shift in the critical care covid bays

18.05.2025 13:18 👍 2 🔁 0 💬 0 📌 0
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Supporting medical science in the USA The pursuit of rigorous medical science is not compatible with capitulation to government demands aimed at weaponising and eroding science. On April 14, Edwin R Martin Jr, the Trump-appointed interim ...

www.thelancet.com/journals/lan...

04.05.2025 12:10 👍 0 🔁 0 💬 0 📌 0
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#COVID5years

A little ‘thank you’ light show is projected onto the hospital

Parallels are made between the Nightingale facility nearing completion, and pandemic flu facilities 100years earlier

We start collecting handprints from our ICU workers

03.05.2025 13:28 👍 0 🔁 0 💬 0 📌 0
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A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study Dear colleagues, We invite you to participate in our survey, "A Review of Clinical Pharmacy Services in Adult Intensive Care Units: An International Cross-Sectional Study," conducted by researchers fr...

docs.google.com/forms/d/e/1F...
Dear Intensive pharmacist, please complete our short international survey . This one for pharmacists, more coming for pharmacy team, including pharmacy technicians #bepartofresearch @markborthwick.bsky.social @chrisremmington.bsky.social and team

02.05.2025 06:27 👍 12 🔁 14 💬 1 📌 0

Really interesting thread Segun

Balancing sufficient assurance of knowledge, skills, behaviours and experience vs overburdening is difficult, and key

We all -public, payers, colleagues- need some form of objective assurance of competence, not none
(in medicine, nursing, pharmacy, physio, etc)

29.04.2025 20:39 👍 2 🔁 1 💬 0 📌 0
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#COVID5years
PIPA going strong
Clinical trials aseptic unit making hundreds of propofol and NMB syringes each day
Clinical pharmacy services to crit care now 7 days a week, 12hours a day

23.04.2025 21:07 👍 0 🔁 0 💬 0 📌 0
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#COVID5years
Renal replacement fluid supplies now under pressure, and start to be micromanaged
Regular counts commence to report back to NHS central, we write on anything handy

15.04.2025 17:11 👍 0 🔁 0 💬 0 📌 0
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#COVID5years
Neuro ICU takes all general ICU work, other expanded/specialist units take covid patients
PIPA in full flow
Clinical trials mass produce propofol and atracurium syringes

Nationally:
Propofol supply begins to wobble
Epoprostenol demand surges and detabilises supply

14.04.2025 21:13 👍 0 🔁 0 💬 0 📌 0
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#COVID5years
A more robust near patient IV prep area is developed - Pharmacy Intravenous Preparation Area (*PIPA*)

Staff trained in IV making and ANTT in a medical school facility
Nurses, medical students, pharmacy technicians, pharmacists collaborate

Critical care surges into cardiothoracics

11.04.2025 16:49 👍 0 🔁 0 💬 0 📌 0
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#COVID5years
After the IV making service falls over, a new collaboration gets it on its feet again
Outpatient areas are earmarked for an expanded service, shielding nurses and medical students are added to the initiative
More critical care areas are converted to covid bays

09.04.2025 19:00 👍 0 🔁 0 💬 0 📌 0
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#COVID5years

The near patient IV making service falls over: new staff supporting the weekend are not trained in time, the weekday staff are exhausted

Clinical trials aseptics unit start production of prefilled syringes of propofol and atracurium

Home haircuts begin

05.04.2025 13:20 👍 0 🔁 0 💬 0 📌 0