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Ashley Miller
@icmteaching
#zentensivist #FUSIC Haemodynamics National Lead. ICS trustee. BSE level 2. BJJ ⬛️⬛️🟥⬛️ @Turningthe_Tide. No politics, just #foamed #pocus #haemodynamics
United Kingdom
youtube.com/channel/UCfCIB…
Joined December 2015
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  • Pinned
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    Ashley Miller
    @icmteaching
    Jun 9
    I’ve started a Substack: The Dependent Variable. X is great for short-form discussion, but it’s not ideal for building a coherent archive. This will be the home for longer-form writing on cardiovascular physiology, haemodynamics, fluids, shock, ultrasound and critical care
    8.7K
  • user avatar
    Ashley Miller
    @icmteaching
    Jul 29, 2025
    🧵 What is Critical Closing Pressure — and why does it matter for perfusion? A thread to clear up one of the most misused and misunderstood ideas in circulatory physiology. 👇
    72K
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    Ashley Miller
    @icmteaching
    Jul 27, 2025
    🧵 "What really determines tissue perfusion?" – and why most explanations get it wrong. Let’s sort out MAP, CVP, CCP, autoregulation, vasopressors, and the flow that actually reaches your organs. 👇
    70K
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    Ashley Miller
    @icmteaching
    Jan 5, 2022
    Fluids or vasopressors or inotropes & why? CO = HR x SV but altering cardiac contractility or HR (by themselves) won't normally change CO🤯 Here's a 20 minute talk using infographics to try and simplify concepts that often seem very complicated. #FOAMed
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    Ashley Miller
    @icmteaching
    Nov 24, 2020
    How vasopressors increase stressed volume to increase venous return. It's all about the veins! #IFAD2020 @Fluid_Academy @Wilkinsonjonny @FOAMecmo
    GIF
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    Ashley Miller
    @icmteaching
    Aug 16, 2025
    1/ Shock isn’t “give fluids, then pressors, then inotropes.” That recipe misses the physiology. Here’s how to manage shock properly: 🧵 #MedX #haemodynamics
    48K
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    Ashley Miller
    @icmteaching
    Aug 25, 2025
    1/21 Acid–base interpretation often feels like a maze. But there’s a simple way to make sense of it at the bedside. It starts with pH, strong ions, and base excess.
    59K
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    Ashley Miller
    @icmteaching
    Oct 10, 2025
    🧵 The Cardiac Function Curve — why it misleads (Part 1) 1/ The cardiac function curve is one of the most recognisable images in physiology. Unfortunately, it’s also one of the most misdrawn, mislabelled, and misunderstood. Let’s redraw it — and see what it really tells us about
    59K
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    Ashley Miller
    @icmteaching
    Nov 26, 2021
    #IFAD2021
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    Ashley Miller
    @icmteaching
    Jul 14, 2021
    Part 2 of my 'rational fluid prescribing' series 💦 'The micro-circulation' ⭐️Why sepsis doesn't cause hypovolaemia ⭐️The #glycocalyx ⭐️Extended Starling principle ⭐️Albumin ⭐️Capillary leak ⭐️Where IV fluid actually goes ...and more #FOAMed 👇 #Vimeo
  • user avatar
    Ashley Miller
    @icmteaching
    Dec 12, 2020
    500 of these just arrived from the printers to help my mission of safer fluid prescribing @sathNHS £20 well spent when Fife saved 100k/year. Lots more measures to come to improve IV fluid safety.
  • user avatar
    Ashley Miller
    @icmteaching
    Jun 27, 2025
    1/ Most people think the heart drives circulation. But what if that’s backwards? Anderson’s model flips the whole idea of cardiac output on its head — and it changes how you think about fluid, flow, and failure. 🧵👇 #physiology #FOAMed #MedTwitter #criticalCare #cardiacOutput
    89K
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    Ashley Miller
    @icmteaching
    Apr 28, 2022
    Blood gas challenge. Who can explain this? PS I found it hysterical that the glucose was circled 😂😂😂. Note U.K. units
  • user avatar
    Ashley Miller
    @icmteaching
    Jun 30, 2021
    We’ve seen how to measure VTI and stroke volume with #ultrasound Our next #FUSIC haemodynamic question brought to you by @icultrasonica, @wilkinsonjonny and I is: Q2. Does SV respond to fluid, vasopressors or inotropes? #echofirst #POCUS #haemodynamics #foamed