Iain Beardsell @docib Twitter profile

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Iain Beardsell

@docib

3 years

I very, very rarely swear on here, but Lawrence Fox is a colossal twat isn’t he?

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Iain Beardsell

@docib

5 months

I have been a doctor in emergency (A&E) medicine since 1999 (before the four hour target) and I can honestly say it has never been as bad as it is today. Right now. I have no idea how the clinicians, nurse and others will keep going to work everyday.

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Iain Beardsell

@docib

4 years

Evening Abby. Finally a question I can answer! There are many causes of a tachycardia. Sometimes it’s just a physiological response to the body needing more oxygen in the tissues, but it could also be an arrhythmia like fast AF or even VT. I hope that helps. Yours aye. Iain.

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Iain Beardsell

@docib

4 years

Hi Abby. It’s really kind of you to show such an interest. I think it’s probably getting an arterial line in under ultrasound guidance in a patient with no palpable pulse. There’s nothing like it. All best. Iain.

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Iain Beardsell

@docib

3 years

The uncomfortable truth that dare not be said is that many do not need to see a GP or attend A&E. Society is now about the individual not the whole. We’ve seen it for years- “so what if there’s dying people in Resus? What about my sprained ankle?”.

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Iain Beardsell

@docib

5 months

When you attend an A&E/Emergency Department. 1️⃣ We will see people in order of clinical urgency. 2️⃣Arriving by ambulance does not mean you will be seen quicker

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Iain Beardsell

@docib

3 years

Just for fun I asked our night team of doctors how many had been Head Boy/Girl at school. Over 50%. Sometimes we forget just how high achieving our colleagues are. They are (literally) the academic top 1%. We need to empower them, not patronise them in their roles.

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Iain Beardsell

@docib

1 year

I notice the #JuniorDoctorsStrike has dropped off the @BBCNews website front page and isn’t even the top health story. Press coverage often negative and patients undeterred from attending A&E. I fear HMG has no reason to negotiate. What’s the @TheBMA next move?

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Iain Beardsell

@docib

2 years

He’s a farmer in A&E. Immediately refer to ITU.

RCEMLearning

@RCEMLearning

2 years

A 29-year-old farmer presents to your local ED with a bite mark over the upper left calf 🕷️ He is physiologically stable with a NEWS of 0. How do you manage this case? 🆓 #FOAMed ➡️ @HassanNassar90

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Iain Beardsell

@docib

3 years

It is time for a national discussion about what it is reasonable to expect for emergency medical care from #NHS . We can no longer just see everybody and anyone who turns up at A&Es’ doors. It is just not possible. We have to be there for the acutely unwell and injured.

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Iain Beardsell

@docib

5 months

Never underestimate the toll it takes on you walking into a hospital every day. Surrounded by the sick, injured and sad it’s hard to remember that the whole world isn’t like that. I genuinely don’t think the public (or politicians) have any understanding of how hard it can be.

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Iain Beardsell

@docib

2 years

I have a confession to make. Please don’t judge me or think me less of a man or clinician. I really don’t mind when people call it ‘A&E’…

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Iain Beardsell

@docib

2 years

To remove some of the cognitive burden I have scripts I use on each and every trauma call. In essence I am playing a part, and leaving as much brain space for the complex thinking as I can. This is the script I use prior to the patient arriving. #RCEMcpd

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Iain Beardsell

@docib

3 years

For the record: I work on the ‘frontline’ (sic) in the #NHS , I do night shifts and weekends but there is absolutely no way my work is anywhere near as difficult or tiring or stressful as that of a GP. GPs are the true backbone of the #NHS and they deserve all of our support.

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Iain Beardsell

@docib

2 years

I’m just saying that if I can wear one whilst wearing a flight helmet with @HIOWAA you can probably wear one when you’re shopping.

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Iain Beardsell

@docib

5 years

There seems to be an awful lot of pressure to “live your best life”. Some days I’m content just to live an average life: pottering along; trying not to shout at my children too much; eating only 2 of my 5 a day and letting the world pass me by. And not to feel too guilty about it

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Iain Beardsell

@docib

4 years

I work in an A&E/Emergency Department. I do not work on the “front line”. I’m not a solider in battle.

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Iain Beardsell

@docib

2 years

The bit I don’t understand is why no one telling the public that their expectations of the #NHS are simply too high. There needs to be an element of self care first for many. GP appointments are available, as are A&E services, but we cannot cater for the worried well.

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Iain Beardsell

@docib

4 years

Tip number 1: take the top off your inhaler....

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Iain Beardsell

@docib

1 year

I wonder of headline should actually be ‘Consultants standard hourly pay is less than almost any tradesperson who might work on your car, plumbing, tax return, divorce or house renovation’.

Consultants want up to £262 an hour to cover strike days for junior doctors

NHS bosses criticise pay demand for consultants to provide emergency care during junior doctors' walkout.

www.bbc.co.uk

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Iain Beardsell

@docib

4 years

We often hear grand plans for A&E restructuring, but what small things would make your ED more efficient? I’ll start... *Printers that always work *Not having to sign ECGs/VBGs for patients who didn’t need them in the first place *An up to date contact list Your turn....

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Iain Beardsell

@docib

3 years

Is the sunflower lanyard now the 21st Century version of the soft cervical collar?

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Iain Beardsell

@docib

3 years

@zackferguson We now have this. The recorded message is brilliantly blunt and then cuts the caller off.

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Iain Beardsell

@docib

4 years

“The A&E target” and thoughts about why we’re struggling to meet it. A thread👇

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Iain Beardsell

@docib

4 years

Working in A&E over the next few months will be challenging, but I can’t be the only one who thinks it’ll all pale into insignificance compared to the night the lockdown ends....

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Iain Beardsell

@docib

4 years

The ED consultant when one of the inpatient teams is giving an ED junior doctor grief about a referral....

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Iain Beardsell

@docib

1 year

The #NHS should have fewer award ceremonies and more toilets, lockers and parking.

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Iain Beardsell

@docib

4 years

Only because you’re too young to remember ‘Sleek’. The Godfather of all tapes.

Claire Zagorski, MSc, LP

@clairezagorski

4 years

Which is your favorite medical tape and why is it Transpore?

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Iain Beardsell

@docib

5 years

I’d go with “no”, “no” and “no”. The future in the UK is chronic pain, psychiatry and geriatrics.

#badEM Brave African Discussions in EM

@bad__EM

5 years

Do you believe ultrasound is the future of Emergency Medicine? Do you believe video laryngoscopy is the future of Emergency Medicine? Do you believe HEMS is the future of Emergency Medicine? Some of the questions posed by @davidstantonza at #badEM19

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Iain Beardsell

@docib

5 months

🔟Being in a hospital does not make you immune from common courtesy or the law. If you abuse us physically or verbally we will call the police. I’m sure colleagues may want to add to the list…

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Iain Beardsell

@docib

2 years

The rise in energy prices is a worry for us all, but as I sit here in a brightly lit A&E department at 4am I dread to think of the effect on the #NHS . An extra £700 per household? How much extra per hospital?

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Iain Beardsell

@docib

6 years

#NHS confirms Emergency Department (A&E) Opening Times over Christmas and New Year 2017

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Iain Beardsell

@docib

4 years

Should “Advanced Life Support” be renamed “Basic Life Support Plus”? Resuscitation has moved on past generic algorithms. ALS really isn’t advanced at all, but gives the impression to providers that it’s the standard to aspire to. And those going “beyond the manual” are rogue.

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Iain Beardsell

@docib

5 months

We often talk about flow out of the Emergency Department (A&E) but is it time to have a serious discussion about who gets in at the front door? The system simply isn’t capable of looking after the entire population’s range of health concerns. Do we need to redefine ‘emergency’.

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Iain Beardsell

@docib

22 days

A very senior surgical colleague once said to me ‘I have no idea why we expect you to make a diagnosis in four hours. After several days and multiple tests I often still don’t know what’s wrong’.

Elshad 🦀

@ElshadKarbasi

23 days

“Acute abdomen” is not a diagnosis

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Iain Beardsell

@docib

3 years

Those in healthcare aren’t leaving because they don’t want to make sick people better, they’re leaving because of the public demand to tell well people they’re not sick.

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Iain Beardsell

@docib

4 years

Until we all acknowledge that the ED/A&E doesn’t have endless capacity, that corridor care is unacceptable and that the risk must be shared across the whole healthcare system nothing will ever change. I’m tired of inpatient teams using “but we’ve no beds” as an excuse.

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Iain Beardsell

@docib

4 years

Dear Junior Doctors. Next time a consultant questions why you ordered a CRP/D-Dimer/CT/ just reply by simply saying “an abundance of caution”

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Iain Beardsell

@docib

4 years

A patient with known advanced cancer shouldn’t be in an A&E at all. They should be directly admitted to an oncology or palliative care ward. This misuse and misunderstanding of what “A&E” is for is a major part of the problem.

Hugh Pym

@BBCHughPym

4 years

Jeremy Corbyn tells ITV debate a friend with advanced cancer had to wait 8 hours in A&E for urgent treatment - staff under too much pressure

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Iain Beardsell

@docib

3 years

Yes children, phones used to look like this, were attached to a socket and (best of all) when we answered we repeated our own telephone number. Yes. We repeated our own phone number (I can still remember ours from 40 years ago).

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Iain Beardsell

@docib

5 months

5️⃣ Clinicians in A&E are specialists, but in the management of emergencies. We are no good at rashes, chronic illness and other medical problems that have been going on for more than a few days. 6️⃣ We are not a substitute for ‘I don’t have a GP’

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Iain Beardsell

@docib

4 years

We’d never assume teachers would be able to be doctors without years of training, so why do we assume doctors can be teachers?...

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Iain Beardsell

@docib

1 year

As I am sure many medics have, I had an email from a national newspaper today asking me to comment on the current state of emergency care. I redirected them to the @RCollEM Communications Dept who are doing an excellent job. Important we have a single strong voice.

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Iain Beardsell

@docib

1 year

A quick guide to how Consultants in the #NHS are paid (as this may be a hot topic over coming weeks). The basic unit of pay is a ‘PA’ or programmed activity. In ‘normal hours’ a PA is four hours. A full time contract is 10 PAs (40 ‘normal’ hours per week). 1/10

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Iain Beardsell

@docib

5 months

Hypoxic drive as the cause of rising CO2 in COPD is a myth. Please can we stop teaching this?

Oxygen and Carbon Dioxide Retention in COPD

Excessive oxygen administration can lead to hypercapnic respiratory failure in some COPD patients. COPD patients with more severe hypoxemia are at higher risk of CO2 retention from uncontrolled O2...

litfl.com

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Iain Beardsell

@docib

4 years

Honestly. If he can’t get an increased care package to keep him at home what hope have the rest of us got? Prince Philip taken to hospital as a 'precautionary measure'

Prince Philip taken to hospital as a 'precautionary measure'

The duke, 98, was admitted in relation to a pre-existing condition, Buckingham Palace says.

www.bbc.co.uk

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Iain Beardsell

@docib

4 years

Good question Katie. I’m no cardiologist, but it would usually be via your femoral or radial artery as far as I know. Although, of course, in an emergency a clamshell thoracotomy would work too. Enjoy your dinner. Iain.

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Iain Beardsell

@docib

2 years

Just my occasional reminder that being a Clinical Lead in a specialty in an #NHS Trust is an almost impossible job. Trade Union leader and Line Manager. Two masters with often very different needs and you’re stuck in the middle. Did it for three years: it almost killed me.

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Iain Beardsell

@docib

5 years

As Trusts seem to be competing to outdo each other on the quality of their “goody bags” at #induction , I can’t help but feel most starting new posts would swop it all for a (decent) rota in advance, no pointless stat and mand, access to parking, a commited Ed Sup and a pay cheque

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Iain Beardsell

@docib

3 years

The #COVID pandemic has been hard for everyone, but I count myself very lucky that as a doctor I’ve been able to go to work (and get paid well) throughout, had daily interaction with colleagues to keep spirits up and been able to ‘do my bit’.

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Iain Beardsell

@docib

5 months

7️⃣ We are not a substitute for ‘my GP doesn’t take my problem seriously’ (which, by the way we don’t believe). 8️⃣We cannot get your out patient appointment brought forward. 9️⃣ Shouting at us doesn’t make us want to help you

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Iain Beardsell

@docib

3 years

Our next @UCATofficial question. Personally I think Ariel is pretty brave to stand up to Robert. All too often medics stand by and let bad behaviour happen. Ariel isn’t doing this and fair play to them. I’d answer A. (Robert is just the sort of person you’d dread working with).

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Iain Beardsell

@docib

6 months

I’m starting a crusade that not every patient attending the Emergency Department needs a venous blood gas and an ECG. Who’s with me?…

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Iain Beardsell

@docib

4 years

Gosh Katie, I’m surprised I’m opening up to you so soon after meeting, but I’d say spending 10 years trying to tweet someone funny, only for someone else to post the exact same thing 12 hours later and getting 21 thousand more likes than me. At least I was his “inspiration”. Iain

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Iain Beardsell

@docib

2 years

I’m a former Clinical Lead of a Major Trauma Centre Emergency Department and current consultant in EM and prehospital care and due to participation in the AZ #vaccine study and the #NHS vaccination programme I have been the very proud recipient of four vaccines.

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Iain Beardsell

@docib

7 years

The @UHSFT ED #TipsforNewDocs from our senior medical and nursing team.

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Iain Beardsell

@docib

8 years

Just in case you're missing #smaccDUB (or want to know why thrombolysing submassive PE might be a bad idea).....

SMACC DUB Thrombolysis for Submassive PE-Iain Beardsell (@docib)

SMACC DUB is a medical conference like no other. It even lets people "rap" their talks. Here Iain attempts to explain why we shouldn't thrombolysis submassiv...

www.youtube.com

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Iain Beardsell

@docib

4 months

I have decided that it’s misleading for patients when surgeons use the prefix Mr/Mrs/Miss/Ms after passing an exam. Much better if they use Dr Their Name FRCS. Otherwise patients might think they are not seeing a real doctor.

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Iain Beardsell

@docib

1 year

Controversial opinion- higher specialist training should be good enough that the ‘Life Support’ courses are unnecessary.

Ashley Vardon

@vardon91

1 year

I currently can’t afford the £1000 for APLS and NLS, but need to put it on a credit card. 18% APR for the next 5 months, which isn’t insignificant. Doesn’t seem like anyone cares about this?

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Iain Beardsell

@docib

3 years

Saddened to hear one of our very promising FY2s has withdrawn from their place on the GP training scheme for next year. His future is now uncertain, but he said he simply ‘can’t see myself doing that job’. Urgent action is needed.

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Iain Beardsell

@docib

7 years

I still maintain that if we could all just remember these two things patient care and our own work lives would improve hugely. #dasSMACC

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Iain Beardsell

@docib

4 years

I realise I really shouldn’t say this, but I can’t stand the word ‘resilience’....

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Iain Beardsell

@docib

2 years

Here’s an idea- for 24 hours why don’t as many people as possible post their positive experiences of working and training in Emergency Medicine. It doesn’t have to be monumental, just the little things that make it all worthwhile.

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Iain Beardsell

@docib

6 months

After some reflection I have concluded that Emergency Care in the UK has never before been under the constant, unrelenting pressure as it is now. Every shift feels like a struggle (and I’ve been doing it a while). How do you keep yourself positive on shift (and after)?

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Iain Beardsell

@docib

2 years

We’ve been trialling a new way of ‘front door’ working this week at @UHSFT . My biggest take home-we need the most senior decision makers possible available as early as possible. This may make some uncomfortable and echoes of ‘that’s not in my job plan’ will bounce off the walls…

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Iain Beardsell

@docib

4 years

I defy any Emergency Physician not to get anxious watching this. And then to resist telling a trampoline horror story to an unsuspecting passer by.

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Iain Beardsell

@docib

4 months

Most blood tests (and chest X-rays) performed in the emergency department are completely unnecessary.

Paul Wischmeyer MD,EDIC,FCCM⎪ #NutritionMatters 💪

@Paul_Wischmeyer

6 months

🙋‍♂️ What’s your unpopular opinion in medicine that will get you in this position? #MedTwitter

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Iain Beardsell

@docib

5 months

3️⃣Our clinicians each see on average one patient an hour. If there are 70 patients waiting to be seen when you arrive and there are 10 clinicians, and your problem is not urgent your wait will be at least 7 hours. 4️⃣ More tests does not mean better care. Perhaps even the opposite

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Iain Beardsell

@docib

4 years

When, as trauma team leader, you suggest to the newly ATLS certified registrar that the haemodynamically normal trauma patient with an isolated limb injury only needs one cannula.

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Iain Beardsell

@docib

4 years

When my children are taking ages to get ready for school I follow them round the house with a clipboard yelling “you’re going to breach”...

Allison Bond, MD

@AllisonRBond

4 years

How has medical parlance made its way into your everyday language? I'll start: I say that things have "nadired" (verb) all the time, and that it's "not unreasonable" to do a given thing. Ex: My mood had nadired, so it seemed not unreasonable to eat an entire box of Oreos.

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Iain Beardsell

@docib

5 months

A very senior surgical colleague of mine once said ‘I don’t know why we expect you to make a diagnosis in four hours, when often, after they’ve been an inpatient with us for two days I still don’t know what’s wrong with them…’

Jim Crawfurd 💙 🇺🇦

@jim_crawfurd

5 months

Would be interested to know the thoughts of UK surgeons on this, particularly those who don’t think surgery should be taking referrals from ED without a confirmed surgical diagnosis @MStott88 ?

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Iain Beardsell

@docib

4 years

Well Katie, a combination of: Zygomaticus major and minor: Pulls up the corners of your mouth. Orbicularis oculi: Causes the eye crinkle. Levator labii superioris: Pulls up the corner of lip and nose. Levator anguli oris: Raises the angle of mouth. And a few others. Iain.

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Iain Beardsell

@docib

7 years

Please only go to A&E if you have a genuine medical need. It's nothing to do with the cyber attack, just general advice.....

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Iain Beardsell

@docib

8 months

Having high blood pressure with no symptoms is not a medical emergency. It’s a risk factor for future disease. Yes it needs attention, but only in the same way smoking cessation does. And for many the first step isn’t tablets…

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Iain Beardsell

@docib

3 years

Thought this question and answer from @UCATofficial was really interesting. As a consultant I definitely wouldn’t have answered D. Junior doctors are highly trained professionals. Simon sounds like a conscientious doctor, making a patient centred decision.

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Iain Beardsell

@docib

5 years

Two very simple words, uttered by both patients and staff, have crippled healthcare. “What if?....” This has lead to increased attendances, increased length of stay and overinvestigation. I fear this can never be reversed. We seem incapable to accept any risk however small.

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Iain Beardsell

@docib

5 years

Every A&E consultant who is trying to run the ED on a weekend will recognise this feeling.... #RCEMcpd

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Iain Beardsell

@docib

6 years

I’m a complete devotee of the original Morse books (and TV) but having just binge watched the latest series there’s a chance I like @EndeavourTV even more. Beautifully played by all involved.

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Iain Beardsell

@docib

7 years

"Hello my name is" has been hugely successful with patients. Why don't we do it with colleagues? #dasSMACC

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Iain Beardsell

@docib

3 years

Yes there’s an aging population and COVID, but do we really believe that public health is worse now than two decades ago? Phone consultations work because it is a trained person absolving the individual of the responsibility for their own health that they are not willing to take.

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Iain Beardsell

@docib

1 year

Lots on @Twitter about current ‘pressures’ on the #NHS . Some advice from ‘thought leaders’ is frankly absolute nonsense. Here are some @stemlyns resources that offer practical thoughts.

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Iain Beardsell

@docib

3 years

Just a gentle reminder that the answer to A&Es/EDs being busy is not to cancel planned teaching sessions. Value and look after your staff and they will give back tenfold. And if you do cancel these sessions don’t then say you care about ‘wellbeing’

St Emlyn’s Hierarchy of Wellbeing - St.Emlyn's

Estimated reading time: 7 minutes Wellbeing is a very 'trendy' word in Medicine and seems to be the focus of many educational sessions (or even days), with some departments forming 'Wellbeing Working...

www.stemlynsblog.org

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Iain Beardsell

@docib

5 years

Inadvertently I think Dr Kim may have become a standard bearer for humility, reflection and grace. If only all researchers behaved with such honour.

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Iain Beardsell

@docib

4 years

Hi Abby. Just wondering how we can break down barriers between ED and inpatient teams: to work more collaboratively and less in silos; to understand each other and walk in each other’s shoes occasionally. Surely that would not only help staff but patients too? Best wishes. Iain

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@docib

2 years

There are so many good people in the world of Emergency Medicine. It’s a specialty of endless learning where you can do genuine good on a day to day basis. There is huge pressure on EDs at the moment and we must support each other with as much energy as we can muster.

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@docib

5 years

This is the key to #wellbeing I believe. People don’t need fancy schemes, just decent working conditions, the ability to take leave when they’d like and a rewarding work environment for a fair salary. Spend the money (and time) on HR support, not chocolate.

claire gordon

@beans2er

5 years

Great line from an audience member in the session on resilience ‘I want my rota in good time, not a yoga mat’ 🤔 #rcpeSolutions

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Iain Beardsell

@docib

4 years

There really is something genuinely luxurious about getting into bed after a night shift. Have a good day you light loving losers.

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Iain Beardsell

@docib

4 years

Hello again Abby. You have so many questions! Right now I’m wondering if the patient with atypical chest pain really did need a CTPA and an Echo, You really can’t be too careful. Or maybe you can. Oh gosh. It’s tricky.... Take care. Iain.

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@docib

4 months

Let’s be clear- this is association and not causation. When there aren’t strikes most A&Es across the UK are on the verge of a critical incident. The responsibility for this lies squarely at the door of those running the #NHS not the staff.

Sky News

@SkyNews

4 months

BREAKING: A critical incident has been declared at Nottinghamshire hospitals due to sustained pressure on the NHS and reduced staff because of the junior doctors strike 📺 Sky 501, Virgin 602, Freeview 233 and YouTube

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Iain Beardsell

@docib

3 years

Our health system is being killed by the ‘just in case’ attendances followed by ‘just in case’ over investigation, the latter fuelled by a fear of criticism and reprimand.

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Iain Beardsell

@docib

3 years

Ok, Simon Carley has 25k followers and educates on a platform of Emergency Medicine. I have 7K followers and I’m really jealous. Can we make my ‘voice’ as loud as his on Twitter? Follow and RT me. Let’s do this 👍 PS. I know he is a Professor and all that, but I’m really needy

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Iain Beardsell

@docib

4 months

Just been to our new @UHSFT staff gym for the first time. Easy online induction, security added access to my pass without fuss and in I went. Nothing fancy, but a good range of machines and hot showers in the changing rooms. All good stuff.

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Iain Beardsell

@docib

8 years

A career highlight..... Offering my opinion on how to treat a lightsaber wound. #StarWars #foamed

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Iain Beardsell

@docib

3 years

As a doctor in an A&E I keep myself sane by focussing on caring first for those who really need it and I’m afraid the rest may need to wait. But I don’t feel guilty about that: that’s just the system we all work in. Fundamental change is needed. But who is brave enough to do it?

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Iain Beardsell

@docib

24 days

This will come as absolutely no surprise to anyone working in emergency care. A few thoughts on why things have changed so much over the last decade (and why ‘attendance numbers’ are not comparable). 🧵

Matt Discombe

@mattdiscombe

24 days

BREAKING: A&E four hours performance was 74.2% in March - missing NHSE's 76% target

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Iain Beardsell

@docib

7 years

Seriously? Where are they hoping they'll work? The 1970s? Are we not in more enlightened times? @HSJEditor

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Iain Beardsell

@docib

7 months

I realise this may be rather controversial, but is it time we update the expected clinical examination for medical students to reflect real life? Palpating an apex beat for example. Has this ever really changed a single diagnostic decision? There’s plenty more of these examples…

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Iain Beardsell

@docib

4 years

Just trying to think what I could advertise to make a couple of quid. I’ve always thought baby wipes are a work of genius that shouldn’t be restricted to parents. There. That’s it. Buy baby wipes. I’m a doctor and I think they’re great.

NHS doctors make thousands by plugging cars and snacks on Instagram

One trainee orthopaedic surgeon, Dr Joshua Wolrich, was allegedly paid £4,000 to encourage his 244,000 Instagram followers to eat red meat, without mentioning NHS health guidelines.

www.dailymail.co.uk

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Iain Beardsell

@docib

4 years

Lastly. Be honest about the problems. Listen to the experts. Don’t regurgitate soundbites. What A&Es are living with day to day simply shouldn’t be acceptable and we should be embarrassed. And value the staff. They are the only ones keeping this afloat at the moment. Ends/

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Iain Beardsell

@docib

5 years

“You’ve got this. If you need any help look at me”. Surprising how much medical educators can learn from @GlastoFest Remember this next time you’re in Resus with a less experienced colleague and they too can be like #Alex

BBC Radio 1Xtra

@1Xtra

5 years

Alex you absolute legend 👏 This kid just smashed @Santandave1 x @ajtracey ’s ‘Thiago Silva’ live at #Glastonbury2019 #BBCGlasto 🔥🔥🔥🔥🔥

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