Mike Erdman

@nickmmark @neuronalnewbie Diazepam has a much shorter onset (1-3 min) compared to lorazepam (5-10) in status

@neuronalnewbie That’s fair. I said “probably” because I have to acknowledge that some of the more recent studies (e.g. pecarn in pediatric patients) suggesting equivalency. Though I think there are good pharmacological reasons to favor lorazepam. 🤷

Weird medical decision making in the final episode of the Pitt 1. Using diazepam instead of lorazepam in status epilepticus. The latter is probably superior. Probably should have used more mag too. 2. They delayed intubation until she was clearly in status. I get waiting a minute to see if the mag works but giving multiple second line meds before deciding to take the airway is not a great move imho. 3. This is the big one. Using succinylcholine to intubate a seizing woman with eclampsia —> major risk for provoking hyperkalemia and cardiac arrest, which is exactly what happened! The rationale was “we need a neuro exam after”. Dude first of all you are gonna use an EEG to titrate anti-seizure meds (they showed this). Second you can just reverse roccuronium with suggamadex. That’s way more reliable than *hoping* the dangerous drug you gave wears off (in a patient with renal and liver injury no less)! 4. I could quibble about transfusions too. Rapid infusing blood when her Hb was 7 is wrong, though she was actively bleeding so 🤷 . Platelets should be transfused to >50k not necessarily higher. They didn’t give FFP for some reason, which is not good. 5. The depiction of the resuscitative hysterotomy was realistic but not having OBs there? Pretty unlikely. If there are OBs anywhere in the building you better believe they will be at the bedside of the eclamptic seizure code! (When I’ve done resuscitative hysterotomy IRL, lack of OBs was not a problem!) From a realism perspective this is not as bad as ER docs declaring brain death within a few hours of an overdose (season 1) but really felt unrealistic in a big urban academic hospital.

@Kylepaxoll @amandav_pharmd Bacteriostatic is a meaningless term

@amandav_pharmd I tell most of the staff under me, don't use clindamycin unless the resistance profile comes back and it is your only choice. Last thing people need is a c-diff infection. Also don't like zyvox a bacteriostatic in something like a cellulitis where you frequently have poor circ.

when your residents are tired of you questioning their antibiotics so they start putting their entire thought process in the indication lmao honestly I’m here for it

@PhlawlessPharm My experience has been that community hospitals excel at the routine care but can’t handle complex patients/adverse outcomes. AMC may be less efficient but generally have better outcomes especially in complex patients. jamanetwork.com/journals/jaman…

@JustinUSA @JagsFanBrian Following the Trump blueprint, then.

@JagsFanBrian Fishback is not a conservative. He is a lying con man who will say and do anything to appeal to his groyper base. Real republicans won’t let him ruin our party.

This is the Florida Republican party

@PulmCrit I think study replication and publication of data sets is supposed to address this though it’s not feasible nor encouraged in the case of the former and not required in the case of the latter.

Fabrication remains a major weakness of EBM. I think this may be what happened with Marik's initial paper about vitamin C for septic shock in CHEST. Fabrication is extremely hard to detect and we rarely consider this when analyzing studies. medpagetoday.com/special-report…

@MrCommercial @the_transit_guy Dude you’re a transplant from WA according to your bio

@the_transit_guy I don’t mean for this to sound snarky or rude, but it will anyway. We’re not going to listen to somebody in New York when it comes to anything tax related.

So the sidewalks and sewers in Florida will be paid by sales tax?

@rottengirl @the_transit_guy Never bought a car before?

@the_transit_guy I think the point is that in no other scenario do you buy something and still pay taxes on it. There are examples of people paying more in taxes than they paid for their home. Public works can be fee based on usage instead of tax based upon the value of your property.

@PulmCrit The amount of studies that compare non-equivalent doses between hyperosmolar therapies is also painful.

it's wild how badly people dose hypertonic therapy 60 ml of 23% is equivalent to ~500 ml 3%, so this table makes no sense best approach: figure out the sodium change you want and calculate the hypertonic dose math sets you free from a billion stupid consensus statements

@PulmCrit Send me a 1099 and let’s go

@erdapenum1 thanks for volunteering to do my illustrations

adjusted D-dimer FTW 😃 please note however that if your hospital uses D-dimer units (DDU not FEU), the cutoffs are lower by a factor of 2 FEU: nl <500, adjusted <10*age DDU: nl < ~230, adjusted <5*age this is confusing AF & frankly an error waiting to happen … #1/2

@PulmCrit This graph tho 🥴

also bear in mind that values close to the cutoff yeild no real information although we obsess about whether 499 or 501 is a “positive” or “negative” value, these borderline values are truly simply noninformative more on this: emcrit.org/pulmcrit/cutof…

@cassinetobacter @BCB_PharmD They mentioned an impairment charge (write off) in Q4 2024 earnings “The Reported SG&A expense included impairment charges of $504m recorded against the Andexxa intangible asset” astrazeneca.com/content/dam/az…

@BCB_PharmD Is this real?? It looks like it could be AI generated

Would love to hear from the Andexxa truthers

Buh-bye 👋

@JSOPIO How is he a former officer but used his cruiser and authority to detain her?

𝐅𝐎𝐑𝐌𝐄𝐑 𝐉𝐒𝐎 𝐎𝐅𝐅𝐈𝐂𝐄𝐑 𝐀𝐑𝐑𝐄𝐒𝐓𝐄𝐃  Sheriff T.K. Waters announced the arrest of a former JSO police for false imprisonment, a felony, and stalking.   Our Integrity Unit detectives arrested 49-year-old Claude Fleurimond yesterday after receiving a complaint Fleurimond was stalking a former girlfriend. Our investigation revealed he repeatedly followed the former girlfriend, even stopping her in his marked JSO police vehicle and using his police authority to detain her.   Fleurimond immediately resigned after his arrest yesterday. He had been employed with our agency for 3 years and 3 months.   Nobody, including our officers and employees, is above the law.

@AuthorJCHowell @fineout Here’s a study of studies for you to read. I agree with you about the actions of the FL SG this week. ncbi.nlm.nih.gov/books/NBK20693…

@fineout These fools have no studies that support the safety of multiple vaccines for infants. It’s hard to believe we have risen to such incompetence or corruption as physicians.

Inbox: Fla Medical Association on immunization

@PanickedFoodie @ClementLeeMD …mpublications.onlinelibrary.wiley.com/doi/10.12788/j…

@ClementLeeMD Noooooo 😭😭 I need it post-op to help things move!

@RepRutherfordFL Where specifically is the waste, fraud or abuse?

The House just passed legislation to slash over $9 BILLION in waste, fraud, and abuse AND end taxpayer funding for NPR, PBS, and USAID.  Americans' hard-earned money shouldn't be used to bankroll leftist propaganda and organizations that act contrary to U.S. interests at home and abroad. That's why I was proud to vote YES on President Trump's rescissions package today to cut overseas and domestic spending to help get our country back on track.

@RepRutherfordFL Why did you vote to remove $147M in funding from Jacksonville? news4jax.com/news/local/202…

The One Big Beautiful Bill Act will give Americans a much-needed tax break and refocus our country on delivering on the promises made by President Trump for the American people like permanently closing the Southern Border, boosting our economy, offering historic tax relief for seniors, and revolutionizing our national security. This legislation also strengthens Medicaid solvency by rooting out waste, fraud, and abuse to help vulnerable Americans who need it most. Contrary to what you may have heard, this is not a huge deficit bill. In fact, the Congressional Budget Office (CBO) has scored this bill incorrectly, just as they did in 2017 by underestimating revenues from the Tax Cuts and Jobs Act by over $100 billion. They were wrong then, so why would we trust them now? It’s time to get our country back on track. That’s why I was proud to pass this historic legislation to: ✅Boost our economy ✅Make President Trump’s tax cuts permanent ✅Focus resources on permanently closing the Southern Border ✅Provide funding to small, rural, and Medicare-dependent hospitals, rural health clinics, community mental health centers, opioid treatment programs, and more ✅Strengthen Medicaid solvency for those who truly need it ✅Incentivize Made-In-America cars and manufacturing ✅End taxes on tips and overtime pay ✅Slash taxes on Social Security, offering historic tax relief to seniors ✅Increase the Child Tax Credit ✅Secure more than a trillion dollars in mandatory savings ✅Cap SALT deductions ✅Modernize America’s Air Traffic Control systems to ensure safe and efficient air travel ✅Unleash American energy dominance ✅Cut Green New Deal policies ✅Revolutionize national security and America’s maritime dominance rutherford.house.gov/media/press-re…

@NeltnerJoe @RepRutherfordFL When have Democrats voted to defund Medicaid for a tax cut on the wealthy?

@RepRutherfordFL This boondoggle will push us even further down the drain. I honestly think it now didn’t matter which party I voted for. Both parties are the same.

Vice President JD Vance just cast the last vote to pass the One Big Beautiful Bill in the Senate! Now, let’s get to work to pass President Trump’s agenda for the American people in the House.

@MaximePeabody @seeedstudio @home_assistant The reviews I’ve seen have said it’s better to use an external speaker.

@seeedstudio @home_assistant how good is the speaker? Is it good enough to play music, or would you need an additional music speaker with this?

🎉 @home_assistant Voice PE Back in STOCK! Build your open, local, private voice assistant & save on bundles! 🌍 Available now: CN & DE warehouses 🇺🇸 US pre-orders: Ships end of Jan 2025 💫 Bundle deals available! Details ⬇️

@garg2014 @ramit It lowered traffic by 20% and generates almost £100M/year. itskrs.its.dot.gov/2007-b00333

@ramit Congestion pricing is just an excuse to grab more money. It will do nothing to reduce congestion, within a month or so traffic would be back to normal. This has not worked in London to reduce congestion. Just call it an increase in toll but don’t mislead with its goal.

People against congestion pricing are so close to getting it