The Resuscitator

@IM_Crit_ Great post. My biggest pet peeve is after they are optimized and doing well, and someone checks a gas. The PCO2 is sky high but pH is normal and they dial up the inspiratory pressure and/or force them to stay on bipap without breaks for meals. Not nice

Obesity hypoventilation syndrome/obstructive sleep apnea (OSH/OSA) - Some thoughts: The following are some issues I have frequently encountered in the management of patients with OSH/OSA (I will intentionally combine them herein for the sake of the discussion):

Antivaxxers have some explaining to do. In this four-year mRNA safety study from France, which includes: • 23 million vaccinated people • 6 million unvaccinated people • Ages 18–59 Vaccinated individuals had a significantly lower all-cause mortality rate, as well as lower COVID-19 death and disease rates, compared to unvaccinated individuals. This included lower rates of: • Cancer • Pregnancy complications • Birth defects • Heart problems • Mental disorders So it appears that the antivaxxers were wrong yet again. Further evidence that mRNA vaccines are safe and effective. Let’s see whether they will acknowledge this data — or continue to deny it and lie. @MakisMedicine @MaryBowdenMD @stkirsch @BretWeinstein I'm talking to you... jamanetwork.com/journals/jaman… #MedTwitter #MedEd #ClinicalTwitter #Residency #MedEd

@RoughRyderStage @cakemeta Congrats Stage!

WE MADE IT! 🥹🥹 Thanks to the legend @cakemeta for the help 🤝🍻 Monetized ✅ Subs loading... Where are my blue checks? 👇 Building 2026!

@xzKevwwvvvwvvv @KettleMoraineCC Thanks Kev, been exploring the world of real life since my departure from Web3, got into curling of all things. Loving it so far

@CronosICUDoc @KettleMoraineCC long time no post doc. welcome back, LFG

Blessed to have been able to compete in the 5U World Championships of Curling - shout out to @KettleMoraineCC for the opportunity!

@KettleMoraineCC Excellent tournament, congrats to Team Purves and all the competitors!

Congratulations to Team Purves for taking home the 5U World Championships held at Kettle Moraine Curling Club! Missed it? Catch up on all the action at the youtube channel below 👇

@Rough_Ryders We're doing great, thanks partner

@CronosICUDoc Agreed! You look great as pixel doc haha. Hope the family is well 🤝

🚨Minted 3D. Gifted a 2D image for free. Now it's time for era III. Era 3: Pixel Ryders Incoming! 🌌 We’re proud to announce Era 3: Pixel Ryders — featuring brand-new backgrounds and your favorite Ryders reborn in pixel art This is the beginning of a new roadmap. Join us. 🥂

@peanutt @AlexLee_NFT @Rough_Ryders @RoughRyderStage Hey peanut! Yes I did step down. Stage is the founder now. Enjoying my normie life now, prioritizing family. Hope you're well!

@AlexLee_NFT @Rough_Ryders @RoughRyderStage we miss you @CronosICUDoc ❤️

turned the clocks back to the formal west

@mrmoneymustache Do you ever think about writing a book summarizing your blog posts? I think it would be very popular!

So I've been experimenting with some 1:1 coaching, mostly from people who are close to FIRE but looking for a final checkup. Here are some of the things some people miss consistently: 1) If you're going to go to all the trouble of owning rental houses, the damned things should at least outperform the stock market. So make sure your cap rate is better than ~8% after all expenses. But this takes some skill, so I keep sending people to @CoachChadCarson's excellent all-in-one book on the subject, "The Small and Mighty Real Estate Investor" 2) If you're going to invest in stocks, you should understand how to do it right - which in my opinion means long-term accumulation of index funds and NOT trying to time the market by panic-selling or holding out for future crashes. This takes a lot less skill but it still takes some understanding. For this, I keep directing people to read The Simple Path to Wealth by @JLCollinsNH - it really is simple! 3) The rest of the challenges usually resolve around spending, life optimization and confidence. For these, the good ol' MMM Boot Camp email series is still a good start. Anyone can join that for free from the front page of my website and plenty are already doing that. Ideally I can make my coaching job obsolete by writing better blog posts so more people can figure this stuff out on their own. But for now I will keep having fun and learning more as I meet new people, one at a time. If you've read this far (thank you!) - what is YOUR biggest question you'd ask a FIRE coach?

@IM_Crit_ 100% correct- there is 0 utility to it in the ICU

ICU Practice: I should not have to say this but IMHO a guaiac test to detect occult blood in a stool sample or gastric fluid is a useless test (especially in the ICU setting) Of course, I may be wrong #foamed #foamcc #meded #MedTwitter

@IM_Crit_ Terlipressin and Giapreza

What medication(s) is out there, you would like to use but it is non-formulary and/or the other services are not interested in it? I will start first: Ivabradine, a drug that was FDA-approved more than 10 years ago. It is a heart-rate-lowering drug that selectively inhibits the

@7_7_7__7_7_7 Ah thanks Beyond!

@CronosICUDoc — (Heard you’re stepping away … Enjoy Every Day ❣️ — this made me think of you/RR 🤠🙏🤝😎 )

@7_7_7__7_7_7 Thanks! My boys are the best

@CronosICUDoc ( 💜 the new PFP 💜 )

@co1615 Thanks Trent- your support always brought a smile to my face!

With a steady grip on the reins, he pauses for a quiet moment, hat tipped in appreciation for every journey shared along the trail... Well, Doc @CronosICUDoc , reckon there ain’t many words big enough to hold the weight of what you’ve done and what you’re choosin’ now. You rode hard with us Rough Ryders, pourin’ your heart, sweat, and soul into somethin’ you believed in. Ain’t no shame in that—hell, it’s the mark of a true man, one who gives his all. But hearin’ you talk ‘bout your family, ‘bout findin’ that true north in their smiles and their time together, that’s the kinda wisdom most folks spend a lifetime chasin’. Handin’ the reins to @RoughRyderStage , leavin’ it in his eager hands, and givin’ without askin’ a dime in return—that’s a trailblazer’s grace, Doc. You’re leavin’ a legacy, not just in what you built, but in how you’re steppin’ away, head high, heart full. Them kids of yours, your kin, they’re the richest claim you’ll ever stake, and I reckon they’re lucky to have a pa who knows it. As you ride off to make up that lost time, know this ol’ cowboy’s tippin’ his hat to you. You done good, Doc. Ain’t no failure in choosin’ what matters most. We’ll be cheerin’ you on as you tend to your family and keep savin’ lives. Thanks for all you gave, and may the trail ahead be kind and full of love. #MountUp @Rough_Ryders

@wds321 @Rough_Ryders @wds432 @RoughRyderStage @CryptoCaro @BIgJefeInc @DaM_1en @WiseCloud_ @GSEGDirtyMoney @SteveS_DASC @MrOriginalKhan This is great!

🌅GM/GA/GE @Rough_Ryders 🌅 ✨ No one can make you feel inferior without your consent✨ -Eleanor Roosevelt- 😎#JokeOfTheDay 😎 The future, the present and the past walked into a bar. Things got a little tense 😎Bonus Joke😎 "Two beer or not two beer, that's the question!" -William Shakesbeer- The Art of RoughRyders RR minted as a 3D collection on Ethereum. Since we have added a 2D upgrade and blockchain choice. Both 3D and 2D versions exist as one NFT on both Solana and Eth. You choose which version to display. RR was never diluted with a secondary mint or expanding supply. The upgrade was truly free. That a two for one scenario.. GiddyUp #MountUp 🌅 #LetsRide ☀️Have a great day Ryders☀️

@WCInvestor Got my savings rate up to 44% after reading some FIRE books. Will be financially independent just 10 years after fellowship now!

Making a lot of money often comes with a few downsides. Difficult education. Long years of training. Hard work. Ridiculous hours. Onerous call. Management of others. High taxes. Serious liability. Business risks. It may be worth it, but few get a really high income without doing most of those things. Saving a lot of money only comes with one downside. You have to spend less. It can be a pain to have to shop for deals and carefully consider what you purchase, but look what it gets you out of. You no longer have to optimize everything else, and very soon you'll be wealthy enough to not even have to earn and save all that much. What's your savings rate? What mistakes has it bailed you out of?

@DoctorYev Breaking bad Dark Severance Narcos

The Shield Suits X-Files Xena/Hercules Scrubs Dragon Ball Z Smallville Impossible to have a better top 7 list of TV shows? (I only watched kids shows past 8 years 😅 but having a nostalgia moment)

@squirrelsqrl Wow incredible

$SQRL could be nothing....

@nfteeth_art @0xfroggish @_XR8__ @Aaron_Cook2 @amos_gif 🥃

Gm🦷 This list of 30 founders built through the bear of last year, have always shown up for their communities and continue to provide value here💚 Who am I missing ? I know I missed a few good ones💯 I'll scoop one project of a founder i don't have listed here🫡