Tom Grawey

Need help! Where can I learn how to make better slides for my talks? I know what good slides look like just don’t know how to execute #FOAMed #MedTwitter

@_JaceMullen @jducanto Are you mixing it with water?

@jducanto jorvet.com/product/j-lube/ Here’s where I got mine…there’s some discussion on Amazon that it might be counterfeit there but I don’t see how it could be wrong. This bottle will make ~8-10 gallons of simulated airway contaminant

🚨CALLING ALL AIRWAY NERDS🚨 I’ve been experimenting with a new Simulated Airway Contaminant and it is REALLY good! Beautifully goopy, silky smooth and slippery. Based off a veterinary OB lubricant, I’ve been using ~1 Tbsp/liter with some food coloring

@AnnaGaddy @emily_fri Here’s the WI statute that discusses QI. § 146.37, 146.38 discusses QI for our state.

@AnnaGaddy @emily_fri I wonder if some disclosure at the beginning of your M&M saying that this is a part of a formal quality review process would protect that. I think you could argue M&M is part of a formal QI process esp if your department has a formal QI plan and M&M is somewhere in it.

When you’re choosing cases for patient safety conferences (AKA M&M), try to choose a case where you or at least your specialty messed up. There’s no benefit in reviewing a case to say that someone else should do better. It hurts but I think it’s the most useful way to do it.

@UKROBL1 @BMorshediMD @MetroEMSorg @maiadorsett @jemsconnect @EMS1 @hp_ems @DownToFifer @MikeTaigman @CoreySlovis I love this quote. I think it also embodies “the system gets what it’s designed to get” but makes more sense to people who don’t do a lot of quality.

@BMorshediMD @MetroEMSorg @maiadorsett @jemsconnect @EMS1 @hp_ems @DownToFifer @MikeTaigman @CoreySlovis The top of my whiteboard in every office I’ve ever had contained the simple quote “if we do what we always did - we will get what we always got”

We recently added these 2 quotes to our in-house EMT & Paramedic classrooms at @MetroEMSorg. It’s important to not only teach critical #EMS skills, but to grow adult #LifelongLearners with clinical curiosity who can question & challenge dogma. No more spoon-feeding.

We wonder why LPs are so uncomfortable for patients and then put a 3cc syringe and tiny needle in the kit for providers to use when providing local anesthesia. I can think of two easy fixes that I bet would help at least somewhat with pt comfort

Hey @_JaceMullen I just wanted you to know that I still think this is one of the best blog posts on the internet and I still make every paramedic student read it. @FOAMfrat foamfrat.com/post/a-tale-of…

Hey #EMS #educators: ever taught a lesson that didn't result in the change you intended? How do you design ed that works? Here's the latest episode from The EMS Educator podcast w/ guest @EMtgDO. @ReadyMKE @maiadorsett @UKROBL1 @gateshil @MedicalCollege podcasts.apple.com/us/podcast/des…

@DrJeffJarvis I struggle w/ how interventions with minimal/no evidence are added into EMS guidelines and then observational data is used to support the change. How many interventions showed no benefit and then were pulled w/o publication? pts could have been harmed by “progressive” guidelines

More thoughts on why Head Up CPR isn’t ready for Widespread Adoption. Apologies for the title, it didn’t get cleaned up in copy editing. tandfonline.com/doi/full/10.10…

@ssk040 I think it’d be irresponsible to not review your pcg given what happened. Any quality case, even if it isn’t yours, should cause you to make sure what ur doing is standard. If u r making changes bc you were using old terms and unsafe practices from years ago there’s a problem

You've probably heard that Bicarbonate has to turn into CO2 to raise the pH. “Don’t give bicarb if you can’t increase ventilation.” But how much CO2 is there in an amp of sodium bicarbonate? A bicarb 🧵 1/

@jwoodard_md @AmerGeriatrics Curious about checking orthostatic vitals. A lot of the EM literature says these aren’t helpful. What’s the lit saying on your side? What do you use them for in delirium?

@zummie Man Dan this is so awesome!

One thing I love talking about on the #Match2022 interview trail is the collage art I make. Much like medical training, each successive work benefits from the lessons of its predecessors. This is “Trinity Alps” from 2016. Loose on form but big on color.

@fyreman2006 @JonEMTP @dkirch888 I’d say many physicians probably haven’t yielded a syringe in many years depending on specialty so the more idiot proof these can be the better. Many people who might be helping out have little to no experience actually drawing up meds.

@JonEMTP @dkirch888 Many don’t. But the language of this is what I’m curious about…it needs to be added to the “first aid” kits on a plane that anyone can access. Not the Emergency medical staff kits.

So only concern is that these kits are supposed to be for trained medical staff on a plane. Why do they need it as an auto-injector? Seems like maybe they need to have a separate layperson kit

1983 study from Milwaukee Co EMS showed the use of calcium in cardiac arrest reduced ROSC from 38% to 10% & concluded its use was “highly suspect.” Paper is great but so old you can’t find it online! -M. Frakes #CCTMC23

@retrievalmd What's so different in Australia?

I'd love to see a gathering of #HEMS docs worldwide. We can undoubtedly learn from one another.

I recently joined the bell choir at church and feel like my Thursday nights are similar to Roy Kent

@_JaceMullen "Well, we'd tube them but since their mouth opening sucks we'll just place an SGA" or "We'd tube them but since their mouth opening sucks we can just BVM them." I think a good airway assessment helps you pick the right airway strategy for the right patient.

@_JaceMullen I think I get what you're trying to say but your tweet is worded weird. Considering all EMS airways as difficult is great but your 2nd phrase sounds like you're arguing an airway assessment shouldn't be utilized to determine airway mgmt strategy which I doubt is your point.

Difficult airway prediction tools don't have a place in EMS. Either they need RSI/DSI or they don't. There's not some scenario where "well we'd tube them but since their mouth opening sucks..." Approach every airway as you would a difficult one and you wont even miss LEMONS

Doctors are going to sell to PE, that’s not going to stop, but that decision should preclude appointment to leadership positions in organizations which exist to advocate for physicians and patients.

@MDaware @RosenthalHealth Those leaving academics

@RosenthalHealth some others have already mentioned industry etc I’ll also throw in the people who make incremental moves, like docs who leave more traditional practice for “entrepreneurial” urgent care or wellness/ketamine infusion clinics, or Botox centers

We read a lot about physician burnout and MD's calling it quits. Yet it's been hard do find one who has actually done so, except physicians nearing average retirement age anyway. Any docs out there who quit and are willing to tell me why? DM me for a chat!