Nadim Lalani

Just the facts on healthier shift scheduling: “We’re tired of being tired” by @EmICUcanada How does shift work affect you? Your cognition? Productivity? And more importantly what can you do about it? Find out in this JTF: rdcu.be/efZTl

🚨 **Understanding Catastrophic Antiphospholipid Syndrome (CAPS)** 🚨 🔍 **What is CAPS?** A life-threatening form of Antiphospholipid Syndrome leading to rapid vessel thrombosis & multiorgan dysfunction. ⚡️ **Common Triggers:** Infection, surgery, trauma, stopping anticoagulants, and malignancy. 💔 **Mortality Rate:** Alarmingly high, exceeding 50%! Early recognition is key! 🩺 **Diagnosis:** Identify antiphospholipid antibodies + microvascular ischemia through tissue biopsy. 💊 **Management:** - **Triple Therapy:** Glucocorticoids, IV heparin, TPE/IVIG. - Refractory? Consider Rituximab or Eculizumab. 🔄 **Clinical Implications:** Careful monitoring for APS patients, especially during pregnancy! 📈 **Research:** Ongoing studies are vital for improving outcomes in CAPS. 🛠️ **Monitor:** Daily blood work & coordinated care is crucial! ✨ **In Summary:** Early intervention & tailored strategies are essential in confronting the complexities of CAPS! #CAPS #AntiphospholipidSyndrome #Thrombosis #Autoimmunity #ClinicalManagement #MedTwitter DOI 10.1182/hema­ tol­ ogy.2024000544

Cytomegalovirus infection: When and why to detect antibodies. Serological testing in CMV infection. mlo-online.com/continuing-edu…

What is the 4-step cricothyrotomy method? This method uses 4 steps: Scalpel-finger-bougie-tube 1. Scalpel to the cricothyroid membrane 2. Finger insertion into the trachea with downward traction 3. Insertion of a bougie into the track with the finger it in feeling for the tracheal rings 4. Insertion of the tube over the bougie It is a simplified method for performing the procedure that eliminates steps such as the use of trach hook. While this procedure was popularized by the US military through the Tactical Combat Casualty Care guidelines, it has been described for many years before the recent wars in Iraq and Afghanistan. There's obviously no RCT data on this method in humans, but cadaver, mannequin, and case series data demonstrate reliability and efficiency. airmedicaljournal.com/article/S1067-… pubmed.ncbi.nlm.nih.gov/8922017/ jem-journal.com/article/S0736-… airmedicaljournal.com/article/S1067-… PMID: 9950380, 8922017, 9774928 #emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #data #research #army #armymedicine #armyemdoc #trauma #airway #military #tccc #navy #airforce #marines #medx #medtwitter

🔹 Types of Saccadic Intrusions: With Intersaccadic Interval: Square-wave jerks: Frequent small horizontal movements (seen in progressive supranuclear palsy). Macrosaccadic oscillations: Larger amplitude, crescendo-decrescendo pattern (cerebellar lesions).

Comatose with small pupils and no response to naloxone—what’s next? litfl.com/coma-and-small… #MedEd #MedTwitter #FOAMed

Tomahawk Intubation (face-to-face) youtu.be/HIrf4OxMbeQ

Nice infographic of acid base!

A 16 y.o. healthy female with a strong family history of sudden cardiac death undergoes a screening ECG. - What abnormalities are noted? 👉 Answer and Interpretation: manualofmedicine.com/ecgs/ecg-case-… #medtwitter #foamed #ecg #CardioTwitter

@CDCMMWR Clinical 🥡: -Alpha gal syndrome (AGS) is a potentially fatal allergic reaction to an oligosaccharide found in meat -AGS occurs after sensitization by tick bites -people with AGS often have a heparin allergy! -consider premedication prior to heparin in people with “meat allergy”

Congrats @TChanMD

great one pager on acid base

EDs in every province are inundated and struggling. ED overcrowding coupled with rural ED closures everywhere… Where’s the federal coordination and the provincial plans? cmaj.ca/content/195/24…

Identify SBO at bedside (curvilinear probe): - 3+ fluid-filled loops of bowel w/ >2.5 cm diameter - "To-and-Fro" movement of bowel content/ decreased/ absent peristalsis - Thickened bowel wall > 3mm - Free fluid between loops of bowel (higher grade obstruction, poorer prognosis)

@ucsfdem’s Dr. Jeffrey Tabas on Dimers & PE at #EEM2023 🤰🏽D-Dimer use in Pregnancy 👇🏽 🛑Stop if PERC Negative in Pregnancy 📱@MDcalc algorithm here: mdcalc.com/calc/4067/year… #FOAMed @grahamwalker @JHabboushe @ShivGaglani @OsmosisMed @EssentialsofEM @HippoEducation @emergencypdx

The EM Educator Series: Fournier Gangrene - Simple, raging cellulitis #FOAMed #FOAMcc @EMHighAK @long_brit @MPrizzleER emdocs.net/the-em-educato…

Lower extremity DVT #POCUS #anatomy radiologykey.com/lower-extremit… #IMPOCUS #FOAMed

good review thanks!