Garrett

@EM_RESUS “How did they get pneumonia, they weren’t around anyone sick?”

What’s something about a medical condition that’s often misunderstood?

@Bluebirdskiing @zbitter There are a few things, gels as you stated, carb drink, some regular generally salty foods (chips) and at aid stations cokes. The gels are higher concentration than 25g/gel, and they carry larger pouch gels that may be 100g carbs in a bigger gels

@zbitter Maybe I’m a newb to endurance sport but how the hell do they eat that many carbs. Gels are only 25 ish. What specifically are they eating?

Precision released Caleb Olsen’s WSER 100 fuel & hydration data ⬇️

@KevinEspiritu Do you think this could grow in zone 7 willamette valley Oregon? Usually only get it from a small farm on big island of Hawaii. Most people don’t know this exists!

@KevinEspiritu Horchata in fruit form

My first harvest of ice cream beans - fluffy, sweet, and tastes like cotton candy or vanilla marshmallows Also fixes atmospheric nitrogen into the soil as it's a legume!

@eddyjoemd Interesting study of infections. I would assume midline infection rate would be higher as in my shop, patients with midline’s don’t require CHG bath daily compared to those with central lines.

I’ve been digging into the data on midline catheters as they’re an easy choice when one doesn’t need the full PICC. Will the incidence in US studies always be tainted bc of the “culture” games played to decrease CRBSI numbers? 🎩 tip to the authors. eddyjoemd.com/foamed/

@ZachsORoutdoors @OregonDOT Maybe we need to amend the state law that bicycles are vechiles. That seems like a misclassifsction that unfairly categorizes bicycles

Last fall, I wrote about @OregonDOT asserting that McKenzie Pass Highway 242 was 'closed' to recreation in the offseason. The story went bonkers and a lot has happened. Now, the agency has clarified its stance — but it might not thrill cyclists: tinyurl.com/y348farx

@IM_Crit_ That’s the nicest and calmest tubed patient I’ve seen.

Optimal Perfusion Targets in Cardiogenic Shock jacc.org/doi/10.1016/j.…

@eddyjoemd Great discussion. I am CVICU RN. We do a lot of glucose stabilizers requiring Q1 cbg monitoring. Sometimes patients needing it for days. Could be 72 finger pricks! Would be so great to have CGM on patients, even to just to reduce workload/decrease finger pricks.

In this episode of the Saving Lives Podcast, we break down a study comparing continuous glucose monitoring systems (CGMS) to conventional point-of-care monitoring in ICU patients. Learn how CGMS improves glycemic control, reduces variability, and eases nursing workloads, even without reducing mortality. Citation: Chu C, Li J, Yang X, Zhao H, Wu Z, Xu R, Gao J. Continuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial. J Crit Care. 2024 Dec;84:154894. doi: 10.1016/j.jcrc.2024.154894. Epub 2024 Aug 5. PMID: 39106581.

@baramink We have a nursing driven SCAI staging/cohorting process at my hospital. By cohorting and having nursing stage CS patients every four hours we have seen significant decrease of in hospital mortality. Also, we identified that if admitted at SCAI B- 90% of patients end up SCAI C.

Cardiogenic shock Intubation ? MCS ? #GulfPCR

@EM_RESUS Right pneumo w/ deviation

Here’s an impressive Chest X-Ray of a 40 year old woman who presented to the ER with shortness of breath What’s the diagnosis?

@amalmattu @UMEmergencyMed Love these boards. Keep posting!

Friday night shift ⁦@UMEmergencyMed⁩ #foamed #WhiteBoardTeaching

@willyhfrick Oversensing.

What explains the pacing spikes?

@rbarbosa91 @IM_Crit_ A you elaborate on the PA cath not being a good idea/useful? Context: am CVICU RN with lots of PA caths.

@IM_Crit_ 20 years from now, when everyone is still talking about whether pulmonary artery catheters are a good idea, this will be long forgotten.

Many colleagues in the Critical Care world have strong mixed feelings these days but I am very confident that we will pull through and, twenty years from now, we will remember these days with nostalgia while sitting down in the iron lung units...

@rbarbosa91 Nice thread. As a CVICU nurse I use these daily. There is also an adapter for the top hub to add more needles syringe ports. Very handy. Important to realize that if multiIple ports are attached fluids will mix (compatability!) if there is not a separate line in the introducer.

🧵regarding the introducer sheath commonly known as a 'Cordis' catheter. We'll go over what it was originally designed for and why it ended up being adopted by other specialties for entirely different reasons. Also we'll look at its accessories and see what's inside one. (1/ )

@EM_RESUS Diminished left lung volume.

@DrSimonAshworth @TomLettich @IM_Crit_ Not to mention the medications they are on are high risk. Imagine letting an insulin drip go unchecked for three hours because you had three other patients that needed attending to. Also, we don’t have CNA in the ICU to help us with general tasks.

@DrSimonAshworth @TomLettich @IM_Crit_ Hi. ICU RN here. We are not just checking blood glucose every hour. We are managing dips, drawing labs, communicating acute changes with provider, assisting with toiliting, hygiene, managing nausea, vomiting, pain, charting, etc. DKA patients are sick. Sick patients are busy.

ICU Snapshots: Most cases of diabetic ketoacidosis (DKA) are very straightforward ICU admissions. However, some cases are a bit more interesting as far as labs & clinical presentation/history is concerned:

@EM_RESUS Treat the patient not the number

Save a life in one tweet

@ross_prager CVICU rn here. Without echo, view narrowing pulse pressure, JVD, cardiac tones, patient hx, and context as to why they are hospitalized. (Cardiac sx, especially sx utelizing wires, malignancy, etc).

Tamponade on ultrasound is a can't miss diagnosis but isn't always as obvious as people think. ❤️‍🔥 Here's a thread of tamponade cases including regional tamponade (like this one on #tee ) A 🧵 #foamed #foamcc #medtwitter

@DGlaucomflecken The main problem is the limited emoji reactions available. Need a few more to spice up my reactions to trops > 10,000, or when the lactic is > 8

So I recently learned about Epic secure chat. The content gods continue to smile upon me.