Daniel Giddings

🚨💊 EMERGENCY MEDICINE PHARMACISTS 💊🚨 ✨ I’M SO EXCITED!!! Want to make a difference AND be part of something ICONIC? 🎇 We’re building a badass 24/7 Emergency Medicine Pharmacy Service at a non-profit SF Bay Area hospital that’s: 🏥 Level II Trauma Center ❤️‍🔥 STEMI Receiving Center 🧠 Comprehensive Stroke Center …while serving an underserved community that REALLY needs your skills. 💥 Why You NEED This Job 💥 💸 Next-level pay + a strong union to back you up. 🤝 Leadership that gets it – we’ll support you 100%. 🚀 Build a legacy – shape this program from day 1! 🎓 Teaching opportunities – work with residents and students to share your knowledge and shape the next generation of pharmacists. 🗓 Start Date: April 2025 (but we’re open to June/July 2025 if you need time to arrange your move – no stress!) If you’re a seasoned EM PharmD, crushing your PGY2, or a PGY1 with BIG emergency vibes, this is YOUR TIME. LET’S GOOOOO! 😆🙌 📩 DM me for details #Twitterx #Pharmacist #EMPharmacist #EDPharmacist #DreamJob #EmergencyPharmacy #BCEMP #TraumaCenter #PharmacyCareers #BigPharmEnergy #NonProfit

@amber_EMPharm We slow push (5 minutes) up to 260mg, 15 minute bag for loading doses. Bag is set up for the RN to pull components from Omnicell so we avoid delays

Any EM PharmDs out there have experience with giving phenobarbital as a slow IV push for EtOH withdrawal? Would love to hear what you do in your EDs!

@PCC_PharmD Negatory!

For those of you in copperhead country, are you doing maintenance dosing for Crofab after control?

@EMPharmavich I thought these went away with pension plans, but we have definitely kept one part of the 80's!

We haven't been receiving emergency calls on our hospital phone for two weeks. I requested a pager because I knew it would at least work. Serious sense memory from residency, this pager.

🔥INSPIRE RCT🔥 In a cluster-randomized trial of 59 hospitals, CPOE prompts promoting standard-spectrum antibiotics for patients at low risk of infection with MDROs significantly 🔽 empiric extended-spectrum antibiotic use in hospitalized UTI pts by 17.4% jamanetwork.com/journals/jama/…

@CMoffiziell @MLS w ..e

🚨 SIGN HIM NOW! 🦝

@GilbertPharmD My goodness, we're everywhere!

@PharmacyToDose This along with icatibant's trials for ACEI-induced angioedema are my go to citations for the fact that a biochemical rationale for a thing doesn't make that thing clinically relevant. Great trial drop! 😄

The COGENT trial would like a word

@EMPoisonPharmD 300 mg/hr?! 😯

Which of these record holders most definitely developed an iatrogenic lactic acidosis?

@ohsnapimginger Ab-so-LUTE-ly!

Do I need this? Yes or yes? #digoxin

@armyemdoc @vbebarta @JAMA_current I don't believe there were any deaths in either group, so benefit was driven entirely by the last two outcomes. Still love to see it!

GCS less than 8, don't intubate?! In the setting of alcohol- or drug-induced isolated depressed mental status, this RCT published in JAMA found that the non-intubated group had: -Lower mortality -Less ICU days -Less hospital days This definitely practice changing. There's a few limitations to be aware of due to differences in prehospital systems between the US and Europe. I would definitely recommend reading this paper. jamanetwork.com/journals/jama/… #emergency #emergencymedicine #foam #foamed #foamcc #army #armymedicine #armyemdoc #meded #icu #criticalcare #meded #science #research #data #medx #medtwitter

It saddens me to know that somewhere in America, right at this very minute, a well-meaning person is being hornswaggled by a recipe for some ginger-mandarin cranberry compote nonsense when the perfect cranberry sauce already exists and can’t be topped.

A 29 yo F with a BMI of 26.5 started tirzepatide (Mounjaro) for weight loss and within a month was hospitalized for starvation ketoacidosis tandfonline.com/doi/full/10.10…

@UnivHealthSA is looking for an EM pharmacist to join our team!! 7 on/off - overnight Level 1 trauma center (adult and pediatric) Comprehensive stroke center Chest Pain Center Residency program @UHPharmRes And much more! DM me if interested.

@SteveCurryMD @ToxAndHound @ToxicSnowEM Going with C.

MedTox Fellows: A 30 year-old man ingested a liquid in a suicide attempt. 2 hr later in ED: comatose; BP 110/80 HR 115, Resp 24. Labs below. Which did he ingest? @ToxAndHound @ToxicSnowEM A. acetone B. chloral hydrate C. butoxyethanol D. methanol E. propylene glycol

@EMPoisonPharmD Oh man, I hate to deviate from the prompt, but too good. Cardiologist on formation of a multidisciplinary CHF committee including Rx: "I guess you guys can, ahhh, check for drug interactions?" Nothing further suggested.

This one is kind of salient RE public perception of pharmacists. Which is ok, pharmacist have a PR problem that we know. In honor can everyone share there favorite response to “Im an ED pharmacist” My favorite recent was “So do you like talk to them about the drug machines?”

@EMPharmD_Rob @nph_pharmD Implemented this at my old ED! Nice decrease in domestic dog bites getting RIG that should have just been managed w/observation. Your mileage may vary, I recommend an MUE to gauge opportunity if you haven't already.

Antidote stewardship: the act of preventing unnecessary utilization of pharmacological antidotes and emphasizing the notion that the mere existence of an antidote does not warrant routine administration in every single exposure

@AnotherPharmer @PhlawlessPharm I'm pretty sure I'm not who you were thinking of but darned if I don't have exactly these two things!

@PhlawlessPharm I saw someone who kept a binder of their previous whiteboards for perusal by anyone who hadn’t seen the whiteboard when it was up! And of course Goldfrank’s Tox😉

Oh EM pharmacists, please tell me what your desk essentials are? I will be now getting a desk area in an office and want to make it my home, what do you keep in your space 😊 my current ER space is just shared desk space with the whole department so I haven’t gotten to customize

I think the M&M's are to be taken Q2H PRN last day sadness. Trauma team contributed the monitor speculum.

Last day at SAMC after 7 years in the ED and I was greeted with this. I'm so grateful to have had the chance to work with this excellent crew - part of my heart will always be here with them! No medications were harmed in the making of this display. 😁