Michael Sayre

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Michael Sayre

Michael Sayre

@SayreMR

EMS Medical Director, Emergency Physician, Board Member @ResuscAcademy, Opinions not policy of my employer, #UWashEMS

Seattle, WA Katılım Kasım 2008
295 Takip Edilen1.3K Takipçiler
Michael Sayre retweetledi
Julio La Torre, MD
Julio La Torre, MD@jclatorre·
I recently took @tszzl and @RichardHanania (true story lolz-and both advisors to my new venture in full disclosure) to one of the countries largest academic medical centers. @tszzl has since wrote a viral X thread thats worth reading again x.com/tszzl/status/1… It speaks for itself. I'll just add if he's surprised by the missing data .....he'd be further surprised by the data we do capture: fragmented, delayed, and built for billing, not clinical insight. It tells us very little about human disease and how to truly treat it. Epic Systems is at the center of this monumental failure. Simply put: AI cannot reach its full potential in medicine while Epic Systems controls the underlying data architecture. The ideas are fundamentally oppositional at their core. I explain why Epic's culture, regulatory inertia, and the staggering $1B sunk costs of its clients do not guarantee its dominance but if anything bring a slow march into irrelevance.
Julio La Torre, MD tweet media
roon@tszzl

companies like Facebook record every imaginable interaction their users have with the platform. they log each of your clicks and taps. they keep track of how long your gaze lingered on a post, whether you were on the same WiFi as that woman who might be your friend, which instagram reel you watched three times. for a single user this is quaint, but these practices are done on a planetary scale across all technology giants. they create petabytes of data per day and keep it for as long as the European regulators will let them. then they can have machine intelligence instrument it into useful knowledge for their cybernetic control systems that build newsfeeds, serve ads, decide how much compute to spend on you, which SKUs should be in which warehouses right before you want them. the Hive metastore bills run into the billions hospitals throw most of their data and telemetry out after each case, every single day. they record videos of vascular surgeries, endoscopies, discovering interesting physiologies. sometimes they're not recorded at all and most of them the time they delete them as soon as they’re done it's even worse for physiologic waveforms (ECG, EEG, arterial lines) which are essentially never recorded anywhere at all. milisecond scale views of patient's brains, vasculatures, hearts are generated and instantly destroyed. all of these time series of course predict people's hearts stopping, brains exploding, etc ahead of time. surgeons teleoperate robots, none of the micro-movements are recorded, policies never learned, never correlated into which outcomes were successful or not this would be unthinkable to most software people whose instinct is to record everything everywhere never mind the cloud costs, because we are sure there will be some use for it later and some model to be trained later. i don't have a prescription here per se my point is just that our civilization routinely hoards and treasures some of the silliest data in the world "i pressed like on the john pork reel" & destroys much of all the most important data it generates and limits what machines can learn

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Michael Sayre retweetledi
NEJM
NEJM@NEJM·
Presented at #ESOC2025: Among 550 patients with stroke due to large-vessel occlusion who had presented within 4.5 hours after onset, 90-day functional outcomes were better with intravenous tenecteplase before thrombectomy than with thrombectomy alone. Read the full BRIDGE-TNK trial results: nej.md/3GTVKAk @ESOstroke
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Nick Johnson
Nick Johnson@NickJohnsonMD·
Congrats to @jesunshine and team on developing this impressive technology that will certainly improve detection of unwitnessed cardiac arrest. Nature paper here: #citeas" target="_blank" rel="nofollow noopener">nature.com/articles/s4158… @uwmnewsroom @UWAnesthPainMed
Google@Google

The Loss of Pulse Detection feature on Pixel Watch 3 can detect when your heart stops beating from an event like primary cardiac arrest and automatically prompt a call to emergency services. The feature now has FDA clearance, and it will begin rolling out at the end of March.

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Hans van Schuppen
Hans van Schuppen@HansvanSchuppen·
Newsflash: “refractory” #VF is not really that refractory. In patients needing three shocks at rhythm checks, successful VF termination occurred in one or more shocks in 95%. In other words, it is recurrent VF. Check out our new @ARREST_study in the #EHJ: academic.oup.com/eurheartj/adva…
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Michael Sayre
Michael Sayre@SayreMR·
@HansvanSchuppen @ARREST_study @HansvanSchuppen I love the Sankey chart. It took me a minute to realize that all patients on the chart were in VF at the end. On an annual population basis, how many patients were in constant VF through 3 shocks? My sense is that we see one or two a year in Seattle, pop 750k.
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Robert Herman, MD, PhD
Robert Herman, MD, PhD@RobertHermanMD·
Powerful Medical wins Best Overall and Best Science Pitch at the #AHA2024 Health Tech Competition! Thank you for this wonderful recognition @American_Heart.
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AnnalsofEM
AnnalsofEM@AnnalsofEM·
Hot off the Press: A Comparison of Ketamine to Midazolam for the Management of Acute Behavioral Disturbance in the Out-of-Hospital Setting annemergmed.com/article/S0196-…
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Catherine R. Counts
Catherine R. Counts@CatherineCounts·
No difference in airway management (EMS or ED) for cases of acute behavioral disturbance treated with either midazolam or ketamine. A high functioning EMS system can safety deliver ketamine to agitated patients. #UWashEMS annemergmed.com/article/S0196-…
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Tony Walker ASM
Tony Walker ASM@agwalker01·
📢 Call for Engagement: Neonatal Global Resuscitation Alliance (Neonatal-GRA) The Neonatal Global Resuscitation Alliance Leadership Team would like to invite interested organisations and individuals to solicit their feedback on a 10-step approach to improving neonatal resuscitation. The broad objective of the Neonatal-GRA is to ensure knowledge and experience gained in each neonatal resuscitation setting can be shared and used by others in a truly global fashion to support neonatal resuscitation implementation and performance and improve outcomes worldwide. The Neonatal-GRA will host a virtual meeting from 12:00-14:00 EST on September 24, 2024 to discuss the drafted 10-step approach. You can register for the virtual meeting using this link: lnkd.in/gmWa_UbY Access the draft of the 10-step approach and provide your feedback using this link: lnkd.in/g3nPc73t #ItTakesASystemToSaveALife
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Matt Sztajnkrycer
Matt Sztajnkrycer@NoobieMatt·
Evidence is not mounting. There is already ample safety data. It is time to allow this drug in the US!
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Michael Sayre retweetledi
UW Medicine Newsroom
UW Medicine Newsroom@uwmnewsroom·
"Dr. Copass was a beacon of excellence, setting high standards for himself and those around him,” said Dr. Tim Dellit, CEO of @UWMedicine. "He was admired for always being ready for an emergency, whether it was carrying a radio to go to the scene of an accident himself, providing medical advice to paramedics, personally attending to patients or mentoring colleagues.” @harborviewmc @AirliftNW @UWashEM @MedicOneFndn @SayreMR bit.ly/4c05K4N
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Ambulance Victoria Research
Ambulance Victoria Research@VACAR_AV·
😍 Proud of our MICA paramedics for another successful launch of a world-first clinical trial: Today the #PANDA trial enrolled its 1st patient! The #PANDA trial will end the long-standing debate around the optimal vasoactive agent for cardiogenic shock in the prehospital setting
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Aditya C. Shekhar
Aditya C. Shekhar@dj_deets·
Exciting work on false electrical capture during transcutaneous pacing for unstable bradycardia. We found many patients transported by an EMS system in NY had false capture. Takeaway: new strategies (other than pulse palpation) needed to reliably verify capture. @joshkimbre
Joshua Kimbrell@joshkimbre

@JMedic2JDoc and I are excited to share that our manuscript on false electrical capture in transcutaneous pacing was accepted to Prehospital Emergency Care. tandfonline.com/doi/full/10.10… @NAEMSP @tandfonline

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Jeff Jarvis
Jeff Jarvis@DrJeffJarvis·
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…
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