Alex Lucas, MD

Tele-ICU can do a lot to improve care, but ICUs need people immediately available who can perform life saving procedures. Tele-ICU should be an add-on to not a replacement for docs physically in the unit.

Join the EMRA Admin & Ops/Critical Care Committee as they break down the structure of different ED-ICU models on October 21 at 2pm CT: bit.ly/479TwpL #EMCrit #EmergencyMedicine #CriticalCare #ICU

🚨 Attention Applicants - First Virtual Panel of the year is 8/29. Don’t forget to RSVP! @AndreaGCarlson @mcironeMD @travishase

@Gabby_Brauner27 2) it will tell you if the hypoxia is real (on an abg) get you a pH, a lactic acid, and some point of care lytes. All useful in a crashing pt

Two things I was thinking about today: 1️⃣ Is there ever a time when ESR and CRP are discordant? Like do I need both? 2️⃣ Does a blood gas (ABG or VBG 🤷🏻‍♀️) tell me anything I don’t know in a hypoxic patient (assuming I’m not worried about CO2 retention) Thoughts?

this study shows that patients treated with broad spectrum ABX had a <10% rate of drug resistant organisms is being touted as a evidence of antibiotic overuse ok but I have a serious question what is the acceptable % coverage for antibiotics in sepsis? 90%? 85%? 95%? (#1/4)

@ArangoJuanpablo @BrooksWalsh Wait what am I supposed to see here besides the depressions/concerns posterior mi? Is there a stemi equivalent here?

@BrooksWalsh I trully appreciate this. My suggestion is, please add a description of the abormalities seen. In this case, it would be great (especially for the novice ecg readers) to point out what was the STE equivalent. Thanks again!

The ECG that radicalized me. I was a PGY-3. Middle-aged guy with typical chest pain, early AM. Both ED attending and cards fellow say this isn't an indication for the cath lab. Still salty about my attending.

@thePuneetSquare Dissection w/wo aortic insufficiency, maybe chronic mitral insufficiency with the LA size. Rate/bp control and talk to ct surgery

Patient gets transferred to you from a standalone ER intubated on max Levo epi and phenyl looking completely mottled. Not much info is sent with the patient. ultrasound shows this. What are your next moves

@Rajiv_Sinanan @NephroP @Ryan725 @ABCDEcografia @ThinkingCC @icmteaching @TaweevatA @ross_prager @solosa4692 Lungs look reasonable. Nothing wrong with 500cc bolus and see if uop increases. Obv check echo and make sure the hearts fine. Also get a better IVC view

How would you respond about the volume status/ivc of this pt? @Ryan725 @ABCDEcografia @NephroP @ThinkingCC @icmteaching @TaweevatA @ross_prager @solosa4692

IVC of a pt with perf peptic ulcer/duodenal rupture s/p ex lap. Developed oliguric AKI. 5L+ fluid balance. Subcutaneous fluid demonstrable with oedema/anechoic bands in flanks and thighs. Lung US is clear. BP 90/60. Warm peripheries.

So grateful to both @emresidents and @ACMCEM for this award! It has been an amazing experience working with EMRA and I am forever thankful for EMRAs influence on my career. I look forward to continuing my involvement with EMRA in the future!

Interested in learning more about leadership in Emergency Medicine? The EMRA and ACEP Leadership Academy is a leadership/professional development program and virtual community for emerging leaders in EM. Taking applications now - apply today - bit.ly/3rTF9FJ #emresidents

PIPERACILLIN-TAZOBACTAM IS NOT NEPHROTOXIC: exploring the arc of a myth over time this was clearly a myth in 2016: emcrit.org/pulmcrit/piper… blog from 2022 exploring the evolution of this myth: emcrit.org/pulmcrit/myth-… fresh RCT to finally settle this: jamanetwork.com/journals/jama/…

If your at ACEP, be sure to sign up for the Crit Care Committee event! Not every day you get a skills session on ECMO!

Me after a 24

Check out the new edition of EM resident for new content from the CC committee!

@DoctorPICU @nickmmark Pt is on 3 pressors

@nickmmark Trainee’s assessment of a sick ass patient: Patient is stable.

Annoy an ICU doc in one tweet.

@srrezaie Guilty of the reflex 4, will definitely force myself to calculate next time I give it

RANT: Can we Please Stop with the Homeopathic Dose Morphine youtube.com/shorts/DuUXDEM… #FOAMed #Pain #Morphine

@revellegappy You’ll do great!!! Never a doubt

@erickjmasias Can residents help out too?

@parme_Jeanne Gotta set that email to “Out of Office” (even though no one emails me)

Let’s normalize not doing work while on vacation. (me to myself as I check my emails)

First meeting in the books for the 2023-2024 @emresidents Leadership Academy class! Excited to see these bright individuals grow as EMRA leaders.