Will Powers

@JustinKrantz 100% agree blood is best and actually WB, then plasma would be the first choices if available. But hard to bring that to every EMS system. Probably have more to learn from our military colleagues operating at point of injury in this setting given blood availability stateside

So recently I was reviewing some educational content and I saw something for traumatic arrest saying “to restore volume use 20ml’s/kg of NSL prior to administration of blood products” Thoughts on this? If we need to restore volume just use blood, why give the NSL? #medtwitter

@jesseburgess @EAST_TRAUMA @IntuitiveSurg How was the webinar? First I heard of it

Attending the @EAST_TRAUMA #EASTEGS @IntuitiveSurg robotic webinar while facilitating the med student robotics lab.. so much robot for this acute care surgeon!

@jesseburgess @jhessey11 @mattnoorbakhsh @UzerSKhan Agree. Physiology will dictate patch and live to fight another day vs gastrectomy or subtotal. And will need a feeding J most likely at some point

@jhessey11 I’d plan for a laparotomy with possible gastrectomy depending on the location of the perforation. If the patient was sick, could consider doing it as a 2 stage procedure. Anyone else? @beachtraumadoc @mattnoorbakhsh @UzerSKhan

55 yo male with recent gastric adenocarcinoma diagnosis now presents with acute onset abdominal pain. CT concerning for gastric perforation. WWYD? #EASTEGS @jesseburgess

This is a classic example of an asynchrony called “reverse triggering” - let’s start with the basics. First, by just looking at the scalars (the graphical representation of pressure, flow, and volume over time), we can infer we are in pressure control 1/

I have never seen someone command the stage like @DissanaikeMD, Scott Frame lecture @EAST_TRAUMA was packed with hot potato topics like shift work, burnout, depression, physician suicide, we need to be able to talk about it to combat it, improve upon it, prevent it #EAST2022

Love listening to @DissanaikeMD speak. Shift work: “Call isn’t call when it’s a full time job” @EAST_TRAUMA #EAST2022

@yooeeemd @rbarbosa91 This is also done more commonly prehospital for the indications you mention. But tons of literature to show it’s not great

@rbarbosa91 If it’s a true tension and the whole lung is down, you can pretty much place the needle / catheter anywhere. With the wide availability of US in the ER / trauma bay, do people regularly use it to guide urgent decompression? It would make sense to do so.

Here are two CT scans showing how needle decompression at the 2nd intercostal space, midclavicular line can be ineffective due to the catheter not actually reaching the pleural space.

@joshua_b_brown @PittHealthSci @DMuchnok @pitttrauma @PittTTMRC @stat_medevac @Guyettef @ktcollopy @AirLinkVitaLink

Outstanding work by @PittHealthSci medical student & combat medic @DMuchnok presenting his work showing prehospital needle decompression is assoc w/ lower 24h mortality vs pts requiring urgent chest decompression at a trauma center. @pitttrauma @PittTTMRC @stat_medevac @Guyettef

@traumamom4 #value #transparency #clarity are my mantra for 2022. So far I have gotten a “whatever” response from management 🤦‍♂️

I keep seeing this slide in #wellness talks and then seeing lots of slides about EAP, peer mentoring, resilience training, and tranquility spaces. For a bunch of physician-scientists, I would say we are doing a poor job of intervening on our own data. 🤔

@smstreit @doc_on_the_run @EAST_TRAUMA Seriously?!? That’s beyond messed up

@doc_on_the_run @EAST_TRAUMA I got dropped from mine when I was in Afghanistan.

Am I the only one who doesn't have disability insurance?! @EAST_TRAUMA #EAST2022

Always great to hear about #POCUS from such a passionate leader in the field!

@JeffChoi01 enjoyed your presentation but missed your QR code. Would love to delve into your work!

@doc_on_the_run @EAST_TRAUMA Chest Tube Removal: End-Inspiration or End-Expiration? : Journal of Trauma and Acute Care Surgery journals.lww.com/jtrauma/Abstra… can’t remember if it included vented patients though

When in the respiratory cycle do you pull chest tubes? @EAST_TRAUMA #east2022 #advancingscience

@ktcollopy @BMorshediMD @realQrampage I want to know when @AirLinkVitaLink is uncomfortable… then we find a way to make them comfortable at the uncomfortable moments we all face every.single.day

@BMorshediMD @realQrampage Yes, and it’s expected at our team. Our med dir @beachtraumadoc fosters this expectation beginning with orientation

Hey #EMS Clinicians, would you ever admit to your medical director that you're not comfortable with a skill or request help with your knowledge? Has EMS done a good job of fostering your ability to self-reflect & ask for help, or is it a sign of weakness? #NAEMSP2022

Thanks Daniel Hu for the fantastic article highlighting our collaborative research at Novant Health #AirLink. We have great collaboration between our #pharmacists and #Prehospital care teams and this article is just one example of it! lnkd.in/dGaDhFbk

In this EAST Minute, Dr. James Bogert reviews an EAST Landmark Paper on the management of choledocholithiasis. Still ordering MRCPs? This might convince you otherwise: bit.ly/3zxBEUb

Could two followers please copy and re-post this tweet? I'm trying to demonstrate that someone is always there, especially at this time of year. Call 800-273-8255 (National Suicide Prevention Helpline US). Just two. Any two. Copy, not retweet. Let’s all look out for each other.

@topknife @EVMSedu actually held an introductory conference financial planners during last week@of med school. I got to meet with the planners free of charge and still use the same group today. Has to be intentional

If I could go back 10 years wish I could have focused on early career financial planning There isn’t enough focus and training on this in surgery

@ktcollopy @DrKrankyPants @nhrmc @ACParamedicine @pcrfatucla @ParamedicsUK It’s really a group effort @AirLinkVitaLink

@DrKrankyPants @nhrmc @ACParamedicine @pcrfatucla @ParamedicsUK To be fair it is the vision first described by @beachtraumadoc. we’ve adapted a goal of our research having purpose to improve outcomes and decrease cost. This is the crux of improving The value of care! #ParaResearch21

“Our goal is to use FAST exams to bypass ED resuscitation & go straight to the OR. Every 30 minutes saved leads to better outcomes & lower patient costs.” That’s the genius of @ktcollopy #ParaResearch21 @NHRMC @ACParamedicine @pcrfatucla @ParamedicsUK