Giovanni Xotta 🍉

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Giovanni Xotta 🍉

Giovanni Xotta 🍉

@giovX3

Emergency Medicine Physician, in the mountains of Northern Italy (per il resto, le vélo toujours le vélo)

Bassano del Grappa, Veneto Katılım Kasım 2019
423 Takip Edilen175 Takipçiler
Giovanni Xotta 🍉 retweetledi
Powerful Medical
Powerful Medical@PowerfulMedical·
4/ A case report of Hyperacute T-waves interpreted as “normal sinus rhythm, normal ECG” by conventional ECG algorithm, and “normal sinus rhythm, no evidence of STEMI or life-threatening arrhythmias” by the treating clinician.
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Jack Cahill
Jack Cahill@TheECGMedic·
🚨 ED Challenge: Chest Pain Showdown 🚨 4 patients. 1 emergency department. Countless ways this could go wrong… or right. Each presents with chest pain - but only some stories end in the cath lab. ⚡ Who’s having a true coronary occlusion? ⚡ Who’s a mimic? All or none? #ECG
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Dr. Chacón-Lozsán F .'.
Dr. Chacón-Lozsán F .'.@franciscojlk·
💉🩺Rapid sequence intubation in 2026: we are no longer “protecting the airway.” We are managing physiology under extreme stress. The latest evidence challenges one of the oldest dogmas in critical care. RSI was designed to prevent aspiration. But today, the real enemy is often hypoxemia and cardiovascular collapse. 1. Aspiration is no longer the central problem For decades, RSI was built around one fear: aspiration. But emerging data suggest: RSI may not significantly reduce aspiration It may increase hypoxemia and hemodynamic instability The paradigm is shifting: 👉 From aspiration avoidance → to physiologic optimization 2. First-pass success is everything Every additional attempt increases: Hypoxia Hemodynamic collapse Mortality Modern RSI is built around one goal: Get it right the first time. That means: Videolaryngoscopy first-line Stylet routinely Team choreography, not improvisation 3. Preoxygenation is now a therapeutic intervention Not just a step—a determinant of survival NIV > face mask HFNO as adjunct Semi-upright positioning And one key shift: 👉 Gentle ventilation is no longer taboo Done correctly, it reduces hypoxemia without increasing aspiration risk. 4. Hemodynamics matter more than ever Up to 40–50% of patients experience peri-intubation instability. The modern approach: Avoid propofol in unstable patients Favor etomidate or ketamine Consider prophylactic vasopressors Fluid loading? Not routinely beneficial. 5. Cricoid pressure: from dogma to doubt No clear benefit in preventing aspiration May worsen laryngoscopy and ventilation Current thinking: 👉 Use selectively, or not at all 6. RSI is no longer a rigid protocol It is now: Patient-specific Physiology-driven Team-dependent With tools like: Gastric ultrasound POCUS-guided decisions Structured airway protocols 7. The real determinant of success: human factors Preparation, communication, and coordination matter as much as drugs. Because in critical care: The airway is not just anatomy. It is a moment of systemic vulnerability. 🤓Final message RSI has evolved: From speed → to precision From protocol → to physiology From individual skill → to team performance And ultimately: The goal is no longer just to intubate. It is to intubate without killing the patient. 📃Reference Boulos NM et al. Anaesth Crit Care Pain Med. 2026. doi.org/10.1016/j.accp…
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Marco de Luca
Marco de Luca@marcodelucadoc·
Vedere la #SimulazioneMedica pilastro @Agenas_Salute è un cambio di paradigma per il SSN. L'audizione di dic '24 è stata un mattone prezioso per portare dati e voce del campo in sede istituzionale. Orgoglioso di questo traguardo corale. 🧱🩺@SIMMED_Italia
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Ken Milne MD
Ken Milne MD@TheSGEM·
I chose EM because I wanted to be the light in the house of medicine, always on and seeing anyone, anytime, for anything. The ED is a place where science, uncertainty & critical thinking come together in real time to help patients when they need it most. ⁦⁦@CAEP_Docs
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Unibet Rose Rockets
Unibet Rose Rockets@rockets_cycling·
🫶 Happy Milano-Sanremo week.
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AnnalsofEM
AnnalsofEM@AnnalsofEM·
Could we detect ROSC without stopping CPR? Arterial Doppler During Chest Compressions to Detect Arterial Pulsatility Annals of Emergency Medicine In this ED study of 44 cardiac arrest patients with arterial lines, researchers recorded Doppler waveforms during active chest compressions and compared them to arterial line pulsatility at the next pulse check. For detecting arterial pulsatility: • Sensitivity: 97.7% • Specificity: 81.5% • Accuracy: 88.9% A minimal-flow Doppler pattern strongly predicted absence of pulsatility. This was a small single-center study with experienced operators, but it suggests Doppler during compressions may help identify arterial pulsatility, raising the question of whether future tools could help detect ROSC without interrupting compressions. #EmergencyMedicine #EM #CriticalCare #Cardiology #MedED #MedicalEducation #FOAMed #EBM #MedicalJournal
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Giulia Mormando
Giulia Mormando@GiuliaMormando·
🚑 New paper out in PLOS One! In a randomized simulation-based trial we studied whether the presence and position of a CPR coach influence team leader and team performance during simulated cardiac arrest. 📄 doi.org/10.1371/journa… #CPR #Simulation
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Giovanni Xotta 🍉
Giovanni Xotta 🍉@giovX3·
@Devin_Heroux If u got a chance take a car and go in Valpolicella and to Garda Lake. That's not as spectacular as in spring, but still gorgeous. San Giorgio ingannapoltron, Lazise, Bardolino, Marcesine...
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Devin Heroux
Devin Heroux@Devin_Heroux·
Greetings from fair Verona where the sun is splashing down on this stunning ancient city. This is the view from Castel San Pietro. Breathtaking.
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Marco Montanari
Marco Montanari@_marcomontanari·
@FilBarbera I liberali non ce la fanno perché non ce la vogliono fare. Meno Mill e più Hegel è la giusta via
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Filippo Barbera
Filippo Barbera@FilBarbera·
"Salve, sono Yanis Varoufakis e vi do una notizia che sarebbe stata esilarante se non fosse stata così spaventosa. Stamattina, due poliziotti si sono presentati alla mia porta per notificarmi un ordine di comparizione che mi ordinava di recarmi alla centrale di polizia per essere interrogato dalla DEA greca, il nostro dipartimento antidroga. Non come testimone, esperto o meno, ma come accusato." Accusato di cosa? LEGGETE IL RESTO E FATE 2+2. Stanno arrivando ovunque. Il capitalismo politico che è la conseguenza del capitalismo neoliberale ("mettere il capitale al riparo dalla democrazia", cit. @marioricciard18) mette le persone al riparo dalla democrazia. Ogni liberale vero dovrebbe capirlo e agire di conseguenza. Ma da noi i liberali prefiscono evidentemente il capitalismo politico contro ogni tentativo che inizi con "social", come prima hanno preferito il fascismo.
Yanis Varoufakis@yanisvaroufakis

Hello, this is Yanis Varoufakis with a piece of news that would have been hilarious if it weren’t so scary. This morning, two policemen appeared on my doorstep to serve a summons ordering me to the police headquarters to be interrogated by the Greek DEA, our drug busting police department. Not as a witness, expert or not, but as the accused. Accused of what? Shortly after New Year’s, I appeared on a podcast organised by young people to answer their questions on everything that concerns Gen Z today: social media, the meaning of life, their job prospects, what I call technofeudalism etc. At some point, they asked me if I had ever used drugs. Determined not to do a Bill Clinton (remember the laughable “I didn’t inhale”?), I said I had. Apart from pot, I told them, I had one experience of taking ecstasy in Sydney 36 years ago. It was pleasant, I danced for 16 hours effortlessly but then, I added, it gave me a migraine for a week – and so I never used again. That was my introduction to making the point that, however pleasant drug taking may seem, there is a price to pay. And that the ultimate price is dependence, addiction – “the end of liberty”, I said emphatically. Do you see where this is going? Yes, the Greek police have opened an investigation of me under the charge of... aiding and abetting the narco-mafia. [Do me a favour folks: Please don’t tell Trump, OK?] Seriously now, at a time of war, genocide, stupendous exploitation and so on, my little trouble with the inane Greek police is neither here nor there. But it is important. Here, in Europe, many people still live under the illusion that we have liberty, rationality and freedom. We don’t. Dark forces are at work, pushing us into a postmodern version of the Dark Ages. So, beware, people! They are out to take away the last remnants of autonomy and freedom we have left. Resistance is, literally, existence.

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Dr. Andreas Roeschl
Dr. Andreas Roeschl@ecgandrhythmRoe·
If you need to explain to someone what a ventricular escape beat is, you can use these ECGs. A PVC occurs prematurely, a VEB occurs late 👇 For ECG students 😀
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Giovanni Xotta 🍉
Giovanni Xotta 🍉@giovX3·
@The_Iron_grey Calling it NSTE it's wrong also by the actual STEMI guidelines. Shark fin pattern in the inferior leads. J-point in V1-3 is under the isoelettric, so it calls for a posterior OMI. Probably the Rx
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Dr. Chakraborti
Dr. Chakraborti@The_Iron_grey·
A 42-year-old male was rushed in with NSTEMI and acute decompensated heart failure. His LVEF: 35%. Soon required intubation and NORAD support. What's on this ECG #MedX #Cardiology
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