هفيون
607 posts
doxy + ceftriaxone (CAP)
linezolid + piptaz (sepsis, nec fas)
roc + ketamine (RSI)
amio + mg (AF)
nicardipine + mg (eclampsia)
ketamine + dexmed (analgosed)
bipap + dexmed (asthma, copd)
midaz + 200 J (VT)
loop + thiazide (diuresis)
LEV + lacosamide (refrac sz)
Pepsi@pepsi
name a better combo than Pepsi + pizza. we’ll wait.
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Surviving Sepsis 2026 is here & it's even more loony tunes than I was expecting.
They're promoting pre-hospital ABX & preemptive broad-spectrum IV antibiotics for intubated patients.
This insane fever dream is an antimicrobial stewardship nightmare.
Embarrassment for SCCM.
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Based on my recent X posts, it seems risk-based treatment scores are out.
Who knew?
Just treat LDL-c no matter the other risk factors🤷🤷
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@DrDiGiorgio What about 48 hour call, that is good too right? Or is it too long? Not sure what your cutoff is
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One person's personal bias doesn't mean 24h shifts aren't useful. Just to counter this, I'm extremely grateful for my 24h shifts in medical school and residency. It absolutely helped me prepare, honed my ability to traige while exhausted, and made me a better doctor.
Oh, and 1-2x pages per hour is extremely low. Many neurosurgery residents get paged every 90 seconds for 24 hours straight. After that experience, there is literally no middle of the night phone call that a neurosurgeon can't handle.
Allison Fitzgerald, MD, PhD@allisonoconn
I had a 24 hour call shift yesterday and got paged essentially 1-2x per hour for all 24 hours. At no point did I think to myself “I wish I had more 24 hour shifts in medical school to help me prepare for this” 🤡
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من حالات القسطرة ..
في الثلاثين من العمر يشكو من تَرَهُلاتٍ و انسداداتٍ في الشرايين التاجية بسبب التدخين وارتفاع نسبة الكوليستيرول في الدم .. تعرض لجلطة قلبية حادة ولم يتمكنوا من فتح شريانه .. حضر إلى العياده بعد ٦ اشهر يشكو من ألآمٍ في الصدر (الذبحة ) ويسألني إذا ماكان بالامكان عمل شئ لفتح شرايينه ..
وعندما راجعتُ صور القسطرة .. شعرت بحزنٍ شديد .. فكم هو مؤلم آن ترى مثل هذه الحالات في سنٍ صغيرة ..
تمكنا بفضل الله من فتح انسداد تام و مُزْمِن للشريان التاجي الأيمن في إجراء معقد تكلل بالنجاح .. نسأل الله أن يتم له العافية
التصوير يبين خطوات العملية ..
العربية
@HarshGMD @BinAbdulHak_A @ShariqShamimMD Dr. Golwala I am having a hard time understanding how to approach this. If a patient warrants an intervention, why not always straight TAVR?
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@BinAbdulHak_A @ShariqShamimMD Depending on the patient’s clinical condition- if frail etc- BAV and d/c- reassess candidacy for tavr in a month.. if really tavr candidate- would just TAVR without prior BAV- less pacing runs etc- one inflation and done.
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Life saved under pressure.
Critical AS with acute HF and severe LV dysfunction complicated by cardiac arrest during valve crossing. Prompt S3 valve deployment restored hemodynamics, highlighting the vital role of timely valve implantation in high-risk scenarios. #TAVR
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@RobertHermanMD Do you have a plan to add a feature of differentiating wide complex tachycardia (VT vs SVT) to your app in the future?
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36 year old male with chest pain of 2 hours duration. OMI or not?
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Respect for the authors. And I am a huge advocate for remote monitoring but I don’t think vanquishing in person visits is wise.
I’d never be able to prove it empirically but some things need not empiricism
Heart Rhythm O2@HRS_O2Journal
Outcomes associated with remote monitoring without in-person evaluations for patients with cardiovascular implantable electronic devices #EPeeps heartrhythmopen.com/article/S2666-…
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@willyhfrick Not related to this post. Do you have any recommendations for studying EP for first year fellows? Something that encompasses device interrogations/EGM and relevant issues general fellows need to know
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t+8 minutes is the same ECG as the first one in the thread, in case that was unclear.
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I don't understand this. It seems like SOME type of PMT (but not classic PMT or RNRVAS). Interrogation after "normal."
@narrowQRS @SergioPinski @jeffrey_vinocur @AThomazAndrade @DidlakeDW @The_Nanashi_O @Arron_Pearce_ @syamkumarmd @DaveRichley @KostekMilan @SparkyDeviceRN
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@smithECGBlog @PMcardioApp @PendellM I refuse to pay for the check mark so my response is in the photos below
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The point is that at the time the EKG was recorded, the artery was closed. You don’t know which patient’s arteries are going to open by the time of angiography 60- 1000 minutes later. 20% of patients whom everyone would say has a STEMI also have TIMI-3 flow at angiogram. Are you suggesting that they do not need to go to the Cath Lab, because, by the time they got there, the artery was open? This is absurd. You need to understand it from a prospective viewpoint. If the EKG shows an OMI, the patient needs the Cath Lab. And 33% of the time it will be open as either TIMI- 1, 2, or 3 flow.
Since there are skeptics like you who do not understand this rather difficult concept, we published this article in the European heart journal. In it, we show that 38% of patients with complete 100% occlusion of the LAD do not meet STEMI criteria and do not get emergent Cath Lab activation, in spite of having identical infarct size as the ones that do meet STEMI criteria: academic.oup.com/ehjacc/advance…
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New article in Am J EM:
Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (PMcardio, queen of hearts)
52 EM docs: 65% accurate
42 Cardiologists: 65% accurate
@PMcardioApp Queen of Hearts: 89% accurate
sciencedirect.com/science/articl…
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@smithECGBlog @PendellM @DrRajeshG1 @RobertHermanMD What about LVH/LV strain? Not saying it’s a normal variant but it’s also not OMI.
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@PendellM @DrRajeshG1 @RobertHermanMD Anytime there is ANY ST elevation in precordial leads, then ANY ST depression in other precordial leads tells you that the ST elevation cannot be normal variant.
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Disagree. ILR explant near zero value. Percutaneous LAAO could easily be negative value.
Edward J Schloss MD@EJSMD
Loop monitor explant -- Lowest value procedure in all of EP? I could make the case.
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70M with extensive CAD history coming with substernal chest pain. First ECG is his ECG on presentation. Second ECG is one month ago.
@ecgandrhythmRoe @PendellM @smithECGBlog @EM_RESUS @willyhfrick
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العربية
@alahsas363741 @B_ALMASHRAFI اجل فريقك يحتاج شطب في 2022 كنت متقدم بـ 14 نقطه وخسرت الدوري قدام الهلال
العربية
فريولي مدرب أياكس عقده في أياكس ثلاث سنوات، قرر ترك أياكس بعد موسمه الأول "كان قريب من الدوري +9 لولا الانهيار الغريب آخر 5 جولات" وخسر الصدارة في الدقيقة 99 الجولة قبل الأخيرة!
يذكر ان هدف أياكس قبل بداية الموسم المركز الثالث.
سبب مغادرة أياكس هو قانون اللعب المالي النظيف، مدرب عمره 36 سنة كان مساعد دي زيربي.
خيار مثالي لمن يبحث عن مدرب في دورينا.
العربية
@Mohammmed_FCB انت من كثر الخساير قمت تهذري، ماهو خاين ولا باعنا تراه طلع مطرود من برشلونة
العربية
@Mohammmed_FCB مبروك الفوز يا فسيب، تعليقك على ترزز الالماني الاصفر في كل صور التتويج وهو ما لمسها هالموسم
العربية
@ecgandrhythmRoe @arrhythmologist Isn’t this clockwise typical AFL? Positive flutter waves in inferior leads and negative in V1
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@arrhythmologist Typical CCW (isthmus dependent RA) AFL with 2:1 conduction
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