Matthew Tyler

@RajuMehtaMD @BenVolin To be fair, the whole team sucks

Mac Jones’s passer rating is 27.8. If he were 0 for 21 with all 21 passes spiked directly into the ground, it would be 39.6

@RajuMehtaMD @BenVolin

Retweet if you believe we need a nationwide ban on assault weapons.

If you are a doctor or healthcare worker who supports action on gun safety tweet #DoctorsForGunSafety

@khaycock2 I like the call to cardiovert rather than esmolol, especially if shocky. That looks like some wicked diastolic heart failure too

1/ 44 yo patient came to ED with SBP 70 mmHg, HR 150-160 atrial fib. Was s/p ablation for atrial fib 12 days ago and had sudden presyncope and palpitations. POCUS: plethoric IVC and reverse S on HV,diffuse B-lines, TRpv 35 mmHg (so sPAP about 55-60), & the following other images:

@phlegmfighter Hot take: don’t place #CVC in the first place…use midlines, long angiocaths. Keeps RIJ free willy for future HD cath

It’s not as bad as illegally parking in a handicap spot, but if you use the #RIJ for a #CVC, it’s the same principle - taking prime real estate to make yr task a little easier but the cost to the guy who really needs the spot for a #HDcath is much larger. Don’t do it. #MICU #PCCM

Ventured into triage today to eval / dispo patients waiting over 24 hours….

@khaycock2 @Wilkinsonjonny @icmteaching @ThinkingCC @msiuba @Manoj_Wickram @siddharth_dugar @MaxHockstein @KalagaraHari @cianmcdermott @POCUSClub @Pocus101 @load_dependent @NephroP @IM_Crit_ @EMNerd_ @katiewiskar Resolution of bradycardia induced cardiogenic shock in real time. I bet CI was dismal (maybe 1.2-1.4?). No forward flow, elevated right sided pressures, obvious organ malperfusion. Magically gone with a little heart rate boost

@Wilkinsonjonny @icmteaching @icmteaching @ThinkingCC @msiuba @mdmdtyler @Manoj_Wickram @siddharth_dugar @MaxHockstein @KalagaraHari @cianmcdermott @POCUSClub @Pocus101 @load_dependent @NephroP @IM_Crit_ @EMNerd_ @katiewiskar

1/ A case: I was asked to assess a pt that just arrived with hypotension and HR in the 20s by my co-attending in the ED. ECG was with no P waves and RBBB w/ LAFB & severe bradycardia. POC K was ordered, and echo done as epinephrine gtt started at 5 mcg/min.

@khaycock2 Love it. And if bubbles within RA/RV <2 seconds of injection CVC likely at SVC/RA junction. Why then even bother with x-ray you ask?

2/2

1/ Need to use a CVL now and the x-ray tech can’t get there soon? POCUS (wire, check for PTX, & bubble study) and you’re ready to use the CVL.

Don't drown your patients in antibiotics. Save $$. Prevent the MDRsuperbug. Consider using a procalcitonin protocol to guide abx use. #ChoosingWiselyICU @SCCM @AnitaJReddy @GomerFoamER @mommimaya @the_rainster @JenCortesRx

@RajuMehtaMD @pdsalinas @ResusTEEproject Good stuff. I appreciate the challenge to get TEE into the ICU. Especially convincing cards that you aren’t drinking their cool aid. TEE probes are also prohibitively expensive

Yes Doctors, nurses and health groups call for mandatory coronavirus vaccinations for health workers - The Washington Post apple.news/Aoge5hAWuQvuKC…

How many of you are using ultrasound for your subclavian catheter placement? Check out the video discussion on CriticalCareNow by @HarmanSGill & @mdmdtyler for more on this criticalcarenow.com/ultrasound-gui… #FOAMED #FOAMCC #CriticalCare #EmergencyMedicine #Hypotension #Vasopressors

@SAEMonline @CriticalCareNow @meganranney @AliRaja_MD @MDaware @LWestafer One stop shop for all things critical care

SAEM’s FOAM Showcase Voting @CriticalCareNow with ow.ly/p9CN50ELqre 1 point for a like, 3 points for a RT, 5 points for a comment Voting is open until Thurs at midnight - final winner Friday AM! #FOAMed #SAEMsGotTalent @meganranney @AliRaja_MD @MDaware @LWestafer

@ThePeoplesRuben @CriticalCareNow Love me some ‘push-dose pressors.’ Although if I suspect bp will drop with intubation/induction I start a norepi gtt BEFORE intubation to avoid the hypotension altogether

Push-dose pressors are becoming more and more common in the ED in the management of the hypotensive patient. Check out my post on @CriticalCareNow discussing the pearls and pitfalls of push-dose pressors. criticalcarenow.com/pearls-and-pit…

I do not like tachycardia, SAM I AM I do not like inotropes in my veins I do not like catecholamines from my pains I do not like dehydration HOCM can make me a sickly patient I DO like fluids, SAM I AM I DO like phenylephrine & esmolol too @CriticalCareNow #FOAMed #FOAMus

@vibhusharmamd @khaycock2 @CriticalCareNow Absolutely. post-MVR SAM definitely something to watch out for

@khaycock2 @CriticalCareNow @mdmdtyler Yes, post CABG and MVR. The clue was a new murmur post op day 1.

What is SAM and why it matters. New CriticalCareNow video post by @mdmdtyler Have you seen a case like this before? criticalcarenow.com/sam-the-wicked… #POCUS #foamcc #foamed #FOAMus #Cardiology #resuscitation #hemodynamics