Peter Mullins retweetledi
A 56-year-old male applied 17 nonprescription lidocaine 4% patches to his thigh (with some patch overlap) because of thigh pain. The patient did not experience lidocaine toxicity.
tandfonline.com/doi/full/10.10…
English
Peter Mullins
56 posts
Peter Mullins
@petermullins
interventional pain medicine physician via @BrighamAnes & @EMRES_MGHBWH & @GWSMHS | identical twin @mullinan
Vancouver, WA Katılım Ocak 2009
452 Takip Edilen192 Takipçiler
Peter Mullins retweetledi
When an enrollee switches from traditional #Medicare to a “private” #MedicareAdvantage plan, the burden on taxpayers rises by, on average, 22%.
TWENTY-TWO PERCENT
medpac.gov/wp-content/upl…
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Peter Mullins retweetledi
🛑 SIGNS A PROVIDER HASNT BEEN TRAINED IN PAIN
❌blames it just on tissue damage & skips the 🧠
❌recommends only 💊 or 🔪
❌fails to target diet, sleep, trauma, movement, mental health
❌targets only a body part, not a WHOLE PERSON
📣 Pain is biopsychosocial ALWAYS
#MedTwitter
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Peter Mullins retweetledi
Gabapentin - what is it good for (absolutely nothing?)
In this paper, we explore what proportion of gabapentin use has at least some evidence of benefit for patients. #medtwitter #pain 👇1/8
pubmed.ncbi.nlm.nih.gov/37794261/
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Extremely thoughtful analysis of this trial. Agree in particular that this study smells of “agenda” in evaluating a first-line therapy (almost) no one in 2023 uses as first-line. Critically it tells us nothing about opioids for chronic pain but will be used in that context
Stefan Kertesz, MD, MSc@StefanKertesz
1/A new trial in @TheLancet tests whether prescribed opioids are superior to placebo as 1st-line therapy for acute low back pain. No one has ever proposed to offer opioids as 1st-line therapy. But this paper invites debate in their use as 3rd or 4th line
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Peter Mullins retweetledi
Our work in @AnnalsofEM show the economics of US EDs for docs
authors.elsevier.com/a/1hGSfib7EIKMA
It's a story of cost-shifting: ED visit profits from commercial insurance cross-subsidize Medicare, Medicaid & uninsured pts
@DrArvindVenkat @Dr_BrendanCarr @arjunvenkatesh @AlexJankeMD
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@flanaonlyonce @reverendofdoubt Four years worth it to be fellows together 🥲
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Four- and three-year emergency medicine residency graduates perform similarly in their first year of practice compared to experienced physicians
sciencedirect.com/science/articl…
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@petermullins Why did they present with sinus headache the week before and rash the week before that?
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If a patient presents to your ED with back and leg pain and tells you they are scheduled for a steroid injection tomorrow, please do not discharge them with a medrol dosepak.
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Not an exaggeration to say NHAMCS is the single biggest reason I'm an emergency physician and probably in medicine at all. Such a tremendous resource to answer foundational questions in our specialty. Goodbye, dear friend.
Michael L. Barnett@ml_barnett
A tragedy ... After 30 years and hundreds of papers, the CDC-run NHAMCS survey is closing down. This has been a stalwart dataset for understanding emergency care in the US for decades. #anchor_1678674377785" target="_blank" rel="nofollow noopener">cdc.gov/nchs/ahcd/noti…
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Has correcting vitamin D ever been shown to help with anything
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@flanaonlyonce @joshmcgoo Two words to forever change your practice and your patients’ lives: Radiation. Hormesis.
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Y'all should really use ultrasound to diagnose pneumonia/atelectasis
At worst, can still be much more sensitive than portable CXR
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Peter Mullins retweetledi
Here are two statements that might seem at odds:
i) Opioids aren't great for chronic pain
ii) Some chronic pain patients need opioids
There is no inconsistency here, and @haiderwarraich gets it. statnews.com/2022/04/19/med…
English
Peter Mullins retweetledi
Authors report reductions in the use of surgery, opioids, and imaging for chronic low back pain over the 9-year period (commericially insured pts)
If only pain intensity, pain interference, & physical function data were available 😭
jamanetwork.com/journals/jaman…
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Peter Mullins retweetledi
Factors Associated With Opioid Overdose After Initial Opioid Prescription ja.ma/3r8RgLN via @JAMANetworkOpen part of @JAMANetwork
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@baddantakes My human children are named Josie, Jane (Janie), and Deacon. Aja would be next.
Newton, MA 🇺🇸 English
@reverendofdoubt Doesn’t answer the exact question but: jamanetwork.com/journals/jama/…
Newton, MA 🇺🇸 English
Thrilled to have matched at @BrighamAnes for pain medicine fellowship next year!
Newton, MA 🇺🇸 English