Spenser Lang

‘Twelve Tips for Developing Simulation-Based #MasteryLearning Clinical Skills Checklists’ Grateful to work with some of my favorite people in #Meded on this project! @Brown_Emergency @UWEmerMed @NorthwesternEM @NU_MedEd tandfonline.com/doi/full/10.10…

Welcome to our @TamingtheSRU Family, Class of 2028!

@armyemdoc @SCCM @AditGinde Pretty sure the recommendation was AGAINST routinely using steroids after etomidate

The @SCCM guidelines for rapid sequence intubation were just released. Here's the summary: -Use the semi-Fowler postion -Use HFNO or NIPPV to preoxygenate, especially if severe hypoxemia present -NGT decompress only if at high-risk for aspiration of gastric contents (eg bad UGIB) -Vasopressors or IVF to reduce risk of further hypotension if already hypotense... dealer's choice -Use paralytic and sedative-hypnotics -If you use etomidate, consider concomitant corticosteroids -Use sux or roc These were pretty much all based on low or moderate quality data or expert consensus, so I wouldn't die on any of these hills. journals.lww.com/ccmjournal/ful… #emergency #emergencymedicine #foam #foamed #foamcc #army #armymedicine #armyemdoc #meded #icu #criticalcare #airway #medairway #medairwaytwitter #medx #medtwitter #sccm #sccm2024

Great new article in @AnnalsofEM — “Mental Practice: Applying Successful Strategies in Sports the Practice of #EmergencyMedicine” — coauthored by two of my favorite people in EM, @spenserlang of @TamingtheSRU & @Chris__Merritt of @Brown_Emergency annemergmed.com/article/S0196-…

@DrCasteelEM @armyemdoc There is evidence for this in pyelo.

@armyemdoc Dang I’ve never seen or even heard of this hah (only a PGY-3 tho). I do still have attendings who want to give IV rocephin before dc on PO Keflex tho lol.

Single dose vancomycin in patients getting discharged... -There is no evidence that it does anything -It adds a ton of cost -It wastes your pharmacist's time, and your nurse's time -It also wastes your patient's time because now they are stuck in the ER for 1-2 more hours #emergency #emergencymedicine #foam #foamed #army #armymedicine #armyemdoc #meded #medx #medtwitter

@MDaware @BrooksWalsh Bro. Light this up. Get your procainamide outta here.

@BrooksWalsh procainamide for ~everything~

in a lecture or a tweet, it’s easy and obvious IRL it is neither

@Dallas_Holladay @theangrypharm “Well I don’t know my NPI but I can google it for you” 🤷‍♂️

@theangrypharm Clarification on a script, request for substitution of a script or asking for my NPI (which will forever perplex me).

Uh, random question. How often do we even talk to ER doctors? Like maybe the ED Pharmy or Nurse calls us for a med-list, but the actual doctor him/herself? Why would they give a shit about retail when they have their own in-staff pharmacist? Asking for a friend.

@A_Martella8 Good for you 🎉 I’m not even there yet!

@JamesWilsonDO1 @johnbrucewalla1 @DrNeilStone @benabo You get an EKG everyone you rx zofran for? I can’t imagine how high the NNT would be to find the high QTc

@johnbrucewalla1 @DrNeilStone <50yo w ED dose of CRO/CTX w 2L LR after POCUS to r/o hydro/Urinary obstruction? I almost always then DC w some Phenergan/Zofran to take 30min pre PO abx (EKG to ensure no QTc issues), w close PCP f/u of course! @benabo would agree I’m sure ;)

I am sure most cases of pyelonephritis can be managed at home with oral antibiotics I think we admit too many cases #NHS

@MedFactChecks @srrezaie I think that’s the key here, and why the recommendations are kind of silly. If I gave 4-8 mg for every seizure, I would be a crazy person.

@srrezaie Most of the time it’s not status when I’m giving 2mg lol. It’s just “seizure”. By the time it’s status we’re usually past benzos and on to other meds.

RANT: Don’t Under-Dose BZDs in Status Epilepticus youtube.com/shorts/UpTAVnd… Wrong Option: Lorazepam 2mg IV Option 1: Lorazepam 0.1mg/kg (Max 8mg) IV Option 2: Midazolam 0.2mg/kg (Max 10mg) IM if No IV #StatusEpilepticus #Seizure #Lorazepam #Midazolam

@armyemdoc @ACEPNow Unnecessary jab at the great state of Ohio?

Were some states disproportionately affected by the big drop in EM applicants this year? It appears so. 1. Arkansas 2. Nevada 3. Kansas 4. Ohio 5. Michigan I can understand Ohio. Does anyone actually want to live in Ohio? The authors chalk it up to the political climate but that seems like a gross oversimplification. Anyone have thoughts on this? sciencedirect.com/science/articl… #emergency #emergencymedicine #resident #residency #learn #medicine #foamed #data #science #research #armyemdoc #medtwitter

@A_Martella8 @TamingtheSRU

Emergency medicine consults

Here are some guides for spotting limb lead errors in practice

When you see the baby mannequin in the sim lab 😳 @TamingtheSRU

@joshmcgoo EM residency = studying for step 3. Familiarize yourself with the weird case based format for Day 2, and maybe vaccine schedules. That’s it.

How long did you study for Step 3

It’s that time of year again! #EMBound #emergencymedicine #MedEd #FOAMed

@SAEMonline @_drjeffy @AliRaja_MD @LWestafer @andyglittle @AalapMD Gotta be “Hit the Box” - great work by @_drjeffy et al!!

Help pick the winner of SAEM’s FOAM Showcase! Contestant 4 of 4: @_drjeffy ow.ly/tRZz50Ospt7 1 point for a like, 3 points for an RT, 5 points for a comment Deadline: May 25th at midnight #FOAMed #SAEMsGotTalent @AliRaja_MD @LWestafer @andyglittle @AalapMD

@UCAirCareDoc @ChrisRootMD @DitchDoc14 @AMPAdocs @ASTNA2 @ICAPParamedics Two great things about SLN in SCAPE 1) starts to work nearly immediately 2) I can get it before you can even get a pharmacist on the phone to start making a nitro gtt

.@DitchDoc14 : "Two big problems w/ SL NTG in SCAPE: 1. Sublingual NTG only has 38% bioavailability. 2. That NIPPV mask is in your way." #CCTMC23 @AMPAdocs @ASTNA2 @ICAPParamedics