Manrique Umana McDermott

“We do not rise to the level of our expectations, we fall to the level of our training” Had to do an emergency cricothyroidotomy... #Airway

“Doc, should I use ketamine or etomidate to intubate him?” Me…

The only vent math you need! Driving Pressure = Plateau Pressure - PEEP Goal: Less than 15 High DP: Volume too big or lung too small Low DP: Safe ventilation Compliance isn't stiffness; it’s functional size. Comment to discuss.

⭐ META-ANALYSIS: Hospital delirium --> devastating long-term outcomes 253 studies, 137,000+ pts: • 5.4x dementia risk • 2.8x institutionalisation • 2.5x mortality • 1.7x readmission ⚠️ Delirium = a serious acute problem AND a risk warning. ➡️ All pts deserve robust delirium assessment

Today, a year ago… With people I really admire. The power of @IncrEMentuMconf

Going to a rurral low-resource setting to set up workshops after having worked for years at a terciary level teaching hospital, it’s definitely quite a challenge

Last week, IncrEMentuM 2026 sold out. For that reason, we have decided to open only 50 additional places. 👉 Now is your chance. La semana pasada IncrEMentuM 2026 alcanzó el sold out. Por ello, hemos decidido abrir únicamente 50 plazas adicionales. 👉 Este es el momento.

POOs, LOOs, DOOs, and MOOs? Interpreting Research Outcomes with a Little Bathroom Humour @DennisRenMD dontforgetthebubbles.com/poos-loos-doos…

This week open access—my 5 favorite ECG cases of the past decade. Open access. #FOAMed click on link below

Are you doing CPR on the correct part of the chest? We’ve been taught and seen it a million times, hands on the center of the sternum and fast deep compressions. Swami and Charlotte Derr are here to explain the physiology of why we might need to move a bit farther to the patients left for optimum perfusion by compressing the left atrium instead of the LVOT (left ventricular outflow tract). Listen to the whole segment this week on EM:RAP and let us know what you think! #CPR #chestcompression #EMRAP #MedEd #Ultrasound #EBM #emergencymedicine

Cardiogenic shock = a pump problem When the heart fails, it starves every organ of oxygen. Don't let a "normal" BP fool you; the body masks early failure with vasoconstriction. If you wait for the crash, you've missed the window. #CriticalCare #FOAMed #Shock

Mortality for cardiogenic shock is still >40%. Are you using the latest staging & management strategies? 🫀🚑 The new @CJEMonline "Just the Facts: approach to cardiogenic shock in the ED" breaks it down: ✅ Use SCAI Staging (A-E) to predict risk & mortality. ✅ PoCUS is key: check biventricular function & rule out tamponade. ✅ Norepinephrine is your 1st-line vasopressor. ✅ Consult cardiology early for revascularization. 🚫 Clinical Tip: Avoid beta-blockers & CCBs in acute tachyarrhythmias if LV function is uncertain. Read the full Open Access article: 🔗 link.springer.com/article/10.100… #MedTwitter #EmergencyMedicine #FOAMed #CardiogenicShock #CJEM

¿Qué es ser urgenciólogo/a? #SomosUrgenciasLaFe #OrgullodeUrgenciologo #EspecialidadMUYE @HospitalLaFe instagram.com/reel/DVjfHAWDJ…

At IncrEMentuM 2025, @emcrit left us with an amazing reminder: “Be nicer to the people around you… and to yourself. Everyone is more fragile than we think.” In #EM we train for the hardest moments. But sometimes the most necessary skill is simply kindness.

💭 Let’s remember why we do what we do… Because every second matters. Because behind every emergency, there’s a life, there's a family trusting us at their worst moment. Emergency medicine is not just a specialty. 𝐈𝐭’𝐬 𝐚 𝐜𝐚𝐥𝐥𝐢𝐧𝐠.

La TEP ya no se clasifica igual. Si sigues hablando de “masiva y submasiva”… te quedaste en el 2019. Así se estratifica el riesgo en 2026. ¿Ya la estás aplicando en tu guardia?

Training your resident in a critical patient isn’t just about explaining the technique and having them watch. When instability hits, we tend to take over. But if we always step in, they don’t build the confidence they need. Training is also part of saving lives.

#EMlegend #globalEM #fromT2T

When some friends tell me: “you haven’t been that active on Twitter lately…” Cuando algunos amigos me dicen: “no has estado muy activo en Twitter últimamente…”

Increíbles declaraciones. Ahora un trabajador no puede priorizar su calidad de vida? Pero cuando hacen muchas guardias, disponibilidad y turnos extra exhiben sus salarios y los acusan de “sangrar” a la institución.