👇 #medsky #idsky

ChatGPT can recommend thalidomide to a pregnant woman. Sounds interesting... #Medsky #foamed

Merry Christmas to all those celebrating!

Holiday gift for ya: the IBCC chatbot app 😁 Free AI chatbot searches IBCC contents Answers seem pretty good & it links to relevent chapters for additional info Works as an Ebook index on steroids Created by emergency med folks at Columbia (credit to Joshua Farber & David Fisher) #EMIMCC

Christmas is just around the corner (👏 to the creator of this 👇)

Scalpel-Finger-Bougie Cric -Large, midline vertical incision -Palpate cricothyroid membrane w/ finger of nondominant hand -Scalpel through membrane, drag laterally, flip and drag laterally -Scalpel out, finger in -Bougie in guided by finger -6-0 ETT over bougie youtube.com/shorts/jB3vq... #EMIMCC

I am quite sure that this type of aggressive marketing will not be effective in my case…

Given the expanding range of conditions for which Ozempic and Wegovy are being investigated (from obesity to dementia), has anybody evaluated them for the treatment of sepsis? #MedSky

*Pulmonary embolism* versus *Acute myocardial infarction*: Above and below the pen: the size of the clots in each scenario I was looking for a picture like this and found it in a lecture by Dr Sripal Bangalore #foamed #foamcc #meded #Medsky #emimcc

*Pulmonary embolism* versus *Acute myocardial infarction*: Above and below the pen: the size of the clots in each scenario I was looking for a picture like this and found it in a lecture by Dr Sripal Bangalore #foamed #foamcc #meded #Medsky #emimcc

An experienced intensivist enters the patient's room in response to a Code Blue alert #medsky

🔥Fresh blog🔥 Hot take on RSI trial of ketamine vs etomidate RSI & EvK trials both show *more* BP instability with ketamine *but* lower mortality with ketamine 🤔 Cause of BP drops with ketamine? - Less pressor pre-intubation? - Ketamine provides analgesia (eliminating pain-as-a-pressor)? ... #1/2

The fetishization of #albumin is perpetuated by persistent misconceptions & entrenched beliefs among both nurses & physicians A new graduate nurse (still working under supervision and alongside a preceptor) just asked me if I want to give albumin to his pt who is still on norepi

#ICU Quiz: Day #2 of mechanical ventilation. A patient with ARDS has a plateau pressure of 25 on a PEEP of 5 (VCV; Vt 7 ml/kg). Comfortable - synchrony with the vent - ABGs: "OK". Would you decrease the tidal volume to bring the driving pressure closer to 15? Yes? No?

CDC advisory panel votes to limit hepatitis B vaccines for newborns Fun fact: HBV can be spread by household objects (toothbrushes, razors) used by an infected person. Only ~50% of cases before 1991 were a result of transmission from an infected mother www.theguardian.com/us-news/2025...

It took us a while to recognize euglycemic diabetic ketoacidosis (euDKA) in patients treated with Na-glucose cotransporter-2 inhibitors. It seems that we may have to be on the lookout for euDKA in patients treated with glucagon-like peptide-1 receptor agonists (#Ozempic #Zepbound)

#VEXUS: #foamed #foamcc #meded #Medsky #emimcc #pocus

He is a nice guy (and colleague), but assesses the inferior vena cava only in the longitudinal view #foamed #foamcc #meded #medsky #vexus #pocus #emimcc

Crash course in hemodynamics:

True

updated the acute liver failure chapter biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure) now rec'd for clinically overt encephalopathy (Grade 2-4) if admitting to ICU for ALF & encephalopathy, just dialyze emcrit.org/ibcc/alf/ #EMIMCC

If you remain unconvinced regarding the extent of inefficiency & resource waste within US health care, please read this: Today, I admitted to the ICU a pt in etoh withdrawal who was transported by helicopter —a 10min flight— solely for being on Precedex (dexmedetomidine) infusion at 0.2 mcg/kg/min

Ethical review of brain death in the context of familial objections or pregnancy. This is largely intuitive and common sense, but it's useful to have a guideline if needed for reference. #EMIMCC www.neurology.org/doi/pdf/10.1...

There are plenty of sodium bicarbonate haters (😊) in the Critical Care & ED world But what will they say now that an RCT on patients with acute peripheral vertigo found combo therapy with diphenhydramine (Benadryl) provided better symptom relief than diphenhydramine alone? #foamed #meded #Medsky

woah, Tay-tay is vanco? A mildly toxic agent that is problematic to dose, adds little to pipazo, and is generally unnecessary and stopped within <48 hours? I feel like she deserves to be the beta-lactam backbone since she has greater versatility and influence.

All you need to know about antibiotics in 🇺🇸 EDs/wards/ICUs #Medsky #idsky #emimcc

After the administration slashed millions in National Institutes of Health funding, grants for 383 clinical trials were terminated, and the funding disruptions affected more than 74,000 trial participants, according to a new study in JAMA Internal Medicine

Good to remember: Steroids in community-acquired pneumonia #foamed #foamcc #meded #Medsky #idsky #pulmsky #emimcc

The term "ventricular fibrillation flare-up" is not one that I would typically employ in an official statement...

ICU/ED #Oxygenation Secrets: When administering O2 to a hypoxemic patient via nasal cannula (nc), the rule of thumb is that each additional l/min of O2 increases the fraction of inspired O2 (FiO2) by ~4%. However, this rule and the associated table are frequently inaccurate:

ICU #ARDS Secrets: Our body's organs do not care about the PF ratio #foamed #foamcc #meded #Medsky #emimcc #pulmsky

ICU #ARDS Secrets: Our body's organs do not care about the PF ratio #foamed #foamcc #meded #Medsky #emimcc #pulmsky

Mind the gap between research and real life #foamed #foamcc #meded #Medsky #emimcc

This is the cartoon depiction of the old ICU motto: "Nobody dies in the ICU without steroids" I actually use steroids very often, especially in septic shock and severe community-acquired pneumonia #foamed #foamcc #meded #Medsky #emimcc #steroids

This is the cartoon depiction of the old ICU motto: "Nobody dies in the ICU without steroids" I actually use steroids very often, especially in septic shock and severe community-acquired pneumonia #foamed #foamcc #meded #Medsky #emimcc #steroids

I respectfully disagree with the view that "liberal" use of crystalloids decrease the risk of acute kidney injury (AKI) in post-cardiac surgery patients #foamed #foamcc #meded #Medsky #emimcc

ICU Snapshots: Patient presented to the ED with ECG #1 & 7 hours later an ECG #2 was obtained:

ICU Snapshots: Young patient with multiple medical problems presented to ED for evaluation of "weakness". Decompensated; had to be intubated & placed on pressors (norepinephrine) before being transferred to our ICU

If you have to remember one thing today, this is it: #foamed #foamcc #meded #Medsky #emimcc

If you have to remember one thing today, this is it: #foamed #foamcc #meded #Medsky #emimcc

Who would imagine? Louisiana officials waited months to warn public of whooping cough outbreak www.wwno.org/npr-news/202...

Yeah, right...

Yeah, right…

Life in the #ICU is not always fun... #Medsky #emimcc

Updated the IBCC chapter on pancreatitis Added fresh, new guidelines from the AGA (meh) and International Association of Pancreatology (very good) Lets talk about some updates… #1/6🧵 (chapter: emcrit.org/ibcc/pancrea...) #EMIMCC

ICU Secrets: Hope is not a strategy #foamcc #foamcc #meded #Medsky #emimcc

ICU Facts: For patients receiving prolonged mechanical ventilation (>21 days), the mortality within 6 months as well as the readmission rate are close to 50% #foamed #foamcc #meded #medsky #pulmsky #emimcc

ICU Facts: For patients receiving prolonged mechanical ventilation (>21 days), the mortality within 6 months as well as the readmission rate are close to 50% #foamed #foamcc #meded #medsky #pulmsky #emimcc

Public Health secret: Are you partaking in the frenzy around Kombucha, the fermented drink made from tea, sugar, “healthy”bacteria & yeast? Its worldwide sales have exploded to $ billions. Research on what kombucha truly does for your health is limited. But you should know that