My thoughts are with all those people that spent their day at home today with a potassium of 3.3 (and nothing bad happened to them!) #foamcc #electrolytes #emimcc

My thoughts are with all those people that spent their day at home today with a potassium of 3.3 (and nothing bad happened to them!) #foamcc #electrolytes #emimcc

Factoid: The first clinical use of plasminogen activators (do you remember streptokinase?) in humans focused on the management of parapneumonic effusion/empyema, not myocardial infarction #foamed #emimcc

I want to shake everyone’s hand here, but I don’t want my hands getting bruised 🤝 Btw, has anybody heard about senile purpura? Or my Internal Medicine background is acting up?

I thought that routine daily aspirin is no longer recommended for the primary prevention of heart attacks and strokes Please advise

Fact: "Science gathers knowledge faster than society gathers wisdom" -Isaac Asimov

I may be biased here, as I extubate MANY patients directly to NIV when I "feel" they will benefit, without relying on CO2, age, or cardiorespiratory status. This was a post-hoc analysis of two RCTs, and showed that in high-risk patients without hypercapnia at extubation, prophylactic NIV alternating

Fact: "Science gathers knowledge faster than society gathers wisdom" -Isaac Asimov

What is the highest #glucose value you have managed in a patient? #foamed #foamcc #meded #medsky #emimcc #diabetes

"Interesting" screening questions before participating in a medical survey: 🤦‍♂️

What is the highest #glucose value you have managed in a patient? #foamed #foamcc #meded #medsky #emimcc #diabetes

Anticoagulation stories: Friendly reminder that transitioning from apixaban (Eliquis) 5 mg twice daily to warfarin 5 mg twice daily is not the way to do it... True story... #foamed #medsky #emimcc

Anticoagulation stories: Friendly reminder that transitioning from apixaban (Eliquis) 5 mg twice daily to warfarin 5 mg twice daily is not the way to do it... True story... #foamed #medsky #emimcc

When you love both #ECMO and #Impella but also want to keep things tidy and close #foamed #foamcc #medsky #emimcc

On another note, my annual eye exam was canceled today, May 11, because last year’s was on May 12 and my elite, “Cadillac”, private health insurance, courtesy of a prestigious hospital and its mega integrated health network, apparently cannot survive a one-day overlap. If...

Here’s a shocking number: One out of eight American adults is taking a GLP-1, like #Ozempic or Zepbound, according to a Kaiser Family Foundation poll #GLP-1s are a lot weirder than anyone thought Listen to the Ezra Klein show: youtu.be/T_JKQt4mp5I?... via @YouTube

In Critical Care, it doesn't matter how smart you are (it helps, though!) but what you can do in the moment #foamed #meded #foamcc #medsky #emimcc

An audit of 2.5 million academic biomedical-science papers identified ~3,000 w fake references;, ones that could not be traced to known publications. There were 12 times more publications w fabricated citations in 2025 compared w 2023. 🤦‍♂️ Topaz et al, Lancet, 407: 1779-81. (2026)

I am reading this piece in CHEST and thinking that the #COVID-19 pandemic acted as a catalyst for re-evaluating so many aspects of our daily life #foamed #medsky #emimcc

Hollywood (and Netflix) love these stories. Did I mention I don't like cruises? www.cnn.com/2026/05/03/a...

Tell me what you want to prove & I will find you a study! A small study presented at the 🇺🇸 Association for Cancer Research Annual Meeting 2026 suggested that “younger nonsmokers who eat a higher quantity of healthy foods than the general population are more likely to develop lung cancer" #medsky

I am reading this piece in CHEST and thinking that the #COVID-19 pandemic acted as a catalyst for re-evaluating so many aspects of our daily life #foamed #medsky #emimcc

Angioedema? Try tranexamic acid STAT #foamed #foamcc #medsky #emimcc

I just wanted to remind you that the term "institutional loyalty" refers to you being loyal to your institution (hospital), not the institution being loyal to you. You are dispensable... #medsky

“There are three stages of scientific discovery: first people deny it is true; then they deny it is important; finally they credit the wrong person” - Alexander von Humboldt (1769–1859)

ICU Snapshots: This is what I don't want to see when a patient on heparin drip crashes:

ICU - Board Review Qs: 60 yo pt admitted to the ICU because of inferior STEMI. Emergency cath: 100% proximal RCA occlusion treated successfully with stenting One hour post-PCI: dyspnea/anxiety - BP: 94/70, HR: 60/min (sinus). Phys exam: JVD (+), clear lungs, cool extremities

I consider Emergency Medicine the most difficult specialty. That said, in a non-mass casualty ED situation, sending to the ICU a septic patient, hypotensive on 2 pressors, anuric, hypoxic, with a Hb of 5.0, lactate 10.0 & K 6.0, w an IO & a non-functioning 22g may be less than ideal

ICU/ED Airway "Secrets": ~40% of endotracheal intubations (ETI) performed in the ICU or the ED result in hypotension, hypoxemia, or cardiac arrest Of all procedures, ETI is the one I find most intimidating & have the greatest respect for #foamed #foamcc #meded #medsky #emimcc

ICU Secrets: If you use the Swan-Ganz catheter as a long central venous catheter, such as monitoring only the CVP value, then chances are that you won’t become much wiser by inserting it… #foamcc #hemodynamics #emimcc

ICU/ED/OR Airway "Secrets": #foamed #foamcc #meded #medsky #emimcc #airways While you attempt direct laryngoscopy in a hypoxemic patient, you get this view:

ICU Stories (at the beginning of my night shift): Me: Anybody coming? Morning ICU shift attending: Just a young patient with etoh withdrawal from 2D The patient 👇: Not responsive. SBP in the 80s, HR: 150/min, breathing 60/min. O2 sat 96% on 15 l/m non-rebreather mask. Febrile

ICU Stories (at the beginning of my night shift): Me: Anybody coming? Morning ICU shift attending: Just a young patient with etoh withdrawal from 2D The patient 👇: Not responsive. SBP in the 80s, HR: 150/min, breathing 60/min. O2 sat 96% on 15 l/m non-rebreather mask. Febrile

ICU/ED/OR Airway "Secrets": #foamed #foamcc #meded #medsky #emimcc #airways While you attempt direct laryngoscopy in a hypoxemic patient, you get this view:

I consider Emergency Medicine the most difficult specialty. That said, in a non-mass casualty ED situation, sending to the ICU a septic patient, hypotensive on 2 pressors, anuric, hypoxic, with a Hb of 5.0, lactate 10.0 & K 6.0, w an IO & a non-functioning 22g may be less than ideal

ICU/ED Airway "Secrets": ~40% of endotracheal intubations (ETI) performed in the ICU or the ED result in hypotension, hypoxemia, or cardiac arrest Of all procedures, ETI is the one I find most intimidating & have the greatest respect for #foamed #foamcc #meded #medsky #emimcc

“Large language models can be unreliable and say dumb things, but then, so can humans” -Blaise Agüera y Arcas

ICU Snapshots: This is what I don't want to see when a patient on heparin drip crashes:

ICU Secrets: If you use the Swan-Ganz catheter as a long central venous catheter, such as monitoring only the CVP value, then chances are that you won’t become much wiser by inserting it… #foamcc #hemodynamics #emimcc

Not a #fluid situation #sepsis #foamed #foamcc #emimcc

Not a #fluid situation #sepsis #foamed #foamcc #emimcc

Right ventricular (RV) involvement complicates >30% of acute inferior STEMIs, though hemodynamically significant RV infarction occurs in ~10–15% of cases. The classic teaching is that when a patient w inferior STEMI becomes hypotensive & has clear🫁on physical exam, the treatment

ICU - Board Review Qs: 60 yo pt admitted to the ICU because of inferior STEMI. Emergency cath: 100% proximal RCA occlusion treated successfully with stenting One hour post-PCI: dyspnea/anxiety - BP: 94/70, HR: 60/min (sinus). Phys exam: JVD (+), clear lungs, cool extremities

We explore the latest Surviving Sepsis guidelines with lead author Hallie Prescott, including the controversies pertinent to US-based practice icuscenarios.com/lightning-ro... #medsky #emimcc

If you are interested in the new surviving #sepsis #guidelines and the controversy around them, you may find useful this podcast with Hallie Prescott, the guideline co-chair icuscenarios.com/lightning-ro... #foamed #foamcc #meded #medsky #emimcc

If you are interested in the new surviving #sepsis #guidelines and the controversy around them, you may find useful this podcast with Hallie Prescott, the guideline co-chair icuscenarios.com/lightning-ro... #foamed #foamcc #meded #medsky #emimcc

He is a good friend but he intubates with midazolam & fentanyl... #foamed #foamcc #meded #medsky #emimcc

He is a good friend but he intubates with midazolam & fentanyl... #foamed #foamcc #meded #medsky #emimcc

In the management of hemodynamics, you may have a different opinion but you can't have a different physiology #foamed #foamcc #emimcc

In the management of hemodynamics, you may have a different opinion but you can't have a different physiology #foamed #foamcc #emimcc