Any recommendations for leadership courses that people have liked? There may be some upcoming opportunities for guiding/leading an intensive care unit and while I'm quite adept at the learn by doing... I feel there may be a better way to do things right the first time. #EMIMCC #ICUsky #medsky

I cannot imagine the devastation this family is experiencing today. This statement is powerful and must be read.

Alex Pretti was a colleague at the VA. We hired him to recruit for our trial. He became an ICU nurse- I lover working with him. He was a good kind person who lived to help and these fuckers executed him. White. Hot. Rage.

This is the moment to identify media accomplices, false-opposition democrats and those who are readily willing to ignore the truth of their own eyes and ears. I sincerely hope this will be a turning point. The schism between the federal fascists and law enforcement is increasing ever more.

Phenomenal write up for anyone working in EMS/Code Team/RRT quality and safety. I will be referencing this. TCP is always thrown out as "what they should have done"-- but lit is showing this is a low success maneuver. I'll still do it-- but good to escalate chronotropes and prep for TVP.

3 weeks into recovery! Had a child sitting with their family and I could hear them talking about my walker and scars. Mom made it a teaching moment, and had her kid ask me some questions-- to talk to me and not about me. She was so kind and got us a gift card. The world needs more parents like this.

Day 10/10 of self-administered enoxaparin inj. I don't particularly enjoy the sensation of subq needles and meds. However the burn was only minimal and short lasting. I do however appreciate not developing a DVT and the pharmacologic profile is phenomenal Final rating: 8/10 - would stab self again

Walking into 2026. (well... walkering for me) Wishing everyone a happy and healthy New Year

As a doc, 13 days as an inpatient gives you some perspective of what our patients go through in severe injury/illness. What an experience. Thankful to have my health, my mental acuity. Here is a photo of the thank you card my partner and I left our Ortho unit. More reflections to come as I recover.

Turns out my superb pre-hospital trauma care was in reality 4 deployments of WMDs. Do I contact FEMA as a victim of terrorism? www.whitehouse.gov/presidential...

There is no greater betrayal of your own body than waking up in 10/10 pain from hypnic jerks while in an ex-fix. Not even naps are safe

Navigating a critical injury far from home. 1/5 stars. Don't recommend. Thankful for all the support shown by my colleagues and family. It means so much.

Humbled to say the least. The doc becomes the patient. On the road to recovery!

Recently, I've been asked whether every baby actually needs HBV vaccination, largely with the implication that doing this is "one size fits all," and that's not a good approach. Implicit in this assumption is the idea that every individual's physiology is so unique that it demands unique care.

Democratic leadership is dead. The legislative branch of the US government is a complicit arm of the autocratic takeover of government dreamed by the right in the 80s, launched by Cheney post 9/11, continued by institution Dems, and now the cult of personality is here. The branches are trimmed.

Our latest blog is out: Faith, Evidence and the Stars: The ANDROMEDA‑SHOCK‑2 Trial https://criticalcarereviews.com/blog/current

Today I became double board certified, and won trivia.

The fact that the AOC and Sanders Town Hall isn't all over social media tells me exactly what I need to know... Was SO REFRESHING listening to politicians prioritizing people and values. No hate.

Having recently read Mark Bray's book about Antifascist movements... Not at all surprised that these fascist **cks decided he's a threat. Read. Love. Commune. Fight.

As an US EM/CCM doc attuned to what's happening politically, and how it's impacting people daily, I struggle to find the energy and bandwidth to contribute to fighting the fight when I'm facing it at work 20+ days a month and honestly, feels like I'm losing. Anyone else feeling this? Recs? #emimcc

Why must we the health professionals take advice from the non-health professionals; especially when it is to seek advice from health professionals -- professionals whom the non-health professionals DIDN'T take advice from. The weaponized incompetence is here, dizzying, and deadly in magnitude.

Watching Miller / Trump use the Kirk Memorial to divide, sow malice and show how much they hate anyone who stands for democracy, equity and free society is jarring. I've never been more scared, nor more proud to stand on my beliefs. They show how afraid they are of us, and what we can do.

updated IBCC chapter on anaphylaxis, some new additions: 🆕 methylene blue for anaphylaxis refractory to epi & fluid 🆕 sugammadex for anaphylaxis 2/2 roc or vec 🆕 nebulized epi (in combination with IV) for upper airway edema? Don't bank on it but might help? (emcrit.org/ibcc/anaphyl...) #EMIMCC

It's time to start building. Building community. Building resiliency. Building the world we want to see. When the state demands we step in line and maintain social order-- an order that robs our most vulnerable-- it is our duty, to raise the🖕with one hand, and use the other to lift each other up.

I have a small number of rules for my trainees in ED and ICU: 1) Don't lie. 2) Treat the unit and the people in it like you're a guest in their home. 3) Don't violate the Geneva Convention. (Sedate paralyzed patients with drugs with sufficient t1/2) pubmed.ncbi.nlm.nih.gov/33485698/ #emimcc

Still chuckling from an angry phone call I fielded earlier in the ICU. Mid-yelling at my residents/apps/nurses. "I'm tired of talking to these 30 something year old infant residents! We will only talk to the much more experienced and older attending physicians". My 32 year old ass...

scout images for CT scans are hidden gold the scout often gives you high-resolution images of a LOT of the body (FAR beyond the body part getting the CT scan) for example, the scout of a CT C-spine may be great to confirm ET tube position #EMIMCC

🆕💫PROTECT RCT Ceftriaxone to prevent early-onset pneumonia in comatose patients after out-of-hospital cardiac arrest: a pilot randomized controlled trial and resistome assessment (PROTECT) #IDsky #EMIMCC @pulmcrit.bsky.social journal.chestnet.org/article/S001...

Escaped the US for a second ... Fingers crossed they let me back in ...

As a new resident of the area I have been waiting for my first haboob. Did not disappoint. Rolled in as I pulled into the taco shop. Spent the evening sipping margaritas waiting for the dust to settle.

Louder for the nephrons in the back

Health and wealth inequality generated by decades of vacuous greedy profiteering at the expense of an unprotected working class, a targeted erosion of trust in our institutions, and a rising populism driven not by seeking a greater good, but by a destructive nihilism --will be our downfall.

There are 3 pillars of #academicmedicine. 1) Patient care 2) Education 3) Research The irony: the people who get paid the most are administrators who do none of those things.

1/n I finally read the Interstitial Pneumonias #AlphabetSoup update. Principally, I have an aversion to guidelines because of my concerns for the wellness of those who participate in writing them. But. This one (while not perfect) has substantial ➕ aspects publications.ersnet.org/content/erj/...

Does anyone else find it cringe when people "talk" to AI, or try to explain something to AI? Or is this just me...

First week of nights in the books. Out to the mountains to refocus and recenter as I find my new zen-point in this new chapter of my career.

Shift one as an attending intensivist in the books. Thanks for the encouragement y'all. Shout out to @pbafuma.bsky.social for putting up with the new shift jitters and orienting.

Any words of wisdom you would tell yourself before your first day as a brand new attending at an unfamiliar academic medical center? . . Asking for a friend. . . The friend is me. #emimcc #icusky #emsky

In a time when we need more thought leaders to emerge and speak their power. Thank you for your voice @iwashyna.bsky.social

standard approaches to dosing hypertonic therapy are flawed 🧂for hyponatremia, reviews often recommend homeopathically low doses (eg 100cc of 3%) 🧂for elevated intracranial pressure, common practice is to use fixed doses (eg 30 cc 23.4% saline for everyone) can we do better?... 🧵 #1/2 #EMIMCC

Not gonna lie.... I thought this was satire but they're serious... Great insight! De-recruitment is rapid and unforgiving

Last night shift as a fellow is in the books! Just goes to show there are so many ways to be the loudest in the room without raising your voice.

Love how terrible this is for Tesla. At their own demo. Manage to demonstrate that their car will break driving laws (bus with flashing reds)--smack a child running to said bus-- run it over-- and continue driving. Nailed it. S/O to the "oh my God" lady.

It's the photo of the marine detaining the army veteran while in front of two rent-a-cops for me.. hilariously depressing that this is how we break this seal.

When a morning setback becomes some morning art...

RFK Jr. spouted dangerous vaccine falsehoods on national TV. As a parent and infectious diseases doctor, I couldn't stay silent. Here's what the data actually shows. 🧵

There are some dreams that can only be realized at 2am during your last string of nights as a fellow.

Protesters Urged Not To Give Trump Administration Pretext For What It Already Doing

Art. An integral part of any people led resistance

for an intubated asthmatic whose bronchospasm won't break: high-dose ketamine is good, but it should be given with an anticholinergic. why give glycopyrrolate? 🤤reduces secretions from ketamine 👊it causes bronchodilation! so this is a sneaky way to start *two* IV bronchodilators. boom. #EMIMCC