The Art of EM

Reactive arthritis: conjunctivitis, urethritis, arthritis #MedEd #EmergencyMedicine #MedTwitter #FOAMed #GoT #ITEpearls

Dabigatran reversal options: 1. Idarucizumab - 5g given as two successive 2.5mg doses 2. PCC - increase thrombin generation 3. Hemodialysis -dabigatran is mostly renal cleared #MedTwitter #MedEd

Individuals with asymptomatic AAA between 3.0-5.4 cm diagnosed in the ED should be referred to a vascular surgeon and seen within 12 weeks. Patients with an AAA 5.5 cm or larger should be seen within 2 weeks. #MedTwitter #MedEd #CardioTwitter

The kocher technique for shoulder reductions is the oldest described technique with one Egyptian wall painting dating back to 1200 BC. #MedTwitter #MedEd

Delayed cord clamping has been associated with less all-grade IVH, higher BP and blood volume, decreased need for postnatal transfusion, and lower incidence of necrotizing enterocolitis. #MedTwitter #MedEd

Burnout has strong links to physician turnover and work effort. Studies show the cost of replacing a physician are estimated to be about 2-3x the physicians annual salary. 🥴 #MedTwitter #MedEd

A study on ED triage showed only 66% of patients who required life-stabilizing interventions were properly identified as high risk (ESI level 1 or 2). ESI is poorly sensitive for critical illness. #MedEd #MedTwitter

Amiodarone adverse effects: Patient with dilated cardiomyopathy on amiodarone developed severe epididymitis. #MedEd #MedTwitter

Local anesthetic toxicity: Give a bolus of 1.5 mL/kg of 20% lipid emulsion and subsequent infusion of 0.25 ml/kg per minute. #MedTwitter #MedEd

Kids can have incidental free fluid sometimes significant enough to be seen on a FAST exam. A recent review of asymptomatic children found 52/325 of them (16%) had incidental free fluid on ultrasound. #pediatric #MedEd #MedTwitter

Adult patients with a creatinine clearance less than 60 should have their tamiflu dose adjusted from 75mg BID to 30mg BID #medtwitter #MedEd

1.5 yrs out of residency Net worth Jan 2023 : -$15,389 Jan 2024 : +$226,399 Start loan payback Sept 2023: $188,000 Jan 2024: $163,432 Goal loan payoff: summer 2025 #MedTwitter #fintwit

Spinal epidural abscess: ESR is more sensitive and specific than WBC with sensitivity approaching 100% #Medtwitter #MedEd

Emergent appendectomy was a 3 hour surgery for #MikeMcCarthy this week why?? Is this normal for an appy? #MedTwitter #MedEd #NFL

An unblinded superiority trial found no significant difference in mortality among patients who were randomized to a restrictive fluid strategy with early vasopressors or liberal fluids for hypotension-induced sepsis. When to use which one first??? #MedTwitter #MedEd

QuikClot is a dressing that contains kaolin, a substance that activates factor XII that can help internal/external hemorrhage control. #MedEd #MedTwitter

Patients in the ED asking you for a business card or if you have an office location has to be the biggest compliment you can get. #MedTwitter #MedEd

Postural orthostatic tachycardia syndrome (POTS) is defined by an increase of greater than 30 bpm within 10 minutes of change from supine to upright position with lightheadedness or fainting in the absence of orthostatic hypotension. #MedTwitter #MedEd

Esmolol for treatment of refractory VT or VF has started to show improved rates of ROSC. Dose is 500 mcg/kg bolus followed by a continuous infusion of up to 100mcg/kg/min. #CardioTwitter #Medtwitter

Who is prescribing Cam Akers ciprofloxacin for second torn Achilles #MedEd #MedTwitter #NFL