“Vermont lawmakers are considering a bill to streamline providers’ interactions with insurers & give clinicians more bandwidth to see patients — a critical goal amid a chronic shortage of primary care providers and months-long wait times for specialists”👏
vtdigger.org/2024/04/15/pro…

Please let’s be honest.

All over the world — in any ED — for any patient presenting with an acute focal or global neurological deficit , the standard of care needs to be CTA-for-All.

This — combined with endovascular services — will save the most lives.

Fastest and…

for the love of all things holy PLEASE stop propagating the myth that you can’t use beta-blockers in COPD patients 😤

beta-1 selective beta blockers are fine for COPD patients, we use them all the time without blinking an eye.

1/ Hi #medtwitter #neurotwitter #neurocritcare #neurocritical , today will be my 1st attempt to focus on the article mentioned in this tweet from @neurocritcareJ as part of my new role as #socialmediaambassador for the journal! x.com/NeurocritCareJ…

There is no reason to get a second, confirmatory brain death examination.

All it does is create unnecessary work, prolong closure for families, and threaten the opportunity for organ donation.

fresh tiny blog: the cutoff razor

🪒 If a continuous variable is dichotomized using a cutoff, then values near the cutoff provide little information.

link:
emcrit.org/pulmcrit/cutof…

And take a look at how many of the sodiums were above 120

13 out of 15 cases

Also note that only 2 patients had rapid correction of sodium😳

Malnutrition, hypokalemia, and alcohol continue to represent as they do in every study. 4/4

EMCrit Wee - @Ross_Prager on 10 Heuristics for the New ICU Attending. We took an amazing tweetorial and made it into a podcast. Fantastic tips for Resus and Crit Care [ #FOAMed ]
emcrit.org/qus8

Tomorrow, 5/11 at 13:00 EST, I am moderating an ACEP Members panel on the reemerging threat of measles. We have a panel of brilliant ED docs to discuss the patient and department specific aspects of dealing with what should be a banished illness. This is totally free [ #FOAMed ]. Both…

again for the people in the back: if you are giving antibiotics for suspected meningitis, give steroid too. the neuroICU will appreciate it later on 🙏

10 mg dexamethasone IV.

like lung ultrasound: sometimes the artefact is the signal. #ECLYPSE

EMCrit 372 - FoundStab Intubation SOP. Even though it is supposed to be foundational, I think many items will be practice changing and potentially incite controversy... bring it on. happy to debate--please make this better [ #FOAMed ]
emcrit.org/372

Resolution of hypophenobarbitalemia with IV repletion

'the GCS was 8 so we had to intubate the patient'

EKG nerds- any recommendations for a modern reference tome on electrocardiography?

I miss Chou - they seem to have stopped updating it 😢

microsoft's AI is being weird.

seems like they cranked up the speed, at the cost of accuracy.

nice reminder that we are overly obsessed with fluid-responsiveness, but we often ignore pressor-responsiveness

if dropping the pressor dose doesn’t affect the Bp, it’s probably not helping much

(although this doesn’t necessarily apply to inotropes, including epinephrine)

Should I start this inpatient on thiamine?

Should I replace the sponge in the kitchen sink?

If your brain has enough subconscious concern to ask itself either of those questions, the answer is yes.

'Do you want us to do everything?'

This is the most stupid and meaningless question I can ever imagine in medicine.

the best way to treat alcohol withdrawal is with massive doses of lorazepam titrated based on CIWA score, followed by an outpatient chlordiazepoxide taper.

giving ginormous doses of benzodiazepines helps reduce ICU delirium and hospital length of stay.