My stomach is in knots over the EMTALA case in the Supreme Court today.

Here’s what’s at stake:

So - Part two in Right Lateral Decubitus position.

Remember- Last meal was 14 hours previously. What do you see now?

#BILIH #POGUS Jeff Gadsden Block It Like It’s Hot Podcast

Great to finally meet in person!

#BoardThings : Nitrous oxide should be avoided in MTHFR deficiency because it inhibits methionine synthase ➡️ further increases levels of homocysteine ➡️ increased risk of thrombotic and adverse coronary events.

#MedTwitter #MedEd #FOAMEd #Anesthesiology #Anesthesia

DID YOU APPLY #Anesthesiology in #Match2024 ?

Please fill out our survey. Help us help the Class of 2025 make informed decisions about their applications. Mentors, please distribute widely -->
redcap.bswhealth.org/surveys/?s=NPF…

#TILT : Dural puncture can cause CSF volume loss ➡️ cerebral venodilation ➡️ rare cerebral venous sinus thrombosis, particularly in the setting of thrombophilia (eg labor + Factor V Leiden, APLS, etc)

More: bjanaesthesia.org/article/S0007-…

#MedTwitter #Anesthesiology #OBAnes #FOAMed

Ball-in-valve airway obstruction from a vocal cord polyp

nej.md/3H7eYiJ

#BoardThings : ICU side effects of burn care
- Silver sulfadiazine: Can cause leukopenia and/or methemoglobinemia
- Neomycin: Can be oto/nephrotoxic
- Mafenide acetate: Painful, carbonic anhydrase inhibitor➡️hyperchloremic metabolic acidosis
#MedTwitter #MedEd #CritCare #FOAMEd

Pulm. velocity accel time (PVAT) estimates the severity of PA pressure elevation when TR jets are difficult to analyze. PVAT = time from flow onset to peak velocity. PWD at the PV in this PSAX #TTE shows a PVAT ~ 150 ms (normal is > 130 ms). #echofirst #medtwitter

Rhythm (left, center, right)?

#BoardThings - periop stimuli intensity ranked:
1. intubation
2. skin incision
3. tetanic stim
4. laryngoscopy
5. trap squeeze
6. voice

1MAC=anesthetic concentration that prevents purposeful movement on skin incision in 50% of patients

#Anesthesiology #MedEd #FOAMEd #MedTwitter

#BoardThings : Incredible table from ICU OnePager differentiating serotonin syndrome vs neuroleptic malignant syndrome vs malignant hyperthermia

#MedEd #FOAMEd #Anesthesiology

Original image: onepagericu.com/hyperthermic_t…

Sometimes it can be difficult to determine if a pericardial effusion is causing tamponade... patient has a HR of 110 and a SBP of 85/50. Is this tamponade? (see next for poll) #medtwitter #echofirst #CardioTwitter #pocus #foamed

How to keep an open mind:

1. Think like a scientist: treat your opinions as hypotheses and decisions as experiments

2. Embrace confident humility: argue like you’re right, listen like you’re wrong

3. Build a challenge network: seek out people who sharpen your reasoning

Finding a journal to publish #anesthesiology #research can be tricky, especially one that is free or w/o pricey fees💰.We put together this Excel to help fellow researchers find a journal📚 compatible with their paper, expectations & budget.🤓
docs.google.com/spreadsheets/d…

#medtwitter

this is why adenosine is contraindicated in unstable tachycardia.

20 seconds of asystole is scary but OK for a stable patient.

for a patient on the verge of cardiovascular collapse, 20 seconds of asystole could precipitate arrest.

Lung #POCUS with air bronchograms (yellow arrows) - patent airways amid consolidated lung tissue signaling atelectasis, PNA, etc. Dynamic bronchograms move with respiration while static suggest trapped air (RLL atelectasis seen here caused by a pleural effusion) #medtwitter #ICU