STEMI is a failed paradigm

OMI should replace it

New OMI patterns are expected, as the more recent South African flag sign (1st LAD diagonal occlusion) or Aslanger pattern (is.gd/DzYfD8)

PMCardio App may help (no COI)

Contortions To Stop The Gyrations Network meta-analyses are all the rage, vertigo edition.

What's the best maneuver for stopping peripheral vertigo?

Did you even know there were so many???
#medsky
www.evidencetriage.com/p/contortion...

Drainage Course at #EASClub with dr Allegri

Chest Drainage #bedsidepearls

🚫 Never close the drainage tube during pt transport

🩸Haemothorax ➡️ 28-32 Fr tube

#bedsidepearls in Chest trauma

🩻 Severity of chest wall injuries ➡️ RivScore

🫁 Severity of pulmonary contusion ⬆️ significantly when contusions are >20%

#bedsidepearls via #EASBergamo #whiteboard

Brnchodilation during #NIV

At 2nd NIV EUSEM Certification Course, Lisbon April, 10-11

#NIV Indications at 2nd NIV Certification Eusem Course in Lisbon

@Paolo Groff
@Rodolfo Ferrari
@Patrick Plaisance

NIV Certification Eusem Course in Lisbon, April 10-11

⏱️ The golden hour of NIV influence prognosis

via @Patrick Plaisance

Flying to Lisbon for our 2nd NIV Certification #EUSEM Course, April 10-11

Interactive Case scenarios to boost your competence on ARF patients to treat with

HFNC

CPAP

Bi-Level

Folks are really good down here at avoiding unnecessary radiography in kids — the most unusual misalignment of practice I’ve had recently are plain c-spine x-rays in older adults.

If you care enough to order the test, you should care enough to order a test that actually answers your question ….

Such fun to work together @rob-cosentini.bsky.social! And so cool to share ideas beyond medical knowledge.

Pediatric front of neck access (the surgical tracheotomy) Case It is the scenario of nightmares: a young child with an airway obstruction. They came in with stridor, and although you were initially thinking severe croup, the story doesn’t quite fit, there is no response to medical therapy, and this patient is incredibly sick. There is significant hypoxemia despite a nonrebreather. You can’t wait for backup, so you proceed rapidly to RSI.

Pediatric front of neck access (the surgical tracheotomy)
An approach to the can't intubate can't oxygenate scenario in children #FOAMed

Chest pain at triage #bedsidepearls from MEU School Unimi at Albino

🫀Do ECG, always

🧪 Do troponin, unless a specific diagnosis can be excluded at triage (eg: PTX via Echo)

Eating Disorders - Common, Commonly Missed, Misunderstood | EM Cases Recognition, management of eating disorders in emergency medicine; why eating disorders are missed, pitfalls in assessment and management on Emergency Medicine Cases podcast

Eating Disorders #bedsidepearls via @emcases.bsky.social

🧬 Genetic disorder, trigger by precipitating factor

⚖️ No weight threshold

➡️ Best follow ⬇️ over time

Adolescents:

🫀Bradycardia/ortho hypotension:

⚠️ severity signs ➡️ Admit 🏥

emergencymedicinecases.com/eating-disor...

Chest Trauma #bedsidepearls

1️⃣ Identify fatal lesions
ATOM-FC

2️⃣ Evaluate Severity
TTS & RibScore

3️⃣ Treat accordingly
🩸MTP
💉 Chest Tube
🔪 Emergency Thoracotomy

#bedsidepearls on Multiple Myeloma at #EASClubbergamo via Dr Alessio Marra

1️⃣ 🩺 Clinical

🩻 Thoracic vertebral lesions may manifest only with abdominal symptoms

🦴 Bone lesions may ensue when MM is otherwise asymptomatic

2️⃣ 🧠 Mental

⚠️ Don’t fix on 1st diagnosis

🎛️ Take control of your reactions

Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses One year after the deployment of ambient artificial intelligence scribes, The Permanente Medical Group in northern California reports rapid growth in physician usage, highly positive experiences am...

How to incorporate #AI into daily clinical practice

⏱️ Closer than 6 months ago

🛣️ Still a long way to go

Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses | NEJM Catalyst catalyst.nejm.org/doi/full/10....

EMCrit Q&A - Episode 001
Industry involvement? Vasopressor choices in PE and more...
emcrit.org/qa1

Violence pathway at our #EASClubBergamo via Antonella Mangili & Renata Colombi

⚡️ Rising tension

🧠 Deliberate violence

💧 Loving contrition

🔁 Ripetitive

#bedsidepearls

Blood from an MDMA intoxicated patient seen in our ER by IM PG 4 @giacomo de luca

☠️ Methylene blue in methemoglobinemia
From clinical pharmacologist Pharmacy Joe —> pharmacyjoe.com/episode1009/

💉 1–2 mg/kg IV over 5 minutes of methylene blue immediately if levels indicate administration

⏱️ After treatment, MetHb levels on blood gas (ABG) are no longer reliable

#bedsidepearls

My barbers shop in front of Colonne di San Lorenzo, downtown Milano

If this isn’t nice, what is?

2/2

5️⃣ you’re always a role model ➡️ Your actions speak more than your words

6️⃣ Behavioral deviation? ➡️ Set boundaries & pathways

7️⃣ It’s okay to say ‘I don’t know’ ➡️ Be humble & ask questions

8️⃣ Align with people’s motivation ➡️ vision + results + relationship make the difference

147. Your First Leadership Role? Start With These 8 Principles - Orman Physician Coaching Leadership is hard. Here are eight ways to do it better (without losing your mind).

Leadership pearls via @roborman @stmuluspodcast —> t.ly/hqzHj

1/2

1️⃣ Listening is key to Lead

2️⃣ Prioritize. Not all problems need an urgent response

3️⃣ Vision + Patience + Respect are key to succeed

4️⃣ Be ready to judge, even if you don’t like it

Bi-monthly Simulation at #EAS Club Bergamo

☠️ Organophosphate intoxication of patient, paramedic and Team leader

🏁 Great challenge for our EM residents

🏥 Look at our group activities —> easclubbergamo.wordpress.com/attivita/

My two teaching mantras:

“You were not made to live like brutes, but to follow virtue and knowledge.”
Dante Alighieri, XIV century

“One should not teach thoughts, but teach how to think.”
Immanuel Kant, XVIII century

Dyspnea #bedsidepearls

3️⃣ signs of respiratory distress:

# 1 tracheal tub, inspiratory

# 2 jugular retraction, inspiratory

# 3 supraclavicular retraction, inspiratory

a monkey with goggles and headphones says i have spoken ALT: a monkey with goggles and headphones says i have spoken

If you provide the 95% CI, you don't need to supply a p-value with it.

Time to teach 100 million users: ChatGPT 2 months TikTok 9 months Instagram 30 months

Day 1 of AI Master in Clinical Medicine at University of Torino via Prof. Gaetano de Ferrari

📊 Data is the most valuable resource

🤖 ChatGPT spreading is supersonic

🫀AI proved effective in cardiology

Cancer detection: Dermatologists vs AI AI shows better AUC ROC Curves than clinicians

2nd day of AI Master in Clinical Medicine at University of Torino via Prof. Gaetano de Ferrari

AI Anatomy

AI application in clinical medicine

AI and images

AI may outperform clinicians at interpretation of images (see picture 3)

Empirical Evidence of Bias Objective.  —To determine if inadequate approaches to randomized controlled trial design and execution are associated with evidence of bias in estimating treatment effects.Design.  —An observa...

Interesting article on biases in RCTs based on methodological quality. jamanetwork.com/journals/jam... #MedSky