Interesting! Thanks for sharing

Reminder for clinicians: we aren’t obligated to perform interventions that are futile.

This includes CPR

If your patient’s death is inevitable and interventions to prevent it are at maximum, CPR is futile.

It only harms the patient.

Make your patient DNR, despite what the family says.
Its humane

It looks like theyre playing inside an orange juice container

Non-conventional DKA pearls (that should be):

- Start glargine in the ED (don’t wait until the gap closes)
- Scrap the NPO dogma
- Use LR instead of NS, and don’t drown them in 7 liters of fluid

These tips will shorten length of stay and improve HCAPS scores 🦋

Isnt it a vulnerability thing? Like he is showing he is submissive to you

Well said

That was an early question based on a small study but a later more robust study showed that wasnt the case

The data is so strong, it is a shame the conspiracies seem to have won.

The good doctors and scientists aren’t as loud and dont get as much engagement as the grifters. Really the only reason for it

I saw >1000 unvaxxed Covid patients die of Covid.

It was a tragic time for me personally and the world. I hope it never happens again

Regarding data, a hierarchy exists - at the top is randomized, multicenter, placebo-controlled trials.

Plenty of these confirm vaccine safety and efficacy including for Covid-19

However, most folks can’t relate

So I offer an anecdote- I never had a fully vaxxed Covid patient die

Really gaetz me going

Friendly reminder:

Patients don't need to be strictly NPO after midnight for a surgery the next day. The humane and guideline based best-practice?

Clear liquids after midnight until 6 for an OR time of 8

🙏

If you own bitcoin or any cryptocurrency, be fearful when others are greedy.

If you don’t own any cryptocurrency- don’t start now when the hype cycle is at max capacity. You’ll be exit liquidity

Hopefully will prevent a ton of discharges with PICC lines that end up getting infected and prolong the duration of antibiotics that way

This is great thank you

GM partner

As with any support mechanism in the ICU- the level of support and trajectory of said support is very important when it comes to decision making.

This helps for risk stratification for surgeries.

A patient with a femur fracture was on 2 mcg/min for UTI with septic shock after being on 20 mcg/min the previous night.
This urgent surgery was delayed 2 more days as a result.

I didn’t hesitate to encourage the surgeon to take her, however.

Being “on pressors” is not a universal signal of imminent mortality. It constitutes a spectrum.

- The patient that was on 50 mcg/min of norepi last night and now on 2= not very sick

- The patient on 20 mcg/min of norepi and not responding after just initiating it- alarm bells should go off

Really is a breath of fresh air!

Even some doctors and nurses fall for RFK’s disinfo.
Their cult overrides their medical training

Its all irrational

What’s your biggest pet peeve in medicine?

Mine- contrast is not nephrotoxic, let’s get the appropriate imaging done for the patient 🫂

Welcome!

Covid vaccine data:
Multiple randomized, placebo controlled trials involving different countries and well over 30,000 patients. Then rigorous peer review and post-marketing studies. No other drugs are studied this extensively

RFK Jr: “I’m not anti-vaxx, but they need to be studied more”

I add a couple of people every day but there are many more of you who work with critically ill patients. Drop a comment here and I'll add you! But check to see if you're already on it first 😁 go.bsky.app/NC7iD2K

This is great! Thank you

This is great! Thank you

💯