Ultrasound: “no evidence of cholecystitis” Op report: “gangrenous cholecystitis with extremely friable tissue. Purulent drainage with manipulation of gallbladder.” I've seen this many times. Thread 1/

An older man comes to the ED with abrupt onset nausea, & diarrhea He is joined by her daughter whom he is visiting from abroad Testing is below The diagnosis is unclear Until his daughter got just as sick too 🧵 #livertwitter #liverstory #MedTwitter

🔔 Alumni day at our resident conference featuring Eric Blazar, Dane O'Donnell, Adam Brown, MD MBA, and more! 🔔 emresidents Hangouts Live featuring Jefferson EM Residency Wednesday afternoon

PIPERACILLIN-TAZOBACTAM IS NOT NEPHROTOXIC: exploring the arc of a myth over time this was clearly a myth in 2016: emcrit.org/pulmcrit/piper… blog from 2022 exploring the evolution of this myth: emcrit.org/pulmcrit/myth-… fresh RCT to finally settle this: jamanetwork.com/journals/jama/…

I literally had this case in residency. This is why the stroke metrics are hurting patients. Data now shows antiplatelet as equal to lyrics for non disabling stroke. (This pt needs anticoagulant). Rushing to lyrics with questionable benefit hurts patients.

I will put the video of the whole webinar up here when it is ready

A review of the new AHA guidelines for atrial fibrillation 🌟 calcium channel blockers in HFrEF are OUT 🌟 review of the role of magnesium (and over-estimation of level of evidence) Blog/show notes: foamcast.org/2023/12/13/atr… Podcast: bit.ly/47mR8di (or Spotify etc)

1. Medicine is rapidly becoming an expensive hobby- working class people can no longer afford to become doctors given the poor salaries and huge debts on graduation. I am the son of immigrants - I couldn't speak English until i was 5-i was born/ brought up in longsight,

hard cosign: if you’re treating ICP elevation with 3% saline: 🧂safe to bolus peripherally @ 999ml/hr 🧂give a real dose (usually 250 ml) the insanity I’ve seen surrounding 3% over the years is mind boggling (unnecessary central lines, infusions at homeopathic low rates, etc)

In February 2016, three days before residency match lists were due, Dr. Kathleen Crapanzano, the residency PD for Louisiana State University's Psychiatry program, received a surprising email. 🧵.

6 year old Izzy had a post-tonsillectomy bleed at home. She was hypotensive and unresponsive when her Dad called 911. Her Dad happens to be one of our District Chiefs at PBC Fire Rescue . When he called 911 he said “Send the whole blood.” Hearing the 911 call, seeing the emotion from

Kudos to colleagues Rohit Menon and @LeenAlblaihed, quick activation of cath lab on this prehospital ECG led to stents of occluded LAD and 2nd diag; no computer, no AI...just sound knowledge of electrocardiography still saves lives! U of Maryland Emergency Med UMEM Residency #FOAMed

You're working in the ED when a 30 y.o male presents 30 minutes after envenomation to the right index finger by his pet snake (left). He has a picture of culprit (right) , and it is definitely NOT from America. A 🧵on U.S. exotic envenomation management. (shared with consent)

Which vessel? --> pulmonary artery! This was a massive PE. Tough case, but 2 takehome pearls: (1) PE can produce STE, esp. V1, aVR, and III (right side leads), and (2) it is very uncommon for STEMIs/OMIs to produce new right axis; STE + new RAD=PE until proven otherwise #FOAMed

It’s finally out. Please stop giving Paxlovid to vaccinated people. nejm.org/doi/full/10.10…

Patient with a syncope S wave up stroke Will be more than 55 msec in V1 , V2 Which important cardiac pathology you would be concerned of ?

🚨THREAD: Violence against healthcare workers is escalating. This week, another brutal attack took place in a U.S. emergency department. As Editor-in-Chief of Emergency Medicine News, I made sure we covered it—because this is an epidemic we can’t ignore. 🧵(1/6)

Your night shift starts with a 53-year-old diaphoretic male presenting with chest pain radiating to the left shoulder... Is there anything concerning about this "Normal #ECG"? 🤔

Lightheadedness What’s your diagnosis?