First we had an emergency room. As we provided more and more services, we grew into departments with dozens of beds. Now all our beds are filled with inpatients and we once again have a single emergency room - one that we used to call the waiting room.

Reminder that Paxlovid is not a miracle drug, nor is it for everyone. If someone is under 60 and doesn't have any health problems, they definitely shouldn't be prescribed Paxlovid... Regardless of vaccination status.

Think you know the culprit? Send your guesses to [email protected]📩to be part of episode 18! 💀🤖 #FOAMed #FOAMcc #TwitteRx #MedEd #pharmacy #Nursing #medicine #MedStudentTwitter #EMS #MedTwitter #podcast #EmergencyRoom #EMS #EMRx #Twitterx #toxtweets #toxicology

Tomorrow is NYE, there will be partying, pills, and powders. Some leading to overdose. I work in the ER NYE/NYD & expect a few "OD's" from said pills n powders. What exactly is in them? A 🧵from Camden, a VERY human 28 y.o male, on the illicit drug supply #MedED #FOAMed

Stop the press! Our latest guideline: when to use dialysis for ethylene glycol poisoning. Perhaps our best paper yet. Hundreds of articles included, thousands of hours of work. ccforum.biomedcentral.com/articles/10.11…

Summary of evidence for tranexamic acid (courtesy of Mark Ramzy, DO, EMT-P)

#NewBrunswick is the only jurisdiction in North America without affiliation to a Poisons Centre. This limits advice to the public and first responders. @nb_docs Horizon Health Network @IWKHealth CBC New Brunswick Michael K Howlett MD CAEP Time to eliminate this risk and join infopoison.ca/centre/atlanti…

Sodium glucose co-transporter 2 inhibitors (SGLT2-I) can cause a life-threatening complication called Euglycemic Diabetic Ketoacidosis (euDKA). 👇⛈️🧠

What are the potential downsides of getting a URINE TOX in an emergency patient? Talking with two residents last night, a junior and a senior. They had not been exposed to this idea. I gave some thoughts, would love to hear the crowd Ryan Marino is on BlueSky @clairezagorski the corgi from cowboy bebop

Studies suggest that anaerobic bacteria may not play a major role in the etiology of aspiration pneumonia? CAP guidelines recommend against starting anaerobic coverage for those patients unless they specifically have a lung abscess or empyema. #AspirationPneumonia

Just a reminder that a trauma code and a medical code are not the same. When a trauma patient loses pulses, there are only a few interventions that can potentially save their life—and closed chest CPR interferes with virtually all of them.

With consent. The tremor of alcohol withdrawal is postural and easy to miss if you only examine at rest.

Which vasopressor should you use post ROSC for OHCA? #UWashEMS isn't ready to commit, but there were definitely differences between the Epi and Norepi cohorts. doi.org/10.1080/109031…

Urine drug screens almost never change management (or, if they do, they shouldn’t) and we should stop their routine use.* *in the primary care/OTP/OBAT setting. What you tox folks do in the ED is between you and your god.

“Dimenhydrinate is actually diphenhydramine combined with a theophylline derivative intended to counteract sedation. But that didn’t work so they marketed it for motion sickness instead, and now it’s a go-to for nausea despite being mostly hot garbage.”

Closing the xylazine knowledge gap: Editorial by Bob Hoffman MD tandfonline.com/doi/full/10.10…

🆕️⚡️⚡️ AJHP Intravenous push antibiotics in ED decrease the time from ordering to the start of administration and result in significant cost savings compared to IV piggyback #IDXposts academic.oup.com/ajhp/advance-a…

Resuscitation before intubation for shock patients is the only way. This goes for medical and trauma patients alike. It is no longer acceptable for patients to code on induction because “Airway, Breathing, Circulation”.