Your periodic reminder that a trauma code is not a medical code. When a trauma patient loses pulses, there are only a few interventions that can save their life. Closed chest CPR interferes with virtually all of them.

If I’m having massive blood loss, why is my hgb 13 mg/dL? Cause it’s a concentration! Immediately after blood loss, amount hgb per volume blood is the same. There's just less blood. BP 70/40, hgb 13 It takes time to reconstitute serum volume and "dilute down" the hgb/dL. 2/8

Nvidia just released free AI courses. No payment needed. Here are 9 courses you don't want to miss in 2025:

(1/3) Blakemore insertions for variceal bleeds might seem daunting but typically are straightforward.. Until they aren't. This is the BEST trick I have seen for challenging Blakemore insertions. Use a bougie to help make the tip of the Blakemore more rigid in the posterior

How I see patients in the emergency department, after 20 years of seeing patients in the emergency department. emupdates.com/how

My EM/FM compadres - wouldn’t trade this crew for anything! #residency #workfam #weekendwarriors

We've all been there: a Saturday on call in the hospital, with a list of 30 patients to round on 😵‍💫 Ward rounding can seem like an endless task - but it doesn't have to be! ⏰ Here are my top 10 tips for ward rounding efficiency 🧵-

When I was a new attending, I worked in a tiny rural ER in the middle of nowhere, Pennsylvania. 24-hour shifts—mostly quiet, sometimes brutal. No CT. No backup. Just me, a few nurses, and whatever rolled in.

(1/x) In fellowship, I managed a peri-arrest patient in the middle of the night who changed my understanding and appreciation for hemodynamics, ultrasound, and TEE. I've seen similar cases dozens of times now, yet this commonly gets missed, even at top institutions worldwide.

Mom sent me this photo from Glasgow. Big fan of public defibrillator booths.

Check out our new EMRA podcast episode on primary care medicine in the Emergency Department: open.spotify.com/episode/1akhfP…

In our latest EMRA*Cast episode, Peter Lorenz, MD, and guest Bobby Ries, MD, discuss low-risk, high-impact interventions can make a lasting difference for your patients from the emergency department. 🎧 Listen here: bit.ly/48bH2An #EMRACast #PrimaryCare #EMRA

neurosurg: WHAT IS THE GCS? me:

Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 JAMA Internal Medicine This is not a "trial" You cannot properly answer this question with observational data because of residual confounding, immortal time bias, and confounding by indication. Can not.

adjusted D-dimer FTW 😃 please note however that if your hospital uses D-dimer units (DDU not FEU), the cutoffs are lower by a factor of 2 FEU: nl <500, adjusted <10*age DDU: nl < ~230, adjusted <5*age this is confusing AF & frankly an error waiting to happen … #1/2

Residency tip: Never confuse workload with learning. You may handle hundreds of cases and treat/sign them out within days - that is workload. Learning is choosing two high-value cases every day, studying them in depth, and if possible; write an article on them. That’s how

Better term is DOACs for Xa inhibitors over NOACs. Why? -They are no longer that “new” or “novel” -Potential source of medical error when note is interpreted as NO AC or no anticoagulation Still recent publications out there using NOAC!