Joshua Madden, MD (@josh_emncc) 's Twitter Profile
Joshua Madden, MD

@josh_emncc

Midwest gent
PennEM Chief Resident
#NeuroEMScholars
Incoming Penn Neurocritical Care fellow 25-27
#EM #EMNCC #NeuroCrit #Sim #MedEd #POCUS

ID: 1036065281603457027

calendar_today02-09-2018 01:36:27

141 Tweet

89 Followers

349 Following

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

link.springer.com/article/10.100… I find this diagnosis both fascinating and alarming. I’m happy that the research on this phenomenon is steadily growing.

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

New level of respect and admiration for neuroradiology. I’m currently spending elective time with Penn Radiology , learning and growing scan by scan. I thought we worked hard in the ED, but boy do these folks grind! #newfoundpatienceforradreports #NCC #neurorads #EMCC

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

ā€œAs an EM doc, I play a key role in stroke codes. As a neuro enthusiast, I’m often confused when neuro docs ask for CTP in patients <6h from stroke onset, especially since the literature doesn’t support it. Stroke docs, why CTP <6h?ā€

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

pubmed.ncbi.nlm.nih.gov/34844423/ No benefit within 6h of stroke onset (functional outcome nor EVT treatment efficacy) Not to discount its utility, but do you think CTP will become obsolete regardless of time, as the field moves toward EVT in pts w/ LVO and large core infarct?

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

If you’re intubating a pt with status asthmaticus and tachycardia tachycardia, which induction agent are you reaching for? Ketamine or Etomidate or Propofol? Why? What heart rate would make you lean away from ketamine?#EM #ICU #Pulmcrit #EMCrit

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

Are there places to check out lectures by some of our great NCC social media educators???šŸ‘€ #NCC #NeuroCrit #stroke #TBI #ICUpharm

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

Is there some crazy interaction with combined stimulant and opioid ingestion? So far, in every CHANTER syndrome case I’ve seen, the UDS is positive for both amphetamines or cocaine with fentanyl. Have you all seen CHANTER Syndrome? #neurorads #Neurology #NCC #neurocrit

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

pubs.rsna.org/doi/epdf/10.11… Most case reports I see have two common lab findings, very similar to what I’ve seen. UDS: fentanyl + stimulant CK: elevated #CHANTERsyndrome

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

Saving a life with no patient history, labs, or prior imaging is a different challenge. It’s all about intuition, quick reflexes, and thin-slicing, while applying evidence-based medicine in real-time. #SavingALifeFromScratch #EMCrit #EM #Resus

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

facs.org/media/vgfgjpfk… Neurotrauma is truly fascinating—from its complex pathophysiology to the vast landscape of research and the incredible collaboration across specialties! šŸ§ šŸšØšŸš‘ #Neurotrauma #NCC #EMCC #TBI #trauma #NSGY #NeuroResearch #Collaborationā€

Cliff Reid (@cliffreid) 's Twitter Profile Photo

🧵 Managing Challenging Behaviours in Resuscitation Teams: A Thread for Team Leaders (1/13) Every resuscitation team leader can face difficult team dynamics Here are 6 key challenging behaviours you'll encounter and how to manage them effectively in real-time 🚨

🧵 Managing Challenging Behaviours in Resuscitation Teams: A Thread for Team Leaders (1/13)

Every resuscitation team leader can face difficult team dynamics

Here are 6 key challenging behaviours you'll encounter and how to manage them effectively in real-time 🚨
Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

Neuro resuscitation question: Is there ever a role for vasopressors in a patient with concerns for acute stroke needing intubation and sedation but subsequently becomes hypotensive to meet sedation goals? What if giving fluids and changing sedatives doesn’t help?

Anthony DiGiorgio, DO, MHA (@drdigiorgio) 's Twitter Profile Photo

To be comfortable as an attending physician one must have spent a lot of time being uncomfortable as a trainee. Making training comfortable means a lot of discomfort when on your own.

Joshua Madden, MD (@josh_emncc) 's Twitter Profile Photo

Having non-EM physicians frequently ask me if the Pitt is a real representation of the ED, followed by man that’s crazy! Lets me know that non-EM docs have zero clue what we do or go through. The Pitt has opened up consultants minds and is changing consultation culture.