Day 3/9 Pt had surgery at tertiary hospital 4 days ago and comes to your hospital with post op abscess vs seroma able to be drained by IR at your smaller rural hospital 3hrs away Do you keep pt and manage and notify surgeon at dc or attempt transfer immediately? #RuralMed

Day 4/9 questions Do you routinely treat campylobacter diarrhea with antibiotics? What if it is already resolving on its own?

Day 5/9 questions #CommunityMedicine ED requests admit for severe AKI, Cr 10 (b/l 1.3), mild acidosis with bicarb 18, K wnl, no uremic signs/symptoms There is clear hx of hypovolemia There is no renal coverage for the week? No acute indication for HD, do you…

Day 5/9 questions How do you decide between Milrinone vs Dobutamine for cardiogenic shock? With what data? #CardsTwitter #HospitalMedicine

Day 6/9… No questions, on call. Mid service fatigue setting in Who else is on call this Saturday?? If #IMResidents have questions about community medicine or private practice, ask your questions below and I’ll try to answer! #HospitalMedicine

This is a great set of questions about community practice, many of which make people fearful of joining a private group. Let me try and address each question 1. Do I use POCUS? No, didn’t get skilled w/ it in residency to use. Have a colleague who uses routinely

Day 8/9 How do you approach hyponatremia as limiting factor for decongestion in heart failure? #CardsTwitter #NephTwitter #DiuresisJedi

Day 8/9 questions Pt w/ recurrent syncope, numerous admit for workup over the last yr (8!) No obvious findings beyond frequent PVCs, ILR in place Do further inpatient or observation admissions add to care? How do you counsel patient and family? #PrimaryCare #CardsTwitter

Am I cool now, @AaronGoodman33?

Just because a pt is physically in the hospital does not mean they need telemetry monitoring Just because a pt is requiring oxygen does not mean they need continuous pulse oximetry

20 meta-analyses of the same four RCTs x.com/Xudong1966/sta…

Too many urinalysis get ordered in the emergency department without a valid clinical indication. I said what I said.

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