Finally, as a trauma surgeon, I have to point out one of my favorite teaching points: The flow rate of a 16 G IV is **twice** that of an 18 G IV. So the difference between those two IV's may not sound much at first, but it makes a big difference for major resuscitations. ⬛️

everyone please look at your fingers and admire them!! they are yours!!! don’t lose your fingers over a silly decision today… sincerely, an ER doctor on July 4th

We don't need to debate whether it's better to be a generalist or a specialist. The world needs both. Specialists excel at zooming in. They see the details to deepen our knowledge. Generalists excel at zooming out. They see around corners to broaden our view.

Once again: a🧵about 🧵's It's been about a year since I last posted these, but for the new folks, here is a collection of links to each of my 🧵 about surgical sutures. 9 of these are about suture types and the other 3 are miscellaneous suture-related topics. ⬇️(1/ )

A few years ago I was in a position to do something unique in neuroscience. I had been working with the phenomenal Emily G. Jacobs 🦋 @emilyjacobs.bsky.social on menopause and inspired by Laura Pritschet's menstrual study, and I was planning a pregnancy. What if we scanned my brain?? nature.com/articles/s4159…

The actual function of a roomba is to force you to pick up all the shit that you have lying around that is potentially obstructive to the roomba

(1/x) Treating patients who are fluid responsive with IV fluids is kind of like using a credit card 💳 It definitely works (in the short term), but be careful. The debt that accumulates eventually needs to be paid off. A 🧵 #medtwitter #foamed

Think private equity doesn’t affect you? Think again. It's taking over EDs, leading to longer wait times, surprise bills, and rushed care. As Robert McNamara and others warn, corporate investors—not doctors—are calling the shots: vox.com/health-care/37…

In September 2024, the American College of Obstetricians and Gynecologists released an updated guideline on RhIG and spontaneous/induced abortion before 12 weeks. Here's the gist: -Rh testing is not necessary -RhIG prophylaxis not indicated The why: -Previous studies were

(1/x) The term 'pre-renal' acute kidney injury is dated and should stop being taught in medical schools. Why? The term pre-renal is inextricably linked to the idea that the treatment of pre-renal AKI is IV fluids. Here's the paradigm of hemodynamic AKI and why it is helpful. A

A media blitz has been going on to demonize Doctor salaries. It's obviously funded by the Healthcare-Pharma Complex, to deflect blame onto Doctors for high Healthcare costs. It is the worst kind of gaslighting against doctors, because the exact opposite situation is true.

🌙 White noise can improve sleep—but the frequency may matter. A study found that a specific mixed-frequency blend protected sleep in a noisy environment—restoring arousals and deep sleep to baseline levels. So I recreated it for you. 👇 🧵 1/12

Rural hospitals aren’t a relic of the past—they’re a lifeline. They’re the only thing standing between life and death for millions of Americans. You can’t “disrupt” or “innovate” your way out of needing boots-on-the-ground medicine.

No one told me adulthood would require this much multi-factor authentication

It's official. For acute stroke treatment, Alteplase (tPA) is out, and Tenecteplase (TNK) is in. But why? And more importantly, why is it called TNK when there’s no “K” in Tenecteplase?? 🧵

🧵regarding the technique of 2-handed knot tying. It's July again, so it's a good time to revisit this 🧵. 2-handed tying is becoming a lost art in surgery, but I believe it is worth learning. We'll start with just the basic steps. Advanced concepts will come later. (1/)

I tell my older patients who come to see me with osteoarthritis related pain or functional limitations: “We trade wisdom for arthritis.” They get it. We have a good laugh. But the idea is to normalize it. We all get it as we age, and we can find a path forward.

My adderall being washed down with a nice crisp alani nu

Someone just coughed on you. You were on a crowded flight. Now your coworker is sick. The window to prevent infection is narrow. Here’s exactly what to do in the critical hours after a high-risk exposure 🧵1/13