so important & so often done wrong. often see folks putting a bunch of rolls behind the shoulderblades - this pushes the neck into extension 👎

Radial artery cannulation in intensive care unit patients: Does distance from wrist joint increase catheter durability and functionality? journals.sagepub.com/doi/abs/10.117… #WINFOCUS22

30-something woman with a HEART score of zero, EDACS of 2, computer "Normal" ECG, and initial troponin < Limit of Detection hqmeded-ecg.blogspot.com/2022/12/30-som…

you don't want to electrically cardiovert a patient in AFRVR given the embolic risk (say, not on AC, > 24h in rhythm), but then you order amiodarone bolus and infusion...

That feeling of abdominal anxiety as you get the stuff ready for an endotracheal intubation That never goes away just FYI At least it hasn’t after 13 years #pccm

Todays FresnoEM sim

Greetings, #MedTwitter! This is the official twitter account of UCSF Fresno ECMO program. We will periodically be posting ECMO tweetorials as well as sharing consented &/or de-identified patient stories. First tweetorial dropping tomorrow morning. Stay tuned!

Krunal H. Patel ⚕️ nick pulmcrit @cjosephy High LVOT VTI should be expected (or even a "clue") in mod-severe aortic regurgitation. From Blanco's paper in: Ultrasound J 2020; 12: 21 doi.org/10.1186/s13089…

Successful first CCM sim day for the pulm crit fellows!

We’ve extended the deadline for our scholarship for students from “disadvantaged backgrounds” to March 15! Please see below and consider applying!

I ran into a former colleague today whom I haven’t seen in 2 years (while 36 weeks pregnant). He casually says “Hey, what you been up to?!”. I look down at my belly and say “this”. He pulls up his phone and shows me this

Join emresidents ACEP CCM Section @sccm_em AAEM #CCMS, SAEM and others to kick off #EMC3, an umbrella consortium for #EMCCM and hear about what professional organizations representing the specialty can do for you. Register on the EMRA website!

ICU stories (a brief one): A 40+ yo pt w hx of bipolar disorder/asthma/GERD/HTN was brought to the ED by EMS after his wife found him lethargic ("altered mental status"). Apparently, he had spent the previous 2 days isolated in his forest cabin. Upon ED arrival, he was obtunded

Every ECLS center has its #ECMOStories youtube.com/watch?v=OxtUkW… Maura Walsh @civestallman FresnoEM UCSF Fresno

Baby did great at her first sim lab! Proud mama today ☺️

Why is transferring my sleeping newborn out of the car seat one of the most stressful things I've ever done?

remember: PaCO2 > etCO2 targeting etCO2 30-35 will generally put the paCO2 into the 35-50 range (safe) so, the safety of hypercapnia supports the safety of etCO2 monitoring don't phlebotomize patients to fine-tune something that doesn't matter (2/2) emcrit.org/ibcc/co2/

Last day of fellowship but Shelley was eager to hang out in the cath lab for some ECMO

Is there anything better than a satisfying shoulder reduction with just some intraartic lido and some gentle traction ? ED LOS <1 hour I'm gonna ride that high allllll day

Patient arrived to the ED with a known and not unexpected issue post recent surgery and the surgeon Epic chatted me without me calling (I was waiting for labs) about ten minutes into her ED visit! How absolutely wonderful!