John McNamara

EM Attending, lover of FOAMed & Prehospital Medicine & Creator of the BuffEM Podcast - Tweets are only representative of my thoughts /opinions.

[Dallas Holladay, DO (she/her) @Dallas_Holladay]

Every physician who manages transfers at an urban tertiary care center needs to work at a critical access hospital two weeks a year.

[John McNamara @1stJohnnyMac]

@CoffeeBlackMD Seems to work fine.... https://t.co/nPWZunwLH1

[Cliff Reid @cliffreid]

ED Patients (non pregnant <65 yrs) With Severe Agitation - ACEP policy

Use droperidol/midazolam combo

If a single agent → droperidol

If no droperidol → atypical antipsychotic (eg olanzapine)

When safety calls for immediate sedation → KETAMINE

https://t.co/8jECiyALrV

[Josh Farkas MD 💊 @PulmCrit]

fixed this for you.

if you’re worried about nephrons then be cautious with the IV ketorolac & vancomycin… not the contrast.

[John McNamara @1stJohnnyMac]

@BrooksWalsh Or https://t.co/PWIUsmsVyX

[John McNamara @1stJohnnyMac]

@BrooksWalsh Maybe not https://t.co/mWxjQLWOp2

[Josh Farkas MD 💊 @PulmCrit]

@iceman_ex elevation in lactate means the epinephrine is working.

lactate is a fuel for the heart.

unless there is profound/refractory metabolic acidosis, would continue with epinephrine.

blog:

https://t.co/I49OkzvPJ3

[John McNamara @1stJohnnyMac]

https://t.co/tbhF529FNh @drochohan @ChengaziMD @DrChrisNicholas @ImagingDoctor

[John McNamara @1stJohnnyMac]

@MicieliA_MD @MedFactChecks Personally I try to involve the patient in defining what is disabling to them during a risk benefit discussion if possible, usually seems to work well.

[John McNamara @1stJohnnyMac]

@MicieliA_MD @MedFactChecks Unfortunately the definition of non-disabling is not uniform in practice.

[John McNamara @1stJohnnyMac]

@MicieliA_MD @MedFactChecks https://t.co/8HG0dEWsKm

[John McNamara @1stJohnnyMac]

@rob_cosentini @amalmattu So then... ⚡?

[John McNamara @1stJohnnyMac]

@BrooksWalsh Maybe after the MRI?

[John McNamara @1stJohnnyMac]

@BrooksWalsh But that image is a CT...

[John McNamara @1stJohnnyMac]

@jem_journal @aaeminfo Now that the answer's up - didn't want to be obvious - actor that voiced optimus prime - Peter Cullen.

[John McNamara @1stJohnnyMac]

@jem_journal @aaeminfo

[John McNamara @1stJohnnyMac]

Trying to find if there's any evidence base for giving prophylactic levetiracetam for traumatic SDH. Not coming up with much @TheSGEM @srrezaie @docbotjeffrey @EMNerd_

[Josh Farkas MD 💊 @PulmCrit]

your daily reminder to give steroid to patients with severe CAP

[John McNamara @1stJohnnyMac]

@RadDrDuke @jaygirimd @AustinBourgeois @CHICKVIR @SIRspecialists @TheSGEM Also, would need some criteria, can't doppler and cta all COPD exacerbations.

[John McNamara @1stJohnnyMac]

@RadDrDuke @jaygirimd @AustinBourgeois @CHICKVIR @SIRspecialists @TheSGEM Not sure that's truly representative - many exacerbations treated in PMD or urgent care, probably selection bias with ED patients who are you presumably a majority of the cohort.