shreeram shetty.I

Indian.🇮🇳
Emergency Medicine
Live and let live
Forza Juve.

[Dr M Shujat Rasool @DrMShujat]

Med student came to me with this CBC and asked: "Sir, is this bacterial or viral?"

Here’s how I broke it down. Forget memorizing. Use a 4-step approach.

STEP 1: LOOK AT WBC FIRST

[shreeram shetty.I @DRJUVE19]

@albertoortegana @drobiy12 CHB?

[Haney Mallemat @CriticalCareNow]

Three pressors in and the MAP is still tanking — did you check calcium and pH before escalating?

Sara E. Crager, MD (@teachicu) from ResusX:ReUnion:
Hypocalcemia and acidemia blunt every vasopressor you've got. What's your next move at the bedside? Comment to discuss.

[Rishabh @Rixhabh__]

1. Personal Market Analyst

“Act as a professional stock market analyst and analyze the following stock based on fundamentals, financial ratios, business model, management strength, competitive edge, and long-term potential. Present your findings clearly. Stock: [name].”

[Chidanand Tripathi @thetripathi58]

STOP TELLING CHATGPT TO “MAKE IT BETTER”

Most people use weak prompts and get weak results

Use these instead and watch what happens:

[Chidanand Tripathi @thetripathi58]

STOP TELLING CHATGPT TO “SUMMARIZE THIS”

That’s why you get robotic, lifeless notes.

Use these 7 prompts for summaries you’ll actually use :

[CardiovascularCorner @TrackYourHeart]

The minimum ST elevation criteria for diagnosing STEMI in limb leads is:
a) ≥0.5 mm in 2 contiguous leads
b) ≥1 mm in 2 contiguous leads
c) ≥2 mm in 2 contiguous leads
d) ≥3 mm in 2 contiguous leads

[Dr. Nikhil @DrNikhilMD]

🧵 THE ULTIMATE VASOPRESSOR + INOTROPE ICU MASTERCLASS

🚨 Shock kills fast. Choosing the wrong pressor kills faster.
Choosing the right one saves a life instantly.
This is the thread every resident, intern and ICU doctor should read today.
#MedTwitter #CriticalCare #FOAMed

[Osgenic @osgenic]

When performing an emergency surgical airway, the decision-making is the essential step. After the decision, there's no time to look for resources, only for executing a technique learned in advance.

#trauma #cricothyrotomy #coniotomy #orthotwitter #orthoX #meded

[Arnel Carmona @ecgrhythms]

11/18/2025

Slow VT showing AV dissociation, fusion and capture beats. I hope this media works.

[Leaders 𝕏 Junction @LeadersJunction]

I didn't want to run today. Then I remembered what a champion once said...

[Ashutosh Singh @AshutoshSinghMD]

🧵 COMPLETE ECG CRITERIA — THE MASTER THREAD

How do you diagnose LVH in LBBB, RVH in RBBB etc. ?

Lets revise the brain-twisting but exam-friendly, clinically-useful ECG criteria made simple for ECG freak MBBS & MDs👇1/10
@DrAkhilX @anujtiwari11
#MedTwitter #cardiotwitter #ECG

[Ahmed Mohsen @drahmedmohsen85]

🚑 Simple way to differentiate types of shock — no Echo expertise needed!
1️⃣ Get Apical 5-chamber view
2️⃣ Place PW Doppler in LVOT (1 cm above AV)
3️⃣ Trace LVOT VTI
4️⃣ Follow the algorithm based on VTI 📉📈

Ref: https://t.co/m009o66qau

[Mastering the Differential 🩺 @MTD_MED]

Spiked Helmet Sign — ECG

A pattern where the baseline slowly rises before each QRS complex, forming a helmet-shaped upward dome with a spike on top.

It looks like the tracing is being lifted upward before every beat.

What it indicates

👉 Impending death / critical illness
It is seen in severely ill ICU patients and is associated with very high mortality.
Most common underlying conditions:

Acute abdominal catastrophes
Bowel ischemia
Bowel perforation
Ileus
Bowel obstruction

Sepsis

Intrathoracic catastrophes
Pneumothorax
Respiratory failure

Mechanical ventilation with high positive pressures

Mechanism

Not a cardiac problem.

It’s due to synchronous upward movement of the chest wall or diaphragm with each heartbeat, creating pseudo-ST elevations.

The “helmet” = artifact caused by:

Abdominal distension

Diaphragm traction

Severe respiratory distress

Ventilator dyssynchrony

Key point for exams

📌 Spiked helmet sign = artifact seen in critically ill septic or abdominal-catastrophe patients, associated with extremely poor prognosis.

Not a myocardial infarction.

[TA✨ @DrPharmDMDTh]

What causes this

[shreeram shetty.I @DRJUVE19]

https://t.co/kElqsGj6Ub

[Josh Farkas MD 💊 @PulmCrit]

New blog: Fresh dueling guidelines about post-arrest care from the AHA & ESICM

💔 BP & O2 targets
💔 Who needs emergent cath?
💔 pan-CT scans
💔 temp targets
💔 neuroprognostication

Which guideline do I love? 😍 You'll have to read the post to see

https://t.co/pvURD9zg53

[shreeram shetty.I @DRJUVE19]

@DrAkhilX Right main bronchus intubation