The framing for this has always seemed strange to me.
Surgery has a 0% failure rate at preventing recurrent appendicitis (yes if done well) and antibiotics a 44% failure rate.
Unless surgery is strongly contraindicated, appendectomy seems like the right choice.
@nickmmark I do think it has some utility in identifying bacteremic patients - esp if no other source is found and the value is quite positive (>1). Need more research on this but I’ve found the PPV for bacteremia at this level to be quite high.
Independence Day is a reminder that America is not the project of any one person. The single most powerful word in our democracy is the word ‘We.’ ‘We The People.’ ‘We Shall Overcome.’ ‘Yes We Can.’ America is owned by no one. It belongs to all citizens. And at this moment in history—when core democratic principles seem to be continuously under attack, when too many people around the world have become cynical and disengaged—now is precisely the time to ask ourselves tough questions about how we can build our democracies and make them work in meaningful and practical ways for ordinary people.
It is with heavy hearts that we share the passing of Dr. Samantha Garza. In honor of Sam's life, we invite you to donate in her memory to fund brain tumor research. Thank you to everyone who supported Sam throughout her battle. We love you forever, Sam.
https://t.co/UY8r8g4MXD
You would expect international STEMI registries to drive quality improvement.
Unfortunately, incorporation bias leads many to mistakenly believe STEMI is a solved problem—yet patients who are missed never even make it into these registries!
Great editorial on this topic by @matt_bivens
When I’m the on call intensivist, I make it clear to my team that if we’re called to help with critically ill patients, having no available ICU beds is irrelevant
Critical Care is a People, not a Place
Lasix is NOT nephrotoxic 🫘
Please retweet so we can end this myth once and for all 🦄
Rising creatinine is more often an indicator of inadequate Lasix dosing than excessive!!
Lasix can only harm the kidneys if it decreases cardiac output by dropping preload to the point of reducing stroke volume... as someone who scans these patients regularly this is surprisingly rare!
If a patient still has venous congestion (on Doppler), then Lasix is not driving the AKI. Instead, their AKI is from untreated congestion!!
Our article on Sonographic Lavage, using gastric ultrasound in GIB (https://t.co/HY6kmRCswg) was chosen by Probing the Literature, ACEP’s journal club! I’ll be there as this month’s guest host! Hope you can make it!
@smithECGBlog This hurts my soul on so many levels - ED Attending and former long-time paramedic.
FWIW @smithECGBlog this is maybe an area where we some research and work on systems to prevent this from happening. Disbelief in our colleagues in the field can lead to real patient harm.
The most important thing you can do for your team collectively is to understand what growth trajectory each person wants to be on at a given time and whether that matches the needs and opportunities of the team.
NEW on #Trailblazers: Navigating 1st Gen Success
Dr. @MikeGisondi shares his inspiring journey from a working-class background to becoming Vice Chair of Education @StanfordEMED. Discover how mentorship & perseverance shaped his career in medicine. #CME
https://t.co/PxgVgJb6ar