Dan Rolston

System Chief Emergency Medicine Critical Care @NorthwellHealth. Interests: Resuscitation & Improving ED critically-ill outcomes, running, family!

[AnnalsofEM @AnnalsofEM]

Every second counts in cardiac arrest.

This study found that retaining EMS equipment for initial ED rhythm analysis was associated with substantially shorter times to both rhythm analysis and defibrillation in patients with OHCA.

Could a simple workflow change help teams deliver lifesaving care faster?

Check it out at https://t.co/Zx6l9DUv6J

#EmergencyMedicine #EM #CardiacArrest #OHCA #CPR #Resuscitation #EMS #EmergencyDepartment #Defibrillation #FOAMed #MedED #MedTwitter

@Dr_DRoll @danieljafari

[AnnalsofEM @AnnalsofEM]

Could we detect ROSC without stopping CPR?

Arterial Doppler During Chest Compressions to Detect Arterial Pulsatility Annals of Emergency Medicine

In this ED study of 44 cardiac arrest patients with arterial lines, researchers recorded Doppler waveforms during active chest compressions and compared them to arterial line pulsatility at the next pulse check.
For detecting arterial pulsatility:
• Sensitivity: 97.7%
• Specificity: 81.5%
• Accuracy: 88.9%
A minimal-flow Doppler pattern strongly predicted absence of pulsatility.
This was a small single-center study with experienced operators, but it suggests Doppler during compressions may help identify arterial pulsatility, raising the question of whether future tools could help detect ROSC without interrupting compressions.

#EmergencyMedicine #EM #CriticalCare #Cardiology #MedED #MedicalEducation #FOAMed #EBM #MedicalJournal

[AnnalsofEM @AnnalsofEM]

Can Doppler ultrasound waveforms during CPR help predict return of arterial pulsatility?
A new Annals of Emergency Medicine study suggests they can — with strong diagnostic accuracy.

Read more in Annals of EM. https://t.co/2VtFlGiN9q

#AnnalsOfEM #EmergencyMedicine #EM #ER #EMDocs #Ultrasound #Resuscitation #CardiacArrest #POCUS #MedED #MedicalEducation #CriticalCare #FOAM #FOAMed

[Daniel Jafari @DanielJafari]

Arterial line placement during cardiac arrest in Emergency Department is feasible and highly successful! Very proud of our star MS1 @HofstraU @ZuckerSoM Michelle Akerman, leading author on our letter to editor @ResusJournal reporting our experience @NSLIJ_EM @Northwell_EM

[Dan Rolston @Dr_DRoll]

Free access to our paper showing left of sternum compressions associated with higher arterial line systolic blood pressures than guideline-recommended lower half of sternum compressions in select ED cardiac arrest patients. @DanielJafari @sonoattheshore https://t.co/u7bCNffM53

[Dan Rolston @Dr_DRoll]

@BenjaminAbella Congrats Ben!!! Welcome to NYC!

[Daniel Jafari @DanielJafari]

Incredibly happy to share our results which we hope would inform future pandemic preparation. @Dr_DRoll @Northwell_EM @NorthwellHealth @NSLIJ_EM

[Critical Care Medicine @CritCareMed]

#VisualAbstract courtesy @caro__holland @wakeforestmed

Gondhalekar et al: Should Transport Ventilators Be Used in Times of Crisis?
🏥single healthcare system New York🗽
#COVID19 #ARDS pts #mechvent

Link: https://t.co/8ZVE6WaWTM

#CritCareMed @SCCM

[Dan Rolston @Dr_DRoll]

Free access to our recent study in @AnnalsofEM. Right ventricular "bubble time" ≥40 seconds after saline flush has high sensitivity 0.97 and specificity 0.87 for detecting right ventricular dysfunction on comprehensive echo. https://t.co/UV9kpqlqns @sonoattheshore @Northwell_EM

[Mel Herbert @MelHerbert]

Today I leave twitter (X). I do not do so lightly. I have been on this platform for 16 years and enjoyed the people and the conversation. I fear now that X can no longer tell the difference between free speech and hate speech. For me the last straw was reinstating Alex Jones, a man who not only goes into a theater and yells fire. He goes into the theater, after there has been a fire with 26 dead and screams that “there are no dead”. The doctors are lying, the nurses, the paramedics, the police and the families are all lying. Not only is he let back, he is treated as some free speech warrior, a man above reproach, a cure to the corruption in the system. He is nothing but a con man and destroyer of lives. While our colleagues washed the blood of 26 children and their teachers off their hands, after they did all they could to save their lives, this man called out his army to destroy the families and the people left behind. See you on threads. Herbert Out! https://t.co/NFQnzNEmEu

[Arun Nagdev @NagdevArun]

Forward movement in thinking about how to use POCUS in cardiac arrest. @ACEPNow @ACEP_EUS
https://t.co/UFX3kulZd7

[Jesse M. Pines, MD, MBA @DrJessePines]

Our work in @AnnalsofEM show the economics of US EDs for docs
https://t.co/Xf9gQp104m
It's a story of cost-shifting: ED visit profits from commercial insurance cross-subsidize Medicare, Medicaid & uninsured pts
@DrArvindVenkat @Dr_BrendanCarr @arjunvenkatesh @AlexJankeMD

[Daniel Jafari @DanielJafari]

Very proud of our team @Northwell_EM for this @ResusJournal . Cardiac Arrest care is a high intensity & often chaotic process. Unlike non-CA, there is no standardized #EMS handoff. This could lead to miscommunication & delays in critical actions needed. https://t.co/S7FeWkSPIf

[Dan Rolston @Dr_DRoll]

Peri-Intubation Hypoxia After Delayed Versus Rapid Sequence ... : Anesthesia & Analgesia https://t.co/n0fmeqt4lA

[UofL Health @UofLHealth]

"There's only so many times you can walk into a room and tell someone they're not coming home tomorrow. It breaks your heart when you hear someone screaming mommy or daddy. It just becomes too hard day in and day out."
- Dr. Jason Smith on the toll of gun violence in Louisville

[ProPublica @propublica]

Doctors at a major US insurance company deny tens of thousands of claims a month without even looking at patients’ files.

“We literally click & submit,” a former Cigna doctor told @ProPublica & @Capitol_Forum. “It takes all of 10 seconds to do 50 at a time.”

The inside story 🧵

[𝐃𝐚𝐦𝐚𝐫 𝐇𝐚𝐦𝐥𝐢𝐧 @HamlinIsland]

Teaming up with @american_heart in a BIG way!  

The Damar Hamlin 3 for Heart challenge is live! 3 easy steps to save a life❤️

@tombrady, @michelleobama, and @kingjames you’ve all been challenged!

Throw them 🫶 's up!
#3forHeart https://t.co/yn8l8mLT7E

[Daniel Jafari @DanielJafari]

Finishing up a phenomenal #SCCM2023 conference, from @Northwell_EM residents presenting our work to catching up with @PennTrauma family to meeting with phenomenal industry like @Flosonics . Major thanks to @SCCM @SCCM_EM @BenjaminAbella @GomerFoamER @nielsmd

[Daniel Jafari @DanielJafari]

Very happy to share the work of our group on the #PSV correlating better than #ETCO2 with blood pressure.
You can grab a copy of the manuscript from @ResusJournal here:
https://t.co/pWZXq66TJ1

@Dr_DRoll
#FOAMed #FOAMcc