Ryan Spangler

EM resident physician educator, medical student educator, procedural education,and life long EM learner

[Amal Mattu @amalmattu]

#AAEM21 is a wrap! Looking forward to bringing AAEM back to Baltimore April 23-27, 2022...mark your calendars!

[Ryan Spangler @EMTerp2]

My daughter wants to be a “Doctor and a Mommy like Mommy”
#HerTimeIsNow

[Ryan Spangler @EMTerp2]

#HerTimeIsNow @UMEMresidency

[Ryan Spangler @EMTerp2]

My daughter wants to be a “Doctor and a Mommy like Mommy”
#HerTimeIsNow

[Ryan Spangler @EMTerp2]

#HerTimeIsNow @UMEMresidency

[Amal Mattu @amalmattu]

https://t.co/DjMXFfnlHh conference workshops are almost filled; sign up soon! Schedule here: https://t.co/PBX23aBZjE

[Ryan Spangler @EMTerp2]

Lamenting not seeing @EM_Educator at ACEP and missing @PharmERToxGuy at UMMC, obviously! @EmergencyDocs

[Ryan Spangler @EMTerp2]

Testicular torsion documentation: GU exam with creamasteric reflex, time stamp consults, get the ultrasound #ACEP16

[Ryan Spangler @EMTerp2]

Mesenteric ischemia documentation: no risk factors, tolerates PO, downward trend in lactate #ACEP16

[Ryan Spangler @EMTerp2]

The 'other' AMI. Acute mesenteric ischemia. Early lactic acid may be negative. Get CTA with delayed venous phase. #ACEP16

[Ryan Spangler @EMTerp2]

Abd compartment syndrome: inc suspicion if abd pain with resp distress #ACEP16

[Ryan Spangler @EMTerp2]

Abdominal compartment syndrome?! Consider in: gastroparesis, pseudo-obstx, ascites, pancreatits. Get bladder pressure if concerned. #ACEP16

[Ryan Spangler @EMTerp2]

Dissection r/o documentation: symmetric pulses, concordant BP, normal neurovascular exam! #ACEP16

[Ryan Spangler @EMTerp2]

Acute Aortic dissection: mortality inc 1-2% per hour #ACEP16

[Ryan Spangler @EMTerp2]

De. Yemi Adebayo on high risk abdominal complaints! Don't skip the EKG in adults with N/V and/or epigastric pain #ACEP16

[Ryan Spangler @EMTerp2]

@the_TOTAL_EM @NoDesat paper addresses trauma patients, not all cause, good clarification https://t.co/JgNvRWbiOI

[Ryan Spangler @EMTerp2]

Cook et al. 2015, poss safe for select hypotensive pt with +FAST to go to CT. Save morbidity of OR. No inc mortality in study. #ACEP16

[Ryan Spangler @EMTerp2]

Use longer catheter (8cm vs 5cm) for needle decompression for increased success. (Also consider 5th/6th IC space insertion!) #ACEP16

[Ryan Spangler @EMTerp2]

Don't force neutral c-spine immobilzation on baseline kyphotic patients. C-collar can force abnormal/unsafe anatomy for that pt #ACEP16

[Ryan Spangler @EMTerp2]

Consider adding shock index to HR, BP, RR to improve accuracy. SI =(HR/SBP) <0.6=no shock. >1.4=severe shock #ACEP16