Wendy Chang

Emergency physician 🚑🚁 & Neuro #zentensivist 🧠👩🏻‍⚕️ #NeuroResuscitation #IPE #MedSim #WomenInMedicine Views ≠ employer’s ≠ advice

[Wendy Chang @EM_NCC]

Take it from a #Marylander, you don’t want #OldBay, #flu, or #COVID19 in your eyes!

[Wendy Chang @EM_NCC]

Calling our #NCSPharmacy #PharmICU colleagues to weigh in on #NCSVJC discussion!

[Pravin George @RealPGeorge]

@neurocritical It is unclear if propofol is more cost effective than midazolam, but certainly has a shorter shelf life once opened and more stringent storage requirements. /2

[Wendy Chang @EM_NCC]

@neurocritical Agree likely many factors as mentioned. As well as indication for sedation/IMV, choice behind agents, confounding toxic-metabolic encephalopathy, etc.
#NCSVJC

[Wendy Chang @EM_NCC]

🧠 Do you care for patients with acute brain injuries?
🫁 What is your sedation strategy with mechanical ventilation in these patients?

Join the #NCSVJC discussion to learn more about practice variations worldwide and impact on outcomes!

[Neurocritical Care Society @neurocritical]

#NCSVJC is about to begin! Follow us for questions posted started shortly and hourly and discuss in the replies with colleagues. Learn more about how to participate and read the article: https://t.co/JXxXQMDZdD

[Wendy Chang @EM_NCC]

Katherine Sherwood relearned to paint after an ICH with resultant hemiparesis. Facility of Speech incorporated medieval seals of Solomon to promote healing and her own cerebral angiogram.

https://t.co/utqcVnoe09

@MCASD #NCS2024

[Wendy Chang @EM_NCC]

Intersection of art and medicine

Beverly Buchanan left career in medicine, created Medicine Woman including her own pill bottles.

Howardena Pindell created Autobiography: Fire with her own silhouette after a car accident that impaired her memory.

@MCASD #NCS2024

[Wendy Chang @EM_NCC]

Standing room only at #NCS2024 session on @brain_trauma penetrating #TBI guidelines.

Long awaited with useful algorithms including tool for assessing futility. Most importantly, advocates for aggressive surgical treatment and acknowledges challenges with prognostication.

[Kelsey Ladd, PharmD, BCCCP @kelseyel_]

Curious what concentration mannitol those who voted yes use? Mannitol 20% & 25% both higher osmolarity versus 3% NaCl 🤔

[Wendy Chang @EM_NCC]

Exploring Phoenix and learning about sex, gender and diversity through #SAEM24 @AWAEM @SAEM_ADIEM #SGEM scavenger hunt

[Wendy Chang @EM_NCC]

@umarylandneuro Congrats Dr. Lin!! 🥳

[Neurocritical Care Society @neurocritical]

#NCSTJC Q6: The authors also found that prophylactic ceftriaxone did not affect the incidence of late VAP in patients with acute brain injury. Does this finding change your clinical practice? https://t.co/6mrqts0W8V @EM_NCC

[Neurocritical Care Society @neurocritical]

#NCSTJC Q5: The PROPHY-VAP trial found a single dose of ceftriaxone decreased the incidence of early VAP in patients with acute brain injury. Does this finding change your clinical practice? https://t.co/6mrqts0W8V @EM_NCC

[Wendy Chang @EM_NCC]

@EricLawson90 @neurocritical @katskript @KeatonSmetana Great point! #NCSTJC

[Wendy Chang @EM_NCC]

@neurocritical 4 of 9 PROPHY-VAP ICUs routinely screened for ESBL-producing bacteria on admission and discharge #NCSTJC

[Wendy Chang @EM_NCC]

@neurocritical Do you differentiate between ventilator-associated pneumonia vs tracheobronchitis? 🤔
#NCSTJC

[Wendy Chang @EM_NCC]

@neurocritical The PROPHY-VAP ICUs implemented preventive measures including:
🔹HOB elevation
🔹Monitoring tracheal cuff pressure
🔹Oral care
🔹Changing filters/circuits only when necessary
🔹Early enteral feeding
🔹Stress ulcer prophylaxis

None of the sites used SOD/SDD #NCSTJC

[Neurocritical Care Society @neurocritical]

#NCSTJC Q4: Do you routinely screen for antibiotic-resistant organisms in your ICU patients? If so, which organisms and in what type of patients? https://t.co/6mrqts0W8V @EM_NCC

[Keaton Smetana, PharmD, MBA, FNCS, FCCM @KeatonSmetana]

Other resources used around the 🌏 apart from @IDSAInfo guidelines to diagnose #VAP? Join the #NCSTJC conversation 👇#IDtwitter #NeuroTwitter #TwitteRx

[Wendy Chang @EM_NCC]

Do you prefer noninvasive vs invasive sampling? 🫁
Utilize biomarkers such as procalcitonin? 🩸
Use clinical decision tools like the Clinical Pulmonary Infection Score (CPIS)? 📋
#NCSTJC

[Neurocritical Care Society @neurocritical]

#NCSTJC Q3: What criteria do you use to diagnose ventilator-associated pneumonia (VAP)? https://t.co/6mrqts0W8V @EM_NCC

[Neurocritical Care Society @neurocritical]

#NCSTJC Q2: Do you use prolonged IV antibiotics to prevent ventilator-associated pneumonia (VAP)? https://t.co/a90keMyoLQ @EM_NCC

[Wendy Chang @EM_NCC]

@KeatonSmetana @neurocritical We also use chlorhexidine as part of our VAP prevention bundle #NCSTJC