Nadim Lalani

Human being | Dad | ER physician | Professional Coach CANADA. [Posts are my own]

[CJEM @CJEMonline]

Just the facts on healthier shift scheduling: “We’re tired of being tired” by @EmICUcanada

How does shift work affect you? Your cognition? Productivity? And more importantly what can you do about it?

Find out in this JTF: https://t.co/FACJMDDMGb

[Dr.Mukesh , MD , DM @dr_immuno29]

🚨 **Understanding Catastrophic Antiphospholipid Syndrome (CAPS)** 🚨
🔍 **What is CAPS?** A life-threatening form of Antiphospholipid Syndrome leading to rapid vessel thrombosis & multiorgan dysfunction.
⚡️ **Common Triggers:** Infection, surgery, trauma, stopping anticoagulants, and malignancy.
💔 **Mortality Rate:** Alarmingly high, exceeding 50%! Early recognition is key!
🩺 **Diagnosis:** Identify antiphospholipid antibodies + microvascular ischemia through tissue biopsy.
💊 **Management:**
- **Triple Therapy:** Glucocorticoids, IV heparin, TPE/IVIG.
- Refractory? Consider Rituximab or Eculizumab.
🔄 **Clinical Implications:** Careful monitoring for APS patients, especially during pregnancy!
📈 **Research:** Ongoing studies are vital for improving outcomes in CAPS.
🛠️ **Monitor:** Daily blood work & coordinated care is crucial!
✨ **In Summary:** Early intervention & tailored strategies are essential in confronting the complexities of CAPS!
#CAPS #AntiphospholipidSyndrome #Thrombosis #Autoimmunity #ClinicalManagement #MedTwitter

DOI 10.1182/hema­ tol­ ogy.2024000544

[Dr sthanu subramanian @drsthanus]

Cytomegalovirus infection: When and why to detect antibodies.

Serological testing in CMV infection.

https://t.co/fd9AMh4QOu

[armyemdoc @armyemdoc]

What is the 4-step cricothyrotomy method?

This method uses 4 steps: Scalpel-finger-bougie-tube

1. Scalpel to the cricothyroid membrane
2. Finger insertion into the trachea with downward traction
3. Insertion of a bougie into the track with the finger it in feeling for the tracheal rings
4. Insertion of the tube over the bougie

It is a simplified method for performing the procedure that eliminates steps such as the use of trach hook. While this procedure was popularized by the US military through the Tactical Combat Casualty Care guidelines, it has been described for many years before the recent wars in Iraq and Afghanistan. There's obviously no RCT data on this method in humans, but cadaver, mannequin, and case series data demonstrate reliability and efficiency.

https://t.co/UkVVP2fOdH

https://t.co/XmwJ6siLQB

https://t.co/O92ouXjEpF

https://t.co/UkVVP2fOdH

PMID: 9950380, 8922017, 9774928

#emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #data #research #army #armymedicine #armyemdoc #trauma #airway #military #tccc #navy #airforce #marines #medx #medtwitter

[sikandar adwani @SikandarAdwani]

🔹 Types of Saccadic Intrusions:

With Intersaccadic Interval:

Square-wave jerks: Frequent small horizontal movements (seen in progressive supranuclear palsy).

Macrosaccadic oscillations: Larger amplitude, crescendo-decrescendo pattern (cerebellar lesions).

[LITFL @LITFLblog]

Comatose with small pupils and no response to naloxone—what’s next? https://t.co/bXk9Yb5y8B

#MedEd #MedTwitter #FOAMed

[Jack (EMNote) @jackcfchong]

Tomahawk Intubation (face-to-face)
https://t.co/oGxWzKvHul

[Nadim Lalani @ERmentor]

Nice infographic of acid base!

[Manual Of Medicine @ManualOMedicine]

@DrPharmDMDTh @TA_ECG Acid-Base Disorders Worksheet

[Manual Of Medicine @ManualOMedicine]

A 16 y.o. healthy female with a strong family history of sudden cardiac death undergoes a screening ECG.
- What abnormalities are noted?

👉 Answer and Interpretation: https://t.co/X9utfhgpI0

#medtwitter #foamed #ecg #CardioTwitter

[Nick Mark MD @nickmmark]

@CDCMMWR Clinical 🥡:
-Alpha gal syndrome (AGS) is a potentially fatal allergic reaction to an oligosaccharide found in meat
-AGS occurs after sensitization by tick bites
-people with AGS often have a heparin allergy!
-consider premedication prior to heparin in people with “meat allergy”

[Nadim Lalani @ERmentor]

Congrats @TChanMD

[André Picard @picardonhealth]

Teresa M. Chan @TChanMD appointed founding dean of the School of Medicine, and inaugural vice-president, medical affairs at Toronto Metropolitan University. https://t.co/8U00JXHE0q via @TorontoMet @cfpcceo #MedEd

[Nadim Lalani @ERmentor]

great one pager on acid base

[ICU OnePager @OnePagerICU]

The ICU OnePager approach to interpreting acid base including some handy mnemonics:
- metabolic acidosis: BLVD PLACE
- non-AG metabolic acidosis: RAGES
- AG metabolic acidosis: GOLDMARKeT
#TipsForNewDocs
https://t.co/6TfHwVwsWz

[Parksy @PfParks]

EDs in every province are inundated and struggling.
ED overcrowding coupled with rural ED closures everywhere…
Where’s the federal coordination and the provincial plans?

https://t.co/dRnVW0Bay0

[RutgersNJMS_POCUS @RutgersPOCUS]

Identify SBO at bedside (curvilinear probe):
- 3+ fluid-filled loops of bowel w/ >2.5 cm diameter
- "To-and-Fro" movement of bowel content/ decreased/ absent peristalsis
- Thickened bowel wall > 3mm
- Free fluid between loops of bowel (higher grade obstruction, poorer prognosis)

[Mark Ramzy, DO, EMT-P @MRamzyDO]

@ucsfdem’s Dr. Jeffrey Tabas on Dimers & PE at #EEM2023

🤰🏽D-Dimer use in Pregnancy 👇🏽
🛑Stop if PERC Negative in Pregnancy
📱@MDcalc algorithm here: https://t.co/VBKcP2rsnt

#FOAMed @grahamwalker @JHabboushe @ShivGaglani @OsmosisMed @EssentialsofEM @HippoEducation @emergencypdx

[Nadim Lalani @ERmentor]

@CAEP_Docs

[Ken Milne MD @TheSGEM]

190 Calgary doctors warn emergency rooms 'collapsing' in open letter ⁦@CBCNews⁩ https://t.co/29L2EqwQ3q

[emDOCs Team @emdocsdotnet]

The EM Educator Series: Fournier Gangrene - Simple, raging cellulitis #FOAMed #FOAMcc @EMHighAK @long_brit @MPrizzleER https://t.co/5YuoNbHcaa

[NephroPOCUS @NephroP]

Lower extremity DVT #POCUS #anatomy
https://t.co/c5f3bAEUu9
#IMPOCUS #FOAMed

[Nadim Lalani @ERmentor]

good review thanks!

[emDOCs Team @emdocsdotnet]

The EM Educator Series: Meningitis - Unusual Headache and Fever #FOAMed @EMHighAK @long_brit @MPrizzleER https://t.co/tGwefozZCf