Jake Thomas

Hospitalist physician. Interested in AI at the bedside. Not medical advice. Views my own.

[Jake Thomas @JakeThomasDO]

Ward stories:

A patient was recently admitted with a complaint of “The water pill stopped working.”

Admitted with volume overload on the same home furosemide dose he’s taken for years. Why?

Enter the braking phenomenon. 🧵

[Jake Thomas @JakeThomasDO]

@RoupenMD An LLM for a chart would be helpful, particularly with patients who receive care from multiple different systems. It can be very time consuming to have to read through Care Everywhere notes

[Jake Thomas @JakeThomasDO]

What trials are you most interested in for ESC?

[Jake Thomas @JakeThomasDO]

Any handheld ultrasound recommendations?

[Jake Thomas @JakeThomasDO]

@samarthrawal Would love to try it!

[Jake Thomas @JakeThomasDO]

@813JAFERD With how many different drugs can cause DILI, probably will take numerous cases before peptide DILI is documented

[Jake Thomas @JakeThomasDO]

Clinical pearl: A spot dose of diuretic can do more good than a spot dose of hydroxyzine in a patient with heart failure

[Jake Thomas @JakeThomasDO]

Reminder: A patient on DVT prophylaxis can still develop a DVT!

[Jake Thomas @JakeThomasDO]

@doctorbhargav @maxmarchione The time/frustration it would save to be able to view information in one spot instead of having to dig through multiple different sources would be awesome

[Jake Thomas @JakeThomasDO]

@molsjames The EPIC system Im using has an AI generated hospital summary. It will give you the source so that you can go to the original note. Super helpful!

[Jake Thomas @JakeThomasDO]

@jasonryanmd The nuances of medicine is why we train for so long!

[Jake Thomas @JakeThomasDO]

Clinical pearl: rapidity of decompensation and improvement clinically helps differentiates aspiration pneumonitis and pneumonia.

Use the timing, not a sputum culture, to decide on if treatment with antibiotics is needed!

[Jake Thomas @JakeThomasDO]

@nickmmark I think it’d be helpful if ultrasounds were more accessible (although I understand they are expensive). There’s no ultrasounds located on the floor, only in the ICU and ED so I can scan someone I’m admitting, but can’t track progress lager

[Jake Thomas @JakeThomasDO]

@nickmmark Thoughts on hypertonic saline for diuresis augmentation?

[Jake Thomas @JakeThomasDO]

@hjluks @maxmarchione I was just thinking about that this morning. We can’t say yes or no right now, but the mechanism is there

[Jake Thomas @JakeThomasDO]

@AnilMakam 2025 AHA guidelines recommend against routine bicarb administration in cardiac arrest (unless hyperK or TCA overdose is the cause)

[Jake Thomas @JakeThomasDO]

@NephroP 😬😬😬

[Jake Thomas @JakeThomasDO]

@hjluks any thoughts on CYT-108?

[Jake Thomas @JakeThomasDO]

Clinical pearl: Polypharmacy is more commonly the cause of AMS in elderly patients than bacteruria with no other signs of infection

[Jake Thomas @JakeThomasDO]

@unusual_whales Residents everywhere rejoice

[Jake Thomas @JakeThomasDO]

@COREIMpodcast I’ve been using this pretty much daily for the last year, super helpful!