Joshua Davis (he/him)

Pulmonary/Critical Care doc at @WeillCornell via @nyphospital & @BIDMC_IM & @BID_CMRs. Physiology 😍 Languages, travel. #MedEd. Views mine. 🏳️‍🌈🫁🫀🏥

[Joshua Davis (he/him) @JoshDavisMD]

Pulmonary medicine is everywhere you look 🙃

[Joshua Davis (he/him) @JoshDavisMD]

Had a blast talking with @fadamsmd about updated guidelines on steroid use in ARDS, sepsis and CAP on @NYUDocs — though at 6a, my face is only for radio! 😂 Thanks for having me!

[Doctor Radio @NYUDocs]

Corticosteroids for infections, TB and pulmonary embolisms are the topics @fadamsmd is talking about with @JoshDavisMD @WeillCornell, @ericashenoy @MassGenBrigham & Dr. Ezra Dweck @NYULangonePCCSM LIVE at 6amET on Pulmonology. Join the conversation at 877-698-3627!

[Joshua Davis (he/him) @JoshDavisMD]

Excited to be talking about steroids in sepsis, ARDS and CAP this Tuesday morning on @NYUDocs!

[JAMA @JAMA_current]

This JAMA Clinical Guidelines Synopsis summarizes the 2024 Society of Critical Care Medicine guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia.

https://t.co/gADRFLLC8K

[CHEST @accpchest]

As the tragic #CaliforniaWildfires continue, those with respiratory disease will be most impacted as exposure continues. Learn more about treatment protocols from the Chest Infection and Disaster Response Network: https://t.co/b59vjaGuDH
#WildfireSmoke

[Peggy Leung @PeggyLeungMD]

Excited to share our @JAMA_current CGS on SCCM’s 2024 guidelines on use of corticosteroids in sepsis, ARDS, and CAP!

📣learn about the nuanced evidence behind the rec for corticosteroid use.

As always it’s great to work with @AndyDavis @JoshDavisMD!
@WCMGIM @WCM_MedChiefs

[Cliff Reid @cliffreid]

1. Optimise patient position

Ear-to-sternal notch horizontal alignment with neck flexion never lets you down. Also called 'flextension' this is identical to the optimal direct laryngoscopy position

[Joshua Davis (he/him) @JoshDavisMD]

My favorite airway rescue device! One thing I always have at the head of the bed with me when I’m intubating.

[Cliff Reid @cliffreid]

The iGel is a great supraglottic airway device

But like other supraglottic airway devices (SAD) it's not foolproof

Here's how to maximise your success with the iGel - a thread 🧵

[Cliff Reid @cliffreid]

The iGel is a great supraglottic airway device

But like other supraglottic airway devices (SAD) it's not foolproof

Here's how to maximise your success with the iGel - a thread 🧵

[Joshua Davis (he/him) @JoshDavisMD]

Best way to wrap up the pulmonary unit for @WeillCornell MS1s with @Doclief interviewing Dr Chris Belardi — one of our ED physicians, medical educators and COVID ARDS survivor. An inspiration and a privilege!

[Nick Mark MD @nickmmark]

Here’s another pulmonary physiology question that *everyone* who gives O2 to patients ought to know:

What is the primary mechanism by which supplemental oxygen can increase PaCO2 in someone with severe COPD?

1/

[Joshua Davis (he/him) @JoshDavisMD]

@emily_fri @eemoin @msiuba @iceman_ex Especially so when they’re really sick and can’t lay flat! Yes, higher rate of infections with femoral lines. But femoral line for a few days, then convert to IJ — if we’re talking about avoiding intubation, I think it’s worth it

[Joshua Davis (he/him) @JoshDavisMD]

I’m still going to say free healthcare, but… like a good neighbor, State Farm is there. Anyway, thanks for the chuckle, @AlexaKlorman 😂

[a random Brandon @brandomonium]

If not free healthcare, maybe ad-supported healthcare. Like my doctor can stop in the middle of examining me and sing the Liberty Mutual jingle

[Joshua Davis (he/him) @JoshDavisMD]

@meredithturetz gave a ⛹🏻‍♀️🏀🗑️ (slam dunk) talk about restrictive lung diseases and touched upon the finding of clubbing. We can’t talk about clubbing without the great Dr. Cooper’s tweetorial about it! 🧵👇🏻

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

1/
Fingernail clubbing is associated with many systemic diseases, from lung cancer to TB to inflammatory bowel disease.

Why would such different diseases all manifest with clubbing?

The answer is surprisingly simple and elegant.

#medtwitter #tweetorial

[IMCrit @IM_Crit_]

ICU snapshots:

What do you think?

[Joshua Davis (he/him) @JoshDavisMD]

It’s my favorite time of the year — time to teach pulmonary physiology (and patho-) to the MS1s @WeillCornell with my partner in learning @meredithturetz. Had the opportunity to teach a new lecture today on gas transport — and had so much fun! 🥸🫁💨

[Joshua Davis (he/him) @JoshDavisMD]

@jducanto @hraza222 We don’t get 8 minutes of apnea time in the MICU, so would’ve had a tube loaded on a bronch for anticipated difficult airway & lifted tissue with laryngoscope and pass tube over bronch. Just need 2 operators. Especially love now the side by side VL & bronch on the GlideScope now!

[Joel M. Topf, MD FACP @kidney_boy]

And what was the consequence of all that hyponatremia? All that rapid correction? 12 of osmotic demyelinating syndrome.
12 out of 22,858. 0.05%
If you divide by starting Na they found an incidence of:
0.3% with a Na < 120
0.015% with a Na > 120
**2.5% with a Na < 110**

7/10

[Harish Seethapathy @BetterCallSeeth]

🚀Na over-correction (Na📈) as THE (only) cause of ODS/CPM: An absurd over-simplification.

Since 1980s, Na📈 has been portrayed as the main cause of CPM (so far as now the terms ODS and CPM are used synonymously).

However, finding the truth (if it exists) is more complicated.

🧵..
1/

[Josh Farkas MD 💊 @PulmCrit]

“this bronchoscopy could have been an induced sputum”

“this A-line could have been a cuff pressure”

“this intubation for ‘airway protection’ could have been a sternal rub”

“this swan could have been a POCUS”

“this consult could have been a google search”

[Joshua Davis (he/him) @JoshDavisMD]

@galbamd