LadyBroEM

baby faced EM attending, here to say the things I (mostly) can't say at work.
❤️#FOAMed #FemInEM

[Brandon Luu, MD @BrandonLuuMD]

Someone just coughed on you.
You were on a crowded flight.
Now your coworker is sick.

The window to prevent infection is narrow.

Here’s exactly what to do in the critical hours after a high-risk exposure 🧵1/13

[Empress 🖤 @drrdemon]

My adderall being washed down with a nice crisp alani nu

[Jim Eubanks MD @jeubanksMD]

I tell my older patients who come to see me with osteoarthritis related pain or functional limitations:

“We trade wisdom for arthritis.”

They get it. We have a good laugh. But the idea is to normalize it. We all get it as we age, and we can find a path forward.

[Ron Barbosa MD FACS @rbarbosa91]

🧵regarding the technique of 2-handed knot tying.
It's July again, so it's a good time to revisit this 🧵.

2-handed tying is becoming a lost art in surgery, but I believe it is worth learning. We'll start with just the basic steps. Advanced concepts will come later.
(1/)

[Braydon Dymm, MD @BraydonDymm]

It's official. For acute stroke treatment, Alteplase (tPA) is out, and Tenecteplase (TNK) is in.

But why? And more importantly, why is it called TNK when there’s no “K” in Tenecteplase?? 🧵

[Neil Renic @NC_Renic]

No one told me adulthood would require this much multi-factor authentication

[Dr. Rick Pescatore @Rick_Pescatore]

Rural hospitals aren’t a relic of the past—they’re a lifeline. They’re the only thing standing between life and death for millions of Americans. You can’t “disrupt” or “innovate” your way out of needing boots-on-the-ground medicine.

[Brandon Luu, MD @BrandonLuuMD]

🌙 White noise can improve sleep—but the frequency may matter.

A study found that a specific mixed-frequency blend protected sleep in a noisy environment—restoring arousals and deep sleep to baseline levels.

So I recreated it for you. 👇 🧵 1/12

[Third_Eye_Prophet @Third_i_Prophet]

A media blitz has been going on to demonize Doctor salaries. It's obviously funded by the Healthcare-Pharma Complex, to deflect blame onto Doctors for high Healthcare costs.

It is the worst kind of gaslighting against doctors, because the exact opposite situation is true.

First, doctor pay is 6-9% of all Healthcare costs, so even if they worked for free, it would hardly put a dent in Healthcare spending.

Second, many young doctors may not realize this, but Congress froze Medicare payments to doctors in 1997, and real salary adjusted for inflation decreased 80% since then!

Medicare work-RVU payment-
2000: $36.69
2024: $33.29
Inflation since 2000: 70%

Meanwhile, hospital payments and insurance premiums have OUTPACED INFLATION since 2000. That is where the problem lies.

People will argue that doctors are paid more in the US, but so is every other profession- law, finance, tech, nursing, etc.

Average nurse salary-
USA: $82,750
Germany: $33,000

Also, the US has fewer doctors per capita than Europe, resulting in more office visits and procedures per doctor.

And US doctors have on average $227,000 in debt compared to none in Europe. If you just invested that money in the S&P at it's historical return of 10.26% for 45 years, adjusting for inflation, you get $22.97 Million. That is the opportunity cost of becoming a doctor in America.

Anyone blaming doctor pay, which is down 80% the past 25 years, for our high healthcare costs, needs to read this thread and face the facts.

[LadyBroEM @LadyBroEM]

@ravenscimaven Poor lil froggie... RIP since 2013 though!
https://t.co/kSQ8EMseX9

[NASA @NASA]

Some days you're the rocket. Some days you're the frog. #WednesdayThoughts

Ten years ago today, our LADEE launch to the Moon from @NASA_Wallops leapt into internet history when a remote camera captured this image of liftoff, and an airborne frog. https://t.co/4X0TfqKWEQ

[Ross Prager @ross_prager]

(1/x) The term 'pre-renal' acute kidney injury is dated and should stop being taught in medical schools.

Why? The term pre-renal is inextricably linked to the idea that the treatment of pre-renal AKI is IV fluids.

Here's the paradigm of hemodynamic AKI and why it is helpful.

A 🧵

#foamed #medtwitter #meded #hemodynamics

[armyemdoc @armyemdoc]

In September 2024, the American College of Obstetricians and Gynecologists released an updated guideline on RhIG and spontaneous/induced abortion before 12 weeks. Here's the gist:
-Rh testing is not necessary
-RhIG prophylaxis not indicated

The why:
-Previous studies were largely 🗑 and using older assays like the Kleihauer-Betke instead of flow cytometry
-Newer studies (better data but not great) suggest the risk is nil compared to the risks associated with RhIG
-Most of the demonstrated risk of developing HDFN is much later in pregnancy
-Most other societies around the world already ditched the use of RhIG in early pregnancy

https://t.co/s1S40H8SBZ

#emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #army #armymedicine #armyemdoc #resuscitation #research #data #cpr #pediatrics #children #kids #obstetrics #baby #obgyn #medx #medtwitter

[Ross Prager @ross_prager]

(1/x) Treating patients who are fluid responsive with IV fluids is kind of like using a credit card 💳

It definitely works (in the short term), but be careful.

The debt that accumulates eventually needs to be paid off.

A 🧵

#medtwitter #foamed

[AAEM @aaeminfo]

Think private equity doesn’t affect you? Think again. It's taking over EDs, leading to longer wait times, surprise bills, and rushed care. As @RobertMcNamar12 and others warn, corporate investors—not doctors—are calling the shots: https://t.co/rlciNJObMn

[Liz Chrastil @chrastil]

A few years ago I was in a position to do something unique in neuroscience. I had been working with the phenomenal @emilyjacobs on menopause and inspired by @laura_pritschet's menstrual study, and I was planning a pregnancy. What if we scanned my brain??
https://t.co/mTLfToPhru

[mattparlmer 🪐 🌷 @mattparlmer]

The actual function of a roomba is to force you to pick up all the shit that you have lying around that is potentially obstructive to the roomba

[Ron Barbosa MD FACS @rbarbosa91]

Finally, as a trauma surgeon, I have to point out one of my favorite teaching points: The flow rate of a 16 G IV is **twice** that of an 18 G IV.

So the difference between those two IV's may not sound much at first, but it makes a big difference for major resuscitations.
⬛️

[Ron Barbosa MD FACS @rbarbosa91]

Once again: a🧵about 🧵's

It's been about a year since I last posted these, but for the new folks, here is a collection of links to each of my 🧵 about surgical sutures.

9 of these are about suture types and the other 3 are miscellaneous suture-related topics.
⬇️(1/ )

[Adam Grant @AdamMGrant]

We don't need to debate whether it's better to be a generalist or a specialist. The world needs both.

Specialists excel at zooming in. They see the details to deepen our knowledge.

Generalists excel at zooming out. They see around corners to broaden our view.