Joshua Nackenson

Medic/FF turned EM/EMS doc #medic2MD Alter ego: @TheStrengthDoc

[Joshua Nackenson @MedicJoshMD]

@FirstNet why is the ATT site offering iPhone preorder but I can't upgrade my FirstNet phone on your site?

[Joshua Nackenson @MedicJoshMD]

@Apple it's not a good look to make people on the west coast wake up @ 5am to preorder the iPhone 15 meanwhile 0505 and the apple store still isn't ready...cmon guys

[Joshua Nackenson @MedicJoshMD]

Why is a fascia-iliac compartment block NOT universally the standard of care in the US ED setting for hip/femur fractures

[Joshua Nackenson @MedicJoshMD]

Here’s a thought: why don’t retail pharmacies use something similar to Amazon lockers to have people pick up their meds? it seems that would be much more efficient… @Walgreens @cvspharmacy @riteaid

[Joshua Nackenson @MedicJoshMD]

@northstarmtn when is the backside opening up? seems like there's been enough snow....

[Joshua Nackenson @MedicJoshMD]

@IltifatMD I saw your reddit post on EPIC on the iPad via citrix. I was wondering if there is anyway to use the magic keyboard to do "F2"'? ie. remap one of the other buttons to "F2"?

[Joshua Nackenson @MedicJoshMD]

Why is the RUSH exam such a critical assessment tool in EM? Because making the decision to give crystalloids vs blood + AC reversal is a potentially life/death clinical decision.

[Joshua Nackenson @MedicJoshMD]

@rivera @Airbnb Can’t say I’m surprised. @Airbnb customer service is trash, worse since pandemic. You’d never see that at a hotel…

[Joshua Nackenson @MedicJoshMD]

@chungk1031 Prince street pizza FTW

[Adriano 🚀 @AdrianoinJapan]

Elon Musk in 2021:

- He paid $11 billion in taxes, the highest tax bill ever in history.

- He gave $5 billion to charity, one of the highest if not the highest single charity donation in history.

Where are Elizabeth Warren and Bernie Sanders now?

@elonmusk

[Joshua Nackenson @MedicJoshMD]

@drrussellledet My advice is if you’re living a place with strong rental market, if home prices drop due to housing crash usually rents don’t go down as much so if after 5 years you can’t sell you at least have your mortgage covered. I bought a house after match and it’s been a gr8 investment

[Joshua Nackenson @MedicJoshMD]

12 years ago, I was a young paramedic and was reprimanded by the leadership of my volunteer agency for my ardent opposition to the routine use of L&S. I'm grateful for the work of @NAEMSP putting out this joint statement for the safety of our providers & the public! #medic2MD

[NAEMSP @NAEMSP]

Crashes related to EMS lights & sirens continue to harm practitioners, patients & the public. Read our updated position statement w/@AIMHI_MIH @amerambassoc @ACEPNow @PtSafetyExpert @TheIAED @iaemsc @IAFC @NAEMT_ @NASEMSO @NEMSMAnews @QualityEms & @NVFC: https://t.co/RtxcupREl1

[Joshua Nackenson @MedicJoshMD]

@theHappyMedic Does your agency have a QI department? Call-taking is a very difficult job, though that percentage is definitely outside of the national averages and ideally something investigated by a QI team

[Joshua Nackenson @MedicJoshMD]

@ericpaulimd 1) the hourly wage of a surgical intern is below the hourly wage of a typical American making ~ $55k/yr as they’re generally working 40 vs your 80 hours

2) most Americans don’t have $250k of educational debt

[Joshua Nackenson @MedicJoshMD]

@mcmack84 Can I get an AMEN?!

[Joshua Nackenson @MedicJoshMD]

@CVarnellMD Maybe they just like the taste?

[Brian Steixner MD @DrBrianSteixner]

Just overheard a ER doctor tell a patient “If you are concerned about C02 levels from a face mask, then our climate crises is really gonna make you lose your mind”

[Joshua Nackenson @MedicJoshMD]

@Robertfrom305 @JudgeClayJ Because your uninformed decision to not mask can negatively effect the health of others. Plus when the healthcare system is overrun with COVID cases the health of our population as a whole suffers. Come see what it’s like in the ER or ICU during a COVID surge…

[Joshua Nackenson @MedicJoshMD]

@JaceMullen True status I’ll give full dose as you mentioned. If someone has come in and had break through seizure, will usually give 1-1.5G while waiting on remainder of work-up.

[Joshua Nackenson @MedicJoshMD]

Many "metrics" do not allow for clinician judgement/expertise, and only a patient refusal precludes the clinician from a "fallout".

Could you imagine if an airline pilot, asked the passengers their opinion on how to best fly? 2/2

@ACEPAdvocacy @aaeminfo @AmerMedicalAssn

[Joshua Nackenson @MedicJoshMD]

We [clinicians] need to be careful with the direction medicine is going. Quality care and metrics are not the same. At one point those goals were aligned, but we are approaching the point where metrics > patient care. 1/2