Sassy in the ICU, APRN

[Sassy in the ICU, APRN @RNalways4ever]

Nothing in nursing school prepares you for the overwhelming rush of emotions that hit you when you close your car door after a difficult shift. #OneSentenceShift

[Glen O'Humeral @HumeralO]

The attending waiting for me to finish presenting my assessment and plan before changing everything about it

[NurseKatFish @NewGradKat]

Quick question: did we all become nurses because we all have some sort of trauma? At least ICU nurses or any critical care nurse really? 4 of us talked yesterday about parent trauma, relationship trauma, friendship trauma or all 3. I’m like oh. Is that why we’re all here? 😂😳

[HuffPost @HuffPost]

Trump failed to mention the bird flu epidemic, or the fact that Musk’s DOGE initiative mistakenly fired the federal employees who had been working on the government’s efforts to stop bird flu and bring egg prices back down. https://t.co/v2FOLSQuoy

[Kevin C. Klatt, PhD, RD @KCKlatt]

We should be abundantly clear that vitamin A supplementation is a distraction, is not an alternative to vaccination, does not have any evidence from studies done in the USA, and has risks if not done according to the established dosing protocols that few docs are familiar with.

But I worry we leave open a hole for legitimate critique that confuses the conversation by assuming vitA could only work for measles in vitamin A deficiency endemic regions but we don't 100% know that's true. There's only a couple intervention studies that are mixed about it's usefulness outside low resource settings.

The acute phase drives alterations in many serum proteins including those carrying retinol and you see serum retinol reduced in hospitalized pts with measles even in domestic cohorts. Whether replacement with high dose vitamin A (typically 200,000IU 2x) is beneficial is an outstanding question. Legit orgs are recommending it despite the indirectness of the clinical data.

https://t.co/XKGW4aOzYU

[Code Blue Memes @codebluememes]

behind every great nurse that treats heart arrhythmias is a great energy drink that causes heart arrhythmias

[Tristan Snell @TristanSnell]

CFPB - closed
USAID - closed
Medicaid - under attack
NIH cancer funding - frozen
Department of Education - under attack

But do you know who just got a NEW government contract for $38,858,978 literally today?

SpaceX — owned by Elon Musk

[Andrea C. Love, PhD @dr_andrealove]

If you weren’t clear: a President ordering a Federal health and disease agency to delete pages on its website is a public health crisis.

[Sassy in the ICU, APRN @RNalways4ever]

I have many grievances today. #CTICU #STAT

[Andrea C. Love, PhD @dr_andrealove]

Norovirus is a cool virus because it doesn't have a lipid envelope. That means it’s incredibly stable in the environment.

So in addition to causing violent vomiting, diarrhea, & stomach cramping, it can be shed in stool for 2 weeks, AND hand sanitizers are ineffective.

FUN!

1/

[Ross Prager @ross_prager]

Here are 10 things that expert clinicians do everyday, often without realizing it🩺

(and how we can all start to implement these in our own practice)

A 🧵

#foamed #MedTwitter

[Meredith @Mere_Constant]

Thread:

1/ Women in the U.S., I need you to gently set aside your grief for a second and look at me. It's time to operate from a place of planning.

-If you are married and not the breadwinner, depend on your husband for insurance, it's time to start planning.

[NephroPOCUS @NephroP]

#POCUS #FOAMed
Pathophysiology of RV failure with pressure overload. Red frames indicate adverse events leading to RV failure. Green frames indicate adaptive events improving hemodynamics. Orange frames indicate maladaptive events leading to compensated RV failure. Red labels with white script indicate treatment targets in RV failure.
🔗 https://t.co/4yHX2b6F0R

[NephroPOCUS @NephroP]

Interesting #echofirst image of the day.
What’s unusual about this parasternal long axis image?
Apical 4-chamber view in thread.
#POCUS #FOAMed #FOAMcc
Courtesy: Viray, et al. CASE 2019

[IMCrit @IM_Crit_]

Femoral lines (clinical practice) paradox:

ICU/ED world: Oh no, we shouldn't do it, femorals are SO dirty. If we place them, we remove them 3 ds later because we feel guilty & administrators yell

ECMO world: let's put 2 huge cannulas in the groin & leave them there for 3 weeks

[Sassy in the ICU, APRN @RNalways4ever]

@MerkulesMusic need to write a song about #ChimpCrazy #Tonka

[medmalreviewer @medmalreviewer]

⚠️Intraoperative Death During Alleged Splenectomy:

This case has gone viral and multiple readers have sent it to me.

Some of the records are floating around social media, and I republished them here.

This is the operative report and explanation of the underlying situation:

[Sassy in the ICU, APRN @RNalways4ever]

Children should not have to “prove” to their parents why they deserve to be loved. They should be loved unconditionally. They didn’t choose to be here. #loveyourchild