Rival_Dad

Just a rival dad.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer You purposefully left out increased WOB, high CO2 levels.

Respiratory failure will buy you a tube. You know that.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Because in most of my line of work, it does.

There are always adjuncts, things you try prior, if they have refractory hypoxemia or low saturations with other issues then yes, they’ll buy a tube.

Refractory hypoxemia means you’ve tried other things and it hasn’t worked btw.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Why not just ask a clarifying question then?

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Yes. Ignore everything else I posted and act like WCC isn’t commonly used for bacterial infection identification lol.

Bye now.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer No, I’m not.

If they have a mask on, or you’re intervening and they don’t respond like Dr Craig said, it’s probably time to intubate.

Will I do it every-time? No. Patients are dynamic. There is no blanket treatment.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer So you do intubate if they have refractory hypoxemia then?

So you agree that a patients 02 remains low even with initial interventions, that they will be intubated.

Why did it take you this long to agree with me?

[Rival_Dad @RivalDad1]

@norman_pilon @chrismartenson @Craig_A_Spencer The problem is the massive amount of data they took, and not looking at them as subsets.

They just globbed it all together and called it good.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Sats lower than 90%, refractory hypoxemia are indications for intubations.

NIV just like any other treatment is not a cure all. But it is a good adjunct prior to pulling the trigger on intubation if you think they can tolerate it.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Brother NIV doesn’t always fix refractory hypoxemia.

Plus not all patients respond to NIV, or can tolerate a mask on their face.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer So you just leave them below 90% on a mask, until they become unresponsive and die?

Great treatment plan.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer I chose a lot of different ways of looking at the patient and you chose two, because you don’t understand that a singular test can properly give you all the information you need to treat a patient.

But okay.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer WCC has been used forever, what are you talking about?

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Lol alright, so don’t intubate patients with low saturations. Sounds good man.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Man. Shot yourself in the foot.

PCT is a good adjunct with other studies, but doesn’t solely tell you whether or not it’s a bacterial infection.

Keep on backpedaling.

https://t.co/LsflEwvMj2

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Flailing how?

Why are you backpedaling so hard?

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Brother.

He made the argument they were being restricted, I gave a reason why they may not have given them.

I said WCC can indeed prove a bacterial infection or not, you ignored that.

Looking at all the data collected is really important in how you care for the pt.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer You do intubate if they need it, or if you suspect you won’t be able to improve those saturations with some other intervention.

Your gotcha tweets are failing.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer Then it just proves that his original tweet of saying they restricted antibiotics is also wrong, so the thread wasn’t needed.

I said some patients do not receive broad spectrum antibiotics because they have a viral infection, not a bacterial one.

Keep on keepin on.

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer I’m just telling you what we look at while we’re taking care of our patients.

If you don’t like it, or you don’t take a broader look at your patients under your care, fine.

But X-rays are an excellent way of looking at what may be going on in the lungs short of an MRI or bronch

[Rival_Dad @RivalDad1]

@TnAlistair @norman_pilon @chrismartenson @Craig_A_Spencer I didn’t say everyone.

It really depended on what their risk factors were, and if they were responsive to non-invasive methods of oxygen delivery.