Alfred Sacchetti

Practicing Emergency Physician, Teacher, Researcher. Areas of interest include: Pediatric EM, CHF, Arrhythmias, Sedation and Analgesia, Pain Management.

[Alfred Sacchetti @SacchettiAlfred]

“A scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it.” Max Planck

Those opposed to COVID-19 vaccines just accelerate this process.

[Alfred Sacchetti @SacchettiAlfred]

Does anyone have policy regarding CPR and known COVID patients? Or is it case by case?

[Alfred Sacchetti @SacchettiAlfred]

I’m 66 and people keep asking if I want them to see the respiratory distress patients. Very kind. No help on single coverage. One nurse with Lupus brought me some of her Plaquenil to have in case. Thank you forever.

[Amal Mattu @amalmattu]

Just curious, do any of your EDs or hospitals have policies that state that medical personnel > a certain age are not allowed to care for COVID or high-risk for COVID patients? If yes, what age do you use? #COVID19 #FOAMed

[Alfred Sacchetti @SacchettiAlfred]

#FOAMed @EMSwami Use High Flow Nasal Cannula to treat COVID-19/Flu patients. Don’t abandon therapy that reverses hypoxia and avoids intubation for theoretical risk of aerosolizing particles.  Just put the cannula under the surgical mask the patient is already wearing.

[Alfred Sacchetti @SacchettiAlfred]

@lemur_katta1 @EMSwami That information is important in understanding biology of the disease, but can come in time. It will not effect your care of the patient in front of you.

[Alfred Sacchetti @SacchettiAlfred]

#FOAMed, @EMSwami Stop whining about testing kits, treat COVID-19 like RSV. Only need to test a few patients to know virus is in your community, after that symptomatic care. Mild infections home treatment and self quarantine. Severe illness, hospitalize. Staff resp precautions

[Alfred Sacchetti @SacchettiAlfred]

@medic1895 Yep, need that info for learning biology of disease, but that can come with time. Lack of testing will not effect care of patient in front of you.

[Alfred Sacchetti @SacchettiAlfred]

If you have chest pain, you need a diagnostic test because we have a treatment for a STEMI. If you have respiratory infection, we don’t have a viral specific treatment, COVID, RSV, Adeno, etc. Once you know it is in your community no need for testing, manage symptomatically.

[Brian Schatz @brianschatz]

Just a reminder that lots of other countries have been able to deploy and operationalize tests weeks ago. It’s not like freaking out about a lack of a vaccine - some stuff takes time and that’s understandable. But the tests - this is simply inexcusable.

[Alfred Sacchetti @SacchettiAlfred]

Must read

[Emergency Physicians @EmergencyDocs]

As an ER Doctor, I Need You to Know These Things About Coronavirus https://t.co/0GMIyEs8tG via @vice

[Alfred Sacchetti @SacchettiAlfred]

@DrJarrodCross @airwaycam @EMSwami Never had a child irritated by high flow nasal cannula or oxygen when needed. Beauty of HFNC is you can adjust the amount of oxygen to give a saturation of only 92-95%. No hyperoxia, but no hypoxia.

[Alfred Sacchetti @SacchettiAlfred]

#FOAMed @EMSwami

Try this tweet again with the video this time.

Pediatric Respiratory Distress and High Velocity Nasal Cannula. A match made in heaven.

[Alfred Sacchetti @SacchettiAlfred]

@drcarostewart54 @DrJarrodCross @airwaycam @EMSwami Don’t be too quick to discount high flow nasal cannula. Child desaturated every time was removed, took 3 days to wean off.

[Alfred Sacchetti @SacchettiAlfred]

Don’t be too quick to discount the high flow nasal cannula, child desaturated every time was removed from it. Took 3 days before could be weaned off from it.

[Alfred Sacchetti @SacchettiAlfred]

@gregorprosen @TomcMatej @EMSwami No, YouTube, but should. Will try to get one up this week. Thanks

[Alfred Sacchetti @SacchettiAlfred]

#FOAMed @EMSwami

Pediatric Respiratory Distress and High Velocity Nasal Cannula. A match made in heaven.

[Alfred Sacchetti @SacchettiAlfred]

Help fight back, by getting involved and make a difference in the fight against cancer. https://t.co/0jAiU5qGg5

[Alfred Sacchetti @SacchettiAlfred]

At present Geriatric BRUE is of no value other than to prevent misfitting patients into wrong diagnoses. Once defined with diagnostic study recommendations and evidence supported disposition criteria it will be very valuable, like the pedi BRUE.

[Alfred Sacchetti @SacchettiAlfred]

Wife brings in 80 yo husband. 45 second spell, slumped in chair, starring, not responding to voice or tactile stimuli. Spontaneous recovery, now at baseline. TIA?, Syncope?, Seizure? None really fit. Why not Geriatric BRUE.

[Alfred Sacchetti @SacchettiAlfred]

Despite my best efforts there are many elder patients that I just can’t diagnose. Yes, BRUE means I don’t know, but better than faking it and calling them a TIA or Syncope.

[Alfred Sacchetti @SacchettiAlfred]

Despite my best efforts there are many elder patients that I just can’t diagnose. Yes, BRUE means I don’t know, but better than faking it and calling them a TIA or Syncope.

[ACEP Geriatric Sect @GeriatricEDNews]

#GeriED colleagues - just to be controversial @SacchettiAlfred suggests an older adult Brief Resolved Unexplained Event (BRUE) descriptor be derived as in peds #FOAMed https://t.co/W2kP0FRMjx in @AnnalsofEM Thoughts? @AmerGeriatrics @POBanerjee @GERED_DOC @MDTea_podcast @geri_EM