Josh Reandelar

EM PGY-3🚑

[Amal Mattu @amalmattu]

Saturday overnight shift ⁦@UMEmergencyMed⁩ #foamed #WhiteBoardTeaching

[Ali Moradi, M.D. @AlimoradiMD]

Starting residency can be challenging—presenting 10 patients daily on floors is no joke! Here’s my approach to staying efficient:

-Arrive early.

-Review age, PMH, and chief complaint.

-Check ED vitals, labs, imaging, and where the patient came from.

-Review overnight events (ask the night team), vitals, and morning labs.

-Check consultant notes (e.g., cardiology updates).

-Update assessment/plan, and place necessary orders.

-For new patients, review prior hospitalizations.

-Track hospitalization course—know the big picture.

-Check PT/case management for mobility concerns and placement.

-After chart review, talk to nurses, check telemetry, and ensure alignment.

-See patients, update them, take history, do a physical exam—always introduce yourself!

-Review with seniors to catch anything missed.

It’s challenging at first, but practice makes perfect.

I hope this helps future interns; however, I am still learning and improving!

#ResidencyLife #MedTwitter #Efficiency #medicine

[Katie Wiskar @katiewiskar]

Confession: I LOVE hyponatremia 🤓

(I know, I know. What can I say, I'm a true internist!)

HypoNa is often feared, maligned, and misunderstood - but I promise it doesn't have to be scary!

Here are my top 10 hyponatremia tips and tricks - a 🧵

[F. Perry Wilson, MD MSCE @fperrywilson]

Every week, I see a new study talking about this or that effect of GLP-1 receptor agonists like #ozempic. FINALLY, we have a study evaluating all the outcomes (good and bad) in one dataset. There are some... surprises. 🧵

[Ross Prager @ross_prager]

(1/x) Intubating a critically ill patients is the most dangerous procedure we do in the ICU (3.1% cardiac arrest rate) not because of hypoxia or tube placement, but hemodynamic collapse 🫀

(Russotto et al. JAMA 2021)

A 🧵on making high risk hemodynamic intubations as safe as possible.

[Josh Reandelar @drmacjosh]

There is no better feeling than walking into a shift and finding out the best nurses in your department are on your team for the day

[Qasem Ahmed @QAlmulihi]

“Ventilator Modes Overview 🫁:

1️⃣ VC (Volume Control): Fixed volume; good for LPV but risk of barotrauma.
2️⃣ PC (Pressure Control): Set pressure; prevents barotrauma but may cause hypoventilation.
3️⃣ PRVC: Adaptive mode; ensures tidal volume but increases work of breathing.
4️⃣ SIMV: Partial support; useful for weaning but less effective for full support.
5️⃣ PS (Pressure Support): Weaning mode; patient-triggered but no set rate.
6️⃣ APRV: ARDS mode; improves oxygenation but complex settings.

VBG Interpretation 🩸:
1️⃣ pH: Evaluates ventilation.
2️⃣ pCO2: Adjust ventilation to correct acidosis/alkalosis.
3️⃣ FIO2 and PaO2: Assesses oxygenation.
4️⃣ SpO2: Monitor and adjust O2 delivery.

[John Attridge @John_Attridge]

Student I was counting on to nod throughout the lecture stopped nodding

[IMCrit @IM_Crit_]

ICU (Central Venous/Arterial) Line Secrets - Part 1:

An ICU where the patients have no central lines & are not connected to ventilators is not a real ICU. This may be a controversial statement but in my humble opinion not far from truth

[Lea Alhilali, MD @teachplaygrub]

1/Do radiologists sound like they are speaking a different language when they talk about MRI?

T1 shortening what? T2 prolongation who?

Here’s a translation w/an introductory thread to MRI.

[dr. alex @miaowlex]

today I apologized for asking a nurse a question and she responded with “in the clerb, we all fam”

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

1/
Why can furosemide improve dyspnea/pulmonary edema from acute congestive heart failure within minutes of administration?

The answer does not involve diuresis.

#medtwitter #tweetorial

[Josh Reandelar @drmacjosh]

@cocuzzo_kaitlyn @ClementLeeMD Got it, thank you!

[Ron Barbosa MD FACS @rbarbosa91]

🧵regarding the useful technique of 'straightening the wire' during central line placement when the plastic guide is no longer within reach.

If you do a lot of central lines (or a lot of percutaneous procedures), this technique will come in handy over and over again.
(1/ )

[Josh Reandelar @drmacjosh]

Bringing this back for the new interns because this tweet completely shifted my perspective when I started last year. Good luck and enjoy!

[Laura Vater, MD, MPH @doclauravater]

Dear incoming interns:

Remember that your attendings have been practicing medicine for years, while you're essentially getting a new job every 4 weeks.

Know that your job is not to know everything. You job is to show up, ask questions, & care deeply for your patients.

[senior resident doctor najac @tylerjnajacmd]

In emergency medicine we don’t say “I love you” we say “why are you still here go home” and to me that’s beautiful

[Dr. Christian Casteel @DrCasteelEM]

My favorite thing is that ortho fellowships are just named after the body part. Ppl like I matched hand! I matched elbow! I matched knee!

[juju 💰 @ayeejuju]

whoever came up with this shot needs a raise https://t.co/vp2ZhDc4hA