Nirdosh Rassani

Emergency Medicine Consultant
Director ED & Acute Care
MRCEM • FCPS | AKU Alumnus
Building systems where none exist
Resus | Toxicology | Critical Care

[Nirdosh Rassani @emdoc_nirdosh]

@ross_prager How to join this grand round Ross?

[Nirdosh Rassani @emdoc_nirdosh]

“Critical Conversations: Emergency Medicine Unfiltered” is a virtual podcast where we break down complex, often controversial, topics in emergency and critical care. Each episode features experts delving into real-world challenges and cutting-edge practices. In our upcoming episode, we’ll focus on environmental emergencies, particularly heat-related crises.

If you’re an expert with field experience or research in this area, we’d love to have your perspective on the show!

Let’s connect: [email protected]

[Nirdosh Rassani @emdoc_nirdosh]

@nickmmark @jarrodmosier 3. No plan B = plan to fail.

[Nirdosh Rassani @emdoc_nirdosh]

Sodium Channel–Mediated Ventricular Arrhythmia After Delphinium denudatum Ingestion Managed Conservatively in a Resource-Limited Setting | JACC: Case Reports https://t.co/MIinEj9bDj

Published in JACC! A rare toxin leading to PMVT, managed with Lidocaine.

[AJKD @AJKDonline]

In the Literature by Stephanie M. Hu:

Understanding Estimated GFR

https://t.co/yfyrH3PIE8 (FREE)

[Nirdosh Rassani @emdoc_nirdosh]

25 yo male k/c of ESRD
Presented to ED with acute SOB
PoCUS

[Nirdosh Rassani @emdoc_nirdosh]

@TheSGEM Happy birthday to her

[Nirdosh Rassani @emdoc_nirdosh]

@CritCareReviews “Stay with me”

[Nirdosh Rassani @emdoc_nirdosh]

@smithECGBlog Thank you for sharing this @smithECGBlog
He shared this ECG with me and I told him that it’s OMI until proven otherwise.

[Nirdosh Rassani @emdoc_nirdosh]

It was a difficult airway in terms of anatomy as well as physiology. The patient was a middle-aged female with an anterior neck mass, short neck, morbidly obese, and obtunded. BP was 88/40mmHg with tachycardia of 120bpm. The anatomical aspect is very important here as the laryngeal complex was pushed to the left by the huge thyroid which made the laryngoscopy difficult.

[Nirdosh Rassani @emdoc_nirdosh]

A lady in her 60s, presented to ED with SOB for a few days and drowsiness for 1 day. No history of fever.

ABGs showed TIIRF with a CO2 of 91mmHg. I intubated her using C-MAC and Eschmann tracheal tube introducer in the ED.

P.S. - When she arrived in the Resus Room, I did the PoCUS Neck which showed an enlarged thyroid with increased vascularity.

@EM_RESUS @srrezaie @AirwayMxAcademy @JohnCSakles @dastrainees @cliffreid @precordialthump

[Nirdosh Rassani @emdoc_nirdosh]

@cliffreid Ketamine + Rocuronium

[Nirdosh Rassani @emdoc_nirdosh]

@cliffreid Wow! The important part of this intubation was the position of the laryngeal complex as it was pushed towards the left due to huge thyroid. On the 1st laryngoscopy by a PGY5, she couldn't locate the epiglottis as she was going straight like in a normal patient.

[Nirdosh Rassani @emdoc_nirdosh]

@cliffreid Unfortunately, I forgot to record it due to ED chaos!

[Nirdosh Rassani @emdoc_nirdosh]

@TheSGEM @SAEMEBM @SAEMonline Belated Happy Birthday Ken.

[Nirdosh Rassani @emdoc_nirdosh]

@smithECGBlog @willyhfrick If this is an EKG of a young adult with exertional symptoms, then it's most likely HCM. It fulfills the voltage criteria for LVH + Qs in lateral leads.

[Nirdosh Rassani @emdoc_nirdosh]

A young male with severe epigastric pain, not resolving with nalbuphine, morphine, and GTN. What do you think about this EKG?

"To cath or not to cath?"

@EM_RESUS @srrezaie @smithECGBlog @ECGWeekly @EcgsOnly @ekgpress

[Nirdosh Rassani @emdoc_nirdosh]

@smithECGBlog @EM_RESUS @ekgpress @TheSGEM @amalmattu @EcgsOnly @ECGWeekly @ecgguru @srrezaie The cardiologist wasn't convinced that it was STEMI/OMI, the patient wasn't moved to cath. He died of electrical instability. He went into V.Fib 2 more times.

I don't know when they will agree with ER physicians.

[Nirdosh Rassani @emdoc_nirdosh]

48 yo male with OHCA was brought to the ED within 10 minutes of cardiac arrest.

Post ROSC ECG is shown here.

Answer the following:
1. STEMI or No STEMI?
2. Cath or No Cath?

@ekgpress @TheSGEM @amalmattu @smithECGBlog @EcgsOnly @ECGWeekly @ecgguru @EM_RESUS @srrezaie @TheEKGGuy

[Amal Mattu @amalmattu]

Thanks for the props🙏. 20th anniversary edition of volume 1 just published!