Klaus Fessele

[CardiovascularCorner @TrackYourHeart]

Oxygen is NOT contraindicated in COPD.
But it must be controlled.
🎯 Target
Uncontrolled high-flow oxygen → ↑ acidosis, ↑ mortality.

[Klaus Fessele @ernuernberg]

@cysu07 @angelaleran @LopezLizarraga_ @EkgHacks Could be a fascicular VT.

[Rob Buttner @rob_buttner]

‘VT’ versus ‘SVT with aberrancy’.

The long list of VT "suggestive" ECG features is difficult to recall and apply in real time.

How can we simplify things?

Here is my ABCDE approach – five simple Qs to ask:
🧵👇

[Aravind Palraj @Rheumat_Aravind]

🧵 Hyponatremia: The Modern Urine-Based Approach (Part 2)

Tweet 1:
Bedside volume assessment is often subjective and variable.
💡 A physiologic way to evaluate hyponatremia = use urine osmolality & urine sodium.
Here’s the stepwise approach every clinician should know ⬇️
@IhabFathiSulima @DrAkhilX #MedTwitter #MedEd

[Vinson Yew @Dokutah_Vyew]

It’s here, the definition of HATW

[armyemdoc @armyemdoc]

You've got a patient with an LVO pending thrombectomy. Should you lay them supine/flat or elevated the HOB 30 degrees?

In this RCT that was stopped early due to safety, they found that laying the patient supine/flat resulted in:
-Stopped early by DSMB after enrollment of 92 out of a planned 182 patients
-Less clinical deterioration defined as worsening NIHSS >2 (HR 34.4, 4.6-254.4)
-Less clinical deterioration defined as worsening NIHSS >4 (HR 23.5, 3.1-175.9)
-18% reduction in all-cause in-hospital **mortality** (p=0.03)

That's right, you can improve outcomes in this small subset of patients with an intervention that costs nothing. This is even cheaper than the prone positioning benefits in severe ARDS that cost a small fraction of staffing time.

https://t.co/A4TOUFCdUy

#emergency #emergencymedicine #criticalcare #icu #science #data #research #army #armymedicine #armyemdoc #stroke #brain #medx #medtwitter

[Houssein Safa, MD @hsafaMD]

🩸Hematology For the Non-Hematologist🩸

(A practical educational series for internal medicine trainees and physicians)

Episode 4 - Febrile Neutropenia? Here’s your assessment and plan.

Listen up - 🧵

[POCUS Med Ed @pocusmeded]

This is a lung pulse seen with #pocus. This is a clever way to rule out a pneumothorax in patients with absent lung sliding.

While pneumothorax is a likely cause of absent lung sliding, it can also be seen with pulmonary fibrosis, pleurodesis, or atelectasis. In these latter cases, the visceral pleura is still attached, it just isn't moving as it should.

[Aravind Palraj @Rheumat_Aravind]

🧵 “Cryoglobulinemia: 10 Facts You Need to Know”

Cryoglobulins are cold-precipitating immunoglobulins.
Their presence can mean infection, malignancy, or autoimmunity.
Here are 10 essential pearls to help you spot and manage cryoglobulinemia 👇
#Rheumatology #Autoimmune #MedTwitter #ClinicalPearls @DrAkhilX @AskDrShashank @IhabFathiSulima

[Aravind Palraj @Rheumat_Aravind]

🧵 “ANA Positive ≠ Lupus: The Art of Interpreting Autoantibodies”

ANA positivity is one of the most misunderstood findings in medicine.
Here’s how to approach an ANA report systematically, clinically, and with confidence.
👇 #Rheumatology #ANA #Autoimmunity #MedEd @DrAkhilX @IhabFathiSulima #MedTwitter

[Ross Prager @ross_prager]

Sign 3: Patient has an uncontrollable urge for a bowel movement.

Of course this can be seen in many other clinical scenarios, but when you have an extremely unwell patient who is hyperfixated on the need to have a bowel movement, take note.

Why? I can't explain it but have seen it a couple time. Curious if anyone else knows why.

[Cliff Reid @cliffreid]

Tips on bougie use in critical care intubation
https://t.co/VGAPBOCB9O

[Ross Prager @ross_prager]

(5/x) During CPR to ensure high CPR quality I look for:
1. Rate and Depth of compressions
2. Full recoil
3. CPR NOT too high (which it often is!)
4. Avoid overventilation
5. If EtCO2 unexpectedly low, consider whether we are compressing of LVOT or aorta instead of LV. In that situation, even empirically, I will move CPR down and to the left a touch. I have seen in some cases (definitely not all) the ETCO2 improve

[Cliff Reid @cliffreid]

Very easy to be inspiring when one has had such inspiration

The message to those dedicating themselves to the development of emergency medicine:

Make everything you do about the PATIENT, not the SPECIALTY

That is the Emergency Medicine we learned from John Hinds

@DocJohnsMum

[Mounir Basalus (Ⲃⲁⲥⲓⲗⲓⲟⲥ) @Basalus]

🚨 Flecainide Overdose: A Deadly Disruptor 🚨

Flecainide is a powerful antiarrhythmic, but in overdose, it can wreak havoc on the heart and nervous system. Here’s what to look out for and how to manage it. 🧵⬇️

[TBS Zermatt @TBS_Zermatt]

Life 2.0 - What the dead can teach us about living | Matt Morgan | TBS Z... https://t.co/6D0jqm5qaF via @YouTube

[Dr Honey choudhary 🩺 @Doctors__squad]

Signs of respiratory distress in pediatric

[Anaestheasier @Anaestheasier21]

Why you don't want to intubate DKA

[Shane Broderick @DocSBroderick]

So we decided to do something a little different when it came to pre-course reading material for #RESUSCITATE so instead of the usual course book, we condensed it onto a SINGLE PAGE with lots of QR codes. In the interest of #FOAMed, here you go! Feel free to RT/spread!

[Powerful Medical @PowerfulMedical]

📖 Faszination EKG by Dr Grautoff, Dr Fessele & Dr Knapp presents 50+ real-world ECG cases for learning & clinical decision-making. Happy to have contributed by digitizing the ECGs, which feature the distinct blue grid signature of #PMcardio.
📘 Book here: https://t.co/qvLsGcPrvk