Ibrahim Migdady MD, MHA

Physician. Neurologist & Neurointensivist. Restless by design.

[Ibrahim Migdady MD, MHA @itsmigdady]

New account. Lost access to the old one.

[Ibrahim Migdady MD, MHA @itsmigdady]

@rxtoriarsenault 😮

[Ibrahim Migdady MD, MHA @itsmigdady]

@NelsonMogaka_ Better than everyone assuming you need too much support

[Ibrahim Migdady MD, MHA @itsmigdady]

@veev_iloabuchi I’m not a dermatologist and I agree

[Ibrahim Migdady MD, MHA @itsmigdady]

@ntradsteminist does your IRB review submissions in cycles rather than on a rolling basis?

[Ibrahim Migdady MD, MHA @itsmigdady]

@RNSuperHero The most reliable indicator of extubation readiness is when the patient tells you they want the tube out

[Ibrahim Migdady MD, MHA @itsmigdady]

@HandSurgeonMD @DutchRojas We should start telling hospitals: your facility revenue won’t cover your expenses without the physicians.

Maybe physicians should get a percentage of facility fees

[Ibrahim Migdady MD, MHA @itsmigdady]

@juliegirltweets Doesn’t seem to be the case within my circle of single women/men. Is there data on this?

[Ibrahim Migdady MD, MHA @itsmigdady]

@RoyChibuike PSP

[Ibrahim Migdady MD, MHA @itsmigdady]

@jasonryanmd 100%. Frequently on rounds I hear nurses or residents say blood pressure has been ok, stable, etc. And they are on 3 vasopressors

[Ibrahim Migdady MD, MHA @itsmigdady]

@KoaWeb3 My wife likes and retweets my posts

[Ibrahim Migdady MD, MHA @itsmigdady]

My favorite is when RT quickly aborts the SBT because the patient is “apneic.”

Meanwhile, the patient is wide awake, pointing to get the tube out, has no neurologic reason to be apneic, and their latest PaCO₂ is 25.

Sir/Ma’am, they’re apneic because you overventilated the hell out of them

[Ibrahim Migdady MD, MHA @itsmigdady]

@TheMattViera Bidet

[Ibrahim Migdady MD, MHA @itsmigdady]

These are not black and white, and it depends on the depth of conversation that was previously had with the patient.

Did the patient understand what it means to be intubated? Were they opposed to any intubation or only prolonged intubations/mechanical support? What if the intubation was for a quickly reversible etiology? Etc

[Ibrahim Migdady MD, MHA @itsmigdady]

Deskilling is so real in medicine, but it’s been happening before AI.

Every year, trainees seem less inclined to learn stuff on their own, less motivated to read, and their first inclination is to ask what to do rather than figure it out on their own.

The figuring out part is what teaches you to be a good physician. This should supposedly get better with AI, since it’s easier to find information. But it’s not getting better. It’s getting worse, and I’m not sure why.

[Ibrahim Migdady MD, MHA @itsmigdady]

@mujuni_emmy Neurosurgeons for sure

[Ibrahim Migdady MD, MHA @itsmigdady]

@nickmmark Phenobarbital (and phenobarb taper) is way superior whatever this study suggests

[Ibrahim Migdady MD, MHA @itsmigdady]

@ALMannixMD Best feeling. Though sometimes I wonder if it’s a compliment to me or a review of whoever was here before me 😂

[Ibrahim Migdady MD, MHA @itsmigdady]

@PulmCrit This is something that people who never read Marino’s (or any other good icu book) never learned

[Ibrahim Migdady MD, MHA @itsmigdady]

@DrDiGiorgio Always the outliers 😂