Jonathan Cheah 🚢

Emergency Doc ❤️ Education / Geri / POCUS / Quality / New Insights / Learning everyday.

[Aadit Sheth @aaditsh]

The most dangerous addiction today isn't a substance.

Research on 100,000 people confirms that heavy short-form video use is just voluntary cognitive decline. We are actively training our brains to fail at hard tasks.

If you can simply sit with a problem for 10 minutes without swiping, you have a massive competitive advantage.

Basically, boredom is the new IQ.

[Jonathan Cheah 🚢 @joncheah]

@EM_VATA is a CT Scan available at your facility. or the CT was done at tertiary

[Jonathan Cheah 🚢 @joncheah]

i quote this for all our ED trainees who want to give stuff to correct deranged INR prior to paracentesis

[Elliot Tapper @ebtapper]

Guidelines are unanimous;

For look risk procedures like paracentesis we need not check INR and should not give FFP

Liver, gastroenterology, hematology, and interventional radiology societies agree

So why the variation in managing “the cirrhotic coagulopathy”?

🧵

[Keith Siau @drkeithsiau]

Proud to share our state of the art review on acute upper GI bleeding 🩸🆕

1️⃣ Management algorithm
2️⃣ Endoscopic management
3️⃣ Antithrombotic management
4️⃣ Trends over time

📸: @FrontGastro_BMJ
https://t.co/D5FEvSNSrF

[Croakey News @CroakeyNews]

In Aust, number of women in clinical radiology (CR) hovering at 30%, radiation oncology (RO) nearly at parity, 46%. In NZ the numbers are similar, but slightly more for CR and slightly less in RO.

In 2025, 40% of @RANZCRcollege Board are women, up from none in 2022!

#RANZCR2025

[Jonathan Cheah 🚢 @joncheah]

Human factors

[Jonathan Cheah 🚢 @joncheah]

@A_Sapp12 hopefully no needlestick; well done !

[The IMJ @The_IMJ]

IMJ August 2025 #FreeAccess
Editorial: Re-defining Clinical Reasoning
https://t.co/nFfSWCuEt2
@TheRACP @WileyHealth @PaulBridgmanMD

[IMCrit @IM_Crit_]

Did you ever place an arterial catheter and just the next day it stopped functioning?

I thought it was due to my poor technique but it seems that we should pay greater attention to the catheter material

Note: this study was funded by Vygon France

[Cliff Reid @cliffreid]

Clinical Policy: Critical Issues in the Management
of Adult Patients Requiring Endotracheal
Intubation in the Emergency Department

Evidence based recommendations to reduce risk of peri-intubation hypoxemia and/or hypotension

from ACEP @EmergencyDocs

https://t.co/m1TrsH7pSA

(Infographic generated by https://t.co/wQ7o63xJ1l)

[Jonathan Cheah 🚢 @joncheah]

“meth is an ED problem ; it is OUR disease” also Prof Dan Fatovich shares his favorite slide showing long posting drugs showing false positives for amphetamines #acem24 ..

[Jonathan Cheah 🚢 @joncheah]

“A lot of people have holes in their life ; until you fix those ; you are not able to fix addiction” Professor Dan Fatovich from RPA speaking about methamphetamine at #acem24

[Jonathan Cheah 🚢 @joncheah]

@precordialthump speaking on helping obese patients breathe better in ED at #acem24 . advises cpap (roughly weight divided by 10 is your peep target)

[Jonathan Cheah 🚢 @joncheah]

Anastasia Mutic and @DrSimonCraig from the @PREDICT_network presenting factors influencing pediatric fever management in ANZ ; citing lack of adherence to guidelines at #acem24

[Jonathan Cheah 🚢 @joncheah]

@dianagoubrial presenting at #acem24 on how @AlfredHealth reduces medications errors in their ED

[Jonathan Cheah 🚢 @joncheah]

the 3 As of private medicine : availability, affability, and ability.

[Oren Gottfried, MD @OGdukeneurosurg]

Aortic dissection

[Jonathan Cheah 🚢 @joncheah]

Authorship misconduct: professional misconduct in editorial handling of authorship - British Journal of Anaesthesia https://t.co/Rg8TYgCXD7

[Ross Prager @ross_prager]

(#3/5) Frailty (and the premorbid trajectory)

Frailty is defined as lack of physiological reserve - this can be due to many things: comorbidities, nutrition, exercise, social supports, mental health etc.

The collective effect, however, is that the prognosis following cardiac arrest, mechanical ventilation, septic shock etc. is worse ☹️(see: https://t.co/mkdlczEJQR)

What I try to determine is what has the trajectory of frailty been over the past few years.

E.g.
1 year ago independent
6 months ago cane
3 months ago wheel chair
1 month ago bed bound

This is a concerning trajectory. It is unlikely that anything in the ICU will address the underlying cause of this significant physiological decline.

[IMCrit @IM_Crit_]

14. If it is not a real emergency, check with the patient's nurse what the best time for the procedure is. If the nurse has no lunch yet & the pt is not crashing, you can wait for 30 min, right?