Julian Botta

@RWJMS➯@JohnsHopkinsEM➯world; Into cooking, being outside, collecting hobbies; MedEd/sim/spaced retrieval/resus/critcare/POCUS/HALO procedures/human factors

[Julian Botta @julianbotta]

@reverendofdoubt Are you telling me this isn't enough??

[Julian Botta @julianbotta]

@reverendofdoubt There needs to be a cultural shift among patients for that as well, not just tort reform.

[IMCrit @IM_Crit_]

ICU #Airway Secrets:

Intubation may be difficult due to anatomic airway abnormalities but also due to physiologic derangements that predispose patients to cardiovascular collapse during the procedure

This is the concept of "physiologically difficult airway":

[Dr. Rick Pescatore @Rick_Pescatore]

Emergency medicine is a lifestyle, not just a job.

You’ll see the sickest patients, the worst luck, and the darkest corners of humanity—& still be expected to smile, move fast, and get it right every time. A thread on what they don’t tell you about EM. 🧵

[Eric Koch @EricDKoch]

A friend of mine has skin cancer and was about to start a clinical trial at MD Anderson after his other treatments did not work.

Trump's decision to temporarily halt funding for medical research also applies to clinical trials.

His treatment is now canceled.

[Julian Botta @julianbotta]

@reverendofdoubt Or a sign that someone else is insisting on it...

[Roxana Amirahmadi @RAmirahmadi]

Had a great session on #AI in #MedEd alongside @ChrisCarrollMD, @vanholdenmd and Sami Safadi at @accpchest! I focused on how intelligent tutoring systems can meet challenges in medical education. Thank you to everyone who attended and promoted thought-provoking discussions!

[Josh Farkas MD 💊 @PulmCrit]

I for one am looking forwards to improvising volume resuscitation with a continually rotating bevy of weird fluids.

what do we have today? plasmalyte? one third normal saline with phos? 5% albumin? hetastarch? gelofusine? 23% saline drizzled over D5W? LFG

[Amy Faith Ho, MD MPH @amyfaithho]

Dear Doctors,

Happy annual cut-your-compensation day.

This one comes with an additional demand for you to change your practice to address “whole body care” and spend lots of administrative overhead proving your “quality” with metrics that are mostly gamesmanship and complex paper pushing.

Love,
US Government

https://t.co/8CsZW2w7GQ

TLDR: 2.8% cut across the board through the RVU conversion rate. This has decreased every year since 2020, for a 10% cut ever since become COVID "healthcare heroes"...🤬

#medtwitter @CMSGov @MedicareGov @AmerMedicalAssn @ACEPAdvocacy

[Roxana Amirahmadi @RAmirahmadi]

It was such a privilege to present my work on the Ventilator Waveform Interpretation Skills of Attending Physician (VISA) Study at #ATS2024. A big thank you to my wonderful mentors @NitinSeam and Dr. Lee and the CCERC who guided me throughout this project. @NIHCritCare @ATSMedEd

[Nitin Seam @NitinSeam]

Shout out to @RAmirahmadi for her great mechanical ventilation #MedEd research on faculty learning of mechanical ventilation

#ATS2024

[Doctor Money Matters @drmoneymatters]

Never forget why your health insurance costs are significantly higher while most doctors earn less every year. 👇🏾

[Julian Botta @julianbotta]

@EcgOxford @dromron (clarification: the societal expectation is that there is no acceptable miss rate, which is completely unrealistic)

[Julian Botta @julianbotta]

@EcgOxford @dromron From a practical standpoint, maybe except in cases of very high pretest probability, I don't disagree, but I think from a medicolegal standpoint in the states (completely unrealistic as it may be), there is no acceptable miss rate.

[Julian Botta @julianbotta]

@EcgOxford @dromron Rule out? POCUS is great, but generally specific, not sensitive. Is there any literature showing very high sensitivity of a specific structured US scanning approach that approaches CT sensitivity?

[Cliff Reid @cliffreid]

For anyone using iGels in airway management this 14 min video of me getting schooled by my friend and airway mentor @OSWinNSW contains so many useful tips!

https://t.co/8wuHXRbIzc

[Ron Barbosa MD FACS @rbarbosa91]

🧵regarding the Aberdeen knot:

a surgical knot that may be used to secure a continuous suture. It is thought to be more secure than a square knot.

We will cover how to do it, what *not* to do, and also a little-known modification that may make it even more secure.
(1/ )

[Julian Botta @julianbotta]

An interesting thread on the developing tiered healthcare system.

[Will Manidis @WillManidis]

Last year, I paid thousands of dollars for a physical at one of the best hospitals in America

I wanted to see how different healthcare was for the ultra-rich, and what this meant for the rest of the healthcare system

Here's what I learned:

[Julian Botta @julianbotta]

#medtwitter people, anyone making moves over to threads? Who can I follow on there, particularly EM and critical care? Anyone have a list?

[Justin Morgenstern @First10EM]

One of the deepest dives I have done into a clinical topic.
I wasn't a huge fan of the results, because I really enjoy performing LPs
https://t.co/yTvQ0Zp6Ly