Lizzy Varnell Rohrbach

Academic Hospitalist. Interested in Quality Improvement, Patient Safety, and Medical Education. Tweets are my own.

[Alan You, MD @AlanYouMD]

Obtaining cardiac ultrasound images during ACLS can sometimes be a hectic process. How does the quality of these images compare to those obtained outside of cardiac arrest? Check out our full manuscript for more information! https://t.co/EodhHRrRxK @lataylor1218 #pocus

[Emily Fridenmaker @emily_fri]

Sometimes patients and families ask us very direct questions like, “is he going to get better?”

I’ve found that one of our (my) subconscious defense mechanisms in response to the discomfort of directly answering is to answer it in as many words as possible.

[Lizzy Varnell Rohrbach @lizzyvarnell]

@cderekleiner @gmacmommy @CarolMarceloMD I also like to share this podcast with my student learners and resident team - https://t.co/igLWzaI1JU

[Josh Briscoe @jcbriscoe1]

There's been good discussion about the relationship between palliative care and dying recently. Some thoughts of mine... 1/ #hapc #hpm

[Dr. Glaucomflecken @DGlaucomflecken]

Things are getting tense over at glaucomflecken university hospital

[Dr. Glaucomflecken @DGlaucomflecken]

Hanging out with the hospitalist

[Journal of Hospital Medicine @JHospMedicine]

Ever wondered whether to check INR/plts or transfuse before doing that paracentesis in your pt w/ cirrhosis? Wonder no more! This month's #ThingsWeDoForNoReason @drlessing @byrondcrowe @CUDivHospMed @CUAnschutz https://t.co/VcsglUuVuK

[Kate, NP @thelakesshow]

In the setting of advanced stage Incurable disease:

Im not ready to die ≠ I want to be a full code

I don’t want to die ≠ I want maximally invasive care to prolong my life as long as possible

I want to be comfortable ≠ I’m ready to die

#hapc #hpm #pallICU

[Shunichi Nakagawa @snakagawa_md]

In a family meeting, after you explained the situation is worse, I see many doctors ask,

"What would he WANT?"

I think this is a BAD question, although I'm aware it is well-intentioned.

I will tell you why...(thread)

1/

[Jennifer Spicer, MD, MPH, MHPE @JenniferSpicer4]

1/ Supervisor's 💭
Why isn’t the heparin drip ordered yet? I’ll just order it...

Trainee's 💭
Why am I even here? My supervisor repeats everything I do. Do they even trust me?

How can we balance supervision w/ autonomy?

This week’s #MedEdTwagTeam topic: Trust & Empower
#MedEd

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

1/

There seems to be an association between the use of "normal" saline and acute kidney injury (when compared with other IV fluids).

Why would that be?

#medthread #medtwitter #tweetorial

[Rebecca Berger 🇮🇱 @RebeccaEBerger]

@jasonjohnmd Overnight emergencies, you could get 7 cases just from abnormal vital signs: Hypotension, hypertension, tachycardia, bradycardia, hypoxia, tachypnea, Bradypnea/apnea. Hyperglycemia. Hypoglycemia. Agitation. Lethargy/obtundation. Upset family member.

[Lizzy Varnell Rohrbach @lizzyvarnell]

Blown away by @ptfaddenMD and his impressive diagnostic reasoning skills at CPC today! Doctors like Pat make @VCUInternalMed and @RichmondVAMC amazing places to work!

[Kimberly D. Manning, MD, MACP @gradydoctor]

1/
Getting in “reps”

It’s hard to get reading in after I get home. I find myself promising to look things up and then getting swamped by life and family as I walk through the door. I’ve been using the @CPSolvers app on the fly to (as @Gurpreet2015 says) “get in reps.”

[Eric Warm @CincyIM]

Incredible piece from Marie Archambault Carson: You Did Not Teach Me What You Thought You Did https://t.co/0kvTixFsd1

[Lizzy Varnell Rohrbach @lizzyvarnell]

I was just talking about this article with Matt Willis! Any interest in a chief project to improve diagnostic calibration and learning on night float? @AudreyBJernigan @JCHillyard

[Andrew Olson, MD @andrewolsonmd]

So excited for this collaboration! Join us!
#teachdx #jhmchat

[J.D. Zipkin, MD @ZipkinMD]

@MKIttlesonMD Attending: be sure to check his eyes n' nose every day to track his heart failure

Me (a med student): definitely!

* later *

Me: why do we check his eyes or nose?

Resident: .. ... what?

Me: 🤔

Resident: 😶

Me: 😅

Resident: Do you mean I&O's? 🧐

Me: ⚰️

[Kimberly D. Manning, MD, MACP @gradydoctor]

1/
Have I ever told y’all how much I loooove to give #feedback?

Here’s why:
1. It adds meaning to my work in #MedEd.
2. It honors the learners and the patients.
3. It informs my final evaluations.
4. It improves the learning climate.
5. It's necessary.

*Shout out to #2.

[Ross Schumacher, MD @RossCSchumacher]

Anyone ever been curious how/why we target a MAP of 65 in septic shock? Why should we care about how our arterial BP is being measured? What's the actual data behind some of our ICU clinical practices? WELL WELCOME TO MY TWEETORIAL @UTSWIMchief @UTSWInternalMed