Martin Rofael, MD

Pulm Crit Care & Pulmonary Hypertension🫁❤️@ucIrvine | PH @Stanfordmed | PCCM @UCSF | IM @AlamedaHealth | Med @UW | POCUS | MedEd | Immigrants |🇪🇬|Views=mine

[NEJM @NEJM]

The authors discuss the mechanisms, clinical presentation, and evaluation of right ventricular failure, as well as its management. https://t.co/49H4frxcGg

[NFL @NFL]

"The journey will continue." ❤️💙

An incredible moment as @HamlinIsland takes the stage at #NFLHonors.

[Martin Rofael, MD @MartinRofael]

Well that didn’t age well

[Skip Bayless @RealSkipBayless]

HEY, EAGLES: The Cowboys will see you next weekend at your place. This time we will have our starting QB and so will you. But at full strength, we are a little better than you. You'll see. Bye, Eagles, bye.

[Dr. Glaucomflecken @DGlaucomflecken]

I made a video about dental insurance and Medicare and the ADA
https://t.co/c7hYmfURdv

[Nick Mark MD @nickmmark]

Great demonstration of how the diaphragm enables respiration.

[Nick Mark MD @nickmmark]

This tragic event in Cincinnati looks like it *may* have been commotio cordis: blunt trauma causing life threatening arrhythmia.

Blunt chest trauma during a brief window (the 30 msec upstroke of the T) wave can initiate VF. Essentially a mechanical analog to R-on-T phenomenon.

[Austin Gayle @austingayle_]

Ryan Clark’s coverage of the Damar Hamlin injury is phenomenal.

[Buffalo Bills @BuffaloBills]

The thoughts and prayers of all of Bills Mafia are supporting you, Damar. 🙏

[NFL on CBS 🏈 @NFLonCBS]

Brock Purdy ranks since Week 13

Rank
Pass Rating 110.0 1st
Pass TD/Att 7.5% t-1st
Win pct 1.000 t-1st

unreal

[Martin Rofael, MD @MartinRofael]

@IDdocAdi Tranexamic Acid

[Nick Mark MD @nickmmark]

A case everyone needs to know:

A man admitted for CHF exacerbation is normoxic on ambient air. POCUS shows bilateral pleural effusions.

He develops Afib w/ RVR (HR 150s). A med is given. Suddenly he develops hypoxemia (SpO2 84% on NC, 94% on NRB).

What med & what happened?
1/

[Nida Qadir, MD @NidaQadirMD]

🧵 on NIV in #ARDS 🫁

I’ve seen A LOT of inappropriate use of NIV in #COVID19 & have often ranted about it on Twitter. There’s also lot of new data on NIV that’s been inconsistent & confusing.

Let’s break some of it down. I’ll also add in some highlights from #LIVES2022

[Eric Topol @EricTopol]

An isolation period of 5 days after Covid is totally inadequate for most people. New report from >63,000 people. Negative rapid tests are an essential guide
https://t.co/M0P4nQLhCE @JAMANetworkOpen

[Francisco Soto, MD, MS, MBA @FSotoMD]

[1] #Hemodynamics Tweetorial #2

Heart failure pt in ICU is -3.5L after 2d of aggressive diuresis. On day 3, urine output is ⬇️and BUN/Cr is ⬆️

You personally wedge #PAC at bedside and obtain a mean wedge 17 mmHg (a normal mean wedge is 6-10 mmHg). Admission wedge was 24

[Martin Rofael, MD @MartinRofael]

Not all data is equal

[Kristen Panthagani, MD, PhD @kmpanthagani]

Florida just announced the results of an analysis that they performed, saying the results show "an increased risk of cardiac-related death among men 18-39" for the mRNA vaccines, and recommend this group not receive these vaccines.

Is this justified? Let's look at the data...

[ICU OnePager @OnePagerICU]

Non-invasive positive pressure ventilation (NIPPV) can support ventilation/oxygenation & potentially avoid the need for invasive ventilation.

This #Onepager covers the basics of NIPPV: when to use it (& when NOT to), interfaces, & modes of ventilation.
https://t.co/ibbAHbqzmi

[Stanford Wall Center @PHatStanford]

Seeking participants for the SATURN study: looking at the benefit of H01 (hymecromone) on severity of disease in patients with pulmonary hypertension (PH) and interstitial lung disease (ILD)

[ICU OnePager @OnePagerICU]

Tracheostomies are common but can be confusing if you are unfamiliar with them.

This ICU OnePager covers the basics of tracheostomies & how to troubleshoot the 3 most common emergencies: decannulation, obstruction, & bleeding. #TipsForNewDocs #FOAMcc

https://t.co/61G0pB8Sme

[Martin Rofael, MD @MartinRofael]

One of my mentees just had their 1st standardize pt of med school & their proctor didn’t give them any structured or constructive feedback. Didn’t tell them ONE good thing they did. Made them feel bad about themselves.

Educators have to be better at giving feedback.
#MedTwitter