Bryan D Hayes PharmD

EM Pharmacist & Toxicologist @MassGeneralEM | Associate Professor @HarvardMed | Past-President ABAT | EIC | @ALiEMteam EM Pharm Pearls

[Bryan D Hayes PharmD @PharmERToxGuy]

Pharmacy-driven medication histories decreased length of stay and in-hospital mortality https://t.co/fISnf4N5h1 @AJHPOfficial @ASHPOfficial

A monumental team effort and the first study to look at hard outcomes. With @PharmDirJM @jlkoehl @giulietti_Rx @DavidLucierMD, & others.

[Bryan D Hayes PharmD @PharmERToxGuy]

It’s embarrassing that in a specialty where pharmacists and physicians work side-by-side caring for patients at the beside, we continue to see disparaging of other professions.

It’s disheartening because many have worked tirelessly to build collaboration and teamwork.

[Saba Rizvi M.D. FAAEM @sabarizvimd]

A pharmacist can’t take a call from a doctor to fill a prescription for a patient, because they’re too busy playing one.

Pharmacist busy giving a “shot” to a customer.

Unbelievable. We live in a topsy turvy world now.

[Bryan D Hayes PharmD @PharmERToxGuy]

@psychunseen I haven’t looked at that. My focus in emergency medicine is generally acute agitation where we often use parental agents. The studies like to look at time points (15, 30, 60 minutes etc), so it’s difficult to determine actual onset times.

[Bryan D Hayes PharmD @PharmERToxGuy]

We have an ED pharmacist position open on our team at MGH in Boston! Apply here: https://t.co/oyN6SAYHZM

[Bryan D Hayes PharmD @PharmERToxGuy]

It still brings me great joy to watch pharmacology in action while on clinical shift in the ED. My 3 favorites are: naloxone, physostigmine (RIP), and high-dose nitroglycerin + BiPAP (for 'flash' pulmonary edema).

[Bryan D Hayes PharmD @PharmERToxGuy]

@reverendofdoubt What’s your management approach to these patients when they present to the ED: 1) on their own after a home BP reading, 2) on advice of the after-hours PCP coverage clinician, and/or 3) after they were checked in for a same-day procedure at your hospital?

[Bryan D Hayes PharmD @PharmERToxGuy]

I can now retire.

Published in today's issue of @NEJM.

https://t.co/Um9FqC3iMh @MassGeneralNews

[Bryan D Hayes PharmD @PharmERToxGuy]

What a multi-site collaborative effort to see this one through to completion!

Free downloads here in @Clin_Tox: https://t.co/6HZUghIQOY

@PeterRchai @Harvard_Tox

[Bryan D Hayes PharmD @PharmERToxGuy]

@warejko I'm still hoping to understand someday why @aaeminfo included pharmacists in their 2020 statement. We don't perform procedures or detract from resident education (quite the opposite, in fact).

https://t.co/WedmSqeW8F

https://t.co/6jzmLyiRz4

[Bryan D Hayes PharmD @PharmERToxGuy]

This is incredibly disappointing and demonstrates a clear lack of understanding at the leadership level regarding the education and training of the multidisciplinary, allied-health, clinical team members involved in emergency care.

1/however many tweets this takes

[American College of Medical Toxicology @acmtmedtox]

>>https://t.co/J86Ut1MCKa<< New ACMT Position Statement: End Use of the Term "Excited Delirium"
🧵
@TonyPizon @louisekao44 @ZiadKazzi @toxicologist12 @heshiegreshie @johnsonarbor @bpatmurray @DHOvakim @LNelsonMD @twtoxmd @kavitababu

[Bryan D Hayes PharmD @PharmERToxGuy]

I’ve worked side by side with incredible EM doctors for 16 years. I can assure you this sentiment is not representative of the specialty. If you’d like to be educated on what an EM pharmacist is, here’s a thread from the pervious time…

https://t.co/WedmSqeW8F

[Amy Faith Ho, MD MPH @amyfaithho]

How do you tell a medical doctor?

Real doctors: *reluctant to state they are doctors in public/social forums*

Non-MD/DOs: *take every opportunity to say they are a doctor…* (chiropractors, naturopaths, pharmacists, apothecaries, charlatans…)

[Bryan D Hayes PharmD @PharmERToxGuy]

Earning a blue check mark during the pandemic, as a pharmacist, meant a lot. Health care workers sharing real-world experience, educating, and interpreting evolving scientific data was critical. But, the platform and culture changed. Pay-to-play just isn’t what #FOAMed is about.

[Bryan D Hayes PharmD @PharmERToxGuy]

@vlad_sok @AcademicEmerMed @ALiEMteam We use 2-4 gm infused over 10-15 minutes.

[Bryan D Hayes PharmD @PharmERToxGuy]

We love our magnesium in the ED. Here's a new @AcademicEmerMed summary on its use as an adjunct in atrial fibrillation: https://t.co/7Bfg4Q61dH.

And, our @ALiEMteam deep-dive from a few years back: https://t.co/EfYWaYSWvz

[Bryan D Hayes PharmD @PharmERToxGuy]

@doctorsaluja @AcademicEmerMed @ALiEMteam We use it for most patients. 2-4 gm.

[Bryan D Hayes PharmD @PharmERToxGuy]

I spot at least two EM pharmacists on the new Fellow of ASHP (FASHP) induction list. Congrats @DEZ_EM_Pharm and @memusselman!

https://t.co/2DE8ZbX6oD

[The New York Times @nytimes]

Breaking News: The FDA approved Narcan, a nasal spray that reverses opioid overdoses, for over-the-counter sales.
https://t.co/Jtd8ed5FKV

[Bryan D Hayes PharmD @PharmERToxGuy]

Xylazine is back in the headlines as an adulterant (https://t.co/sV6R0NQxUx). It acts similarly to other alpha-2 agonists (clonidine, guanfacine) and causes hypotension, bradycardia, lethargy, and miosis.

Good review on poisonings by @DEZ_EM_Pharm et al. https://t.co/to5043nG6w

[Bryan D Hayes PharmD @PharmERToxGuy]

Xylazine is in the headlines again with a new DEA alert (https://t.co/sV6R0NR5K5).

With poisoning, we see effects as we would with other alpha-2 agonists (clonidine, guanfacine) such as hypotension, bradycardia, and lethargy (https://t.co/to5043odW4).

cc: @DEZ_EM_Pharm

[Bryan D Hayes PharmD @PharmERToxGuy]

Added a bunch of new EM pharmacists to the list after the resident match this week. The growing family is up to 615. Let me know if I'm missing anyone (I go by what's listed in profiles). Follow the list if you want to see what EM pharmacists tweet about! https://t.co/YYQr9Ks4cR