Matthew Rowe

EM-Here to learn and connect; opinions are my own.

[Ken Milne MD @TheSGEM]

'What the hell are we doing here?' Inside Canada's shockingly violent hospitals
https://t.co/i0BZKEteuV

[Dr. Glaucomflecken @DGlaucomflecken]

Let physicians own hospitals. Put ownership of healthcare back in the hands of people actually doing health care.

[David Carr @davidcarr333]

I find myself wondering why as an ED physician, I am often the one clarifying code status on cancer patients towards the end of their journey. These are important discussions and considerations that should occur upstream by their longstanding trusted treatment team.

[Raghu Venugopal MD @raghu_venugopal]

The ultimate policy contempt for Ontarians is the early opening of 8500 alcohol retailers using $225M of taxpayer's money while ER doctors like me every single day treat Ontarians who want to access detox or rehab - but there are no options. @MaritStiles

[Raghu Venugopal MD @raghu_venugopal]

The 11 ER tasks of post-partum hemorrhage. Thanks to @EMSwami @emrap_tweets
Consider: Tone, Trauma, Tissue, Thrombin
The 11 ER tasks:
1. Uterine massage, external and internal bimanual
2. Oxytocin 10 IU IM after placenta delivery
3. Oxytocin 20-40 IU in 500ml NaCL titrated to sustain contractions
4. Manual sweep of uterus if placental pieces missing - if cannot be removed placental remnant may be invasive
5. Misoprostol 600-1000ug PO, SL or PR
6. TXA 1000mg IV, can repeat 1X. Yes, worked based on WOMAN trial (Lancet, 2017)
7. Carboprostol (hemabate) if refractory, 250ug IM - can repeat Q15min up to 2000ug
8. Methylergonovine (Methergine) 0.2 mg IV or IM Q2-4 hours PRN, maximum of 5 doses
9. MTP with 1:1:1 ratio of PRBC: FFP: platelets.
10. Intra-uterine balloon tamponade (500cc NS maximum) - Bakri Balloon
11. Consultants: ob-gyn, interventional radiology, ICU and if no other option general surgery

[🌱Alex Nataros❤️‍🩹 @alexnatarosMD]

@CanadianKayMD @pat_health **October 25** why did it take nearly 6mo for @CFPC_e to notify its members 🤔

[Daniel Pepe @dpepe88]

Sorely needed, not complicated to do and would have a huge impact - doctors should dictate when some needs a referral. We should not need to find out - who, when, how and chase the entire process to make sure it happens. That’s a system function that must exist.

[alan drummond @alandrummond2]

And that would be a shitload of ER nurses. Just saying.

[André Picard @picardonhealth]

Canadian medical residency spots have remained stagnant for a decade, a @cbcnews analysis shows. There are only 167 more spots than a decade a go; the population has increased by 5 million in that time, by @JPTasker https://t.co/qxO7rrCH83 via @CBCTheNational #MedEd

[alan drummond @alandrummond2]

But they aren't the cause of prolonged waits for emergency care.

[alan drummond @alandrummond2]

The obscenities continue. Ontarians access to care where and when they need it is at an abysmally low level and the decline into patient care hell seems to have started in earnest when Ms. Jones became Health Minister. Just sayin’.

[RJ MacDonald MD 🚴‍♂️🏄🏻🎾 @Kidsdoc1Rick]

I cannot speak for adult medicine but I can tell you actual current wait times for some of my pediatric patients;
📍hypospadius repair >24 mos
📍hernia repairs >24 mos
📍G/tube insertions >12 mos
📍adenoidectomy >12 mos

Hard to tell my parents that’s progress.

[Andrew Petrosoniak @petrosoniak]

How does this make sense in a single payer system? Hospitals are worsening their financial situations by having to take out loans yet have little to no recourse in making up this ground in a not for profit environment. 🤦‍♂️

I don’t understand this.

Patients lose in this scenario.

[Avis Favaro @Avis_Favaro]

How can provinces allow patients to wait 20 hours in ER - or days in the hallways to be admitted for care? It’s a violation of the commitment to citizens under the Canada Health act ⁦@CTVNews⁩ ⁦@AlexandraMaeJ⁩ https://t.co/znF3TEfB95

[Wayne Gates @Wayne_Gates]

Doug Ford is spending $650 million of your tax dollars on a private luxury spa - while my community in Fort Erie is facing a shortage of care at the urgent care centre.

Share if you agree - taxpayers shouldn't be paying a dime to a spa when people don't have 24/7 health care.

[Kevin Mcleod @dockevinmcleod]

It’s funny. There will be a bunch of anger over a movie being filmed on an empty floor at a hospital. That’s a non issue. Truly. Just easy politics.

What should be the issue? Why are we not training enough nurses, technologists, allied health staff? Even if the beds were open and fully funded we aren’t training enough people to fill the jobs in a province that is growing and aging.

The public has no idea how many jobs that would improve care and shorten waiting times are FULLY budgeted and funded but are sitting empty. If you are waiting for a surgery or scan it’s in large part because we haven’t planned the human resource properly. Instead we put more and more money in to a limited resource.

Does paying me more improve your access to care? Does training more of me improve it? Option 2. Pick option 2.

[David Carr @davidcarr333]

@alandrummond2 @CBCTheNational Great piece. I think the tragic misunderstanding is that it’s not just waiting room deaths that show the cracks. Patients have their outcomes dramatically worsened by their excess time spent in the waiting room. Every shift we pick up charts of sick patients who waited too long.

[Ken Milne MD @TheSGEM]

This right here. I’m less interested in assigning blame and more interested in working cooperatively towards solutions. @CanadianKayMD @snewbery1 @NightShiftMD @Kapur_AK

[CBC News @CBCNews]

Premier Doug Ford's government gives a for-profit clinic more funding to perform certain OHIP-covered surgeries than it gives Ontario's public hospitals to perform the same operations, CBC News has learned. https://t.co/SWIVPenLlH .

[OntarioHealthCoal'n @OntarioHealthC]

While she was Health Minister, Don Mills Surgical, a private for-profit hospital, got a 278% increase in funding. She didn't run again in the 2022 election, and now Christine Elliott @celliottability has become a lobbyist for Don Mills Surgical.

It should be illegal.