Sam, DO/EMT-P

he/him, EM/EMS. Medic/firefighter & emergency management. #PatientSafety, #CaregiverWellness & #CISM. Experienced little brother & novice Jeep mechanic

[Sam, DO/EMT-P @scbroder]

"Though I once believed that fundamental concepts do not change, I have since changed this fundamental concept." - An important lesson on medical education from Dr. Felson. From his 1973 edition of Chest Roentgenology. @JCBroderMD

[Sam, DO/EMT-P @scbroder]

@AndrewShanes Great work!

[Sam, DO/EMT-P @scbroder]

@OneArmWonder @jab_doc Intravenous injection for infiltration and nerve block? That’s weird… I don’t understand what that means

[Sam, DO/EMT-P @scbroder]

@pfrostamis @EaglesGather @HandtevyMD @BradGoldbergMD @PEMTweets @PEMatCHOP @EmoryPedsICU I’ve certainly delayed transport while either waiting for resources or seeing how they do on alternative therapy

[Sam, DO/EMT-P @scbroder]

@pfrostamis @EaglesGather @HandtevyMD @BradGoldbergMD @PEMTweets @PEMatCHOP @EmoryPedsICU I think the clinical answer in the moment is going to always be “it depends.” You can try alternatives and see how they do, we used to not have HFNC for transport at all, but if I’m admitting a kid to PICU because they need HFNC, that is certainly a tough spot.

[Sam, DO/EMT-P @scbroder]

@pfrostamis @HandtevyMD @EaglesGather @BradGoldbergMD @PEMTweets @PEMatCHOP @EmoryPedsICU So two answers: in the moment I need to get the kid out safely so I’d call a helicopter. After: I’d work to understand the limitations of local resources and the best way to either supplement them or call for help.

[Sam, DO/EMT-P @scbroder]

@pfrostamis @HandtevyMD @EaglesGather @BradGoldbergMD @PEMTweets @PEMatCHOP @EmoryPedsICU Yes, but it depends on your catchment area/call volume and what level of service/training/recruitment it can support. It would be nice to have ground CCT many places but it’s not an easy or cheap endeavor.

[Sam, DO/EMT-P @scbroder]

@pfrostamis @HandtevyMD @EaglesGather @BradGoldbergMD @PEMTweets @PEMatCHOP @EmoryPedsICU I’d call a helicopter

[Sam, DO/EMT-P @scbroder]

@mack505 @chicagomedic @JonEMTP Yeah, I’ve see that happen and been in those groups. It takes a skilled educator to be able to engage everyone where they are, consider their practice environment, and to be able to work the group into harmony. If done well the mixed group can be a lot of fun and can bridge gaps

[Bryan McNeilly @bp_mcneilly]

Baystate Health in Western Mass. has officially started its EMS fellowship!!

Now open for applications for the upcoming 2023-24 academic year.

Check out their one-pager below!!

@seth_kelly @emresidents @BaystateEM

[Sam, DO/EMT-P @scbroder]

@XianJaneway @WilMcmillen Alternatively, don’t ventilate the house. Evacuate and call the fire department so they can measure the CO levels with their gas meter and you know if the CO level is the culprit. The air filter and dust collection systems are likely not the culprit, if it is CO.

[Sam, DO/EMT-P @scbroder]

@med5690 @romduck @LWestafer I don't know of any but agree with
@LWestafer - Perhaps could make sense for special ops medics on USAR & TEMS

[Sam, DO/EMT-P @scbroder]

@LWestafer @DrAlexisLa The pharmacists love it when I write on the script "please adjust & substitute concentration as needed for insurance authorization"

[Brown EM Residency @BrownEMRes]

XYALZINE - What do we need to know?

- Alpha-2 agonist (think clonidine)
- Common in drug supply, fentanyl cutting agent
- Respiratory depression, bradycardia, and hypotension in patients with overdose, limited response to naloxone
- Consider pads, pressors, intubation, and MICU

[Sam, DO/EMT-P @scbroder]

@NAEMSP @natalie_zink This is great! For many medical students every dollar spent is coming from loans & gaining interest. Glad we can help support them. Strong work!

[Sam, DO/EMT-P @scbroder]

@DrAshleyBonheur Molly? @broder_md

[Sam, DO/EMT-P @scbroder]

@Neph_Lon So frustrating! I've had luck with "the theoretical risk of IV contrast induced nephropathy is less than the risk of a complication due to a delayed diagnosis of an acute process" same logic/argument with scanning pregnant patients