David Baldwin, DO

Internal Medicine. Opinions are my own. I’m interested in many things.

[David Baldwin, DO @sci_david]

Great thread. On my last Nephrology rotation my attending told me “albumin doesn’t work... but it does, so... give albumin.”

There is quite a schism in people’s opinions on albumin use depending on the clinical scenario.

[Paco Dardón @PacoDardon]

Some days ago i had a pt with cirrhosis Child Pugh C admitted for AKI during my shift. Offending meds were withdrawn, IVC was seen at 0.9 cm and albumin infusion was started.

This common situation got my mind started: why is 🥚 so good for cirrhotic pts kidneys?

A brief 🧵:
👇🏽

[Tyler Larsen @TylerLarsenMD]

1/ Why are hypodermic needles and IV catheters referenced by gauge numbers?

And why does the needle diameter get smaller as the gauge number increases?

Let's explore the obscure history of IV sizing in the following #histmed #tweetorial.

[ScratchpadMD @scratchpadMD]

But they were, all of them, deceived, for another CT modality was made. In the reading room, forged in secret, a master image study to control all others. And into this CT scan he power-injected his contrast and his will to visualize all life. One CT Angiogram to rule them all.

[Zaven Sargsyan @sargsyanz]

Code blue: as the code runner, do you walk or jog?

I have a Russian friend who’s read a lot of Tolstoy. Once I asked him if he ever runs to codes. He said-

“A general should never run. In peacetime, it looks foolish. In wartime, it induces panic.”

1/2

[André Martin Mansoor @AndreMansoor]

1.1.2021

[David Baldwin, DO @sci_david]

So my request to #MedTwitter to help with people recovering from COVID. Let them know the struggle they may face after their illness when people in their respective communities view them as a pariah. I have seen this far too much, and it is upsetting.

[𝒌𝒆𝒗𝒊𝒏 𝒌 @radiokeller]

tweetorial on asymptomatic hypernatremia & free water flushes

1) find blank piece of paper, write out formula for free water deficit
2) crumple up the paper & throw it in the trash
3) arbitrarily choose a FWF amount/frequency
4) if too much, give less; if too little, give more

[David Baldwin, DO @sci_david]

Cross cover on a Friday the 13th was something that would reaffirm certain superstitious inclinations if I had them... which I definitely don’t but...
#MedTwitter

[David Baldwin, DO @sci_david]

Not happy about the extra hour of cross cover tonight #MedTwitter

[David Baldwin, DO @sci_david]

This is my life right now
#MedTwitter

[Adi @IDdocAdi]

When you are on call and get a 3 am page 📟 https://t.co/MVWFUpjOrz

[David Baldwin, DO @sci_david]

These tweets are an infinity loop.

[David Harker, MD, FAAD @HarkerDavid]

What’s your ddx? Will discuss path tomorrow.

#HarkerDermPearls #Dermatology #DermTwitter

[Adi @IDdocAdi]

When you order the wrong diagnostic test #stewardmeme

[David Baldwin, DO @sci_david]

@lhamtil Add aspirin = Excedrin. Can work for some people with headaches/migraines.

[David Baldwin, DO @sci_david]

@shailinthomas The earliest time you are allowed to sign out to the night team

[Tony Breu @tony_breu]

1/14
Why do we feel cold (i.e., experience "chills") when we have a fever? Shouldn't we feel hot?

And what are rigors?

Answers to these questions will help us better understand when we should obtain blood cultures.

When do you think is the best time to draw them?

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

1/
Ever wonder why eosinophils vanish from the blood after exposure to steroids?

I assumed that steroids somehow destroy them and that is why they disappear.

But there's a lot more going on.

#tweetorial #medtwitter

[John Mandrola, MD @drjohnm]

Thread: To me, the most stunning report from #ESCCongress thus far: RATE-AF trial
Older pts w/ permanent AF + shortness of breath. (there are lots of these pts).
Rate control is crucial
In 2020, most receive beta-blockers.
But BB can cause dyspnea.
What about dig?
Gulp! 1/

[David Baldwin, DO @sci_david]

Great thread as usual. Ferritin and anemia of inflammation.

First thought when I saw the picture was “alpha helix, that’s a thing right?”

#MedTwitter

[Tony Breu @tony_breu]

1/13
Why is ferritin elevated in anemia of chronic inflammation?

If the evolutionary point was/is to keep iron away from bacteria, why is our main maker of iron stores elevated?

[Dr. Glaucomflecken @DGlaucomflecken]

The short white coat

[Dr. Shadowgazer @DShadowgazer]

Crocs for All Docs:

Emergency medicine- the all terrain edition.

Trauma shears, ketamine, your Patagonia vest - you can fit it all in the bitchin’ front pockets. Imagine having an admit turned down while wearing these bad boys. Forget about it!