𝘿𝙧. 𝙄𝙣𝙩𝙚𝙣𝙨𝙞𝙫𝙞𝙨𝙩𝙖

Especialista en Medicina Crítica y Urgencias, apasionado por la tecnología médica y enseñanza. Primun non nocere.

[𝘿𝙧. 𝙄𝙣𝙩𝙚𝙣𝙨𝙞𝙫𝙞𝙨𝙩𝙖 @starktmc]

Una Rx de tórax infradiagnostica el derrame pleural, usa el USG para:
👉 Diagnosticarlo antes🧐
👉 Estimar el volumen 🤔
👉 Guiar la punción diagnóstica 😎
mas info aquí 👇👇
https://t.co/9RpZjfWp9e
#MedCritUni #criticalcare #Foamed #Foamcc #usg #POCUS

[Eddy J. Gutierrez, MD @eddyjoemd]

The decision as to whether we should provide bicarb to our critically ill patient takes places every single day. This paper breaks things down amazingly well. Don’t forget to pay attention to the serum CO2. 🎩 tip to the authors.
https://t.co/wtiQFg1wGN

[PERIODISMO DEL SUR @oro_negro26]

HOLA @DanielNoboaOk

[Matthew Ho @MatthewHoMD]

Awesome summary of Hypoglycemia!

Here’s my approach

[Lorenzo Fácila @mi_cardiologo]

Fallo de Ventriculo derecho. Excelente revisión. Enhorabuena @carlosreal42 https://t.co/B9xjYwa3mt

[IMCrit @IM_Crit_]

ICU Secrets:

[NephroPOCUS @NephroP]

Focused Cardiac Ultrasound for the Nephrologist: Utility of the M-mode
🔗 https://t.co/l1PINoVgnr
#POCUS #FOAMed #Nephpearls

[Dr. Joshuan J. Barboza @joshuanbarbozam]

¿Qué es el Odds Ratio (OR)?
Aquí te presento una definición más allá de la fórmula.
Si te gustó, comparte.
Conoce más en: https://t.co/my7jgMjvMr

[IMCrit @IM_Crit_]

ICU snippets:

70 yo. Out-of-hospital cardiac arrest. Intubated. Re-arrested many times. Eventually made it to the ICU.

ICU Nurse: What maintenance iv fluids do you need, doc?
👨‍⚕️: I don't think we need any maintenance iv fluids...

[Ross Prager @ross_prager]

A med student asked me what being an ICU doctor was like…. after struggling for a bit I used the analogy of a symphony conductor.

As an ICU doc I don’t know how to play the violin, cello, or French horn (nursing roles, RT, or pharmacist) however, I am responsible for knowing when each of those sections aren’t performing at their best and to try to help. Perhaps that is getting the 1st violin (charge nurse) to help mentor, or taking a bit of time to teach and facilitate deliberate practice.

This analogy also recognizes the fact that the music (patient care) continues almost entirely without me! However, without someone waiving a baton the tempo may become to fast, to slow, or things might slowly become out of tune.

I like this analogy as it celebrates the fact that to provide excellent patient care (beautiful music) we require every section of the orchestra to perform at its best.

This is why I love being an ICU doc.

#MedTwitter #foamed #ICU

[Residente de Crítica @DailyUrgencias]

📍Algoritmo para iniciar diuréticos en Insuficiencia Cardíaca Aguda #HeartFailure 🫀💦

[Orlando RPN @OrlandoRPN]

Usan:

- Etamsilato
- Citicolina
- Cerebrolisina
- Dióxido de Cloro
- Plasma convaleciente

Y se quejan de los Homeópatas... 😔

[Oren Gottfried, MD @OGdukeneurosurg]

Knowing Liver Segments is knowing your right hand by Craig Hacking / Couinaud

[Salim R. Rezaie, MD @srrezaie]

Peripheral Norepinephrine

-Another Observational Study
-Some Important Points on Running Pressors Peripherally

https://t.co/KCry8o3UqY

#REBELEM #FOAMed #FOAMcc #Resuscitation #Norepinephrine #Vasopressor

[Saikat Mitra @saikatmitra05]

#POCUS #Haemodynamics #MedTwitter #FOAMed

VExUS likely predicts imminent fluid congestion even before clinically evident !!👇

> A patient with aspiration pneumonia and septic shock (D2 in ICU) —> still on nor adr 6-8 mcg/min.
> EF 60%, mild TR
> Fluid balance: + 1.5lit
> Oxygen requirement stable ~ 35-40%
> No pedal or sacral oedema

Repeat POCUS: VTI 28cm 😳
—> Likely high output state from sepsis

More deets to be followed below 👇

[Butterfly Network @ButterflyNetInc]

You asked. We delivered. Meet Butterfly iQ3 - our easiest-to-use POCUS device with the sharpest image quality, rapid data processing, AI, advanced imaging tools, user-centric ergonomics, and outstanding scan time. #ButterflyiQ3 🦋

Check out Butterfly iQ3: https://t.co/P67kIpILIJ

[Paul Wischmeyer MD @Paul_Wischmeyer]

🩸ROTEM & TEG Coagulation Testing: Excellent summary & review

👉Critical appraisal of new methodologies & current literature

🔗 https://t.co/uJxBTh7p1I
#FOAMcc #SCCMSoMe #MedEd #MedTwitter
@FOAMecmo @laxswamy @CritCultivation

[CardioMotorizado @EmergPOCUS]

🚨 #Tratamiento del Status Epilepticus en la UCI 🚑 🪜

🧶🧵👇🏼 Aquí te enseñamos esos tres pasos clave para un manejo efectivo del SE 🧶🧵👇🏼 (#HILO)

🔸 Medidas Iniciales:

🚨 Como en toda emergencia médica, es crucial la estabilización inmediata de las funciones respiratorias y cardiovasculares.

🧠 Como regla general, el tratamiento dirigido hacia la causa subyacente, si se identifica, tendrá el mayor cambio de éxito.

🧪 Los tratamientos farmacológicos del SE se estratifican tradicionalmente en tres pasos ó escalones consecutivos de compuestos mayormente administrados por vía intravenosa.

[ICU OnePager @OnePagerICU]

How do you recognize and diagnose shock?

This ICU OnePager provides a framework for classifying each etiology of shock. Including physical exam, POCUS, & physiological findings (Guyton curves):
🫀cardiogenic
🫁obstructive
🦠distributive
🏜️hypovolemic

https://t.co/UQh1I7TOIT

[Intensive Care Medicine @yourICM]

🪡 Some of @yourICM most liked/shared (on #SoMe) articles for 2023... 🧵 4th post
🩸 High‑risk PE in #ICU
🔓 https://t.co/8q83i2Ixqk
🧠 Status epilepticus in emergency/critical care setting
🔓 https://t.co/vBvV76nAF8
🫁 Severe CAP guidelines
🔓 https://t.co/SlbzCv903O

#FOAMcc

[Orlando RPN @OrlandoRPN]

Criterios de Ingreso a Terapia Intensiva 🏥

☑️ Quienes deben entrar

❌ Quienes no

🚶🏽‍♂️ Criterios de alta de UCI

Hecho por un excelente consenso de expertos: https://t.co/tp8kkS16uy