Vincent Gould

NP | Pulmonary & Critical Care | 🔴TTUHSC⚫️ Grad | tweets = my views only | #run #cycling #coffee

[Vincent Gould @vgould311]

Had a blast @boulderthon running the 1/2 marathon!! But “Nobody asked me” 🎙️@karagoucher @des_linden #savethe10000

[Vincent Gould @vgould311]

@karagoucher @des_linden Any chance a group shakeout run Boulderthon weekend will turn into a reality later this month?? Asking for a friend 😉 and devoted listener of the pod 🎙️. Would love to go for a quick run around Boulder!! Thanks for the strong work on the pod & all you do & Des do for running!!

[Vincent Gould @vgould311]

@karagoucher Any recommendations on where to stay for the Boulderthon near Pearl Street?? Signed up to run my first half next year & looking for advice from a local :) maybe a "Nobody Asked Us" shakeout run next year ?? @des_linden what do you think? Thank you!!

[Vincent Gould @vgould311]

@Rodfuenmayor @Skhatib55 @OchsnerCardio Nicely done friend!! 💪🔥🙌

[Vincent Gould @vgould311]

@CoachJonMurray #tradition

[Ross Prager @ross_prager]

Myth #3/5: Being a great intensivist is 'doing more'.

In fact, in many cases, being a great intensivist is knowing when to do everything, and when to do little.

One of the hardest parts of critical care is the constant need to transition from a resuscitative mindset to a de-resuscitative mindset. During resuscitation, challenging decisions based on incomplete information need to be made.

During de-resuscitation (or maintenance ICU care), a thoughtful approach that often employs watchful waiting is needed.

Additionally, for many patients, doing the right thing is actually doing less. Excellent care might be treating acutely addressable issues, but then helping pts. navigate a course that involves symptom management, exploration of values, and a comfortable and natural death.

The best intensivists I have worked with can balance the need for aggressive resuscitation and then a #zentensivist mindset.

[Vincent Gould @vgould311]

@samaureus 🥳🙌💪

[Vincent Gould @vgould311]

@karagoucher @des_linden Thank you so much for the recommendations!! Much appreciated!! Can’t wait for next year!! Love the pod and the merch 🥳 🙌. You and @des_linden are soo great to listen to and bring such great vibes!! Good luck and happy training on your upcoming 5k challenge 💪🔥

[Vincent Gould @vgould311]

👏

[Josh Farkas MD 💊 @PulmCrit]

@BenjaminBier CHEST guidelines: Albumin recommended in cirrhosis + ascites following large volume paracentesis, or with spontaneous bacterial peritonitis.

(Recommended against albumin for all other indications)

- @BenjaminBier at #critcarecards24

[Vincent Gould @vgould311]

@elishaPA_C love this thread-->thought I'd share with you friend!

[Ross Prager @ross_prager]

(3/6) Base Rate Neglect Bias

Base Rate Neglect bias occurs when the prevalence of a disease is not considered in the diagnosis / workup.

On one hand, we look for zebras and send expensive tests (that have false positives) for very rare disease, but more commonly...

We fail to empirically cover for high prevalence diseases. Most commonly in the ICU I see this in the undifferentiated shock patient that does not get prescribed antibiotics. Most shock in the ICU (up to 70% in some ICUs) is septic.

If you don't have a clear alternative cause of shock, then empiric treatment for sepsis is probably warranted as the dust settles.

[Vincent Gould @vgould311]

Great thread!!🧵 #PCCM

[Ross Prager @ross_prager]

Sepsis is a leading cause of ICU mortality but remember... not all that glitters is gold...

Here are 5 life threatening classes of sepsis mimics you can't afford to miss ☠️

A 🧵

Credit to @pulmcrit for his thoughtful approach 👇

#medtwitter #foamed #meded

[Vincent Gould @vgould311]

Loved 🙌💙 this research article by my amazing PharmD colleagues @kristilee13 & company #MedTwitter #PharmDs

[Vincent Gould @vgould311]

@lancearmstrong @wedusport How about getting @hopesolo on the Forward #podcast ?? Watched Netflix documentary and was in awe of her indomitable spirit 💪🇺🇸

[Vincent Gould @vgould311]

@wedusport @lancearmstrong #mosca

[Vincent Gould @vgould311]

@MirMahnoor 🤣🤣🤣

[Vincent Gould @vgould311]

@BandakGhassan @UTHSA_PCCM Too kind sir, thanks!

[Vincent Gould @vgould311]

@ChiefEmergRN @okstate Nice work man!! 💪

[Vincent Gould @vgould311]

@karagoucher @des_linden Well deserved 🥳!! 💯

[Vincent Gould @vgould311]

@des_linden Thank you so much!!