Medic/FF turned EM/EMS doc #medic2MD Alter ego: @TheStrengthDoc
California, USA
Joined March 2009
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Why is a fascia-iliac compartment block NOT universally the standard of care in the US ED setting for hip/femur fractures
100%Lack of training
0%Time requirement
0%Lack of hospital protocol
3 votes • Final resultsHere’s a thought: why don’t retail pharmacies use something similar to Amazon lockers to have people pick up their meds? it seems that would be much more efficient… @Walgreens @cvspharmacy @riteaid
Why is the RUSH exam such a critical assessment tool in EM? Because making the decision to give crystalloids vs blood + AC reversal is a potentially life/death clinical decision.
Joshua Nackenson retweeted
Elon Musk in 2021:
- He paid $11 billion in taxes, the highest tax bill ever in history.
- He gave $5 billion to charity, one of the highest if not the highest single charity donation in history.
Where are Elizabeth Warren and Bernie Sanders now?
@elonmusk
12 years ago, I was a young paramedic and was reprimanded by the leadership of my volunteer agency for my ardent opposition to the routine use of L&S. I'm grateful for the work of @NAEMSP putting out this joint statement for the safety of our providers & the public! #medic2MD
Crashes related to EMS lights & sirens continue to harm practitioners, patients & the public. Read our updated position statement w/@AIMHI_MIH @amerambassoc @ACEPNow @PtSafetyExpert @TheIAED @iaemsc @IAFC @NAEMT_ @NASEMSO @NEMSMAnews @QualityEms & @NVFC: bit.ly/3Bmduxp
Joshua Nackenson retweeted
Just overheard a ER doctor tell a patient “If you are concerned about C02 levels from a face mask, then our climate crises is really gonna make you lose your mind” – at South Lake Tahoe, CA
We [clinicians] need to be careful with the direction medicine is going. Quality care and metrics are not the same. At one point those goals were aligned, but we are approaching the point where metrics > patient care. 1/2
Many "metrics" do not allow for clinician judgement/expertise, and only a patient refusal precludes the clinician from a "fallout".
Could you imagine if an airline pilot, asked the passengers their opinion on how to best fly? 2/2
@ACEPAdvocacy @aaeminfo @AmerMedicalAssn
The only e-mail newsletters I actually take the time to read in their entirety are @spoonfedEM's Journal Feed & @WCInvestor
The problem w/ assuming all WCT is VT is this LACKS clinical context. ie. the patient who's HR is borderline say 150-160, has a cough, SOB, fever (likely septic). In sepsis tachycardia is compensatory to optimize cardiac output. Controlling the rate is dangerous!
CONTEXT is 🔑.
As a doc early in my career, I've reached two financial milestones recently: 1) I now owe less in student loans than on my mortgage and 2) my net worth is no longer negative. #winning
I won't be flying @AmericanAir again. Get an email looking to change flight due to "busy flight". I call up and willing to take flight with connection arriving hours late to avoid a packed flight but get told it will cost more than original ticket to change.
@AmericanAir Last I checked, COVID-19 cases in this country are soaring. Be part of the solution, not part of the problem. If you have customers willing to take less desirable flights so that you can have less people per plane say thank you -- don't shake them down for $.
Joshua Nackenson retweeted
Still remember the call 13 years ago when I was declined from a minimum wage job washing dishes at a local hospital.
A few weeks ago I was invited by that same hospital to interview for a job as an interventional cardiologist.
Trials -> Testimonies – at Boston, MA
Joshua Nackenson retweeted
Neck gaiters are garbage. Bandanas are barely any better. Please wear an actual mask, that covers your nose and mouth. The green dot represents the droplet count with no face covering at all. I want you all to stay healthy.
Source: advances.sciencemag.org/cont…
Joshua Nackenson retweeted
☝️I actually counsel students looking at residency programs to evaluate the research output of the department. The majority of manuscripts should have trainee or junior faculty first authors. Otherwise it’s a signal that senior members of the dept don’t know how mentorship works.
As I scroll major journals, I sometimes wonder: why’re long tenured full profs still first authoring major publications? What’s the driver? #MedTwitter #radonc
Joshua Nackenson retweeted
You hate your mask, you’re really gonna hate my CMAC blade and an 8-0 ET tube down your gullet. #notthehilltodieon
Joshua Nackenson retweeted
I guess the lesson is find somebody to sleep with who knows how to do CPR. Seriously don’t waste your time with non-CPR people, it’s a matter of life or death.
I realize we're the midst of a pandemic, but am I'm missing something that @amazon shipping goes from 2 days to 1 week+? I can't imagine prioritizing "essential" items basically caused their highly efficient system to grind to a halt...seems opportunistic