Pulm/crit nurse practitioner @SOMC_Health 🫁 Formally Flight-Retrievalist @UC_Health 🚁. Retired Firefighter/NRP @UTlocal3412 👩🏻🚒. Fisherman 🎣. #FOAMed
Ohio, USA
Joined October 2009
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Shad Ruby retweeted
Por amor de Dios, ya NO usen Soluciones IV de Base ❌ 💦
Un estudio de >12,000 pacientes demostró que las Soluciones Base (mantenimiento) se asocian a:
-Mortalidad
-Lesión Renal Aguda
-Terapia de Reemplazo Renal
a 30 días 📈 (MAKE30)
En buena onda prueben no usarlas, no pasará nada malo y al contrario, estarán mucho menos hinchados (o nada) sus pacientes, menos derrames, ahorran diuréticos, evitan alteraciones electrolíticas, no diluyen la Hb, etc.
Bastante tiene ya de líquidos con los que se pasan los medicamentos (infusiones, arrastre y lavados) y la nutrición que le den.
DOI10.1016/j.jcrc.2026.155619
Shad Ruby retweeted
🚨 BREAKING: The Chief of Chicago Police is being praised nationwide for the moment he STOOD WITH ICE instead of the Left
"Let me make this CLEAR! Federal agents, ICE, HSI, are officers. They are agents of law enforcement."
"If you box them in...plow a VEHICLE, you're using DEADLY FORCE. And THEY can use deadly force in response to stop YOU!"
"We need to be clear about these laws. We cannot become a society where we just decide to take everything in our own hands and start to commit crimes against law enforcement!"
"It is a crime. You may not like what they're doing. I can understand that there's a lot of emotions out there, but that does NOT mean that you get to commit a crime, especially one that could lead to deadly force."
"We need to keep everyone safe. Our responsibilities when it comes to federal agents, and I've been asked these questions, we do not interfere with the duties and responsibilities of federal agents."
This is literally just common sense.
Every single police chief should be saying this. This is DEEP BLUE CHICAGO!
Shad Ruby retweeted
New Pulm PEEPS Pearls episode out today about the use of methylene blue in septic shock!
Listen here: pulmpeeps.com/2025/11/25/111…
Shad Ruby retweeted
CT scan of a 25F with abdominal pain and feeling full after a meal. What’s the diagnosis?
Shad Ruby retweeted
Ever heard someone say ‘too sick to be intubated’
No one is
Here’s a ‘physiologically challenging airway’
Intubation for hypoxaemia & septic shock
2 emergency medicine specialists -1 on hemodynamics & oversight, 1 on oxygenation & supervising registrar intubation
Art line in, Peripheral norepi, epi 1:100000 ready to push
POCUS excluded RV failure
Ramped, preox via NIV-ST mode, allowing supported ventilation during induction
Intubated 1st pass over bougie using VL
No desat, no hypotension
Resus nurses all over it
Calm, smooth, safe. Just like we train
A shared mental model in a cohesive trained team leads to effective resuscitation
Resuscitate Before You Intubate!
Shad Ruby retweeted
#POCUS quiz of the day:
What is the linear structure arrow is pointing to?
How is the LV systolic function?
#MedEd #FOAMed #Nephpearls
Shad Ruby retweeted
I would like to reiterate Ukraine’s commitment to peace.
None of us wants an endless war. Ukraine is ready to come to the negotiating table as soon as possible to bring lasting peace closer. Nobody wants peace more than Ukrainians. My team and I stand ready to work under President Trump’s strong leadership to get a peace that lasts.
We are ready to work fast to end the war, and the first stages could be the release of prisoners and truce in the sky — ban on missiles, long-ranged drones, bombs on energy and other civilian infrastructure — and truce in the sea immediately, if Russia will do the same. Then we want to move very fast through all next stages and to work with the US to agree a strong final deal.
We do really value how much America has done to help Ukraine maintain its sovereignty and independence. And we remember the moment when things changed when President Trump provided Ukraine with Javelins. We are grateful for this.
Our meeting in Washington, at the White House on Friday, did not go the way it was supposed to be. It is regrettable that it happened this way. It is time to make things right. We would like future cooperation and communication to be constructive.
Regarding the agreement on minerals and security, Ukraine is ready to sign it in any time and in any convenient format. We see this agreement as a step toward greater security and solid security guarantees, and I truly hope it will work effectively.
Shad Ruby retweeted
Oral Antibiotics for Staphylococcus aureus Bacteremia: Who, What, When, and Why?
PharmD Ryan Stevens @Stevens_AK
✍️Understanding pros and cons is essential!
#MayoClinicIDUpdates2025 @MayoClinicINFD @MayoClinicAZID #IDMedEd #IDFellow
Shad Ruby retweeted
So much excellence coming from our residents and fellows at #CHEST2024! Here are just some examples 🫁
Shad Ruby retweeted
Can’t wait for this discussion and live episode!! We’d love to see you in the audience if you’re at CHEST!
Join us on Mon., Oct. 7, 11 AM-12 PM ET for a live #CHEST2024 podcast recording with @PulmPEEPs discussing the Black Angels, nurses who cared for TB patients in NYC sanatoriums. Don’t miss it! hubs.la/Q02RL4kp0
Shad Ruby retweeted
NEW: Kamala Harris has announced that, If elected, she will make it a FELONY to continue vancomycin if the MRSA swab is negative.
Shad Ruby retweeted
What's the best treatment for MSSA bacteremia in someone with penicillin allergy?
Cefazolin (⭐NOT vancomycin!)
Reasons:
1. Cefazolin has a unique R1 side chain and does not cross react with other beta-lactams
2. Vancomycin is proven inferior to beta-lactams for MSSA
Shad Ruby retweeted
Idk. If scorpion bite isn’t the first thing out of a students’ mouth when asked the causes of pancreatitis, then something’s wrong.
Shad Ruby retweeted
Classic case with classic findings. If you’re wondering, yes the patient really bred pigeons !!!
Time for another #RadiologyRounds! This case is brought to you by our Associate Editor @pulmtoilet !
A 55 year old man presents to the hospital with progressive dyspnea and a chronic cough. Here is his initial CXR. How would you describe it (let us know in the comments!!)
Shad Ruby retweeted
How would I prepare for and manage a critically injured pedestrian needing prehospital intubation and ventilation? What if they’re also bleeding to death?
Had such a great time chatting to flight clinicians Ryan Roberts and Jason Herman on the @ASTNA2 podcast
Spotify: open.spotify.com/episode/5lA…
Apple : podcasts.apple.com/au/podcas…
