Emergency Medicine + Ultrasound + Critical Care Physician + Airway Enthusiast. Editor for https://xitter.cf/t.co/ZjhxWIRfd5 and https://xitter.cf/t.co/GwUJKPwG6C.

Joined October 2014
POCUSing the Pulse #ResusXROSC @tsquaredmd @CriticalCareNow Replace manual pulse palpation ➡️ Femoral artery doppler Flow in the femoral artery 20cm/s = SBP >60 mmHg
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In cardiac arrest, corticosteroids may help improve neurological outcomes by mitigating shock-related sequelae/complications such as inflammation and edema. #ResusXROSC @tsquaredmd @CriticalCareNow
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Eight RCTs examining 814 patients demonstrate a trend toward increased rates of ROSC but not toward good neurological outcomes. @tsquaredmd @CriticalCareNow #ResusXROSC
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Terren Trott retweeted
Congrats to ⁦@ParijatSen11⁩ who successfully defended his MS in clinical and translational science from ⁦@UK_CCTS⁩. ⁦@ResearchKY⁩ ⁦@ukypccm⁩
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Is the #POCUS echo pulse check #DNR? Some studies stirred some controversy, but what if we didn’t look at the heart at all (apart from identifying reversible causes & procedural)? In this video, @tsquaredmd and I discuss two recent studies: youtu.be/isFJBHckiPA #FOAMed #MedEd
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I'm struggling with a slide. Can you help me with which one is more effective? (Also, don't judge me for teaching non-POCUS stuff thaaaaaaanks)
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Curious how my Twitter #CriticalCare and #ID peeps practice… 🩸🦠Do you remove central lines, ports, tunneled lines, etc for GNR bacteremia?🦠🩸
37%Yes/usually
29%No/not usually
16%Only if it’s the source
18%Depends (explain plz!!)
38 votes • Final results
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FINALLY! An easier way to use the @ButterflyNetInc iQ+ for #POCUS guided procedures! @Oculine1 has created a great peripheral for your phone/probe. Watch my review here: youtu.be/nuwjOQ96Ceo #FOAMed #MedEd @NagdevArun
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Phenomenal news that @KateShrakeMD will be joining the crew at the University of Kentucky! @ukypccm @ParijatSen11
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Jason Balangee WON the Top Rapid Fire Case Report session at CHEST this year for "outstanding original scientific presentation". Congratulations 🎉 Rock Star!!!
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...one...zero! Thanks @ParijatSen11 for the poster!
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And look at these superstars who will be part of our Fellowship Family next year!! The future of PCCM is bright 🤩🤩 @ukypccm @tsquaredmd @UK_HealthCare @UKYInternalMed
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Words of truth.
I can’t figure out why we give tPA so liberally for stroke but everyone is afraid to give it for massive PE.
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Echo is one of the more skilled ultrasound exams you can do. Having learnt it and now teaching it, I see the same mistakes being made over and over again. I have put together thread on beginner mistakes in echo. #tweetorial #POCUS #FUSIC #askpocus
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Terren Trott retweeted
Epinephrine in refractory vfib? -> overactive catecholamine release -> Increased myocardial O2 demand, ischemia, and depression of VF threshold @tsquaredmd @CriticalCareNow #Resusx2022
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Terren Trott retweeted
Refractory VF: why esmolol? Beta-1 selective & ULTRA short acting! Dosing: 500mcg/kg bolus & 0-100mcg/min gtt (consider avoiding epi?) @tsquaredmd #ResusX2022 #FOAMed
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Replying to @tsquaredmd
@tsquaredmd takeaway: - Limited studies on pigs determined that RR 10 is ideal which is used in AHA guidelines. "Sounds crazy!?" to use this in a critical pt! Seems low to get to the goal: cerebral & coronary reperfusion. #resusx2022 @CriticalCareNow
Dr. Sen makes an excellent point! mechanical ventilation in arrest is not an absolute contraindication.
I would ask why even take off the vent? There’s nothing magical about bagging (though most do it) other than really high dangerous tidal volumes. 🤷🏽‍♂️ On top the vent can give us important data once CPR stops.
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Let me get this straight - my pt who is on the vent, pH 7.01 pCO2 18, bicarb 4, RR maxed to 36, goes into cardiac arrest & now per AHA guidelines, I'm to bag at 10/min?? Clearly complex physiology at play but that sounds like donzo to me @ParijatSen11 @msiuba @IM_Crit_ @EM_RESUS
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Let's also not forget the patient with severe metabolic acidosis who arrests on intubation..
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