pbafuma.bsky.social
EM-turned critical care PA.
POCUS, dogmalytics, & infectious disease.
Formerly a mastiff, now a dobie.
183 posts
470 followers
199 following
Getting Started
Active Commenter
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Do you know if Calgary experienced a bump in endocarditis or other oral-flora based infections by the end of that decade?
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I mean .... How do you reconcile this with outcomes?
Especially with a handful of papers recently saying aggressive control probably confers worse outcomes?
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Do you know if there is some nonprofit picking up the slack on this? Specifically trees in these neighborhoods
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Yup!
When people are actively fighting the brain trust for clout/sales, and the public believes them because of the desire to "prove them wrong" / not wanting to believe what's told to them by actual professionals, that's not on the healthcare team.
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Found a place for PCT: 😁😁😁
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However, there WILL be another healthcare issue that will ravage lower socioeconomic classes first. And the foundations are being laid now.
No crystal ball, but some guesses:
Crypto / sports gambling?
Ketamine?
TB?
Vaccine preventable illness?
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Ehhhhhh....
If you're delaying, they probably weren't as sick on initial presentation, which probably explains why delayed is "better"
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journals.sagepub.com/doi/10.1177/...
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This was mind numbing. Saw another paper recently saying AC didn't really matter even if a clot, which sort of aligned with experience... Not sure what to make of it all. 🤔🤷🏼♂️🤷🏼♂️🤔
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oh look, **another** negative PCT study!
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Looks rough down your way. Godspeed.
Also, cheers & well wishes from SB. Have a drink up here sometime!
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Wait, you mean putting someone in a K hole then shoving plastic in their gullet leads to lower patient satisfaction scores? 😱😱
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Didn't stop tPA or Pirfenidone🤣
(Or any number of devices...)
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Role for transplant patients?
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🤣🤣🤣🤣 underrated quote.
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Sweet, so now they get to play the beloved martyr card!
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Coming from a place that almost exclusively does radials...
Feel like good waveform + pocus guided resus/spot checks are generally helpful and sufficient way more often than not. I've tried hunting for a better central pressure & rarely find it.
Perfect is the enemy of good enough
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Though danger was positive, thats counter to at least 3 negative trials before it. Idk. Impella may do something (and I've def pushed for them before)..., but low threshold to encourage removal if any complications from the device arise.
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Last I looked maybe 3 years ago, there were no head to head trials, and abiomed played alot of statistical games. Basically wasn't better than a balloon pump, possibly even more complications.
ABMD would do single arm comparisons to historical controls that weren't well matched.
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One thing we learned:
1) still a 💩
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Love the links and banter!
But for me, when lungs are already trash, not worth risking dropping one. Especially if doing under emergency consent.
Not to mention if alone at night, other options available, and armchair quarterbacks coming in the morning 😱
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I do kinda wonder about NSAIDs+bactrim for hyperK /AKI... And gi upset too (for just about any PO abx + NSAIDs).
Hence the 10mg x 1 in the nondiabetic. But ya know, anecdotes and all ...
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The cost benefit generally weighs to the "first so no harm" no matter which way I slice it, and trends towards not doing anything unless affecting hemodynamics.
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Idk. At best Tylenol minimally decreases LoS for survivors + perhaps a small comfort (though questionable) and at worst massively extends it for non survivors.
The reality is that it's not worth fighting with nurses over, but I draw the line at a cooling blanket for infectious fevers.
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We already use steroids for PTAs all the time (plus septic shock!).
Anecdotes not data, but for that gnarly facial or buttocks cellulitis, 1x dex =👨🏼🍳💋
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IDSA SSTI guidelines 2014:
“Systemic corticosteroids could be considered in nondiabetic adult patients with cellulitis” ... “The benefits of systemic corticosteroids in this situation [cellulitis] are consistent with their efficacy and safety as adjunctive treatment in other infections”
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I mean, it may not be a bad parallel.
Especially considering how often antipsychotics are continued past the ICU stay.
A loading dose as a one and done, if it decreases/nixes antipsychotic rx 1 in 3 times.... That sounds like a huge win?
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#emimcc
@erinmccreary.bsky.social
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