Nate D

Thanks!
Sorry, I should have known.

This is great!
Is this based on literature? Do you have the paper handy?
Or your review of many patients?

📊 #Ebola update (Kasai, #DRC)

- 42 suspected (38 Bulape, 4 Mweka)
- 5 confirmed (all Bulape)
- 15 deaths (CFR 38%)
- 9 patients in care, 0 recovered
- 157 contacts, only 19% under follow-up

⚠️ Ongoing risks:
- unsafe burials ⚰️
- weak contact tracing
- population movement ➡️ spread

Procal where I work anecdotally leads to more inappropriate abx use. Never used correctly. I pretty much never find it helpful myself.
If you like it, convince me otherwise

I often hear they failed because of apnea (they set the apnea alarm off). Unless they have a neuro problem this is (almost) never a cause for failure in my book. Often the abg shows they are alkalotic as RT was maybe focused on normalizing the bicarb

Interesting… Can you link the evidence?

It’s a day when parents or friends of the school come in and teach kids about what they do for work and expose them to future career possibilities. I hear good to have a little fun activity

Should have doge look into this. Doesn’t seem
“Efficient”

#medsky #idsky
I’m going to my kids career day at their K-8 school in a few weeks. Any suggestions for activities to do with them?

I try it periodically and makes numbers better sometimes.
CCB OD it can be magic and save lives.
But, why calcium gluconate not CaCl?
I’d talk to pharmacy but I feel like we use CaCl more.
I’ve used on more normal iCal and felt I’ve seen results too. Anything magic about 0..8?
Thanks

#emimcc

Hmm I’m surprised how long they get antibiotics for in this study. I wonder if the drain is all they needed for both groups and maybe no culture is best. We know with good source control 24 hrs or at most 4 days abx is all that’s needed most of the time. What am I missing about these patients?

Our hospital recently went to antigen tests for flu rsv and covid. It’s annoying…as I don’t have a good idea of the performance of these tests..anyone else hospital doing this? Any thoughts?

Who recommends this?
In what situation?
Antigen tests and Ct values I find very helpful in deciding if someone is likely infectious and even if an antiviral is likely to be helpful. Though I wish there was better data to support this…

"[here we go] WHO plays a crucial role in protecting the health and security of the world's people, including Americans [who it should be obvious are members of the world community], by addressing..."

Large Language Model Influence on Diagnostic Reasoning This randomized clinical trial evaluates the diagnostic performance of physicians with use of a large language model compared with conventional resources.

I’ve used OpenEvidence and ChatGPT. The Jama paper they used chat gpt a year ago. It’s better now. But of course verify everything and open evidence nice as easier to find source.
I’m trying to figure out what is best too.

jamanetwork.com/journals/jam...

#EMIMCC

Does anyone on here work ICU nights and not have a call room or place to lie down when things quiet down?

How about those that work an electronic icu?

Flip a coin?
I’d probably just keep ceftriaxone going. If someone had already switched to pcn, I’d continue that. I haven’t done a recent deep dive into the literature though…I’m open to other thoughts. If volume is an issue, especially with fluid shortage issues ceftriaxone maybe better?

Beautiful crow against a black background

It seems to me that the time is ripe for a Bluesky thread about how—and maybe even why—to befriend crows.

(1/n)

I don’t do this much as I’m not outpatient anymore but I had a woman last week I thought would benefit and so I went to UTD and the authors don’t recommend it.
What are people doing for recurrent UTI’s? Does anyone have a reference you like on this topic you could share? Or an approach? Thanks

I agree it is complicated and requires a lot of nuance can’t capture in a tweet. Often we get called to run codes on patients and families we have never met, or the patient has a history with the healthcare system or religious beliefs…

I see. But guidelines post valve replacement are 4-6 weeks when cultures are positive, so what is wrong with those recommendations? Do you do something different? Seems reasonable to me. I wonder if can go shorter even, but would want a good trial of course

Agree. What’s the thinking behind 12 weeks? @cortes-penfield.bsky.social

I would do 6 weeks. I think with surgery should have excellent source control. Does the datipo trial suggest longer for you? Or would you do something different?
Does vre matter for you? For me it doesn’t…but I’m open

Tiny Coffins: Measles Is Killing Thousands of Children in Congo Problems with getting vaccines to families have left many children unvaccinated and in danger of contracting the virus.

It is important for people in countries like the U.S. - where we are so lucky to have measles elimination (for now) - to remember why measles is so important to keep eliminated

Most parents today have never seen measles

It is not good for many reasons

www.nytimes.com/2024/12/18/h...

By chance was it GBS?
I feel like that one disproportionately has no obvious source and is seen in diabetics…

So did they have a verifiable infection in the end? What was it?
Thanks for this.

I like the computer alert idea...anything to keep those things away!

The paper is overall done quite well and large. The separation between the two groups wasn't as big as I might expect (the 3.5 group had a K ~4.0 and the 4.5 group K ~4.3). But this is what happens in the wild, no?

I'd love to hear your thoughts and experience.