Brooks Walsh @BrooksWalsh Twitter profile | Pikagi

Pikagi

Brooks Walsh

@BrooksWalsh

7,021

Followers

1,916

Following

4,350

Media

31,656

Statuses

Emergency physician, devoted student of emergency electrocardiography and echocardiography. Plus all the other stuff. @brookswalsh .bsky.social

https://t.co/vSBGlOr1KH

Joined August 2012

Don't wanna be here? Send us removal request.

Pinned Tweet

@BrooksWalsh

Brooks Walsh

1 year

"We urge that @ACEPNow actively rescind any explicit or implicit endorsement of the 2009 Report on #ExcitedDelirium Syndrome. This position should be communicated to law enforcement and to expert witnesses testifying in civil and criminal litigation."

Tweet media one

4

14

60

Last Seen Profiles

@Khoedep99Tuoi

@AWildDragogriff

@EskCoolblood

@rams_north

@Anime_love6969

@SurgeryMiami

@ARedJay1

@__TheAlien

@CapswanApp

@m____noas

@LionsYouba72049

@moodukie

@attesilvennoine

@wake_sleep

@alephksa

@astralbaes

@Amane_ROKI

@Orbyt_off

@AqilSzn

@NuitDuDroit

@iamcjh0401

@cheesyjennifer

@BOpulent

@DaniellaJa62473

@deeeee91

@stw_pdg

@The_Hendersongs

@karenzeribi

@448dubb

@4SSM0

@steakandhonour

@makknkenzx

@F1

@ScrogginSh89066

@she_hermanhater

@jandakembangstw

@BrooksWalsh

Brooks Walsh

3 years

Sometimes a single view is sufficient to call in the specialist

Tweet media one

101

122

2K

@BrooksWalsh

Brooks Walsh

11 months

Don't give CPR to a 🐇 that has just been killed by a cat. It's a traumatic arrest, CPR doesn't help. What does help? Rapid access through the chest to release a tension ptx or drain a tamponade. Next step... 1/47

@jenniferTVTweet

jennifer cummings

@jenniferTVTweet

11 months

Two nights ago I gave a wild baby rabbit CPR w breaths after I took it from my Petey (cat). Today, I’m being admitted to the hospital with signs of “bunny fever” (Tularemia). I’m on 8L oxygen, a cocktail of very expensive antibiotics, anti-diuretics. Need light & love, please!

1K

793

9K

55

101

1K

@BrooksWalsh

Brooks Walsh

4 years

Ok time to back off the PEEP

Tweet media one

30

43

929

@BrooksWalsh

Brooks Walsh

3 years

A recent study found that kids (ages 9-12) often had a very high rise in troponin following an intervention that is *claimed* to be healthy. The dotted line shows the threshold of troponin that diagnoses a heart attack! 1/3

Tweet media one

18

168

826

@BrooksWalsh

Brooks Walsh

4 years

"Every day you put on a mask, think to yourself, 'I rock. I may be saving 20 people’s moms or dads today alone.'" This is how I think about #Zachsmath . 12/

@ASlavitt

Andy Slavitt 🇺🇦

4 years

COVID Update July 25: Right now in this crisis, good or bad is less important than early or late. If saving lives is important to your mayor & governor, they need to be early to action. 1/

77

2K

6K

6

128

759

@BrooksWalsh

Brooks Walsh

2 years

EM residents everywhere hit the buzzer midway through the second paragraph.

Tweet media one

112

48

768

@BrooksWalsh

Brooks Walsh

1 year

@Caulimovirus Meanwhile, EM be like "Ma'am, please finish swallowing that burrito, I'm about to push the Michael Jackson drug."

12

15

716

@BrooksWalsh

Brooks Walsh

9 months

I will never not be disappointed in physicians who post rectal foreign body pictures. Grow the fuck up please

@drkeithsiau

Keith Siau

9 months

Caption competition time! 😅

Tweet media one

294

35

592

64

20

691

@BrooksWalsh

Brooks Walsh

15 days

The ECG that radicalized me. I was a PGY-3. Middle-aged guy with typical chest pain, early AM. Both ED attending and cards fellow say this isn't an indication for the cath lab. Still salty about my attending.

Tweet media one

63

49

650

@BrooksWalsh

Brooks Walsh

5 years

Me: "Hey, calling for a consult, young healthy female, syncope." Cards: "Uh, do you really need us? Unstable vitals?" "No" "ECG concerning?" "No" "Don't tell me that you sent a..." "Actually, troponin is undetectable." "Then why..." "There's a plop." "..."

@treborut

Robert Rodriguez

5 years

25 yo female, admitted secondary to syncope, plop is auscultated and echocardiogram is shown #EchoFirst

22

128

300

26

151

581

@BrooksWalsh

Brooks Walsh

3 years

The same effect can be seen in e.g. competitive swimming! () So... should we have kids stop swimming or kicking balls around? Or maybe should we just be a little more careful when using troponin as an outcome? 😉 3/3

Tweet media one

11

37

549

@BrooksWalsh

Brooks Walsh

2 years

Big T waves can be seen in LVH, hyper-K, or in hyperacute STEMI. A 🧵 showing each of these conditions in the *same* patient (at different times) 1/10

6

109

444

@BrooksWalsh

Brooks Walsh

3 years

The intervention? It was soccer. () 2/3

Tweet media one

Tweet media two

9

38

421

@BrooksWalsh

Brooks Walsh

3 years

Wut

Tweet media one

54

33

329

@BrooksWalsh

Brooks Walsh

4 years

@hrh_approved @emresidents @ACEPNow @AAEMRSA @SAEMonline @CORD_EM @ACOEPRSO @aaeminfo @ACOEP @SAEM_RAMS With all the other challenges facing *all providers* in healthcare these days, not feeling the need to "battle" another clinician. Venture capital, big pharma, and Insurance concern me more than a f_&+ng resident PA

15

1

296

@BrooksWalsh

Brooks Walsh

6 years

"Sir, it sounds like you had a simple fainting spell. We don't usually have to do much testing, just hold still while the tech gets the ECG." "Um, please record that."

Tweet media one

10

75

286

@BrooksWalsh

Brooks Walsh

4 years

Performed a tactical intubation last night, minimal noise, silent team communication, moved patient under cover. Was trying to get my yearly tube without the resident popping up "Hey, I heard there's an intubation!"

13

11

286

@BrooksWalsh

Brooks Walsh

2 months

Medfluencer trying to litigate, based on vibes, the effectiveness of an intervention that has been addressed by RCTs.

@OGdukeneurosurg

Oren Gottfried, MD

@OGdukeneurosurg

2 months

Would you trust CPR by machine or human more?

166

15

120

19

7

268

@BrooksWalsh

Brooks Walsh

1 year

@EMPAthy_atrophy This was just covered in the Risk Management Monthly podcast. If the patient is not in custody, this could be a HIPAA violation, unless the patient consents to sharing information... ( @BadHippa come @ me)

4

8

245

@BrooksWalsh

Brooks Walsh

7 months

TL;DR on the new AF guidelines. For acute control of RVR: - CCB vs BB is a tired discussion - Don't kill mod-severe CM with CCB tho - Mag is fetch - If not hemodynamically unstable, and don't have decomp CHF, it's not an emergency.

Tweet media one

Tweet media two

Tweet media three

11

69

234

@BrooksWalsh

Brooks Walsh

1 year

If I have decades of experience with DL ... ... this study suggests I should NOT switch to VL at this point. 😬

Tweet media one

@NEJM

NEJM

1 year

#CCR23 : In the DEVICE trial, the use of video laryngoscopy in critically ill patients undergoing intubation in the ED or ICU resulted in a higher incidence of successful intubation on the first attempt than direct laryngoscopy.

20

238

594

29

32

226

@BrooksWalsh

Brooks Walsh

1 year

Why would someone not see the acute MI on this ECG? I'm *not* being snide - I'm looking for common cognitive errors, problems with ECG education, etc. I'll start: The computer said "normal" 😬

Tweet media one

50

41

220

@BrooksWalsh

Brooks Walsh

7 years

Holy cow. Today, I think I convinced am anti-vax mom to vaccinate her infant. Just for Hib and PCV, but it's a start. #Babysteps

7

10

203

@BrooksWalsh

Brooks Walsh

4 months

The paradox of interpreting the ECG with a RBBB: - Overt STE may be present, satisfying OMI/STEMI criteria, but it is not appreciated; or conversely - The widened QRS of a normal RBBB ECG is misinterpreted as suggesting OMI/STEMI, despite normal ST segments. A 🧵. 1/6

3

37

197

@BrooksWalsh

Brooks Walsh

3 years

@drjohnm

Tweet media one

0

7

176

@BrooksWalsh

Brooks Walsh

5 years

Saw this in the wild for the first time. Thought this only happened on #CardioTwitter !

Tweet media one

Tweet media two

15

50

179

@BrooksWalsh

Brooks Walsh

4 years

"Keep me away from my wife. I don't want to give this to her" The last thing my #COVID19 patient said to me, as I was doffing at his door. Just saw he didn't make it out of the ICU. Damn

7

13

173

@BrooksWalsh

Brooks Walsh

3 years

@VPrasadMDMPH "Little Bear Attacks a Strawman" is available for pre-order on Amazon, think you'll like it!

1

1

169

@BrooksWalsh

Brooks Walsh

2 years

Sarcoidosis or ARVC? Apparent usefulness of R' in V1-V3

Tweet media one

2

42

170

@BrooksWalsh

Brooks Walsh

2 years

"That's not in ACLS!!" Working title for ED talk about things we do in resus that we shouldn't; things that we don't that we should; and controversial therapies Your thoughts? Examples below: 1/2 @smithECGBlog @tbouthillet @critconcepts @srrezaie

35

24

170

@BrooksWalsh

Brooks Walsh

2 years

So we're just not going to talk about the lead placement I guess. Fine.

@BrownJHM

Journal of Brown Hospital Medicine

2 years

Flail chest (Credit: Dr Luciano Trombini) #Medtwitter

21

350

2K

16

13

170

@BrooksWalsh

Brooks Walsh

3 years

@GoodishIntent Artifacticardia

3

4

168

@BrooksWalsh

Brooks Walsh

3 years

Gonna have to suspend Twitter dialogues for a short bit!

Tweet media one

19

1

159

@BrooksWalsh

Brooks Walsh

1 year

Why is the farmer always the go-to meme for "tough ER patient," and not, e.g., the undocumented Guatemalan mom?

@EM_RESUS

Sam Ghali, M.D.

1 year

Trauma Surgeon: What was the indication for an automatic trauma activation on this patient? Me: He’s a farmer.

259

597

9K

11

5

162

@BrooksWalsh

Brooks Walsh

3 years

"We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED) crowded to 250% over capacity"

Tweet card media

Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways

We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED) crowded to 250% over capacity. His initial symptoms of...

www.ncbi.nlm.nih.gov

11

47

155

@BrooksWalsh

Brooks Walsh

7 years

If you care about #MeToo Weinstein, Spacey, etc... Stop telling students to use "Dubin's" to learn ECGs! He drugged and raped a 16 y.o. He owned and made child pornography. There are many, many other good sources to learn ECGs. #DumpDubin

23

62

152

@BrooksWalsh

Brooks Walsh

4 years

@shesinscrubs @critconcepts From the nyt story about DHR. "Some elective procedures" is the buried lede They want the $$ to keep rolling in. Vulnerable Border Community Battles Virus on ‘A Straight Up Trajectory’

Tweet media one

4

69

146

@BrooksWalsh

Brooks Walsh

15 days

Non-urgent cath found 100% OM1.

1

1

149

@BrooksWalsh

Brooks Walsh

3 years

"Many EDs have increased functional ED capacity by designating ED hallway space (despite the serious privacy and HIPAA issues that creates). There is no other setting in health care where placing patients in public hallways is considered routinely acceptable. "

5

19

144

@BrooksWalsh

Brooks Walsh

2 years

Patient's fitness watch said AF. Ecg computer said AF. Chart says Hx AF. Phone consult says AF.

Tweet media one

22

32

142

@BrooksWalsh

Brooks Walsh

3 years

@SocialAdmission @MDaware "But if rabies were airborne..." Dude, do *not* jinx 2022 for us.

5

1

140

@BrooksWalsh

Brooks Walsh

3 years

Walked by an ECG in the ED, didn't know the patient, but it struck me as odd. 1/4

Tweet media one

4

32

138

@BrooksWalsh

Brooks Walsh

1 year

Two different patients. The ECG computer flagged one of these as *** STEMI ***. But it was the other ECG. Which is which?

Tweet media one

Tweet media two

20

28

134

@BrooksWalsh

Brooks Walsh

3 years

Sent to the ED with this ECG. Why? 😉

Tweet media one

95

14

133

@BrooksWalsh

Brooks Walsh

5 years

ECG myths of hyperkalemia: the "peaked" T wave is tall. The [K] was > 8

Tweet media one

17

48

129

@BrooksWalsh

Brooks Walsh

6 years

My review "Misplacing V1 and V2 can have clinical consequences" is free access for a few weeks - Please read/share/comment! #foamed for now...

Tweet media one

3

65

128

@BrooksWalsh

Brooks Walsh

3 years

@Toaster_Pastry I've worked in urban EDs for 15 years, and what heartens me is that patients and family are *overwhelmingly* understanding and even empathetic. While horrible, what you witnessed is an aberration.

3

4

127

@BrooksWalsh

Brooks Walsh

1 year

@JohnathanPerk The only *truly* broken English is when folks use 'less' when they mean ' fewer."

8

6

123

@BrooksWalsh

Brooks Walsh

3 years

... and so rather than fruitlessly aim to educate or correct clinicians, we feel it is better to just accept these "alternative" ECG lead placements. As a result, what we formally termed "artifact" or "garbage" will now be the standard. All the stakeholders agreed that ... 3/4

Tweet media one

6

32

124

@BrooksWalsh

Brooks Walsh

4 years

KETAMINE, KIDS, AND DOSING While legal authorities looked on, two white men injected a young brown-skinned child with a big dose of ketamine. They then handcuffed him and deliberately shoved his face underwater. The child lived.

7

47

126

@BrooksWalsh

Brooks Walsh

3 years

@AndrewHouk2 Hmmm ... looking the image over more carefully now... Nope! No hippos here.

1

1

122

@BrooksWalsh

Brooks Walsh

1 year

Provocative take: Dilt or metop for AF with RVR is *not* an urgent intervention. Little reason for EMS, or EM in the first hour, to do this. Risk >> possible benefit #OculoDiltReflex

16

11

124

@BrooksWalsh

Brooks Walsh

9 months

JUST NOW: @ACEPNow withdraws approval of the 2009 White Paper on Excited Delirium. "This means if someone dies while being restrained in custody, people can’t ... point to ACEP’s endorsement of the concept to bolster their case" @EmergencyDocs

Tweet card media

A doctors group calls its 'excited delirium' paper outdated and withdraws its approval

A leading doctors group is formally withdrawing approval of a 2009 paper on “excited delirium.” Critics say the document has been used to justify excessive force by police.

5

52

124

@BrooksWalsh

Brooks Walsh

10 months

New evidence about bicarb, Mag, and calcium in cardiac arrest! (It's negative)

Tweet media one

5

37

119

@BrooksWalsh

Brooks Walsh

1 year

"A federal judge said New Hampshire has one year to stop holding psychiatric patients in hospital emergency rooms ... also said the state can only hold people in emergency rooms for up to six hours, before transferring ... for treatment."

Tweet card media

NH must stop 'ER boarding' within one year, judge rules

State attorneys previously argued they would need up to two years to stop the practice, citing labor shortages and other challenges.

27

30

120

@BrooksWalsh

Brooks Walsh

6 years

Fulminant myocarditis from H1 influenza a few years ago. Healthy adult --> pericardiocentesis, ECMO, LVAD It ain't just sniffles - get yer flu shot!

4

91

119

@BrooksWalsh

Brooks Walsh

3 years

Both the ECG patterns of early repolarization and of pericarditis can show ST segment elevation. It may be difficult to tell the difference between these 2 ECG diagnoses. Herein, a case-🧵 of pericarditis developing on top of a baseline ECG with ER 1/

3

41

117

@BrooksWalsh

Brooks Walsh

3 months

@dieworkwear @charlie_mas Frank Hammilton may have had his problems, but collar gap wasn't one of them

1

0

117

@BrooksWalsh

Brooks Walsh

3 years

@Cardiac_Cutie A button battery starting a small fire in a kid's food pipe. (Eventually they did fine.)

0

1

110

@BrooksWalsh

Brooks Walsh

3 months

I am *not* speaking to any specifics about the ER crew care of Mr. Knotts. I would highlight, though, that the *moment* our patient comes in our doors, they are, well, our patient. And we need to anticipate and prevent restraint asphyxia, even when LEOs are "in charge." 1/2

@chrisvanderveen

Chris Vanderveen (yep…me)

@chrisvanderveen

3 months

I can’t stress this enough. If you are reporting on the death of Kenneth Knotts in Texas…you MUST NOT cover it like an isolated event. He died while being held PRONE (facedown) AFTER he’d already been handcuffed 1/

Tweet media one

14

103

394

8

22

113

@BrooksWalsh

Brooks Walsh

2 years

Older guy, vague history of MI, CVA. Syncope witnessed by wife. Called cath lab activation. Was this a good or bad call?? (Everyone play nice this time ya hear, this is the nice corner of Twitter)

Tweet media one

38

21

112

@BrooksWalsh

Brooks Walsh

2 years

Emergency doc says wut

@NotoriousB_E_G

Hassan Ali Beg

@NotoriousB_E_G

2 years

Consultants, if you wield any power at all in your workplace, don't let shit like this happen. Working on office-less wards is miserable. The most prescribing errors (and general errors) I ever made on a job was on a ward like this where we just got constantly interrupted.

Tweet media one

55

177

1K

12

3

105

@BrooksWalsh

Brooks Walsh

9 months

de Winter pattern was initially defined by *up-sloping* STD in the anterior leads. But a lot of cases of reports of de Winter show flat or even down-sloping STD. 1/2

Tweet media one

Tweet media two

Tweet media three

Tweet media four

3

27

101

@BrooksWalsh

Brooks Walsh

11 months

Long-standing LBBB. Presents ... not well. Bad vital signs. The ecg:

Tweet media one

11

25

103

@BrooksWalsh

Brooks Walsh

4 years

@cathmk @thatgirl409

Tweet media one

0

4

101

@BrooksWalsh

Brooks Walsh

7 years

#POCUS during cardiac arrest - don't wait for the pulse check! Acquire the apical or subcostal view BEFORE stopping compressions. @EM_RESUS @Yale_EUS @EmergencyEcho @EchoholicsAnon @UTS_Australia

4

85

95

@BrooksWalsh

Brooks Walsh

3 years

yOuNg pEoPlE dOn'T gEt sIcK fRoM cOvId. This person is, shall we say, old enough to buy beer, but still young enough to get hit with a special add-on fee at Hertz car rental. And they're only alive because of massive critical-care efforts.

Tweet media one

5

17

96

@BrooksWalsh

Brooks Walsh

9 months

Number of patients I've seen where high BP causes nosebleeds: 0 Number of patients I've seen who have been told their high BP is the cause of their nosebleeds: 10+

@jasonryanmd

Jason Ryan

9 months

Number of patients I've seen where high BP causes headaches: 0 Number of patients I've seen who have been told their high BP is the cause of their headaches: 100+

21

41

467

7

13

94

@BrooksWalsh

Brooks Walsh

3 years

@SDSheriff @SDSOSanMarcos @Up2SD Ok, some ER doc edits: "Recently, a @SDSheriff Deputy [fainted] and nearly [drowned from a nasal Narcan] overdose. If it wasn't for the quick-thinking of his Field Training Officer in [putting a pillow under his head], that deputy would [have a crick in his neck]"

2

2

93

@BrooksWalsh

Brooks Walsh

4 years

Wrong answers only?

Tweet media one

168

12

94

@BrooksWalsh

Brooks Walsh

8 months

I work with Emily in the Bridgeport ER. I know her very well. When she comes to me, alerting me to a problem, I believe her, and I respond. So now *you* have to believe her. The nurses and doctors, the people, the children in Gaza are being killed and maimed.

@KhaledBeydoun

Khaled Beydoun

8 months

Watch this. Emily Callahan is a nurse with Doctors Without Borders. She shares her experience being in Gaza for 26 days. I’m genuinely surprised @CNN aired her testimony.

74

1K

3K

8

31

91

@BrooksWalsh

Brooks Walsh

1 year

Reminds me of a case I wrote up for @smithECGBlog 's blog, also presented at an electrocardiology conference. I was accused by a cardiologist, in public, of wasting their time presenting an EKG with obvious artifact lol

Tweet media one

@MubarakAlhatemi

Mubarak Alhatemi

@MubarakAlhatemi

1 year

48 years old male, ECG taken after cardiac arrest. Cath or not? Culprit? @The_Nanashi_O @DidlakeDW @smithECGBlog @EM_RESUS @AslangerE @syamkumarmd @ShariqShamimMD @ecgrhythms @EcgsOnly @BrooksWalsh

Tweet media one

31

18

123

6

25

91

@BrooksWalsh

Brooks Walsh

8 months

The deputy medical examiner has made 9 diagnoses of "excited delirium" in their career. In 8 of those cases there was "positional restraint" involved. Further evidence that almost no one dies from "excited delirium" in the absence of aggressive restraint.

@DorianHargrove

Dorian Hargrove

@DorianHargrove

8 months

56-year-old Oral Nunis was in a mental health crisis. No drugs or alcohol in his system when police arrived. In just 20 minutes, after being placed in a WRAP and a spit sock, Nunis was dead. SD's Med Examiner blamed "excited delirium."

2

3

4

2

32

91

@BrooksWalsh

Brooks Walsh

1 year

@AuschwitzMuseum Finally, a post from this account I can "like"

2

0

91

@BrooksWalsh

Brooks Walsh

1 year

... and so rather than fruitlessly aim to educate clinicians, we feel it is better to just accept these "alternative" ECG lead placements. As a result, what we formally termed "artifact" or "garbage" will now be the standard. All the stakeholders agreed that ... #ECG 3/4

Tweet media one

7

17

87

@BrooksWalsh

Brooks Walsh

4 years

@MargaretZhangMD @venkmurthy If you're rotating in the ED, you *are* ED. Thanks for being there.

2

2

82

@BrooksWalsh

Brooks Walsh

4 years

You can't use tele monitoring leads to judge ST elevation. Example #137

Tweet media one

Tweet media two

7

22

83

@BrooksWalsh

Brooks Walsh

7 years

The LV is like the boomers. It complains that the RV can't handle stress... ... that was dumped on it by the failure of the LV. #Noflake

@POCUSClub

Nicolas Lim

7 years

The RV is like generation Snowflake. It does not respond well to high pressure situations. #pocus

0

3

6

4

32

81

@BrooksWalsh

Brooks Walsh

2 years

I will never stop posting bad ECG computer interpretations. Computer spit out the ** ** STEMI ** ** warning with this tracing. #Artifacticardia

Tweet media one

15

9

80

@BrooksWalsh

Brooks Walsh

4 years

Middle aged, ischemia sx. - Clearly needs urgent angio? - Or rpt ECG/echo/labs? Especially interested in IC perspectives!

Tweet media one

31

14

79

@BrooksWalsh

Brooks Walsh

1 year

@DrCasteelEM I did a procedure *no one* else in the ED dared . Installed a new child car seat for someone who had never done it before.

2

0

80

@BrooksWalsh

Brooks Walsh

11 months

Can we finally quash the garbage of "Women typically present atypically?!" New ESC guidelines emphasize that we need to be focused on a wide range of symptoms, but especially chest discomfort, in *both* women and men. @HeartSisters thoughts?

Tweet media one

8

23

74

@BrooksWalsh

Brooks Walsh

9 months

@psych_biscuits Yes, it can be quite educational. It can show those patients that when they show up in the emergency department, they will be the subject of humor, giggling, and derision. Quite educational for them.

1

2

80

@BrooksWalsh

Brooks Walsh

15 days

FWIW I'm not still salty with cards fellow. This was many moons ago, and I'm sure they learned to appreciate this ECG pattern at some point later.

1

0

79

@BrooksWalsh

Brooks Walsh

6 months

Reviewing literature for presentation. As always, the money quotes come from @PulmCrit

Tweet media one

3

19

78

@BrooksWalsh

Brooks Walsh

1 year

"Lead placement error," I said after being handed this ECG, "Lead I is artificially flat. Please repeat?" But... 1/2

Tweet media one

1

8

73

@BrooksWalsh

Brooks Walsh

3 years

The old STEMI criteria miss patients who need emergent PCI - new evidence

Tweet media one

@smithECGBlog

Stephen W. Smith

3 years

Just published online today. @PendellM This is our best and most important work ever. Another nail in the STEMI/NonSTEMI coffin. Accuracy of OMI ECG findings versus STEMI criteria for diagnosis of acute OMI. Full text:

9

135

312

2

30

75

@BrooksWalsh

Brooks Walsh

2 years

@miblogestublog I -

Tweet media one

1

3

73

@BrooksWalsh

Brooks Walsh

5 years

A *stellar* teaching ECG! Forget looking for type 4 Brugada, subtle deWellens' sign, or hyper-early repolarization. THIS is the ECG to not miss!

@coscardio

Cróchán O'Sullivan

5 years

84 yo 👵 hx of Parkinson’s disease with right arm tremor. Incorrectly diagnosed as Torsade de Pointes and given IV magnesium. The key to correct diagnosis is found in lead III i.e. artefact @ecgrhythms #Cardiotwitter #epeeps

Tweet media one

31

144

364

4

30

76

@BrooksWalsh

Brooks Walsh

2 years

A rant about defining "posterior" MI The @ACCinTouch put out a pretty good report on evaluating chest pain in the ED this year. One highlight: A handy chart of "STEMI equivalents," informed by recent EM literature! (and authors! e.g. @debdiercks ) But... 1/7

Tweet media one

1

29

74

@BrooksWalsh

Brooks Walsh

4 years

Maybe a rare beast? Middle-aged, hx untreated HTN, no meds, no drugs Has dizziness and "pounding heart" No change w/ lIdocaine Adenosine had transient undocumented effect Verapamil produced this rhythm change 1/4

Tweet media one

Tweet media two

8

28

72

@BrooksWalsh

Brooks Walsh

3 years

Pushing nitroglycerin IV. Not 0.4 mg Not 1.4 mg. Two pushes of 16 mg IV!!

Tweet media one

9

17

72

@BrooksWalsh

Brooks Walsh

1 year

We need to hear more about the #EMS response. We failed Eric Garner, we failed Earl Moore Jr. Did we also fail Tyre Nicholas?

Tweet media one

9

15

73

@BrooksWalsh

Brooks Walsh

1 year

What are the potential downsides of getting a URINE TOX in an emergency patient? Talking with two residents last night, a junior and a senior. They had not been exposed to this idea. I gave some thoughts, would love to hear the crowd @RyanMarino @clairezagorski @fakeQrampage

61

14

71

@BrooksWalsh

Brooks Walsh

2 years

@MaizeandLube Abscess. Grab an 11 blade and voil-

1

0

70

@BrooksWalsh

Brooks Walsh

4 years

@cardiojaydoc02 Corollary: if asymptomatic, please don't send by EMS to ED to prevent fore-mentioned "stroking out"

3

4

68

@BrooksWalsh

Brooks Walsh

3 years

Middle-aged folks, both with chest discomfort. The computer read both as "Normal ECG" Turns out they both had same problem!

Tweet media one

Tweet media two

10

16

67

@BrooksWalsh

Brooks Walsh

6 years

Thanks computer, I'll take it from here!

Tweet media one

Tweet media two

5

22

67

@BrooksWalsh

Brooks Walsh

4 years

@shesinscrubs This *may* have been a triage typo

Tweet media one

6

2

67

@BrooksWalsh

Brooks Walsh

1 year

I'm not going to have follow up, lo siento. Syncope, fever. Labeled as "possible Brugada" I am dubious. (Yes, yes base of triangle @adribaran but EP calipers doesn't calculate that!)

Tweet media one

Tweet media two

7

16

63