Emily Pavich, PharmD, BCEMP @EMPharmavich Twitter profile

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Burnout prevention. I have really enjoyed sharing the bounty with my work friends.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Order in queue: 300 mg IV Push Ketamine Pt: 60 kg 80 yo F at one of our rural EDs Me: Frantically calling rural site Seasoned ED nurse at rural site picks up phone: hell no, I wasn't going to give that. What are we doing today, euthenasia? God bless a seasoned ED RN😬

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Hi, to the urologist who told my PA not to listen to the pharmacist because we don't make clinical decisions. Can you show me where on the doll clinical pharmacy hurt you in the past? Can we sit down and talk? Are you all right? Love, your friendly CLINICAL EM Pharmacist

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

Not me "playing doctor" today, finding that adrenal crisis following abrupt discontinuation of chronic steroids. Would love to hear examples of how all my other rockstar pharmacy colleagues "played doctor" today! #EmRx

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Spent an hour yelling at my BIL on Christmas Eve. He was just sitting there, smugly telling me all the "facts" behind why he is not vaccinated. Educating me, the pharmacist. In that moment, he was everything HCWs have been facing this year. I let him have it. #sorrynotsorry

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

Today I discovered a patient had been prescribed ceftazidime 1 gm IV Q24H as an outpatient for the treatment of sinusitis because they weren't tolerating oral cefdinir. What is your favorite part of this and why is it multidrug resistant bacteria ending the world?

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Was thinking this tax season there be a question like "Have you been working as a Healthcare worker during the year 2021?" You mark✅ The government thanks you for your service and refunds your income taxes that have been deducted over the past year. A girl can dream.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Me getting pulled over for speeding on my way to work. Me attaching my badge to my scrubs. Me driving slowly away with a warning.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

What topic makes you look like the worst clinical pharmacist on the face of the earth? For me, it's the eyes. Why are there so many different eye drops? I have no idea what is formulary or what we carry. I am so sorry, I just can't.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

@movinmeat Me tonight: you have covid when did your symptoms start Guy as a coughs in the phone: oh, I'm not having any symptoms Me: ok, I guess we are done here. Have a nice night.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

PSA: friendly reminder that both alteplase and tenecteplase are tPA. Your body even makes tPA. The term tPA should not be used in place of using the term alteplase. #endrant

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Stop using Q18H vanc dosing you monsters.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

When the department didn't get your spot a computer on the first day of opening the new ED, but your docs take you into their doc cave, say "this is your spot now", and also steal a file cabinet for you. #idontdeserveyou #EMpharmacy

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Monitoring a pt on tele after starting NE drip. While doing that, I noted pt next door had 5 sec run of bradycardia in 30s (resolved). Patient cc: fall w/ "sinking feeling". Showed event to doc. Patient admitted and has pacemaker now. No one else saw it. ED pharmacist luck

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

11 months

@chrissyfreeMD So, I suppose my pharmacy residency wasn't a thing, even though we did have shifts where we "slept" overnight in house to respond to things...huh, kind of like a medical resident does now that I think about it.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I don't think I will ever love anything the way nephrology loves sodium bicarb.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Listening to Damar Hamlin Live coverage is wild. These lay people who have never seen a cardiac arrest jumping to COVID vaccines. Wild. WE unfortunately do this daily and we are sorry you had to see that. But just because you saw it doesn't mean you understand medicine now.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

It could be the 14 hour work day today. It could be pharmacy being removed from the ED committee monthly agenda. It could be the IT group continually shooting down every request I put through. It could be that maybe I am just done with this job. Too bad I just had vacay.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

A physician I frequently disagree with said this to me on my last stretch of work together, and I am going to hold on to it for a bit. "I think you are right about that girl, you usually are right."

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

When someone requests something that's been in the queu < 2 minutes. 📣YOU ARE SLOWING ME DOWN.

Laura Celmins

@EMToxRx

2 years

@spry_ann I tell them I’m doing the orders in the order I get them and thank you for the interruption I’ll go back to what I was doing.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Since it is SO far outside of my scope & training, I guess I'll stop answering the daily "Is my patient a Paxlovid candidate?". Have you met a clinical pharmacist? We have been updating and educating doctors on COVID therapy and lit for 2 yrs. It has been exhausting. #TwitteRx

AMA

@AmerMedicalAssn

2 years

Paxlovid is a critical tool in fighting #COVID19 . Those who test positive should discuss treatment options with physicians who know their medical history.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

My doctors asking me about meropenem.

Aileen Ahiskali

@ailley_

2 years

“I suggest you order ceftriaxone and stop trying to destroy the human race” is officially my new favorite punch line. @DGlaucomflecken I need more of this type of content to passive aggressively share with every doc I work with 😈

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

For ED Pharmacists not sporting the fanny pack, my question is- what are you waiting for? #TwitteRx #emergencypharm

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I started taking tea time at work in the afternoon to remind myself I am a person. I am not my job. I am worthy of taking a gosh darn break. Of course I have to multitask and pee while my water warms up because I wouldn't want to commit time theft. This is America after all.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Been a pharmacist for 9 years, 8 in the ED and just got to see the interaction between PDE5 inhibitors and nitroglycerin this week. The hypotensive duration is similar to the PDE5I action duration, because of the inhibited cGMP breakdown. Gonna last longer than that nitro.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Today I talked with a man about how the COVID-19 vaccine did not contain aborted fetal remains for 15 minutes. No amount of Pharmacy school or residency can prepare you for real life. When I got up this morning this was definitely not in the plans. #twitterx #emergencypharm

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

Phew, this had me looking into requirements to be FAAEM, guess it is just a societal fee and no actual duty to the profession. Man, would hate to work at the bedside alongside an ED doc with this attitude. Give respect. Get respect. Don't, and well...enjoy the backlash.

Saba Rizvi M.D. FAAEM

@sabarizvimd

1 year

A pharmacist can’t take a call from a doctor to fill a prescription for a patient, because they’re too busy playing one. Pharmacist busy giving a “shot” to a customer. Unbelievable. We live in a topsy turvy world now.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

I wonder if @taylorswift13 knows how many times she gets mentioned at pharmacy conferences. #EMPRx22

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

I need someone to manufacture a 10 mg ketorolac vial.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Me cringing thinking about having to pick a 4000 unit bolus of heparin as a max dose on a test question for a STEMI PCI patient, when I know that was only ever meant for fibrinolysis patients. I just feel it. It's gonna happen.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Losing my EM pharmacy partner. Anyone want to come play in Bloomington, IN? -7 on/7 off 8:30-7pm -Moving to Regional Academic Health Center in Dec-->New hospital -Great partnership with our docs, providers, & nurses -Emerg response, order verification, micro f/u collab practice

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

EM pharmacists. We sit in a unique position to get to see quite a few unique cases, because we see everyone's patient. Me talking to my dad about how I ordered some labs or helped diagnose something. He told me that is not my job. Respectfully disagree. #weknowathingortwo

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Been asking for these bad boys for 7 years. #hyperkalemia #ChristmasInJuly

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Just saw a hilarious thread, and now I want my position title changed to antibiotic sommelier. Introduce me as such, "Have you met our ED'S abx sommelier?" "Yes, yes, of course we have one on staff."

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Love all the "I am going to be an Emergency Medicine Pharmacist" posts! Keep 'em coming. Congrats all!

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Got my first Pfizer shot last year on this date. So young. So full of hope. SO NAIVE. Had no idea, in all MY excitement, that a year later only 50% of Indiana would be vaccinated. Now I am So bitter. So tired. So confused. So disappointed. SO OVER IT.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Me calling CVS, trying to treat GAS pharyngitis, asking what suspensions they have: You got amox? No. You got pen VK? No You got cephalexin? No You got augmentin? No You got clindamycin? No You got cefdinir? No You got cefpodoxime? No Them: We have azithro Me: No Girl, bye.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Continually impressed by staff and general clin pharmacists. They get a wild amount of emails regarding workflow changes, very specific weird situations, etc that they have to incorporate daily. Me: Skim, delete email, and call them if I encounter the said thing once a year.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

When someone changed the PAR level for DigiFab but didn't ask me if it was ok or bother to tell me at all, and we get a hypotensive, bradycardic chronic dig tox seeing yellow that we can only partially treat.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Can't wait to drop my BCCCP for BCEMP. List of things I don't care about begins with SUP literature. EM pharm- what is your least favorite crit care topic you have been forced to mindlessly read and answer questions about for re-cert credit? #EMisNOTcritcare #YAWN #empharmacy

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Has every hospital system gone from discussing appropriate evidence based clinical care at meetings to discussing how to provide care to make CMS happy? Or just mine? Because above all else, this, this is burning me the frick out. Maybe just a feeling, but I feel a shift.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Tired of being at the bedside and missing my children's childhoods. Is this the feeling directly preceeding attrition? Because that's what it feels like.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

ED pharmacist level up unlocked-->recognized an SAH on the CT

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Just remembering when I got pulled over and breathylzed this weekend and blew an expected 0.00. So happy to be served and protected.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

When the doc barely humored me and begrudgingly ordered the thyroid study labs for the hypotensive, bradycardia, cold, slightly hypoglycemic pt....I tried not to act shocked at the results.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

The CDC now says most of the Surviving Sepsis Campaign recommendations are based on 'High Quality Evidence'.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I estimated someone's weight within 2.5 kg today. #EDpharmgoals

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

11 months

Me finding a small nook to hide in behind the Pyxis in the resuscitation room while my resident is shining.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I used to have time to get some more administrative things done on my shifts. Lately, I show up and don't stop clinical care for 10+ hours. New norm?

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

Studying and just got reminded what an alpha level of 0.05 actually means. It means that 1 out of every 20 times we claim there is significance there actually isn't. Is evidence based medicine even real? Just a reminder that tightly held conventions could just be Type I error.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

Accidentally wore my new running shoes to work today. Me in the car: shoot, eh, it will be fine. Me at work, mixing and priming the hydroxocobalamin:

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

I signed up for this conference yesterday, the CE looks great. This seems like more quality EM pharm education than I would ever get from spending thousands of dollars to go to Midyear, for just $75. (Sorry, but not sorry for the anti-Midyear sentiment).

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

This was such a fun week professionally. Sat for my EM Pharmacy boards yesterday- was it me, or did that test feel like a really fun day at work? And...Honored by Purdue University College of Pharmacy as the inaugural recipient of the Sustained Teaching Excellence award. ☺️

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

Trash talking your co-residents loudly at breakfast and boasting on yourself is a bad look. 👋 Hi, just FYI, all these other breakfast tables are pharmacists.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

I don't always write notes...but when I do it's because I have vehemently disagreed with you about something. #stopusingpccforstablegibleeds

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

@h_wilsey Me when the allergy list has > 5 allergies:

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Why is the inpatient side so direly against RSI practice for intubations? Every intubation on the inpatient side is a new mystery. What 8 meds will they give? What tiny smattering of baby doses will they use? Will there be paralysis? Why are you making it so hard?

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Busy end of shift. Anyone else's ED have a physical kit obsession? Still trying to figure out how to dismantle such an ingrained process. #EDRx

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Anyone else who works 7 on/off feel like they live a double life? I will straight up resident mode work/party/rage for a week, then flip to SAHM with playdates and homework.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

My face when I find out at dinner that night shift travelers be bolusing dexmedetomidine.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

2 people in the doctor's fish bowl knew who the Soup Nazi was yesterday. 2 people out of 7. I am having a hard time coming to terms with this.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Seriously though, every other conference is garbage now. #EMPRx22 Way to go @PharmD_intheED and team!

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

When a graph is nice to convince someone the hypercalcemia is from their new HCTZ Rx and not cancer.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Tomorrow we start interviews for my new EM pharm partner. Bittersweet. I have lost 2 outstanding partners over the years to changing circumstances. For a person I never see, it is so nice to say I have gained 2 great friends, sounding boards, and co-miserators. #goodluck

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

My soul's soul feels this.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I will never understand 'Disneyworld' people. Of all the places, in all the world. Why.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

In the past 3-6 months we have been given the added responsibilities of boarding consults and inpatient micro discharge review (already do ED micro discharge review for 4 hospitals). Starting to hate my job as it morphs into inpatient care. Screaming into the void.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Just thinking about when I walked into a cardiac arrest room once being run by 3 men (yes, necessary tidbit) and the ED doc was precordial thumping the patient who had pads on. I dead ass just turned around a second, and thought I'll come back when we are doing medicine things.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Thanks EMPIRE-C authors. Using your data to try to get some more EM pharm coverage. That culture follow-up data. 🔥 Wish me luck.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

11 months

When you are doing micro f/u and the Urine shows >100k Staph aureus....you call them back because this patient has no reason to have that there. Then you wait for the blood to declare itself...there it is.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

1st born daughter here, have had a hard time with being a perfectionist even when it comes to things like emails. If I didn't have enough time to dedicate to the perfect response I just wouldn't send it and it would pile up...

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Anyone else find this time of year so draining? New IRBs and project planning for students Resident orientation presentations and calendar planning Research planning with residents Manuscript edits from last year Just realizing if I dropped the research gigs I would be golden.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

Request begun to change the Alaris propofol bolus rate from hard max of 25 mg per min to anesthesia parameters, no hard max rate...here we go. Med safety I asketh you what is more dangerous self-extubation or temporary hypotension/bradycardia? #whymedsafetyhatesme

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Love my physician group, just collaborated with one of my newer docs to present on the evidence-based management of acute agitation in the ED. Well received. ❤💉😀💉❤ #EMpharmacy

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I wish the retail said "ED Clinical"

6079 Smith W

@dubblecounter

2 years

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Me, practicing as an EM Clinical pharmacist going on 8 years. Hell, I teach in and coordinate an intro to EM Pharmacy course...but I will probably still read the study materials for BCEMP because I am neurotic. How weird is it for those that have been doing this for a decade+?

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Hi there, To the physicians that feel the need to interrupt me when I am talking to a learner or RN. What is the compulsion? I am getting to what you just blurted. The fastest there gets no prize. Calm down.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Not me leaving the room after we intubate, look at the monitor and proceed directly back in the room to request we get those pads on. Here we go.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

The recommendation to consider charcoal for factor xa reversal pts makes me wonder if I am a crazy person. Because never would I ever give charcoal to someone who has a head bleed, going for emergent surgery, or going to the endo suite...and these are the people I am reversing.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

When the sermon is about death and god's goodness and you guess you didn't process the second hand grief from your friends working a terrible pediatric code this week...you cry, you cry the whole service. 😢

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Daughter, coughing. Husband staring at my accusingly this evening, like I am killing our child: Isn't there something, anything we can do? (Pleading voice) Me: Not really, you know I am going to say honey Husband: Gives her all the things anyway Daughter 1 hr later, coughing

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

A word of encouragement from a friend on day 7.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I do, I hate it when pharmacists call themselves "pharmers". It might be the 10 years of 4H or the 4 years of FFA, but something hits wrong.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Me adding all 500 strengths of levothyroxine to one of the Pyxis to appease nursing leadership. Will they still request the med from pharmacy? Absolutely, they will.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

For some reason, went my whole career without calculating the mg of salicylic acid in Pepto, so here you go. In regular strength Pepto, there is ~1 gm of salicylic acid for every 4 oz of Pepto. Makes for easy math, given bottles come in multipliers of 4 oz. #yaypeptobismol

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

I just randomly thought about THAM. Weird drug nostalgia.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

11 months

Anyone else super judgy when they annotate studies? (And yes, I am just now catching up on my reading list.)

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Congrats to all these BCCCPs blowing up my feed. Also, don't look at the price of CE for like another year, just give yourself a moment to bask in the glow. #moneygrab

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

Dying regarding "top 10 reasons why tpa sucks for acute ischemic stroke...written by an emergency physician" #spoton

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Started out the morning with a dispatch call that 24 buildings with 40-80 people in each, could be effected by a phosphorus fire. Everyone in our department is immediately good at math as we calculate a possible 2k patients. We got 1. 1 inhalational exposure. They went home.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

3 years

@AshleyGWinter Made my husband wear this to his appt. post twins.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

Game recognizes game.

Josh Trebach, MD

@jtrebach

2 years

i've worked in many emergency departments over the years and can say with absolute certainty: if you do not have an emergency medicine pharmacist then u are missing out

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

He's a 10 but he ordered rabies PEP when animal control has the animal and it can be watched.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

@SC_Pharmacist @BJDSOP_ADAA @corevalues5 @RxSpencer D) Put it in a jar on your stove so you have something to dip your Lipitor pill in to help it slide down easier [-said an elderly lady in one of the rural clinics around where I work]. You can't make this stuff up. 🤣

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

1 year

How's the large health system thing working out for everyone else? It is so many committees, I just end up giving up TBH.

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Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

When you eavesdrop on report. PA: Yeah, they have pacreatitis and hyponatremia. The pt said they haven't drank alcohol in yrs. Lab couldn't read the Hgb b/c the sample was lipemic. <hangs up phone> Me: You might want to get a triglyceride lvl. Also, that's pseudohyponatremia.

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15

Emily Pavich, PharmD, BCEMP

@EMPharmavich

2 years

@PharmD_intheED This is real. 7 years out now. I say NO now. I skip meetings I don't benefit from attending. I try to only extend myself for the professional things I enjoy. I built a garden this summer, excited to spend my 7 offs outside in the sun being a real person.