Rick Pescatore, D.O. @Rick_Pescatore Twitter profile

Pinned Tweet

Rick Pescatore, D.O.

6 months

I gave #EmergencyMedicine everything I had for a decade. Hundreds of publications, recordings, and lectures. Countless hours of study, scholarly work, and struggle. Here’s the most important thing I learned.

18

69

668

Last Seen Profiles

@khongtinmotai

@BurakAta34000

@koutei007

@masapeko33

@onyourjaemm

@laila_butt66

@ChampIsHere

@iiii651228

@just_me0811

@SnowHimbo

@RbyShmsan40426

@bcplace

@Mandybrtrans2

@laila_butt66

@nap4956

@l6sJMtnYdu44292

@BeamBIO

@HornyOniiSan

@VmaniakJ

@rubichoudhary_1

@bokeplokalmalam

@kuro_tetsu1379

@couple_mallu

@Sun1347640

@sebebihusntalil

@landrgates

@xukaichen1

@FlorencWatl

@bokeplokalmalam

@XPhzin

@kittendsut

@thesismea80237

@TieAndCrypto

@lbybmmd515455

@Mandybrtrans2

@_frankiss_

Rick Pescatore, D.O.

@Rick_Pescatore

4 months

I’m an emergency doctor, and I love it and am very grateful for the skills it’s given me and the experiences and insights I’ve gained over the years. But it’s a really hard job, and it takes a toll over time.

40

32

736

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

The ER down the street staffed with emergency physicians that make up <2.5% of the physician workforce but that provides >50% of all care and >90% of uncompensated care to vulnerable populations would like a word.

Michael "Mike" Albert, MD

@MichaelAlbertMD

1 year

If an individual physician sees 40+ patients daily, they are not providing healthcare.

16

28

143

4

47

358

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

#EmergencyMedicine is a tough job Once--maybe twice--a year, a moment comes along that sustains you in this career. I had one of those moments last night. I am so very grateful to the knowledge sharing of #medtwitter that can make a lifesaving difference.

4

8

211

Rick Pescatore, D.O.

@Rick_Pescatore

4 months

I’m a 37 year old ER doctor with high blood pressure, high cholesterol, and a family history of early cardiac disease. I’m the guy who dies young of a massive MI on the drive home after an overnite shift. I’m not waiting for my troponin to rise to make changes for my longevity.

9

1

189

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

My success with phenobarbital for alcohol withdrawal far outstrips my experience with escalating benzodiazepine doses, and the operational benefits are significant. My typical approach is 130mg mild, 260mg moderate, 10mg/kg severe. Short course of 100mg capsules for those dc’d.

14

12

144

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@Caulimovirus Hydralazine

12

0

130

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

I am saddened by the implosion of emergency medicine residency training we say yesterday, and fearful for the future consequences. On top of that, I’ve been particularly burned out recently…

17

15

126

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

PGY-10, headed in for a string of night shifts. A decade in, I still genuinely love my job and am grateful for the chance to help patients every single day.

5

4

109

Rick Pescatore, D.O.

@Rick_Pescatore

7 months

I apologize. I havent been paying attention ACEP has invited an election-denying, conspiracy theory-repeating, anti-DEI urologist congressman ..for no appreciable beneficial reason ER docs, stand up for what you care about I am dropping FACEP status. What a leadership failure

ACEP Members

@ACEPNow

7 months

We heard all your questions and comments. Please listen to an update from ACEP President as she shares about LAC, Rep Murphy's appearance, and using our voice for change. To protect DEI, we need your voice too! #ACEPnation - will you join us to advocate for emergency physicians?

14

4

11

20

102

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Every emergency clinician would benefit from reading this discussion of the 2023 @escardio ACS guidelines by @smithECGBlog + @PendellM in @EMNews !

Guidelines Merge STEMI and non-STE ACS: ECS emphasizes that ... : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

1

32

91

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Ambulatory BP monitoring may be guideline-supported, but clinicians recommending home monitors MUST inform patients that there’s no such thing as a BP so high that you “have to go to the ER.”

Home blood pressure measurements ‘missed opportunity’ to tackle CV risk

BOSTON — Out-of-office BP measurements provide the clearest picture of CV risk for patients and are the ideal method to diagnose and treat hypertension, yet most clinicians still rely on inaccurate...

www.healio.com

9

16

89

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

This is sage and easily-forgotten advice. Thanks for the reminder, Sam.

Sam Ghali, M.D.

@EM_RESUS

2 years

Just a friendly periodic reminder that what has become routine to you, may be one of the scariest times in your patient’s life.

71

1K

6K

0

2

82

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

I am humbled and grateful to take on the role of EMN Chair. I stand on the shoulders of giants, especially Jim, and am dedicated to continuing his great work of fostering important conversations in our specialty. I hope you’ll join me on this next great adventure.

Emergency Medicine News

@EMNews

2 years

. @Rick_Pescatore is the new chairman of our edit board! And in some heartwarming continuity, he will write InFocus, which Jim Roberts took on when he became bd chair. Announcement , his vision , his 1st column

4

1

28

10

3

78

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Hot take: CHS is rampantly over-diagnosed in the ER, and often a gross oversimplification of complex derangements in the brain-gut axis. This label is too-often applied willy nilly, particularly to women (who suffer chronic abdominal pain syndromes at a high rate) (1/3)

10

7

71

Rick Pescatore, D.O.

@Rick_Pescatore

2 months

Yelp reviews of emergency departments are rife with people complaining of long waits while pearl-clutching about being forced to sit amongst “homeless crack addicts and junkies.” I will always be thankful for the perspectives and the insights being an ER doctor has brought to me

5

7

61

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

The ED can be a special place, if you let it Recent patient conditionally suicidal due to phantom limb pain, unable to access complex pain management resources Pain-free and tearful after ketamine infusion in the ED Theyre here at our doorstep—let’s do what we can, when we can

3

4

57

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

While I recognize emerging data pointing toward withholding abx in diverticulitis, I am extremely reticent. This can be a severe disease with significant complications, and the risk/benefit calculation should include profound downstream morbidity impacts. (1/2)

12

3

58

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

How an ER doc spends days off. Thanks for helping me build great memories for my kids, @HomeDepot .

2

0

51

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Watched a resident use dermabond, some ED supplies, and a dash of innovation to repair an important medical component for a vulnerable patient. Amazing ingenuity @EinsteinEMed

2

44

Rick Pescatore, D.O.

@Rick_Pescatore

2 months

You don’t have to be a doctor forever if you don’t want to.

2

42

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@Dr_mac2 The pandemic did a lot, not the least of which was revealing the many socioeconomic factors that affect when and why patients present to the ED, as well as the indisputable fact that these presentations are what help to keep the lights on. Gotta let these ones roll off you.

4

0

41

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

This, from @Anaes_Journal , is such an important finding. Critical to highlight when teaching trainee intubations.

1

18

41

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Email in my inbox from @MelHerbert stepping down as CEO of @emrap_tweets . Mel—thanks for transforming medical education and our specialty as a whole. You’re a titan. @skobner — best of luck on this next great adventure! #FOAMed #MedTwitter

2

6

39

Rick Pescatore, D.O.

@Rick_Pescatore

3 months

Life’s short, but so is the trip to Vegas. Trust me, I’m a doctor.

6

0

40

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Medicine is a tough job. The stakes are high, and emotions are just as heightened. Day after day, these things can wear on anyone who chose to wear the white coat. Hang in there—even though sometimes it might not feel like it, you’re making the world a better place.

0

7

41

Rick Pescatore, D.O.

@Rick_Pescatore

7 months

@ACEPNow For what possible purpose would we continue to invite someone that the membership has objected so strongly to? Is it about having a senior lawmaker present at LAC? What is the benefit? Im happy to help the team find a more appropriate speaker Also, was this filmed in a bathroom?

4

0

40

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Great narrative on @emdocsdotnet of a moonlighting resident treating a sick patient in a small critical access hospital. Excellent application of AVERT-Shock findings and use of vasopressin. Are you using vasopressin in patients with hemorrhagic shock?

Perspectives - Aortic Laceration in a Rural Mississippi ED: A resident’s response

A tough case in a rural ED...

www.emdocs.net

3

7

40

Rick Pescatore, D.O.

@Rick_Pescatore

2 months

This is the proudest achievement of my career. Doesn’t come with any money, though. 😞

4

1

37

Rick Pescatore, D.O.

@Rick_Pescatore

7 months

@EmergencyDocs @ACEPNow

2

5

38

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

As an #intern , I couldn’t perform a lumbar puncture (spinal tap) to save my life—or anyone else’s. My attending pushed me to embrace the procedure and perform it as often as possible, seeking out patients who might benefit. Years later, my patients and I are grateful for it!

3

1

37

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Most pts in the ED with isolated HTN need no intervention at all, and the risk of iatrogenic harm far outweighs any potential benefit of acute BP lowering. That being said, initiation (or up-titration) of oral antihypertensives is easy+safe, and may improve downstream outcomes.

2

5

34

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@RosenelliEM @JournalofGME @jbcarmody @drharrislakers This is a bit disingenuous. One of the reasons for the sustained stigma is undoubtedly the anachronistic call for osteopathic “distinctiveness,” and the continued charade of COMLEX where USMLE parity would level the playing field.

1

35

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Looking at a lot of people in the #FOAMed community right now, but especially you, @PulmCrit . Thank you, truly.

1

0

32

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

I often leave #chatgpt4 open on shift as a cognitive assist and, frankly, on-demand clinical tutor! Example: in a recent patient presenting with an acute neurologic deficit, AI immediately localized the infarct location (later confirmed on MRI) I think this will grow over time!

6

2

33

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

IMO, the latest evidence supports largely abandoning “stone search” CTs—stones aren’t obscured by contrast and miss rate is not low. Recent patient: flank pain similar to previous stones. Gross hematuria. CT: Stone in Renal Pelvis AND Type B Aortic Dissection #GiveTheContrast

6

4

33

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

The Practice of Medicine knows exactly when to humble you.

1

5

32

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

…but even as we lamented the NRMP news on shift, we practiced incredible medicine full of critical and non-critical interventions, cross-specialty and allied health collaboration (shoutout to pharmacists, texts, nurses, and even surgeons), and experienced life-altering moments.

1

0

31

Rick Pescatore, D.O.

@Rick_Pescatore

6 months

ER doctors unite! ✊

1

3

31

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

I’m not a “believer” in push-dose pressors, having seen so many dosing errors that could have been avoided with relatively little preparation and the hanging of a norepinephrine drip.

8

5

29

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Another ER night shift on a cold #Philadelphia night.

1

30

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

And minorities, who can be victims of dismissive diagnosis and incomplete investigation. Yes, CHS is real and increasingly common, but assignment of severe symptoms to cannabis use without considering the broad spectrum of chronic GI disorders is potentially harmful. (2/3)

1

2

29

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Also, until this practice permeates medicine, the well-meaning ER doc striving for antibiotic stewardship will be left on a very lonely island in the event of infectious complications. Thoughts? @EMNews @alimkakeng @AustinChiangMD @blondemedSJW @VenkBellamkonda @AliRaja_MD

10

0

28

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

A few years ago in @EMNews I wrote that Emergency Medicine was dying. (). Now I find myself on the other side of a very steep hill and feel strongly that EM has the tools, resources, and people to beat back against these assaults on our specialty…

What to D.O.: Emergency Medicine is Dying : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

2

28

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

The lumbar puncture is one of Emergency Medicine’s most powerful diagnostic tests, and critical for the broad differential that we encounter everyday. We shouldn’t shy away from performing these.

5

0

27

Rick Pescatore, D.O.

@Rick_Pescatore

2 months

It took me ten years and thousands upon thousands of patients after medical school to learn the most important thing they should have taught us before putting on the white coat:

2

26

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

With apologies to my residents: Leaning into the release of #GRACE3 and new #EmergencyMedicine #vertigo recommendations by requesting all dizzy patients today to my pod from the charge #nurse . We improve most by confronting the difficult and unfamiliar.

2

1

26

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

I had tremendous recent success with ketamine infusion and oral nortriptyline in a patient with severe cervical radiculopathy who had failed multiple other analgesics including high-dose opioids. Effective pain management in the ER can be such a rewarding experience.

4

0

25

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@sy5temfire @SaltyEMNY Yes yes yes yes

3

0

25

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

And every doc at the bedside need remember the importance and sanctity of their clinical work, and take pride and comfort in the tremendous care that is delivered across US emergency departments every day.

1

2

25

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Fortunately for many, the therapeutic approach to CHS mimics many other syndromes. Acute care clinicians should exercise thought and care in blaming cannabis for symptoms, particularly among patients in whole cannabis use is therapeutic. (3/3)

AHEAD OF PRINT: WHAT TO D.O. : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

2

1

25

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Good fun on a recent ⁦ @EinsteinEMed ⁩ shift discussing key pearls in the ED. Med students looking for a great place to learn EM, don’t forget to check us out!

1

25

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@DavidBroderDO @jbcarmody @AOAforDOs Whoa. Citation needed here.

1

0

24

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

@813JAFERD I think this is an oversimplification, and a dismissive take that almost certainly causes harm to some subset of patients.

1

0

23

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Tremendous article in this month’s ⁦ @EMNews ⁩ by the unmatched ⁦ @HandtevyMD ⁩. A must-read!

2

6

23

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Also, not for nothing, but I work with some amazing doctors and see some amazing patients at @EinsteinEMed and @EMCM_EM and if you’re looking for a place to train, please check us out!

1

2

22

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

This is a great one pager! I prefer phenobarb for withdrawal, generally 130mg for mild, 260mg for moderate symptoms I appreciate the focus on thiamine replacement here, and feel we should be aggressive in parenteral thiamine administration in the population w/ EtOH use disorder

Mark Ramzy, DO, EMT-P

@MRamzyDO

2 years

Check out this Alcohol Withdrawal @OnePagerICU by @nickmmark & I! ⌚Finding out time of last drink can change management 🍻Know what symptoms to expect based on timing 💉Have a Benzo or Barbituate based approach to treatment #FOAMed @acarriebear @emedtox @ToxAndHound @ToxTalks

1

32

101

1

4

23

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Learned today that Bell’s Palsy in #LymeDisease can be treated with 21 days of oral doxy, and doesn’t require the IV ceftriaxone I used once-upon-a-time in residency. Reminder for physicians in endemic areas (lookin’ at you, Philly) to consider #Lyme , particularly in the summer!

4

3

22

Rick Pescatore, D.O.

@Rick_Pescatore

11 months

It wreaks havoc on home life, but I’ve always enjoyed the 3p-11p shift. It’s usually “in the thick of it” and a chance to work with multiple nursing teams. Ideal shift for an after-work drink in the event of a tough case.

2

0

22

Rick Pescatore, D.O.

@Rick_Pescatore

6 months

In this month’s @EMNews , I wrote about @SAEMonline ’s #GRACE3 recommendations for #vertigo , Jay Gatsby, and the #orgastic future of #EmergencyMedicine . I hope you’ll check it out.

3

7

20

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@miguel_reyesMD Just this, by @poisonreview in @EMNews : I really think @PulmCrit is the prophet here.

Toxicology Rounds: Is Phenobarbital for Alcohol Withdrawal... : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

0

3

20

Rick Pescatore, D.O.

@Rick_Pescatore

3 months

If you’ve ever been to the ER with crippling abdominal pain and vomiting and been told “there’s nothing wrong,” I wrote this article to bring with you and discuss with your doctor in case it ever happens again. We can be better with belly pain.

GRACE-4 as a Call to Action : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

4

5

19

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

FWIW, I just fed ChatGPT this ECG, and it thought it looked fine.

Shubham Saboo

@Saboo_Shubham_

1 year

ChatGPT: The doctor in your pocket 🤯 ChatGPT can now look at X-rays, prescriptions, or medical reports and answer any question in a matter of seconds. Future of health talk - simple, snappy, and AI!

109

327

1K

4

1

20

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Have encountered this previously—a sewing needle inserted at the hairline of a newborn in a failed infanticide attempt. We discovered it years later on an unrelated CT.

Oren Gottfried, MD

@OGdukeneurosurg

1 year

80 year old with this finding. She denies a history of trauma or surgery.

28

30

249

3

1

19

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Sitting on shift discussing with the residents what this will mean for the future of the specialty. What do you think?

Emergency Medicine News

@EMNews

2 years

Bad news for #emergencymedicine : 555 #residency slots were unmatched. @3rdRockUS @RobertMcNamar12 @Rick_Pescatore

6

9

40

5

2

19

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@WillSapwell @smithECGBlog The presence of chest pain means the ST elevation cannot be BER? Can you elaborate? My sense is that I have seen quite a few young healthy individuals with early depolarization and musculoskeletal chest pain.

3

0

18

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

“That’s the way I was taught” is never an excuse in medicine. Trust but verify. Let evidence and data guide your practice.

2

1

18

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

The NRMP EM disaster (and, plainly, that’s what it is) will reverberate across our specialty for many years… But an historic, diverse, and competent workforce of emergency physicians stands ready to face what needs to be done.

1

0

18

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

More research chicanery from @pfizer , this time comparing their new intranasal CGRP ant to placebo for treatment of #migraine Except…we don’t treat migraine with placebo. We treat it with safe, cheap, and successful meds that are the genuine comparator

2

0

15

Rick Pescatore, D.O.

@Rick_Pescatore

8 months

The nite before I wrote this article in @EMNews , I was on the phone w/an ICU doc friend who had to hang up for an emergency. Before saying goodbye, I overheard him telling the resident to order adenosine to the bedside Adenosine v CCB in SVT, my thoughts:

11

2

16

Rick Pescatore, D.O.

@Rick_Pescatore

11 months

I wrote about something we don't think about often in the emergency department, but what I think can make a substantial difference in the lives of patients who present to our care. I hope you'll give it a read.

The Tapestry of Thiamine: Thiamine is a vital strand in the ... : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

1

2

16

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

I believe there may be a role for increased assessment of diastolic dysfunction in the ED, presumably using E/e ratio. I’m working on trying to gain these skills at the bedside—any hot tips?

8

2

16

Rick Pescatore, D.O.

@Rick_Pescatore

4 months

0

16

Rick Pescatore, D.O.

@Rick_Pescatore

9 months

A few months ago a resident asked me about utilization of CTA for GI bleed--a hot topic highlighted by recent pro-utilization pieces in @AnnalsofEM and @spoonfedEM Please check out my thoughts on LGIB and CTA in this month's @EMNews !

The Delicate Balance of Diagnosing GI Bleeding in the ED : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

1

5

16

Rick Pescatore, D.O.

@Rick_Pescatore

11 months

Recently faced a shift brimming with critical and complex patients. In these moments, the value of support becomes crystal clear. Deeply thankful for the collective expertise and dedication that surrounds me in the ER. Together, we turn daunting days into life-saving teamwork.

0

1

15

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

…and the healthcare system as a whole. In January, I wrote in @EMNews that “we find ourselves at a precipice in Emergency Medicine.” Never has that rung so true.

Viewpoint: A New Era for Emergency Medicine and: EMN : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

1

15

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Many complex and complicated patients the past few days at @EinsteinEMed . I’m grateful for the shared expertise and collaboration of my partners!

0

15

Rick Pescatore, D.O.

@Rick_Pescatore

6 months

Congrats, @TheSGEM !

Raghu Venugopal MD

@raghu_venugopal

6 months

Dr. Ken Milne has it all. Valued community member, attending rural ER MD, evidence-based master, and all with a sense of humour and goodness. The best of Canadian healthcare. @TheSGEM

3

24

90

0

14

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Now is the time for our oft-warring specialty societies to unite under the banner of resuscitation—advanced life support for a specialty in critical condition. From PE, insurer, and governmental influence to a splintered and disunited workforce, there’s much to do.

1

0

15

Rick Pescatore, D.O.

@Rick_Pescatore

4 months

@Toxi_Cab I think I went into this fairly eyes wide open, but a decade down the road, I'm tired. Is it in the nature of ER docs to seek out the next adventure?

3

0

14

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Post-coital Transient Global Amnesia is a great diagnosis to make in the ER, and the “stroke alert” is quickly defused by asking about recent sexual activity.

0

14

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

My article in this month’s @EMNews Saline is likely not the murder weapon it has been made out to be, but reasonable arguments can be made for clinical impact and downstream consequences, particularly among patients receiving large-volume resuscitation

Infocus: Saline is Far from Normal : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

1

5

13

Rick Pescatore, D.O.

@Rick_Pescatore

10 months

2023 was my best year yet, and I'm looking forward to what 2024 has in store. I'm lucky enough to continue to learn #EmergencyMedicine alongside the incredible @EinsteinEMed residents+share those lessons with so many through @EMNews ! Here are the 12 topics I covered this year:

2

4

13

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

"The longer you stay, the longer you stay."

Mohan Dutt, MD

@slumberingdoc

1 year

Dutt’s first law of #Residency “Leave the hospital immediately after your shift is over, to stay is to tempt the fates” Follow me for more useful information.

1

0

8

1

0

13

Rick Pescatore, D.O.

@Rick_Pescatore

6 months

An old ECG from many years ago. Pro-tip: you generally should not have this tracing. 😂

2

1

12

Rick Pescatore, D.O.

@Rick_Pescatore

10 months

@armyemdoc @gruntdoc I honestly don’t know if this is a serious question. It’s literally in the beginning of your post. Low dose titrated to abatement of bradypnea reverses the life threat without having the patient puke their guts out in your ER. Are you ok?

1

13

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Good teaching point today on shift about the high incidence of viral urticaria (not all hives are an allergic reaction!). I appreciated recent @LWestafer @ACEPNow article drawing attention to @AAAAI_org guidelines discussing 2nd-gen antihistamine use!

6

4

13

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

So many hours spent wedging a carefully-crafted foil stent into a bloodied field…

Ryan Radecki, MD MS

@emlitofnote

1 year

Nail injury with nail avulsion? Significant nailbed laceration requiring repair? Unlikely any advantage to trying to wedge anything back into the nail fold. #FOAMed

1

10

38

2

1

12

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

In this morning’s ⁦ @spoonfedEM ⁩, ER doc age (>40) correlated with ⬆️ patient mortality. At 36.9 and PGY-10, I’ve never felt more “on my game” than at present in the ED. Is it all downhill from here?

Experienced or Rusty? Physician Age and Patient Mortality - JournalFeed

Spoon FeedEmergency physician (EP) advancing age was associated with higher 7-day patient mortality. This is a call to keep current with literature, clinical skills, and best practices. SourceAssoc...

journalfeed.org

5

2

11

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Little doubt that this will be a fellowship with tremendous opportunities and exposure. Pretty cool addition to the Philly EMS scene.

Penn EM Residency

@UPennEM

2 years

We're excited to announce that we now have ACGME approval for our EMS Fellowship. We are currently seeking candidates to begin July 1, 2023 as well as July 1, 2024. You can learn more at #EMS #leadersinem #emergencymedicine

0

4

23

0

2

12

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Proud of @ACEPNow today, and very grateful for advocacy by leaders like @BrooksWalsh Recognizing our past mistakes is the first step towards growth. We must actively dismantle the narratives we once believed and champion change for a just future. @EMNews

Anachronisms in Agitation : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

Carla K. Johnson

@CarlaKJohnson

1 year

Today, ACEP withdrew approval of its 2009 white paper and says the term 'excited delirium' should not be used by members who testify in civil or criminal cases.

2

9

14

1

3

11

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

Important consideration, and something I’ve been thinking about lately. I suspect we should be routinely echoing prior to rate control in AFRVR, and my guess is it would lead to less CCB and more BB use.

Shahrukh Bakar

@shahrukh_bakar

2 years

@TheSGEM @EMO_Daddy @emergmedottawa @CJEMonline Except that AF is rarely present by itself. It is frequently accompanied by HFrEF, CAD, other structural heart disease etc. The study will not pick up the patient that will VF because their LVEF was 10%.

2

0

7

3

11

Rick Pescatore, D.O.

@Rick_Pescatore

10 months

@armyemdoc @gruntdoc What? I’m very familiar with this study. Every ER doc since 2011 has taught and known this study since it was published. I think we’re more opposed to the unnecessary PW. I’ve reversed, conservatively, a kabillion opioid ODs…but I don’t push them into withdrawal unnecessarily.

1

0

12

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

@DraMo_deAraujo @ETSshow These are the moments that power me through all the other ones. It's a hell of a career, and I'm proud of it...but it comes with costs, like all of medicine.

0

11

Rick Pescatore, D.O.

@Rick_Pescatore

2 years

@DOResMatch @DavidBroderDO @AOAforDOs

0

11

Rick Pescatore, D.O.

@Rick_Pescatore

1 year

Iron infusion for symptomatic anemia in the ED: once seemed outlandish to me, but recently have had very positive experiences with Ferrlecit Coupled with some of the #hemeTwitter takes on #IDA I’ve seen, I’m wondering if this might have a greater role in my practice You?

2

3

11

Rick Pescatore, D.O.

@Rick_Pescatore

8 months

@IM_Crit_ Thanks for posting this wonderful article. I feel more and more that I’ve lost much of what led me to medicine. Our humanity and compassion get stripped away continuously in the face of constant assault. I should certainly try harder to recognize and mitigate this for my trainees

2

1

11

Rick Pescatore, D.O.

@Rick_Pescatore

4 months

@bluelionpolitix It’s got plenty of it, that’s for sure.

1

0

10

Rick Pescatore, D.O.

@Rick_Pescatore