EM/IM Doc Working in ICU; Founder of REBEL EM & RezaieStrong; Medical Director at Impact EMS; Doing my Part to Cut Down on KT Time (Tweets are opinion only)
This is not my normal post but something important to me...
I have depression
I am not depression
I am not my mental illness
My mental illness does not define me
My mental illness is part of me
Don’t be ashamed of your story. It will inspire others.
#breakthestigma
As a frontline ER doc in San Antonio...
@GregAbbott_TX removing mask mandate sends wrong message to public...the pandemic is not over and this is a BIG mistake...
For everyone else...PSA: DO NOT look to political leaders with no medical background for your medical advice
For me...officially the lowest O2 sat on room air in a #COVID19 patient who was awake and talking
No respiratory distress
No increased work of breathing
No AMS
#silenthypoxemia
This is such a humbling disease!!!
#COVID19FOAM
Lung Injury Ventilation & ARDSnet...I am not an Intensivist...I am a frontline ED doc...wanted to create a useful aide for myself for when I am on shift...TY @emcrit for peer review...hope this helps others (feedback welcome)
rebelem.com/covid-19-airwa…#COVID19FOAM#growthmindset
I agree with @cameronks we need to stop intubating patients early in #COVID19 disease course...these patients need O2 not pressure...putting them on ventilators will trash their lungs...this is not ARDS...these patients act more like HAPE
#COVID19FOAM
Sitting here on my 10th overnight shift in a row and thinking...What other industry functions like American medicine today? None that I can think of...the system is asking me to be more resilient...but it is the system that is broken?
Most of the research thus far on treatment in #COVID19 seem to be targeting the wrong timeframe of disease...the point is to start treatment prior to hyperinflammation...would like to see more studies target earlier timeframe of disease #COVID19FOAM
Acute Decompensated HF: Time Critical Interventions via @amalmattu at #ACEP20
-Morphine-> No role
-Diuretics-> No immediate effect
-Nitrates-> High-dose (Initial 200-400mcg/min)
-ACEI-> If don't tolerate NTG (SL Captopril, IV Enalaprilat)
-NIV-> Use early (Reduced intubation)
COVID19 is NOT "Typical" ARDS
Pts on CPAP + resp distress should be intubated early
High PEEP results in severe HD impairment & fluid retention
MV buys time...Do with lowest possible PEEP & gentle ventilation
More O2, Less Pressure
atsjournals.org/doi/abs/10.116…#COVID19FOAM
I cried for the 1st time in 20yrs yesterday. I cried hard for 5hrs straight. I am not embarrassed & happy that it happened. In a society where we are expected to be strong all the time I am here to tell you...there is no weakness in being open about mental health
#RezaieStrong