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Sam Ghali, M.D.
ER Doctor | Resuscitation | Airway | Emergency Ultrasound | Cardiovascular Emergencies | ECGs | Trauma | Critical Care | | Patient Advocate
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Sam Ghali, M.D. 4h
Outcomes of Cardiac Catheterization in Tombstone Coronary Occlusion With and Without Prayer: A Randomized Controlled Trial.
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Sam Ghali, M.D. 4h
No that part is clear: 1. Activate the Cath Lab 2. Pray
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Sam Ghali, M.D. retweeted
Sam Ghali, M.D. Jun 16
Watch this video of one of my residents reducing a dislocated shoulder after an Interscalene Nerve Block. Keep an eye on the shoulder or you’ll miss it. This is why I haven’t had to do a conscious sedation for shoulder dislocations in years. (With consent)
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Sam Ghali, M.D. 21h
Pericarditis
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Sam Ghali, M.D. 22h
Holy crap! Differential: Left Main Occlusion in a Left Dominant System (would most likely be dead), more likely either Proximal Wraparound LAD or Proximal LAD superimposed on CTO of RCA with compromised collaterals.
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Sam Ghali, M.D. 23h
Replying to @canisCleo
Haha, nice reduction! Patellar dislocation are notorious for spontaneously reducing. I jokingly tell my residents that if you just blow really hard you can get them back in.
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Sam Ghali, M.D. Jun 17
Replying to @EM_VATA
Very nice. The supraclavicular is a great block!
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Sam Ghali, M.D. Jun 17
Replying to @RogueDadMD
Yes you definitely have to have the right patients. I’m sure I have some videos of the actual block somewhere, I’ll have to post one.
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Sam Ghali, M.D. Jun 16
Replying to @shouldergeek
Intra-articular Lidocaine works OK. I’ve used it many times in the past. But I must say it’s nothing close to an Interscalene Nerve Block.
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Sam Ghali, M.D. Jun 16
Replying to @JGullMD
Yep exactly! Have a few where the resident goes back to see if the block has set in & the shoulder’s already slid back in. Obviously the sensory block is amazing bc they feel no pain but people don’t realize how powerful the effects of the actual motor block.
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Sam Ghali, M.D. Jun 16
Agreed!
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Sam Ghali, M.D. Jun 16
Replying to @POCUSClub
He gave expressed verbal and written consent so I don’t see why not. When I asked him if I could use it for teaching purposes he said “hell yeah!” 😁 Love this guy.
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Sam Ghali, M.D. Jun 16
Replying to @emedtox
Nope he was in a ton of pain so we just went for the block straight away.
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Sam Ghali, M.D. Jun 16
Replying to @MThallinger
Lidocaine. Want it to be short-acting and Lido is readily available in most every ER. Need to repeat the exam after the anesthetic wears off.
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Sam Ghali, M.D. Jun 16
Replying to @AndyMeiman
First
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Sam Ghali, M.D. Jun 16
Replying to @POCUSClub
100% Nicolas!
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Sam Ghali, M.D. Jun 16
Replying to @EMariosklant
We did it together. It was his first one. He did a great a job!
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Sam Ghali, M.D. Jun 16
Watch this video of one of my residents reducing a dislocated shoulder after an Interscalene Nerve Block. Keep an eye on the shoulder or you’ll miss it. This is why I haven’t had to do a conscious sedation for shoulder dislocations in years. (With consent)
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Sam Ghali, M.D. Jun 14
I believe what Alain meant was competing ST Segment forces between elevation from direct transmural ischemia of the High Lateral Wall, versus High Lateral depression reciprocal to Inferior Transmural ischemia. So the real question is: was it a Wraparound LAD?
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Sam Ghali, M.D. Jun 13
Yup. Obvious LAD Occlusion... and those relatively huge upright Inferior T waves make me wonder about a Wraparound (Type III) LAD.
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