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Lauren Westafer, DO MPH MS
EM doc | fellowship director | SoMe editor | co-founder | |🏳️‍🌈she/her
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Lauren Westafer, DO MPH MS Nov 22
RNs use Vocera, We each have portable phones with our on the tracking board. Biggest game changer is secure text messaging app (useful within ED and with consultants)
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Lauren Westafer, DO MPH MS Nov 19
Replying to @LWestafer
Most people w/simple,true abrasions do fine but can disrupt life.Acknowledging ophtho colleagues often disagree,&data is very limited, small amt (like squeeze out most of the bottle) of tetracaine is probably fine for a select group that WILL f/u & understand potential risks(8/)
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Lauren Westafer, DO MPH MS Nov 19
Replying to @LWestafer
tetracaine did appear safe, acknowledging the limitations of a retrospective study in which not all patients got follow up. also, the adverse events are a reminder to remember that other dx (herpes) can masquerade as a corneal abrasion, but needs diff tx (7/)
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Lauren Westafer, DO MPH MS Nov 19
Replying to @AnnalsofEM
Other studies have looked at safety, e.g. retrospective study clinicians in the only regional referral hospital began discharging patients w/tetracaine & asked-what happened? ⭐indication creep! (nonsimple abrasions got tetracaine) (6/)
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Lauren Westafer, DO MPH MS Nov 19
Replying to @LWestafer
importantly, this study was NOT powered for safety. when taking into account this AND that only 27% of patients had ANY follow up at 1 week, we can't be confident (sure, they were probably all better and couldn't be bothered to come in, but we don't now that) (5/)
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Lauren Westafer, DO MPH MS Nov 19
Replying to @LWestafer
Now onto the results: ⭐Not shocking: tetracaine works (pain 7 points lower on 10 cm scale) ⭐Patients in tetracaine arm took ⬇️ hydrocodone (but this isn't something we routinely Rx for simple corneal abrasions in our ED) ⭐safety events didn't appear different ..but.. (4/)
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Lauren Westafer, DO MPH MS Nov 19
Replying to @LWestafer
were patients really blinded? (they probably got a topical anesthetic in the ED and had that experience...) (3/)
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Lauren Westafer, DO MPH MS Nov 19
Replying to @LWestafer
⭐Population: adult ED patients w/simple corneal abrasions ⭐Intervention: tetracaine q30 min ⭐Comparator: artificial tears q30 min (all got ABX drops and opioids?!) ⭐Outcome: primary: pain at 1-2 days, secondary: opioids/safety (2/)
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Lauren Westafer, DO MPH MS Nov 19
At journal club yesterday we covered a new RCT on tetracaine in corneal abrasions ⭐kind of an odd question - is tetracaine efficacious? we didn't think this was controversial (more that the safety was controversial) (1/)
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Lauren Westafer, DO MPH MS Nov 18
Replying to @MacEmerg @TChanMD and 2 others
Congrats !
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Lauren Westafer, DO MPH MS Nov 18
My interns are the best…(Also it appears that our “stats are fun”indoctrination program is working...)
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Lauren Westafer, DO MPH MS retweeted
Jessica Halem 🌈 Nov 16
It is and it is time for Academic Medicine and our teaching hospitals to ensure a safe and welcoming environment for transgender and nonbinary doctors to train, teach, and practice medicine.
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Lauren Westafer, DO MPH MS Nov 16
Replying to @AdvocacyMD @cortknee
Here’s my routine for pumping during (Admittedly it’s probably overkill because from my transmission is quite low; however, it made me feel better)
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Lauren Westafer, DO MPH MS retweeted
Lauren Westafer, DO MPH MS Oct 8
We are recruiting for a multidisciplinary R01 sponsored by the to help hospitals improve care of patients with COPD Information: Fill out this short form and we'll see if your hospital qualifies
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Lauren Westafer, DO MPH MS Nov 8
Replying to @reverendofdoubt
Sorry to hear this. Thinking of y’all
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Lauren Westafer, DO MPH MS Nov 5
Explicitly? I don’t think so (although I work at a single place that works very hard to reduce this). Implicit bias surely exists...as it does in most places
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Lauren Westafer, DO MPH MS Nov 5
Having trouble buying into seeing substance use disorder as a disease? At harm reduction symposium Friedmann asks...have patient w/a1c of 13-do you say no insulin til you eat better? That’s what we often do to patients with SUD
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Lauren Westafer, DO MPH MS Nov 5
Replying to @BillSoaresIII
Interestingly, looking at our opioid epidemic in western MA (and ⬆️⬆️⬆️ in overdose deaths) stigma plays a large role —not just population or healthcare level but the patients family / culture / religion
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Lauren Westafer, DO MPH MS Nov 5
Replying to @BillSoaresIII
after a heroin OD, 1 year mortality is 5.5%! OUD is a lethal disease...it’s also a chronic disease. MOUD can help save lives. Think about other chronic disease...we don’t take away a diabetic’s insulin because they ate poorly last week
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Lauren Westafer, DO MPH MS Nov 5
Replying to @BillSoaresIII
And...as we ascribe blame to patients with Opioid use disorder...when we look at how patients with opioid use disorder started, heroin users...75% started with prescription meds
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