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josh farkas
intensivist • US nerd • FOAMite • skeptic • caffeine & iphone addict • leader of the rebel alliance • writer • resuscitationist • feminist •own opinions, no COI
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josh farkas 6h
murphy’s law of impellas: it’s perfectly positioned, then the patient sneezes, and...
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josh farkas 19h
Replying to @TomZeu
fantastic!! for those of you who don't have access to epidural (many/most medical ICUs don't) there's also ketadex or clonidex
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josh farkas Jan 20
is TED dead? great BMJ piece on the evolution of the conference, featuring the recent EMCrit conference.
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Salim R. Rezaie, MD Jan 20
Undifferentiated Shock via Common complaint and important workup...
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josh farkas Jan 20
reminder that health policy must be based on solid evidence, not just stuff that sounds like a good idea (cough cough cough SurvivingSepsis).
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Salim R. Rezaie, MD Jan 19
Vancomycin Pharmacokinetics: Make Vanco Great Again via "Should consider whether or not the patient truly needs MRSA coverage (rather than just reflexively blanketing every critically ill patient with vancomycin)"
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josh farkas Jan 19
- don't delay to get sterile field if pt dying - better to have incision too long rather than too small - avoid tendency to right-mainstem the ETT (only insert a few cm!). Cuffed shiley is ideal and greatly preferable if available as it will naturally avoid this problem.
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josh farkas Jan 19
K, you can always post one about potassium instead
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Salim R. Rezaie, MD Jan 19
Acute Infection & Myocardial Infarction: How Afraid Should we Be? via "Most studies of acute infection have not distinguished between type 1 and type 2 myocardial infarction."
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josh farkas Jan 19
agree. ideally after a positive trial, a replication trial would be done to differentiate whether you've really found the magic mix or just statistical noise.
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josh farkas Jan 19
this is a bit reminiscent of the studies of TPA in stroke, where folks kept on doing studies until one was positive (NINDS). when a positive trial finally emerged the conclusion was "we found the magic bullet!" not "eventually a positive trial will occur due to random chance"
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josh farkas Jan 18
👇 great rebellious thread here on proning. agree with & on this - enthusiasm has eclipsed evidence.
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josh farkas Jan 18
Replying to @MDaware @EMNerd_
maybe we could add that into the meta too! count it twice?
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josh farkas Jan 18
Replying to @EMNerd_
yeah trying to blend together CESAR and EOLIA is a stretch
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josh farkas Jan 18
wouldn't get too dyspneic over this - it only combines two RCTs, which are rather heterogeneous. (although I guess it's a step up from some Cochrane reviews which identify *zero* eligible studies )
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Internet Book of Critical Care Jan 17
fresh chapter & cast: undifferentiated shock - significance & theoretical definition - early recognition & red flags - causes & approach to sorting out - stabilization maneuvers
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the EMCrit Crew Jan 16
EMCrit Wee - Getting Things Done 2019 Update
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Meghan Groth Jan 16
Don’t pass up an opportunity to learn from the best! “Troponinitis” w/ POCUS w/ and Pain control w/ And tox w/ and Get your spot for today:
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josh farkas Jan 16
agree 100%, would be really helpful if the CDC could track the number of patients *intubated* due to flu.
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josh farkas Jan 16
Replying to @accpchest
have seen some influenza ARDS so far, somewhat reminiscent of the 2009 H1N1 but lower volume so far
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