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josh farkas ๐Ÿ’Š
intensivist๐Ÿ˜ท FOAMite๐ŸŒŠ pocus nerd๐ŸŽ› coffee & iphone addictโ˜•๏ธ leader of the rebel allianceโš”๏ธ writerโœ’๏ธ resuscitationist๐Ÿ’‰ feminist๐Ÿ‘ฉโ€โš•๏ธ aweful spellur๐Ÿ˜ฌ no COI๐Ÿ’ฐ
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josh farkas ๐Ÿ’Š 21m
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josh farkas ๐Ÿ’Š 1h
Replying to @Rick_Pescatore
you want some peer-reviewed science? here ya go ๐Ÿ˜‚
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josh farkas ๐Ÿ’Š retweeted
Venk Murthy Jun 24
Wow. is on fire. Finds serious issues and discrepancies between and paper on PROTECT2 Impella trial. Read this. Some stuff is merely questionable, other stuff is pretty shady.
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josh farkas ๐Ÿ’Š 14h
Replying to @MDaware @smithECGBlog
endorse. pneumo is the only thing I can see on a shoulder film so at least Iโ€™m getting the first step right.
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josh farkas ๐Ÿ’Š retweeted
GomerBlog 17h
Did you this AMAZING abstract?!? Fixed it.
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josh farkas ๐Ÿ’Š 17h
yes it's real ๐Ÿคฆโ€โ™‚๏ธ and please, please, please - we *don't* need further studies on this question. we already have one study too many.
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josh farkas ๐Ÿ’Š 20h
Replying to @drjgutt @emlitofnote
not aware of any data on this. for a patient with significant contraction alkalosis from vomiting, normal saline is a rational solution which I would use.
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josh farkas ๐Ÿ’Š 23h
strong ref, but Iโ€™d go more with tyrion for you. Adam is such a rockstar that I usually forget heโ€™s still training (although not for long)
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josh farkas ๐Ÿ’Š Jun 25
Replying to @TimLaheyMD
the link seems to be broken but definately agree- addiction may be a greater life threat ultimately but we donโ€™t see this in the hospital under our watch
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josh farkas ๐Ÿ’Š Jun 25
Replying to @EMHighAK
it often seems impossible to define what is beneficial vs. excessive practice variation. the reality of bedside medicine often diverges from neat algorithms constructed within the serenity of a practice guideline.
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josh farkas ๐Ÿ’Š Jun 25
understanding practice variation can be tricky, so here's a powerful algorithm to help sort it out.
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josh farkas ๐Ÿ’Š Jun 24
yep, last time I checked our numbers the difference between NS vs LR was 25 cents. varies with vendors etc but its trivial.
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josh farkas ๐Ÿ’Š Jun 24
Replying to @drjgutt @emlitofnote
increasing data that saline may be harmful no clear data on LR vs plasmalyte, currently they seem roughly equivalent
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josh farkas ๐Ÿ’Š retweeted
Rick Pescatore, DO Jun 24
Revisiting this article by today. I like adding DDVAP in severe hypoNa as a guardrail both in the ED and once the patient is sent upstairs. The downside is often longer time to correction. A fair trade off, IMO.
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josh farkas ๐Ÿ’Š Jun 24
Replying to @Rick_Pescatore
thanks, agree ๐Ÿ’ฏ. DDAVP eliminates dangerous problems ("oops, the Na autocorrected by 15 mM overnight") at the cost of some irritating, yet safe problems ("damn it, the Na only increased by 4 mM").
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josh farkas ๐Ÿ’Š Jun 24
Replying to @apskovsen
not bulletproof but its out there
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josh farkas ๐Ÿ’Š Jun 24
Replying to @antonyashton
on brand
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josh farkas ๐Ÿ’Š Jun 24
Replying to @emily_fri @msiuba and 3 others
nice thing about US is it's all essentially the same skill. once you learn it you can put in a line anywhere.
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josh farkas ๐Ÿ’Š Jun 24
agree, another superiority of subclavian CVC may be decreased risk of cath-associated DVT. we generally don't think about this much because it's a delayed complication which we don't take personal responsibility for, but it can be a real problem.
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josh farkas ๐Ÿ’Š Jun 24
Replying to @ThirdTimePlucky
solid reasoning
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