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Alfred Sacchetti
Practicing Emergency Physician, Teacher, Researcher. Areas of interest include: Pediatric EM, CHF, Arrhythmias, Sedation and Analgesia, Pain Management.
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Alfred Sacchetti Mar 28
Does anyone have policy regarding CPR and known COVID patients? Or is it case by case?
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Alfred Sacchetti Mar 28
I’m 66 and people keep asking if I want them to see the respiratory distress patients. Very kind. No help on single coverage. One nurse with Lupus brought me some of her Plaquenil to have in case. Thank you forever.
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Alfred Sacchetti Mar 13
Use High Flow Nasal Cannula to treat COVID-19/Flu patients. Don’t abandon therapy that reverses hypoxia and avoids intubation for theoretical risk of aerosolizing particles.  Just put the cannula under the surgical mask the patient is already wearing.
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Alfred Sacchetti Mar 7
Replying to @lemur_katta1 @EMSwami
That information is important in understanding biology of the disease, but can come in time. It will not effect your care of the patient in front of you.
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Alfred Sacchetti Mar 7
Replying to @medic1895
Yep, need that info for learning biology of disease, but that can come with time. Lack of testing will not effect care of patient in front of you.
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Alfred Sacchetti Mar 7
If you have chest pain, you need a diagnostic test because we have a treatment for a STEMI. If you have respiratory infection, we don’t have a viral specific treatment, COVID, RSV, Adeno, etc. Once you know it is in your community no need for testing, manage symptomatically.
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Alfred Sacchetti Mar 7
, Stop whining about testing kits, treat COVID-19 like RSV. Only need to test a few patients to know virus is in your community, after that symptomatic care. Mild infections home treatment and self quarantine. Severe illness, hospitalize. Staff resp precautions
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Alfred Sacchetti Mar 4
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Alfred Sacchetti Feb 6
Never had a child irritated by high flow nasal cannula or oxygen when needed. Beauty of HFNC is you can adjust the amount of oxygen to give a saturation of only 92-95%. No hyperoxia, but no hypoxia.
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Alfred Sacchetti Feb 6
Don’t be too quick to discount high flow nasal cannula. Child desaturated every time was removed, took 3 days to wean off.
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Alfred Sacchetti Feb 6
Don’t be too quick to discount the high flow nasal cannula, child desaturated every time was removed from it. Took 3 days before could be weaned off from it.
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Alfred Sacchetti Nov 29
No, YouTube, but should. Will try to get one up this week. Thanks
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Alfred Sacchetti Nov 25
Try this tweet again with the video this time. Pediatric Respiratory Distress and High Velocity Nasal Cannula. A match made in heaven.
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Alfred Sacchetti Nov 25
Pediatric Respiratory Distress and High Velocity Nasal Cannula. A match made in heaven.
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Alfred Sacchetti 9 Jun 19
Help fight back, by getting involved and make a difference in the fight against cancer.
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Alfred Sacchetti 25 Mar 19
At present Geriatric BRUE is of no value other than to prevent misfitting patients into wrong diagnoses. Once defined with diagnostic study recommendations and evidence supported disposition criteria it will be very valuable, like the pedi BRUE.
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Alfred Sacchetti retweeted
Steven Kornweiss 22 Mar 19
Replying to @SacchettiAlfred
Geriatric BRUE sounds great. Next step would be to do some risk stratification and assessment for modifiable neuro-cardiovascular risk factors which would guide subsequent management.
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Alfred Sacchetti 21 Mar 19
Wife brings in 80 yo husband. 45 second spell, slumped in chair, starring, not responding to voice or tactile stimuli. Spontaneous recovery, now at baseline. TIA?, Syncope?, Seizure? None really fit. Why not Geriatric BRUE.
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Alfred Sacchetti 21 Mar 19
Despite my best efforts there are many elder patients that I just can’t diagnose. Yes, BRUE means I don’t know, but better than faking it and calling them a TIA or Syncope.
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Alfred Sacchetti 5 Oct 18
Number one cause of SIDS in our shop.
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