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Ryan Radecki
Emergency Medicine & Clinical Informatics. NW Permanente, University of Texas Medical School at Houston & Annals of EM. &
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Ryan Radecki retweeted
Bloodman 3h
If < 150 would replace - can’t make clots without fibrinogen!
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Ryan Radecki retweeted
Bobby Foulcamp 3h
Replying to @Bloodman @emlitofnote
hmmm still not sure how you'd use a low fibrinogen in a cirrhotic with GI bleed?
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Ryan Radecki retweeted
Bloodman 4h
Replying to @emlitofnote
Fibrinogen can be helpful in liver patients where it can be really low. Agree most times INR worthless esp in liver disease
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Ryan Radecki 6h
Technically, bones are continuously growing - probably should be extra-avoided in anyone at risk for osteoporotic complications.
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Ryan Radecki 7h
Replying to @broomedocs @MDaware
Uhm ... where I work, I have that.
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Ryan Radecki 7h
I'll be there doing my best to match the matchless with the EM literature update! Hope to see you all! Can't wait!
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Ryan Radecki retweeted
Andy Slavitt 8h
1/ MY STATEMENT ON MURRAY-ALEXANDER: Here is my statement on the bipartisan agreement.
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Ryan Radecki 8h
Replying to @adamcifu
EPIC mostly angers me when I'm trying to dispense 1 tube of something. Does not compute.
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Ryan Radecki 8h
Replying to @jasmin_hamzic @EMCases
Agree – I think PT/PTT should be effectively retired in exchange for TEG/ROTEM in situation where coagulopathy needs evaluation.
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Ryan Radecki 8h
Replying to @jasumback @EMCases
Agree – in the undifferentiated massive bleed, all conservative thinking is off the table. When you have a talking, stable patient, however.
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Ryan Radecki 9h
Replying to @EMCases
INR is for measuring warfarin activity. Agree PTT can have value for novel oral anticoagulants. So they have value in *selected* patients.
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Ryan Radecki 9h
HMMM, unless you're initiating a massive transfusion, obtaining an INR/PTT and fibrinogen are rarely of value.
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Ryan Radecki retweeted
Vince DiGiulio 10h
Replying to @emlitofnote
How fitting that I sent this out at almost the exact same time as your tweet (spotted in a local ED)
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Ryan Radecki 11h
I'm sure that was its goal, but in practical usage, I see the observation zone language mostly as permissive to CT.
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Ryan Radecki 12h
Unfortunately, most clinicians use criteria as "rule" to obviate independent assessment – without any evidence it's better than gestalt.
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Ryan Radecki 12h
In that respect, we shouldn't switch to any *one* – we should just be aware of the contribution of risks from all of them and synthesize.
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Ryan Radecki 12h
... but, but ... all those decision rules scan more kids than baseline practice in the study setting! We just need to be AUZ/NZ smart.
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Ryan Radecki 13h
Replying to @em_geek
That's what happened here: Stats look good because patients carry their initial "sepsis" dx through to discharge.
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Ryan Radecki retweeted
Tweddit 15h
Hospital I'm at is putting cookies on the patient trays for Halloween. I don't think they thought this through.
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Ryan Radecki 13h
More from the last – qSOFA, not a great screening tool, but fairly useful for prognosis.
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