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reuben strayer
emergency physician maimonides medical center
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reuben strayer Jun 24
The complicated precipitous delivery might be the scariest High Acuity Low Opportunity procedure in emergency medicine. This flowchart provides specific guidance and is designed to be used in the midst of a crisis. Bonus section on postpartum hemorrhage.
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reuben strayer May 10
A Mass Casualty In Slow Motion: Emergency Medicine During the COVID-19 Surge in New York City. What coronavirus did in March and April to the city, my department, and me.
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reuben strayer May 2
Pediatric emergency shift in a pandemic. As usual, child life specialists rise to the challenge.
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reuben strayer Apr 9
Lots of opinions on how to treat covid19, which raise many questions, but we have no answers, because answers require science. Every admitted covid patient should be in a trial. If your institution is gearing up, include research folks, be ready to enroll when the surge hits.
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reuben strayer Apr 8
It is fascinating how decisions evolve as the pandemic worsens in your area and inpatient resources are stretched beyond their limits. I remember that kind of decision tree 2 weeks ago but now, in NYC, if you will not die before you can make it back to the hospital, you go home.
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reuben strayer Apr 6
New York City, 3 weeks in. Where we are on well patients, the intubate early paradigm, alternative oxygenation therapies, anticoagulation, cardiac arrest, and ED/hospital flow.
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reuben strayer Apr 3
COVID-19 Data Sharing Project. We are making anonymized patient-level data from our COVID ICU openly available to assist clinicians who haven't seen critically ill coronavirus patients yet–but will, soon. Data updated in near real time.
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reuben strayer Mar 31
Initial approach to the arrival of a patient in cardiac arrest to the emergency department during COVID19. Goal is to avoid chest compressions and ventilation until advanced airway + viral filter placed by providers wearing maximal PPE. 2 minute video.
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reuben strayer Mar 27
Covid lung disease: we are all noting hypoxia out of proportion to dyspnea. In our COVID-ICU, patients do well over time with shockingly low SpO2. This is anecdote. We hope to web-publish our data very soon. Consider withholding ETI in hypoxic patients who are otherwise OK.
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reuben strayer Mar 20
Ventilator Allocation Protocol. Unfortunately we will all need one. May be edited and used without attribution.
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reuben strayer Mar 15
many of us are in disaster mode, which provides license to not practice defensive medicine. here's my dot phrase. Management decisions made amidst COVID-19 public health emergency; admission vs. discharge standard has necessarily shifted.
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reuben strayer Mar 13
Covid19 Intubation Checklist. Stay safe everyone.
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reuben strayer Mar 7
Serg: prescription HM (or prescription heroin) is not first or second line OUD treatment, in fact blurs the line between treatment and harm reduction, but there is clearly a role in selected patients. To understand the context in which it makes sense:
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reuben strayer Mar 3
The first half is for me, the second half is for them. and
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reuben strayer Feb 24
Replying to @cpesyna @vmoitra and 3 others
too much for 280 characters
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reuben strayer Feb 13
Yellow tree on yellow flowmeter, green tree on green flowmeter, until you can't find the right color and just grab one. After yet another patient accidentally bagged with room air, a theoretical emergency department has replaced yellow/green with clear. Credit: Michael Turchiano
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reuben strayer Feb 1
Replying to @emupdates
Is it catatonia or a pontine stroke? Hold the MRI, let me try 12.5 mg ketamine.
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reuben strayer Jan 30
"...intravenous injection of ketamine is an effective and safe method for immediate resolution of intraoperative penile erection with a high success rate." is there any condition this drug does not treat
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reuben strayer Jan 28
1 of 8 North Carolina patients who improved after prehospital naloxone was dead at 1 year. Opioid addiction is far more lethal than the diseases we have rebuilt our emergency systems to prioritize (MI, trauma, stroke, sepsis) and very, very treatable. Prevent, protect, treat.
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reuben strayer Jan 24
Just because you have an IV doesn't mean you should use it. Naloxone rescue of opioid OD is in most cases smoother and safer with intranasal administration, compared to IV. For many other drugs, slower absorption is superior–ketamine (for pain) and dexmedetomidine come to mind.
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