Discover and read the best of Twitter Threads about #TipsforNewInterns

Most recents (5)

1/🧵🎥 MAJOR TIPS about #Liver Disease
 
Why do we ask pts to “hold up traffic”? When people get severe liver disease, “asterixis” is a finding on exam we often see.

What does it mean?
 
#MedTwitter #NurseTwitter #TipsforNewDocs #Addiction
2/ Asterixis indicates that toxins like ammonia have built up in the body because the scarred liver no longer filters them out. The brain cells no long function normally (#Delirium or Hepatic #Encephalopathy) & can no longer control muscle movements like posture!
3/ These same toxin cause vessels to dilate and develop problems with blood flow in the skin and lungs. A skin finding is called “spiders.” They look like a multi-legged spider, right? It’s a tip-off.
Read 9 tweets
1/🧵 Giving & Receiving Advice:

My medical advice is not infallible. Maybe I’m wrong and maybe my patient knows it? Maybe that’s one reason she/he is non-compliant. Even if I am right, it might not be the time in that person‘s life to hear the message.

#selfcare #medtwitter
2/ A pt may seem to be listening & carefully taking it all in. But later that morning she/he may leave against medical advice (AMA). What are we to think when we give our best #advice and others don’t take it? Especially in the medical field?
 
#tipsfornewinterns #tipsfornewdocs
3/ First of all, of course, unsolicited advice is #criticism. Especially when I’m not with a patient, I try to resist all urges to give unsolicited advice.
Read 13 tweets
1/🧵🎥 Hepato-Jugular Reflux (HJR)?
 
Neck Veins tell us a lot about how much fluid people have in their body. Look at this video & you’ll learn a trick doctors use that tips us off about blood volume! (Movie w perm)
 
#medtwitter #nursetwitter #TipsForNewDocs #TipsForNewInterns
2/ My patient had kidney failure & too much fluid, making him short of breath. I press down over his liver & watch his neck veins pop up (or not). When they do, it correlates w high pressures in the heart from too much blood volume.
 
bit.ly/2UDAVkl

#MedStudentTwitter
3/ Another way of seeing this is the CXR (see pic). This simple measurement from a vein to an artery called the Vascular Pedicle Width (VPW) also tells me the heart pressures are too high. His VPW is 84 mm and > 70 is way too much. So he needs to pee a LOT!
 
#LASIX #DIURETIC
Read 5 tweets
As I embark on #PGY30 , I’m reflecting upon my transition to #Intern year and thinking of the new #Residents starting this week…a short thread 1/

#TipsForNewInterns Image
Don’t listen to the #intern jokes.

You are a doctor now and fully a part of the #HealthcareTeam …a VERY important part! 2/

#TipsForNewInterns Image
Take the opportunity to learn from everyone…especially your #nurses.

Also take note of the ppl who treat other staff and patients rudely.

You’re not too young in the game to gently correct them…as you’ve been part of the #HumanRace for a long time. 3/

#TipsForNewDocs Image
Read 8 tweets
Tips for you on your rotation in the ICU! 💉

How to 🧠 if a vasopressor is low, medium, or high dose? 🤷🏻‍♀️

Arbitrary & depend on dosing strategy but @md_hatton uses the rule of 🖐 ‘s (just move the decimal based on the pressor)

⬇️Low dose = <5
➡️Medium = 5-10
⬆️High = >10
Let’s take norepinephrine as an example: 💉 👩🏻‍⚕️

NE dose of <0.05 mcg/kg/min
▶️⬇️LOW dose

NE dose 0.05-0.1 mcg/kg/min
▶️➡️MEDIUM dose

NE dose >0.1 mcg/kg/min
▶️⬆️HIGH dose

Thanks @md_hatton for the pearl and
#tipsfornewinterns this week on rounds! #PharmICU #critcare
Read 3 tweets

Related hashtags

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!