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#medtwitter- now not time to dress up at work. Do it like staff in operating room. #COVID19 #ICU #pulmcc #PedsICU

1. Wear “Commute clothes” from home. Old stuff/shoes you don’t care about.

2. Remove commute clothes before any pt/team contact in office/locker room.

1/
3. Wear Surgical scrubs from machine if possible- if you don’t have access see if you can get it. Otherwise keep several clean pairs of scrubs in locker/office

4. Deposit scrubs end of day or if not from machine,keep in closed bag.

#covid19 #medtwitter #icu #PedsICU #pulmcc
2/
4. Wear Commute clothes home, straight into wash.

5. Repeat.

Trust me this is important- do not wear your clothes home. #SocialDistancing #covid19 #medtwitter
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#medtwitter #covid19 #icu #pulmcc #PedsICU #SocialDistancing

More from @SapnaKmd see all

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Sapna Kudchadkar, MD, PhD 👩🏽‍⚕️
@SapnaKmd
The moment we have been waiting for!! @jerjohzimm #sepsis @PedCritCareMed @ESICM #ccc49 (thread)

#sepsis #PedsICU

bit.ly/3bJIr1k
.@PierreTissieres is up first introducing the process & rationale #CCC49 #PedsICU #Sepsis
@TexKissoon tells us “Why Now”? #ccc49 #PedsICU #sepsis

Burden is highest on #children, and deaths occur early in the course
Read 21 tweets
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Sapna Kudchadkar, MD, PhD 👩🏽‍⚕️
@SapnaKmd
Every summer my heart is heavy with memories of a time when I even came close to leaving #medicine-when career & motherhood collided and I didn’t ask for help.

I want to share that story in case it helps even 1 person.(Thread) #medtwitter #meded #womeninmedicine #TipsForNewDocs
I share this now because July is full of #tipsfornewdocs but August comes & we all get swallowed up in the hustle & bustle of heavy clinical loads- when orientation ends and the real work begins.
I had just finished #pediatric residency and started #anesthesia residency with a 6 month old baby. Orientation was over & we were deployed to do our first cases in the OR without an attending always in the room with us.
Read 19 tweets
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Sapna Kudchadkar, MD, PhD 👩🏽‍⚕️
@SapnaKmd
Citation counts come from OTHER RESEARCHERS. They are important, yes.

But, sharing #science on #SoMe=broad & instantaneous dissemination to those who focus their time AT THE BEDSIDE. Which may surprise some- but is MOST OF MEDICINE especially....#anesthesiology.(Thread) #AUA2019
A metric like the “Kardashian Index” *MAY* be relevant in genome biology where the proportion of basic/translational science is significantly higher and no immediate bedside application for a general practitioner is there. (and I’m making an assumption here) #medtwitter #aua2019
When your #research is relevant primarily to other #scientists who are also writing research papers then citation counts do more wholly reflect the paper’s impact. But in clinical research, it’s different. Bedside clinicians are looking to the literature for guidance & new ideas.
Read 13 tweets

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Tamas Szakmany
@iamyourgasman
Some #medtwitter #CritCareControversies musings on #COVID19 after my first week. (Thread)
1. It’s a new disease. Normal ICU routines don’t seem to work. When you think they are ready to wean from the vent, they are not. Desaturation is common and deep.
2. They seem to like high PEEP as reported before. You can’t wean this fast as with a “normal” pneumonia. All this means light sedation doesn’t work and causes asynchrony. AKI is common and if caught early responds well to diuretics combo. Bloods are weirdly normal.
Still don’t understand what’s the best way to catch superinfection. CRP is up after day 2. We use PCT and it’s fine when sky high, but what about 2.0-3.0?? More data needed. Patients tolerate drying out without haemodynamic instability. Shock is not a prominent feature.
Read 9 tweets
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Sethina Watson
@morefluids
Work-home hygiene separation for healthcare professionals 🩺🦠💊! Our top tops for #COVID19

This has been our routine for many years (to protect our DD with #CF) but we’ve ramped things up a bit now due to #COVID. Things we do because we once brought home multi drug resistant..
pseudomonas, which scared us all. We do everything possible to reduce risk of hospital germs at home. I may sound quite mad or sane, I have no idea. OCD even. But here we go!
If we have not showered at work, we come in, yell hi to the kids & run up for a shower🚿. Clean change of clothes (you can wear those to work next day). Hugs come after. It’s fine.
Read 14 tweets
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Alex Evans
@alexevansuk
Futurists! Anyone up for a brainstorm about medium-long term scenarios of #COVIDー19? Am thinking both indirect impacts - 'consequences of consequences' - and longer term shifts in norms / politics / markets / society / psychology / public services / tech / etc.
What if prolonged home schooling disrupts education models the way telemedicine has healthcare? (h/t @axelheitmueller)
Community resilience. Already seeing lots of communities self-organise in amazing ways, which could build a ton of agency and belonging that lasts beyond the outbreak.
Read 17 tweets
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Moritz Kuhn
@kuhnmo
@christianbaye13 & me have been thinking about the big differences in mortality rates so far during the corona outbreak in Europe. The differences in case-fatality rates are humongous. Italy has one of 6% while countries like Norway, Denmark & Germany have rates still close to 0.
Of course the rates will likely converge somewhat over time as the virus spreads and there are many effects in this. Division bias may play a role, as does the time since the outbreak.
However, we thought maybe there is something to learn in this in order to help to organize our lives in a way to minimize the risks for us and we pose to others. We picked up a striking data difference that @AndreasShrugged pointed out.
Read 23 tweets
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TheBossRoss 🇪🇺 🧶 ❄
@BettinaSRoss1
Let me tell you about my dad's #care workers, who
- picked up countless plates of food he threw around the room
- wiped up his vomit when he drank too quickly
- answered his question "How old am I?" patiently a million times a day
- repaired the fridge door he unhinged at night
2/
 - made sure he wore his glasses & took them off when he fell asleep, so they wouldn't hurt
- coaxed, flirted, convinced him into washing himself as much as possible
- told him his wife/car/staff/dog were fine whenever he worried
- put on the radio w/ 70s music & sang with him
3/
 - celebrated Xmas Eve at the care home (ALL of them)
- had to hand in all their tips to the care home's social activities fund (so I bought vouchers instead)
- were with him, holding his hand, when he died.

And now tell me again that they're #LowSkilled.

#immigration #Brexit
Read 3 tweets
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Arjun Arya, MD, MSc.
@aryadoctoryet
#medtwitter #tweetorial on one of my favorite, elegant little mechanisms. This is something every #resident and #medstudenttwitter will see ALL the time! Bonus inclusion: a simple way to think about macro/micro-cytosis.

So, why is basically everyone in the hospital anemic?

1/
Principles:

- it is useful to remember that the venous blood “drawn” for a lab test is composed of many parts: plasma, RBCs and WBCs.

- Hemoglobin (Hgb) is a direct measure of the actual Hgb molecule within the RBCs

&

- hematocrit (Hct) is the % volume of RBCs

2/
So why can we “cheat” and just multiply the hemoglobin by 3 to get the hematocrit?

Well - in a healthy RBC, approximately 1/3 of its space is a hemoglobin molecule!

So, imagine each RBC as just a Hgb molecule wearing a coat! The Hgb is 1/3 of the space, the coat 2/3s!

3/
Read 17 tweets

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