Seth Trueger Profile picture
23 Dec, 15 tweets, 5 min read
morning huddle to start @GridlockedGame
@LandoAware had to do some patient safety modules
it’s getting real. resident pulled away to conference (but comes back smarter!) and PP CP SOB in resus while I’m solo. bunch of new patients but fortunately my med student is good
OH NO
OH NO WE’RE GETTING BUSY DOWNSTAIRS AND NOW WE’RE OUT OF INPATIENT BEDS

this game knows how to hurt me @TChanMD
ok a new doc came in and just discharged 3 people. things are getting tight but we are cooking with gas.
whoa busy hour, stabilized a sick DKA and sent all these patients home!
not helping @drtsega
we’re all on the same team and we just cleared the ED except for boarders so…
some inpatient beds opened up and we just cleared out the whole ED!
so of course we just lost 3 nurses, bolus of 18 new patients including 3 level 1s
couldn’t do everything but helped a lot of patients this round, made good progress
got a code! but no one in the bed. false alarm
alright finished up this crazy shift. a bunch more level 1s in the final hour, signing out a mess (boarding DKA, 3 new level 2s, full fast track TBS) but none in the WR. and no safety events!
things got busy near shift change so we stabilized the level 1s & the nurses got slammed; I made an executive decision that the doc w actions to make could do some (appropriate) nursing actions (vitals/bloodwork) but spent action points bragging to the residents about it @TChanMD

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More from @MDaware

21 Dec
Image
the real one, fyi Image
because while detached nihilism is cool, space is really cook
Read 5 tweets
9 Dec
this is an excellent point

some of my COVID vaccine thoughts (thread)
bottom line:
vaccine, good.

I will get vaccinated as soon as I can, which, as an ER doc, will be "soon"
the data we have is very good & very reassuring. I suspect the pfizer data will be published soon, but the fact that they prioritized the EUA, knowing the FDA would release it as part of the process, seems reasonable
Read 24 tweets
7 Dec
what about the other 2 in 10 Image
x 283,000

which is

0.97 US deaths in the Vietnam war

or

19 x 9/11s

or

14,150 Benghazis
to be clear, this is just the deaths in Americans *under 65 years old*

whose lives this FDRLST author apparently does not think matter
Read 4 tweets
7 Dec
this is a very good thread--esp from someone not in health care--and makes a lot of great points about how bad ICU occupancy is
some things to add:
forget who I stole this from but hospital capacity is a lot like a tetris endgame -- you can be really full even when there is technically "space"
additionally, things don't happen instantaneously. even when there is space and everyone wants everything to move, things take time--turning over a room (ie cleaning), staff communication, patient transport
Read 14 tweets
26 Jun
At this point many physicians and scholars have discussed how and why COVID-19 disproportionately affected black and brown folk. @ezekielRMed #ShareTheMicNowMed 1/
They’ve said it better than I have: decades (centuries) of systemic racism that created packed housing, chronic illness, and the lack of capital that disallowed many to adjust. @ezekielRMed @uche_blackstock @dn_charles @CamaraJones #ShareTheMicNowMed 2/
So what do we do about it? Why aren’t the issues that spread COVID like fire through kindling as central to the field of medicine as sterile technique? (serious question) @ezekielRMed #ShareTheMicNowMed 3/
Read 10 tweets
27 Apr
@GitRDoneLarry Larry the stuff in that video is just wrong, even some simple facts like "we've never quarantined healthy people before"

it's happened countless times across history including in the US during the Spanish flu in 1918 and various other outbreaks of smallpox and plague
@GitRDoneLarry I absolutely appreciate that millions of people are hurting economically and it's hard because the models looked worse than what we've experienced but a big part of that is because the shelter in place is working well!

and despite that, over 53,000 Americans have died
@GitRDoneLarry these guys are extrapolating out their experience from their urgent cares which is not at all representative of anything; epidemiology is a lot more complicated than multiplying out numbers particularly as we have been so far behind on testing
Read 6 tweets

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