1/ 🚨New Episode! 🚨

What is an “appropriate” Hgb bump?

Why do we usually say 1g/dL for 1 pRBC?

iTunes: bit.ly/coreimpodcast
Show Notes: bit.ly/3eUgyGw

First, let’s figure out how many grams of hemoglobin are donated?
2/ What is the patient’s PRE-transfusion #intravascular volume?

Usually 6.5% of body weight for women 👩
Usually 7.5% of body weight for men👨
3/ What is the patient’s POST-transfusion intravascular volume?
4/ What rise in hemoglobin can be expected after transfusion?

It's all division here to get the g per dL bump you expect and viola!

It works out nicely for a 13g/dL donor Hgb to a 70Kg male recipient !
5/ While the 1g/dL bump for 1 unit pRBC is a good rule of thumb, there are other factors that can affect hgb response to transfusion!
6/ Let’s apply two different scenarios with different:
(1) amount of g/dL of donor and
(2) body weight of the recipient

Takeaway: 1 unit pRBC can increase hgB response anywhere from 0.6g/dL to ~1.6g/dL!
7/ Thanks for following along, #MedTwitter!

And a huge thank you to our team:
Hosts: @FreedoBaggins, @ShreyaTrivediMD
Peer Review: Bentley Rodrigue, MD
Graphic: @Preeyal_P
Audio Editor: @onlysolon

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More from @COREIMpodcast

28 Dec 21
1/ #MedTwitter, welcome back to our #TriviaTuesday series

Today's question:
What disease is prevented by the "4-inch law"?

Hint- the reservoir/host is 4 inches...
2/ Non-typhoidal salmonellosis is prevented by the "4-inch law" !

What is the "4-inch law" ? Keep scrolling to learn more!
3/ The U.S. FDA bans the sale of small turtles <4 inches in length.

Did you know that turtles GI tracts are colonized with non-typhoidal Salmonella and often pet turtles swim in their feces?!
Read 6 tweets
19 Oct 21
1/ Good Morning #MedTwitter and happy #TriviaTuesday!

Think you know where we’re going with this? Read on ⚡️
2/ The answer is… Takotsubo cardiomyopathy

Comment other triggers you can think of!
3/ So what is Takotsubo cardiomyopathy?

Let’s define it. Takotsubo cardiomyopathy refers to acute, stress-induced reversible dysfunction of the left ventricle. It has also been called “broken heart syndrome” 💔
Read 5 tweets
13 Oct 21
1/🚨 New #MindtheGap Episode🚨

#MedTwitter, Can you use oral diabetes meds in the hospital? If so, which ones?!

🎶Listen on any podcast app!
iTunes: bit.ly/coreimpodcast
Show Notes: bit.ly/3mGXXRG
CME/MOC: bit.ly/3oVhwbI
2/ What about DPP-4s?

Usually well tolerated because they ONLY release insulin with a glucose load

So we don’t have to be too concerned if the patient will be NPO!
3/ What about GLP-1s? They act similarly to DPP-4s.

When should we avoid GLP-1s?
Read 5 tweets
7 Oct 21
1/ Good morning #MedTwitter, it’s time for another episode of #12LeadThursday! Remember to approach every EKG systematically. Grab your calipers, and let’s dive in!

What are potential causes of this pause?
2/ We can think about pauses in three buckets below. We’ll get into why we think a PAC is causing the pause above, but stop for a moment and consider: what would the EKG look like if AVN blockade or sinus node dysfunction were at play?
3/ In the above EKG, we see the PAC hiding in a T wave! This PAC reset the SA node, and a pause was born!

Before we move on: if the AVN is dysfunctional, how do you differentiate a blocked PAC from a dropped beat?
Read 5 tweets
24 Jun 21
1/ Good morning, #medtwitter, and happy Thursday! We’re excited to bring you our latest edition of #ReadingRoom. Dim the lights, and get ready to clinically correlate!

You’ve got two abdominal plain films below. Which one is from a patient with a SBO?
2/ Let’s take a closer look, starting with the image on the right: here, there’s no abnormal dilation and the distribution of gas is normal. This is a normal abdominal film.
3/ On the other hand, here we see an abnormally dilated small bowel with predominant small bowel gas while there is no rectal gas and scant colonic gas. This is concerning for a SBO.
Read 7 tweets
13 Apr 21
1/ Good morning, #MedTwitter, and happy Tuesday! We’re excited to bring you our latest installment of #ReadingRoom today. Dim the lights; it’s time to clinically correlate!

What object is labeled in the CXR below? What is it used for? Image
2/ That, friends, is our dear friend: the NG tube. It is our portal for tube feeds and PO meds (technically Per Nasus?), or if you put the thing down flip it and reverse it you can use the NGT to decompress the stomach. Image
3/ Next question: should you place that order that says “OK to use NG tube”?

The graphic below shows a systematic approach to ensure correct placement. This one is good to go! Image
Read 6 tweets

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