Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Ryan Feldman PharmD DABAT Profile picture
@EMPoisonPharmD
Jan 4, 2023 • 14 tweets • 20 min read • Read on X
Scrolly
A few years ago I made a digital resuscitation game with a working cardiovascular system. A playground to play with pressors/resuscitation.

TODAY I REALIZED I COULD PLAY IT IN Virtual Reality

So I made a video. An 11 part 🧵for VR septic intubation!
#FOAMcc #FOAMed #MedEd
Part 2/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 3/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 4/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 5/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 6/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 7/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 8/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 9/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 10/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
Part 11/11

Virtual Reality Septic Shock Resuscitation/Intubation

Video YouTube link here🔗: )

Play game ➡️: rfeldman.itch.io/the-resuscitat…

#Medtwitter #FOAMcc #FOAMed #TwitteRx #MedEd
More resources on shock and how to play the game:

Basics on shock/vasopressors go here:

For game walkthrough on PC:

Rapid tutorial:

SUPER RAPID Tutorial:
That's the end. I've used this game + YT video on shock to teach ABC's/ACLS and show Shock/Vasopressor effects in real time for years now.

If you find any of this useful please RT the tweet below to share this free resource!
#MedEd

@threadreaderapp unroll

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Ryan Feldman PharmD DABAT

Ryan Feldman PharmD DABAT Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @EMPoisonPharmD

Ryan Feldman PharmD DABAT Profile picture
Dec 18, 2024
Christmas came early! 🎄 The @PoisonCenters 2023 Annual Report is here! 📊 It captures U.S. poisoning & overdose data and highlights emerging trends.
🔗 (Free copy at end of the 🧵)

This year’s trend? Unregulated psychoactive substances. #MedEd #FOAMed shorturl.at/23n3lImage
⚠️ Unregulated Psychotropics

Phenibut, tianeptine, kratom, & nitrous oxide = growing public health risks.

🛒 Sold in gas stations, vape shops, & supplement stores as “nootropics” or enhancers.

💡 Awareness is crucial—here I am w/ some gas station kratom! 🌿 Image
🤔 What are these substances?

🌿 #Kratom: Hit U.S. in 2010s. Plant extract w/ opioid effects (mitragynine) for mood, pain relief, & opioid withdrawal.

💊 #Phenibut: ~2015 arrival. Baclofen analog, GABA-B agonist ➡️ CNS depression/euphoria, used for anxiety, insomnia, & more. Image
Image
Read 17 tweets
Ryan Feldman PharmD DABAT Profile picture
Sep 29, 2024
I know someone else has chewed on this as long as me.

Help.

Rumack's oral NAC for acetaminophen planned 2.5 mmol NAC per hour

2.5= 1.5 mmol to cover natural glutathione (GSH) turn over per hour
+
1 mmol/hr to achieve 4 mmol in 4 h.
shorturl.at/LY0b0
4 mmol was selected because animals see hepatic necrosis from APAP when 70% glutathione (GSH) is depleted.

Bench data showed average liver was 4 mmol GSH/L and 1.5 L. So the average liver had 6mmol GSH (1.5L x 4L), and 4mmol was 70% of the GSH

shorturl.at/LY0b0
A 15.9 g dose of acetaminophen contains = 0.105 mols, which is 105 mmols.

At 4% NAPQI production (which we know is wrong but that’s what it was derived from) That dose makes 4 mmol NAPQI (0.04 X 105)

After it is ENTIRELY metabolized
Read 16 tweets
Ryan Feldman PharmD DABAT Profile picture
Mar 25, 2024
You're working in the ED when a 30 y.o male presents 30 minutes after envenomation to the right index finger by his pet snake (left).

He has a picture of culprit (right) , and it is definitely NOT from America.

A 🧵on U.S. exotic envenomation management.

(shared with consent)
Image
Image
This involved a Blue Indonesian pit viper (Trimereserus Insularis) but this could have been any exotic snake. There have been 50-110 exotic snake bites reported to Poison Centers annually since 2012.

P.S. limited free copies of report available here:
tandfonline.com/eprint/D6PYXIG…
Exotic venomous animals are found in several environments within the U.S. including zoos, homes of reptile enthusiasts, laboratories of venom milking industries, and in illegal venomous reptile trafficking rings. In this case, it was a pet of a reptile hobbyist.
Read 22 tweets
Ryan Feldman PharmD DABAT Profile picture
Jun 21, 2023
Toxicologists are often consulted about 🍄foraging misadventures (wild mushroom ingestion).

Usually you don't get a clear mushroom image like this video (at best a blurry photo of some OTHER mushroom), or more often no image.

So what to do?

A 🍄🧵
#FOAMed #FoamCC #MedEd
If you do have a good sample or photo you can work with a mycologist (your posion center knows one) to identify the shroom. But this is not frequent.
Since we almost never have that we usually rely on history and symptoms
Key to differentiating mushroom toxicity types: time to onset of GI issues. Most mushrooms upset the tummy. The 5hr “rule” helps identify bad ones.
Read 15 tweets
Ryan Feldman PharmD DABAT Profile picture
Jan 17, 2023
Had the opportunity to be part of a fascinating work. Americas Poison Center Annual report.

A comprehensive poisoning epidemiology study compiled of data from all 55 U.S. Poison Centers

Free 🔗➡️bit.ly/3wbIwWS
Pubmed🔗➡️bit.ly/3wdgeLP

A🧵on emerging trends
This year we highlighted two important trends in addition to baseline poisoning data.

Firstly, THC product exposures have been increasing since 2016, and the demographics are changing. In 2021, edible products (red line) eclipsed plant based marijuana (blue line) for products Image
The change in products also represents changing demographics. While Adults (gold) comprise the majority of exposures, pediatric<6 (green) is taking an ever increasing share of the THC exposure calls since 2016. Image
Read 12 tweets
Ryan Feldman PharmD DABAT Profile picture
Jan 16, 2023
We wrote this case of #fentanyl exposure w/ NO clinical effects (bit.ly/3k7I1dF) to help realign fentanyl exposure risk perception.

I thought it was one of the only confirmed cases...turns out there are quite a few.

A 🧵on NIOSH health hazard evaluations
#MedEd
If someone is concerned that hazards are interfering with their job function, NIOSH can get called in to do a field evaluation.

They review exposures, med records, forensics, and write public reports.

They have QUITE a few confirmed fentanyl reports.

cdc.gov/niosh/hhe/defa…
Like this one, where a law enforcement officer had CONFIRMED methamphetamine/fentanyl blown all over them, rubbed sanitizer on it (don't do that), felt dizzy, had hypertension, were alert, breathing normally. No Opioid effects. Back to normal in a few hrs.
cdc.gov/niosh/hhe/repo…
Read 15 tweets

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/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

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

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

Send Email!

:(