Core EM Profile picture
Jun 17, 2023 7 tweets 3 min read Read on X
Let’s take a minute to recap our latest blog post on a pretty daunting hematological emergency🩸

A thread 🧵 1/7 #MedEd #MedTwitter Image
An imbalance between ADAMTS-13 and von-willebrand factor can lead to catastrophic physiological damage 💔

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The classic FATRN presentation actually only occurs in less than 7% of cases 😳

Instead, look for:
🧠 CNS symptoms - 60% of cases
🤮 GI symptoms - 35% of cases
🫀 Cardiac symptoms - 25% of cases

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Send an ADAMTS-13 Activity but most labs won't have it resulted for a few days so here are other lab findings to search for in the ED 🧪

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Since we can't rely on confirmatory testing in the ED, use the PLASMIC score to risk stratify patients and help guide management 🧠

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Get your juniors ready to place a dialysis catheter since the most effective treatment for TTP will require one 💉

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Head over to our website for references and a more comprehensive dive into TTP

Link: coreem.net/core/thromboti…

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More from @Core_EM

Feb 27
What if we had a secret vasopressor that had no adverse affects, was low cost, effective, and likely already stocked in our hospitals?

Today in Journal Review we look at a high quality study evaluating the use of Methylene Blue as exactly that, take a look.. 🧵 Image
Consider Methylene Blue more as an “indirect vasopressor”..
If the physiology suggests it could help mitigate hypotension from sepsis, what if we just used it right away for patients in septic shock? Image
Read 7 tweets
Nov 22, 2023
Time for another EKG review, let’s go over a finding you simply cannot miss..

👇🧵 #MedEd Image
Here’s the breakdown, now what’s your next step?

🧵 #MedEd Image
These patients need immediate discussion with cardiology for consideration of emergent cath lab activation, and be sure to get serial EKGs to watch for evolution to an acute STEMI.

🧵 #MedEd Image
Read 4 tweets
Oct 25, 2023
Dizziness is a notoriously tricky chief complaint to work up in the ED. Let’s review one of the most up to date guidelines on how to approach it.

🧵 1/8 #MedEd Image
This is the third set of GRACE guidelines aiming to provide emergency room providers with evidence based recommendations for common chief complaints.

🧵2/8 #MedTwitter Image
If we’re concerned for a possible central cause for dizziness it’s important that we don’t give ourselves false reassurance by ordering poorly sensitive studies

🧵 3/8 #MedEd Image
Read 9 tweets
Sep 13, 2023
Today we review our podcast on vasopressors with Dr. Catherine Jamin, Vice Chair of Operations and associate professor of emergency medicine at NYU, along with being triple boarded in emergency medicine, internal medicine, and critical care medicine.

Listen in on our discussion of this essential yet nuanced topic.

🧵 1/9 #MedTwitter @BrianGilberti
Image
Some quick basics..

🧵 2/9 #MedTwitter Image
There are various reasons to start pressors outside of the textbook blood pressure cutoffs, keep these in mind as you assess your patient’s whole clinical picture..

🧵 3/9 #MedTwitter Image
Read 9 tweets

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