The paradox of interpreting the ECG with a RBBB:
- Overt STE may be present, satisfying OMI/STEMI criteria, but it is not appreciated; or conversely
- The widened QRS of a normal RBBB ECG is misinterpreted as suggesting OMI/STEMI, despite normal ST segments.
A 🧵.
1/6 This person presented with classic CP.
The computer doesn't have much to say, but the troponin is sky-high.
The clinician's suspicion turns to PE.
2/6

I actually don't think it's a big deal if ER docs use the term "excited delirium."

I'm not the frickin' language police, and making it a "naughty word" is unnecessary and trivializes the issues.

Let me expand...
1/10

https://twitter.com/BrooksWalsh/status/1659585795865321473

First off, I don't even think most #JAFERD docs even understand, let alone believe, the description of excited delirium that LEOs have been taught, and that courts have heard described by experts.

Normal docs don't believe in mysterious syndromes that ...
2/10

Using lung #POCUS during a COVID surge
Recognizing a (?) rare presentation of severe preeclampsia
The central importance of racism in American health.
And an injunction to vote to save lives.
(Full, enthusiastic pt permission)
1/20 30s woman, had a C-section 7 days ago, discharged feeling fine
Now in the ED with a severe headache, and marked marked HTN.
LFTs up
Hx of preeclampsia with a prior pregnancy, so … Dx made?
2/20

Critically hypoxic patient came in early AM.
Incomplete story, but ?COVID from the patch.
Medic starting to move pt to resus room bed Nurses/techs assembling outside room, getting PPE
It seemed like there was a note of ... concern? preoccupation? that i hadn't seen earlier in the night