Well, @nytimes at it again w/misleading, irresponsible headlines bit.ly/3HEOpmo

AHRQ bit.ly/3YoQYiz looks at 20 yrs of papers to estimate diagnostic errors

Lead should be:"ED evaluations pick up 99.7% of serious diagnoses" but, who would read about success? 🧵 AHRQ report found:
Diagnostic errors: 5.7%
Any harm: 2%
Serious harm: 0.3%
Deaths: 0.2%

A 99.7% success rate is outstanding considering the challenges to ED care (massive crowding, resources, occult presentations etc). AHRQ recognizes this but buries it (pg 17)

Lots of docs writing about abandoning masks in schools. Arguments are important but, those arguments should be based on facts.

Let's take a look at how this @washingtonpost opinion piece distorts the truth wapo.st/3u4ZTca
🧵 Starts off well: N95s highly effective in protecting user

But, wearing an N95 protects others too. 2 people wearing N95s better protection than only 1

Women are grossly underrepresented on primetime media covering COVID19 bit.ly/3mmS8Xu

- 30% of guests, 27% of interview time
- Women less likely to be repeat guests
- FOX had 0% female physicians Lots of other interesting data
- Only 1 in 5 guests was a doctor + very few DOs
- Only 1 in 4 doctors were women

Didn't collect data on race/ethnicity (particularly important with the disproportionate impact of COVID on racial/ethnic minorities)

Lots of questions about ivermectin for tx + prophylaxis. @srrezaie + I reviewed a bunch of articles

Bottom line: No high-quality evidence to support use for any indication in COVID19. Based on available data, this is another distraction like HCQ. Let's not fall for it again

🧵 Ivermectin is an antiparasitic that's FDA approved for onchocerciasis, helminthiases, and scabies (most common use in US)

Limited side effects: rash, n/v diarrhea, neurologic (seizures)

Widely available in developing countries + dirt cheap

I'm an ER doc. I've never suffered from depression but, last 4 months have been incredibly hard.

I started seeing a psychologist for the 1st time

It feels selfish to take an hour once a week to talk about myself

But i've already learned a lot

https://twitter.com/choo_ek/status/1282005053427990529?s=20

I thought I was dealing okay with seeing the same patient day in and day

seeing people dying every day with little to offer

I wasn't okay. I'm not okay.

I'm stressed and anxious: do we have enough PPE? Is another surge coming? When is it coming? Am I putting my family at risk?

Notes from the Front Lines: Prepare Now #COVID19
- Hospitals need to design + implement emergency wards: cafeterias, auditoriums are perfect
- Vent/equipment allocation protocols: create criteria for palliative extubation to get vents to slavageable pts Notes from the Front Lines: Prepare Now #COVID19
- Cross-train RNs to work in ED + ICU
- Cross-train docs to work in ED, wards + ICU outside of their specialty

Notes from 24 hours on the front lines #COVID19
- Hypoxemia common but, doesn't always correlate w/ symptoms
- Seeing comfortable pts, speaking full sentences w/ sat 75%.
- Others in clear resp distress w/ similar hypoxemia
- Sat no longer appears reliable correlate w/ symptoms Lots of intubations
- Upper airway edema - despite absence of stridor/signs upper airway compromise - common
- Due to edema, troubles w/ gum elastic bougie. Using more rigid stylet with better success
- Asynchrony + extubation common: sedate heavily, add pressor if necessary