VASOPRESSIN! A short thread on this medication & its various uses...

with a homemade infographic summarizing its pharmacokinetics, indications & adverse effects!

#FOAMed @MSharifpourMD @drjohnm @aroradrn @srrezaie @EMSwami @CriticalCareNow @GoodishIntent @Wilkinsonjonny @msiuba 🥈2nd line agent in vasodilatory shock
💉Helpful in Hepatorenal Syndrome
⚠️Dont give it peripherally as extravasation can be a nightmare
👀Watch for digital ischemia (esp if combining w/other vasopressors)
👇🏽Helpful post from @PulmCrit & @emcrit: emcrit.org/ibcc/pressors/

#FOAMed

The medical community is divided when it comes to treating #COVID19. Various debates/theories dominate #MedTwitter & #FOAMed. Im glad to see these discussions & our progress, however patients sometimes get caught in the middle….

@cameronks @srrezaie @emcrit @EMNerd @airwaycam This thread’s intention is to simply share observations & the experience of a #COVID19 patient code named “Halo” (yes consent received by mother) whose story might seem unique but sadly a common occurrence throughout many NYC hospitals

@sinaiem @jacobi_EM @LincolnEM @NYEmergency

More of our #COVID19 experience here in #NYC:

Most if not all ICUs are full & the ED is quickly becoming an ICU. There's been a push away from early intubation for those that may not need it

1/9 #COVIDfoam #FOAMed @cameronks @srrezaie @ThinkingCC @emcrit @19criticalcare As a result, theres a very large number of “Happy Hypoxic” patients who have been tolerating HFNC for hours & sometimes for days. SpO2 continues to remain unreliable (as do certain "traditional" exam findings of respiratory distress). PaO2s continue to correlate

2/9 #COVIDfoam

From experience in our #COVID19 ICU so far:

What started as an HFNC ICU has quickly turned into an ARDS unit treating iatrogenic ALI from patients being intubated

#COVIDfoam #FOAMed #FOAMcc @cameronks @PulmCrit @ThinkingCC @srrezaie @First10EM @gattinon @precordialthump

1/12 As physicians we see a low SpO2 combined with a low PaO2 & the knee jerk reaction is early intubation instead of assessing patient's overall clinical picture including their work of breathing & mental status. Here's a walk through what happens after...

2/12 #COVIDfoam #Covid_19