
Jacob Miller NP CNS NRP
@JacobMillerACNP
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Paramedic π| #EMS Nurse Practitioner & Clinical Nurse Specialist π| #FOAMed | Opinions not employers' | Retweets not endorsements | Coffee not optional β
Ohio, USA
Joined April 2017
Thank you to the @FlightBridgeED team for the opportunity to speak at #FAST24 today! An amazing conference packed with top-notch speakers and cutting-edge topics! . Looking forward to #FAST25!.
Thanks, Jacob, for an excellent and educational talk this morning! The right ventricle has unique challenges that must be considered in patients with RV pathology; what's right for the left might be wrong for the right! #FAST24 #FlightBridgeED.πΈ: Mark Mennie
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Trauma arrest β medical arrest. Chest compressions won't fix hemorrhage, tension PTx, or tamponade. Fix those FIRST, then *maybe* compressions. ACLS meds probably unhelpful too, but DO consider vasopressin +/- calcium. @ResusOne #FAST24 @FlightBridgeED.
We know that in medical cardiac arrest, chest compressions are the cornerstone of care b/c the pump is failing. In traumatic arrest, the problem is most likely hemorrhage or obstruction. Compressions wonβt fix those! -Dr. Zaffer Qasim #FAST24.
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THIS is a great message from @REsusurrus - while we might get in to the business to save lives, more importantly, what we more commonly do is relieve suffering, enhance dignity, and provide comfort & warmth to our patients. Never forget that. #FAST24 @FlightBridgeED
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RT @ktcollopy: Relentlessly pursue excellence. Seek out opportunities to improve every case, every patient encounter. Seek out new knowledgβ¦.
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Premeditatio malorum: (a good) premeditation with failure; Seek not to simply succeed, but to predict and avoid failure. @REsusurrus @FlightBridgeED #FAST24.
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Representing @SCCMohio on the @uc_health Mobile Intensive Care Unit during Blue ICU day to recognize #CritCareMonth! .@SCCMohio @SCCM_Nursing @SCCM_EM @AACNme @ASTNA2 #SCCMSoMe
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Discussing #hemorrhage (and other #obstetric emergencies) in early #pregnancy at @AAENP2 #EmergNP24. Great resources available from @cmqcc (in addition, of course, to @acog @ACOGPregnancy . #FOAMed
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Hypertensive #emergencies in #pregnancy:.SBP β₯160 .**or** .DBP β₯110. Management per @acog @ACOGPregnancy guidelines: @AAENP2 #EmergNP24
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>25% maternal deaths 2Β° CV disease. Consider ACS, Aortic Synd, Heart Failure in DDx, although mom may look otherwise "young & healthy," and CV sx may be attributed to "normal pregnancy sx". Resources from @acog @ACOGPregnancy:.. @AAENP2 #EmergNP24
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US maternal death rate higher than gun violence or traffic accidents!. Anat/phys changes can last up to 1 YEAR post-partum; 65% of maternal deaths are post-partum. Ask: "Are you pregnant now or have you been in past 12 months?". @AAENP2 @acog #EmergNP24
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#Coffee still flowing at 4pm at #EmergNP24. This should be standard of care for all medical and nursing conferences. Kudos to @AAENP2 β
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.@michaelsharmapa on ECGs: . In addition to Sgarbossa's criteria for LBBB (and other #OMI equivalents), don't sleep on concordant STE in RBBB either! . @AAENP2 #EmergNP24
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Patient teaching points: . β keep epi available, always.β when in doubt, JUST. TAKE. THE. EPI. as first-line. @AAENP2 #EmergNP24
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Anaphylaxis, at @AAENP2 #EmergNP24 conference:. * 2 or more systems (derm, CV, resp, GI) after known or suspected allergen exposure = anaphylaxis . *More deaths in males & adults. * Maybe anaphylaxis? Not sure? .β JUST. GIVE. THE. EPI!.β IM (not SQ).β May need re-dosing
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Learning Jedi mind tricks to optimize team dynamics during high-stress situations from @kmconnel78 at @uc_health Air Care conference
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Happy #CriticalCareTransportNursesDay!. Check out the new @ASTNA2 podcast, Runways & Roadways - just dropped today! Bringing awesome #FOAMed from the world of air & surface transport to your favorite #podcast platform at least once a month. Details in the linked post.
ποΈASTNA #PODCAST LAUNCH!. ASTNA is announcing the launch of our brand-new Runways & Roadways Podcast! Tune in to hear cohosts Jason Herman & Ryan Roberts discuss all things transport with expert guests:.@Spotify: @ApplePodcasts:
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RT @calldaburd: Kudos to @mr_astvad and the @scanfoam team for broadcasting a world class conference for free. This team dedicates weeks oβ¦.
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This π§΅ on bicarb from @nickmmark popped up in my feed today. Recent Am J Emerg Med article looked at bicarb in humans:.βοΈ avg 20 mmHg (2.6 kPa) rise in EtCO2.π onset within seconds (avg 17 sec).ποΈ peak 30-60 sec.β increase lasted 7-10 min.
You've probably heard that Bicarbonate has to turn into CO2 to raise the pH. βDonβt give bicarb if you canβt increase ventilation.β. But how much CO2 is there in an amp of sodium bicarbonate?. A bicarb π§΅.1/
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