Joseph Nicholas
@joebeigemd
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URMC Med Ed, clinical reasoning and orthogeriatrics. Finger Lakes junkie.
New York, USA
Joined January 2013
wonderful emphasis on perfusion and microcirculation over MAPs and protocols- every person is unique.
9.When physiology and protocol clash, physiology wins — Always. 10.Respect uncertainty — The sickest patients will humble your algorithms. Stay curious, not dogmatic.
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RT @Turningthe_Tide: 1/ 💉 Resuscitation fluids – life-saving in true hypovolaemia. Give them for the wrong reason and you harm patients.….
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RT @Turningthe_Tide: 1/.Last time we tackled maintenance fluids – what the body needs day to day. Now let’s talk ab….
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RT @Turningthe_Tide: 1/.IV fluids have two main purposes:.💧 To maintain daily needs.🔄 To replace losses. (We’ll come back to whether we sho….
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Critical famine risk in Gaza. Support @RESCUEorg. The International Rescue Committee helps people whose lives and livelihoods are shattered by conflict and disaster to survive, recover and regain control of their future.
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RT @Turningthe_Tide: 🧵 Lymphangions: The Hidden Pump Protecting You From Oedema.1️⃣ What if I told you that you have hundreds of tiny heart….
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RT @ThinkingCC: Right here. And that clinician is truly misled by the fact that there was a brief positive response to the fluids. “They re….
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RT @khaycock2: @Rajiv_Sinanan @icmteaching @ThinkingCC @ArgaizR @NephroP 3/3 followed by a clinician brainstem reflex to continue a prescri….
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RT @BraydonDymm: 💥 July 1 is coming. That means brand new interns and brand new Neuro residents! Ready to turn that reflex hammer into a GP….
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RT @icmteaching: 1/.Most people think the heart drives circulation. But what if that’s backwards?.Anderson’s model flips the whole idea of….
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RT @JefVandenEynde: 🚨 Heart failure (HF) decongestion ≠ simple fluid removal. Let’s explore the fascinating electrolyte changes happening….
onlinelibrary.wiley.com
In heart failure, sodium retention generally occurs out of proportion to water retention and may occur disproportionate to chloride retention, requiring excretion of other cations (i.e. potassium,...
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RT @Turningthe_Tide: 1/.You might think:."Why give NaCl to someone overloaded with salt and water? Shouldn’t we be pulling sodium out, not….
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RT @Turningthe_Tide: @FH_Verbrugge @ArgaizR Some pearls of wisdom on this subject in this thread 👇🏻.
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RT @Turningthe_Tide: 🧵1/.Hypovolaemia is the most overdiagnosed concept in medicine. We say it reflexively — especially in sepsis. But here….
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RT @PCSDSchools: Congratulations to @PCSDsutherland senior Aaliyah Nicholas for earning a spot in the top 10 of the NYC Bound regional Jimm….
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RT @curromir: Can a patient be fluid responsive and venously congested at the same time?.Yes — and this changes everything. Our recent stud….
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RT @a_l_bailey: One of the most important trials at @ACCinTouch #ACC25 ! Compared fluid restriction to liberal approach in #HeartFailure.….
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