Salim R. Rezaie, MD @srrezaie profile

Salim R. Rezaie, MD

@srrezaie

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EM/IM Doc Working in ICU; Founder of REBEL EM & RezaieStrong; Medical Director at Impact EMS; Doing my Part to Cut Down on KT Time (Tweets are opinion only)

https://t.co/wQ503R7WC8

San Antonio,TX

Joined February 2013

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Pinned Tweet

Salim R. Rezaie, MD

@srrezaie

9 days

The Good, The Bad, & The Truth About the New Weight Loss Drugs #RezaieStrong #Ozempic #Wegovy #ZepBound #Mounjaro #WeightLoss

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Salim R. Rezaie, MD

@srrezaie

2 years

Officially the highest BP I have ever seen!!! 🤯🤯🤯 And yes...A-line was zeroed and leveled #FOAMed #MedEd #Hypertension

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Salim R. Rezaie, MD

@srrezaie

3 years

This is not my normal post but something important to me... I have depression I am not depression I am not my mental illness My mental illness does not define me My mental illness is part of me Don’t be ashamed of your story. It will inspire others. #breakthestigma

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Salim R. Rezaie, MD

@srrezaie

3 years

@GregAbbott_TX As a frontline ER doc in San Antonio... @GregAbbott_TX removing mask mandate sends wrong message to public...the pandemic is not over and this is a BIG mistake... For everyone else...PSA: DO NOT look to political leaders with no medical background for your medical advice

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Salim R. Rezaie, MD

@srrezaie

2 years

Nice reminder of #STEMI equivalents and why the paradigm is changing to occlusion myocardial infarction #OMI #FOAMed #FOAMcc #MedEd #MedTwitter #ECG #EKG

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Salim R. Rezaie, MD

@srrezaie

4 years

For me...officially the lowest O2 sat on room air in a #COVID19 patient who was awake and talking No respiratory distress No increased work of breathing No AMS #silenthypoxemia This is such a humbling disease!!! #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

Lung Injury Ventilation & ARDSnet...I am not an Intensivist...I am a frontline ED doc...wanted to create a useful aide for myself for when I am on shift...TY @emcrit for peer review...hope this helps others (feedback welcome) #COVID19FOAM #growthmindset

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Salim R. Rezaie, MD

@srrezaie

4 years

I agree with @cameronks we need to stop intubating patients early in #COVID19 disease course...these patients need O2 not pressure...putting them on ventilators will trash their lungs...this is not ARDS...these patients act more like HAPE #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

3 years

Sitting here on my 10th overnight shift in a row and thinking...What other industry functions like American medicine today? None that I can think of...the system is asking me to be more resilient...but it is the system that is broken?

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Salim R. Rezaie, MD

@srrezaie

4 years

Never thought I could learn so much about masks...hope this helps... #COVID19 #growthmindset #FOAMed #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

Most of the research thus far on treatment in #COVID19 seem to be targeting the wrong timeframe of disease...the point is to start treatment prior to hyperinflammation...would like to see more studies target earlier timeframe of disease #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

Acute Decompensated HF: Time Critical Interventions via @amalmattu at #ACEP20 -Morphine-> No role -Diuretics-> No immediate effect -Nitrates-> High-dose (Initial 200-400mcg/min) -ACEI-> If don't tolerate NTG (SL Captopril, IV Enalaprilat) -NIV-> Use early (Reduced intubation)

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Salim R. Rezaie, MD

@srrezaie

4 years

COVID19 is NOT "Typical" ARDS Pts on CPAP + resp distress should be intubated early High PEEP results in severe HD impairment & fluid retention MV buys time...Do with lowest possible PEEP & gentle ventilation More O2, Less Pressure #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

2 years

I cried for the 1st time in 20yrs yesterday. I cried hard for 5hrs straight. I am not embarrassed & happy that it happened. In a society where we are expected to be strong all the time I am here to tell you...there is no weakness in being open about mental health #RezaieStrong

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Salim R. Rezaie, MD

@srrezaie

4 years

Debunking Spinal Immobilization in Trauma Pts #FOAMed #FOAMcc #dogmalysis -DOES NOT immobilize cervical spine -DOES NOT decrease rate of SCI -INCREASES difficulty of airway -WORSENS pulmonary function -INCREASES ICP -INCREASES pressure ulcers

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Salim R. Rezaie, MD

@srrezaie

4 years

Bougie-Assisted Cricothyrotomy Scalpel-Finger-Bougie 1. Toughest part of procedure is decision to cut 2. Know the anatomy 3. Need 4 things to keep the procedure short & simple -Betadine -Scalpel -Bougie -6.0 ETT #FOAMed #FOAMcc #cricothyrotomy #deliberatepractice

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Salim R. Rezaie, MD

@srrezaie

4 years

Potential Workflow for COVID-19 None of our current dx tools are great RT-PCR assay has long turnaround time (currently 1 – 7d) Availability (we simply don’t have enough tests to test everyone) This seems to be what makes the most sense #COVID19 #nCoV19

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Salim R. Rezaie, MD

@srrezaie

4 years

The Crashing Asthmatic via @EMSwami at #ResusX20 If usual care not working consider... 1. Mg2+ 2g IV x3 in 1st hr, then 2g IV/hr 2. Epi 5 - 10mcg IVP then infusion at 1 - 20mcg/min Also consider Ketamine 0.1mg/kg bolus then 0.05 to 0.4mg/kg/hr #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

6 years

10,000 hours of practice to master a skill is a myth. It is the quality of learning (deliberate practice) not the quantity of repetitions (mindless repetition)...Find a Feedback Buddy!!! #FOAMed #MedEd PING @EMSwami @EMManchester @_NMay

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Salim R. Rezaie, MD

@srrezaie

4 years

CCB Toxicity -High Dose Insulin (1U/kg bolus --> 0.5U/kg/hr) -Norepi 2 - 20mcg/min -Epi 2 - 20 mcg/min -CaCl 1 - 2g IV over 3min OR CaGluc 3 - 6g IV over 10min -Glucagon 5mg IV -Lipid Emulsion Therapy (1.5mL/kg bolus --> 0.25mL/kg/min) -ECMO #ResusX20 #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

2 years

2020 and 2021 have certainly taken a toll on me personally. I have been struggling with my mental health…Too many hours at work, patients being verbally abusive, the amount of sickness/death, and lack of time with my family/friends. #RezaieStrong #mentalhealth

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Salim R. Rezaie, MD

@srrezaie

10 months

RANT: Stop lowering sedation dosing for unstable hemodynamics during mechanical ventilation POSSIBLE OPTIONS: -Start a vasopressor -Change up sedation/analgesia -Ensure no other etiologies to low BP -DO NOT USE SUBTHERAPEUTIC SEDATION #FOAMed #Sedation

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Salim R. Rezaie, MD

@srrezaie

4 years

Hypertensive Emergencies via @mizuhomorrison at #ACOEP19 Target BP Goals.. Acute Ischemic Stroke (Non-tPA <220/120) Acute Ischemic Stroke (tPA <185/110) Pre-Eclampsia/Eclampsia (<160/110) Aortic Dissection (<120) Hemorrhagic Stroke (<140 if BP 150 - 220 OR 140 - 160 if BP >220)

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Salim R. Rezaie, MD

@srrezaie

2 years

2 Options for Elevated ICP in Severe TBI Mannitol -Bolus Only -Onset 30min -Lasts 6hrs -Causes Osmotic Diuresis -Dose 0.25 – 2g/kg over 30 to 60min HTS (3%) -Bolus or Drip -Onset 5min -Lasts 12hrs -No Diuretic Effect -Dose 300mL over 1hr #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

5 years

Burnout doesn’t happen because we work too hard...burnout happens because we feel under appreciated Give recognition publicly and frequently for work well-done...appreciation improves performance @amalmattu #evolvED19 #MedEd

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Salim R. Rezaie, MD

@srrezaie

5 years

Only two things have been proven time and time again to improve survival with good neurologic outcomes: 1. high quality CPR (Bystander CPR) 2. early defibrillation (AEDs) #ACEP19 #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

7 years

Can never remember vasopressor dosing, so made a card to help #ACEP17

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Salim R. Rezaie, MD

@srrezaie

6 years

Be More Efficient in the ED: 1. Run ur List After Every 3rd Pt to See What is Pending 2. Communicate the Plan w/ RNs 3. Use PO Instead of IV When Possible 4. Take Care of Yourself Otherwise You Can't Take Care of Others 5. Shared Decision Making #FOAMed #MedEd

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Salim R. Rezaie, MD

@srrezaie

7 years

Interventions we do from the doctor and patient perspectives @psirides #dasSMACC

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Salim R. Rezaie, MD

@srrezaie

6 years

Where is Your Ischemic Stroke Located? REBEL Review #60 --> Ischemic Stroke Syndromes #FOAMed #MedEd REBEL Reviews:

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Salim R. Rezaie, MD

@srrezaie

6 years

Deliberate Practice & Mastery: 1. Devote 15min a day to improve 1 skill 2. Break skills down into chunks (microskills) 3. Quality of feedback matters (What went well/bad & how to modify) 4. Take on difficult challenges 5. Don't become stagnant (Growth mindset) #FOAMed #MedEd

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Salim R. Rezaie, MD

@srrezaie

5 years

Emergent Treatment of Hyperkalemia – Insulin/Dextrose via @FOAMpodcast #FOAMed 5U IV insulin NOT 10U IV insulin in pts with renal insufficiency...been my practice for years now

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Salim R. Rezaie, MD

@srrezaie

7 years

FANTASTIC POST: Liver Function Tests Decoded via @TamingtheSRU #FOAMed

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Salim R. Rezaie, MD

@srrezaie

5 years

TXA for Everything That Bleeds? at #SMACC #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

3 years

Learning a ton up in the ICU...Some useful things to think about before extubating pts: RSBI <100 = RR/TV (Liters) MV <10 = RR x TV Pick up Head PEEP <8 FiO2 <50% PaO2 >60 Cough Follow Commands Low Secretions Cuff Leak #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

4 years

Aerosol Dispersion of Multiple Oxygen Delivering Modalities #COVID19 #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

Thinking this through...SARS-CoV2 binds to porphyrin & heme on Beta-1 chain of Hb -> Dissociates iron from heme -> Hb w/decreased O2 affinity -> O2 dissociation curve shifted to rt -> release of O2 which may be why pts appear perfused w/low O2 sats? Is this right? #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

BRASH Syndrome via @PulmCrit #FOAMed #FOAMcc B-radycardia R-enal Failure A-V Nodal Blocker S-hock H-yperkalemia

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Salim R. Rezaie, MD

@srrezaie

5 years

Airway Management in OHCA... Supraglottic airway is easier to place, more likely to be successful, & allows for more focus on high quality CPR compared to endotracheal intubation...Pick the method that does not distract from high quality CPR #EMSWorldExpo2019 #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

2 years

One of the things I have learned up in the ICU is how to do flexible bronchoscopy...Should this be something ED docs can do in the ED? @emcrit @PulmCrit @EMSwami @CriticalCareNow @ThinkingCC #bronchoscopy #ResusX21

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Salim R. Rezaie, MD

@srrezaie

7 years

Update on the ED Management of Intracranial Hemorrhage: Not All Head Bleeds Are the Same via William Shyy #FOAMed

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Salim R. Rezaie, MD

@srrezaie

4 years

Pt w/HD stable SVT... Modified Valsalva x2 -> NO EFFECT Diltiazem IV 20mg x2 -> NO EFFECT Single Syringe Adenosine 12mg IV -> Tell Pt We Are Going to Give You Adenosine -> Pt Vagals Before I Can Give Med (Remembers Last Time He Got Adenosine) -> NSR BTW...NOT #COVID19 Positive

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Salim R. Rezaie, MD

@srrezaie

6 years

There is no room for rudeness in medicine...Rudeness affects our ability to think, manage information, make decisions, and teamwork, which ultimately affects patient care. So think before speaking...we are all on the same team, which is taking care of patients. #FOAMed #MedEd

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Salim R. Rezaie, MD

@srrezaie

5 years

Resuscitation Room Ergonomics via @petrosoniak Poor resus room design results in sequential failures and ultimately poor patient outcomes 1. Make the resus room your orchestra 2. Plan your space before patient arrives 3. The patient is not a table #resusTO @ToResus

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Salim R. Rezaie, MD

@srrezaie

4 years

Managing the Sick Asthmatic via @HedayatiMD at #ACOEP20 -EtCO2 > 40 = bad sign -Early NIV (decreases intubation rate) - Early IV steroids -Ketamine 0.4 - 0.5mg/kg IV -IV Mg2+ 2g over 20min x3 doses -Epi 0.5mg IM --> push dose 0.5 - 1mL --> start drip at 5mcg/min -IVF 500-1000mL

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Salim R. Rezaie, MD

@srrezaie

4 years

Anaphylactic Shock Tx: -->Epi 0.3 - 0.5mg IM (Tx of Choice) -->Other Epi Options -Push Dose: 5 to 20mcg IV -IV Infusion: 1 to 20mcg/min -->Glucagon 1mg IV for Beta Blocker Reversal #FOAMed #FOAMtox

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Salim R. Rezaie, MD

@srrezaie

4 years

Two major types of COVID-19 L Type (70%): More prevalent; More aggressive & spreads more quickly; Often seen in patients in Wuhan China S Type (30%): Less aggressive; Strain spreading in countries outside of China #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

As the amount of information coming out on #COVID19 is much like the virus...fast and furious...we have created a REBEL EM COVID-19 Section on the site #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

Vasopressors via @PulmCrit #FOAMed #FOAMcc #vasopressors

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Salim R. Rezaie, MD

@srrezaie

5 years

No difference in survival with good neurologic outcomes between iGel vs endotracheal tube in cardiac arrest...BUT would argue that iGel is simpler, less cognitive load, ergonomically makes more sense, and allows for focus on HIGH QUALITY CPR #ACEP19 #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

2 years

@DGlaucomflecken Its fine...eyeball is perfused adequately...move forward with surgery...lol

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Salim R. Rezaie, MD

@srrezaie

2 years

Lets talk IV calcium... -100 – 300mg Ca2+ raises serum Ca2+ by ≈0.5 – 1.5mEq -1amp CaCl2 (10mL of 10%) = 270mg Ca2+ -1amp CaGluc (10mL of 10%) = 90mg Ca2+ -1 amp of CaCl = 3 amp CaGluc (i.e. 1 to 3) #FOAMed #MedEd #Calcium

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Salim R. Rezaie, MD

@srrezaie

3 years

Why do I feel so exhausted, depressed, & like such a failure at my job? Increased menial tasks, long hrs, lack of respect, & increased documentation have depersonalized what I do. Maybe instead of me being more resilient we should create a system that supports what we do better

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Salim R. Rezaie, MD

@srrezaie

4 years

COVID-19 Lung Ultrasound in the ED (CLUE) Protocol Lung Ultrasound Scoring System (LUSS) = Anatomical parameter O2 Requirement = Physiological parameter Can it help ED docs make disposition decisions? Article: #COVID19 #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

6 years

Instead of MONA in ACS, Think FAN #ACOEP17

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Salim R. Rezaie, MD

@srrezaie

7 years

The #1 cause of burnout , is not working too hard or trying to be a high achiever...it is having a lack of purpose #TTCAus17 @LizCrowe2

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Salim R. Rezaie, MD

@srrezaie

3 years

58 y/o female with colorectal Ca on 5-FU chemotherapy presents with chest pain, diaphoresis and SOB. ECG is shown below and has hyperacute T-waves in inferior leads. Called cardiology who wanted to wait for TnI level which was undetectable at presentation

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Salim R. Rezaie, MD

@srrezaie

4 years

REBEL Review 63: Treatment of Hyperkalemia #FOAMed #FOAMcc #hyperkalemia

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Salim R. Rezaie, MD

@srrezaie

4 years

Running out Ventilators? Consider thinking outside the box...1 Ventilator for Multiple Pts!!! CAVEAT: No Human Studies YouTube Video: Pubmed: PulmCrit: #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

2 years

@NephroCrit 60s years of age...basal ganglia bleed

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Salim R. Rezaie, MD

@srrezaie

6 years

Paediatric Arrest via @TheResusRoom #FOAMed #FOAMped WET FLAG W = Weight E = Energy (4J/kg) T = Tube Diameter (Age/4) + 4 F = Fluid L = Lorazepam 0.1mg/kg A = Adrenaline 0.1mL/kg G = Glucose (Dextrose 10% 2mL/kg)

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Salim R. Rezaie, MD

@srrezaie

8 years

Acid Base that Matters in the ED #ACEP16 #FOAMed

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Salim R. Rezaie, MD

@srrezaie

10 months

Making Push-Dose Epinephrine from a Vial #FOAMed #FOAMcc #Epi #Epinephrine #Adrenalin #PushDosePressors

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Salim R. Rezaie, MD

@srrezaie

4 years

Sodium Bicarbonate for Acute Symptomatic Hyponatremia via @ALiEMteam #FOAMed -1 ampule (50 mL total) of sodium bicarb 8.4% over 5–10min -1 ampule of sodium bicarb 8.4% (50 mL) contains 50 mEq of Na, comparable to 51.3 mEq of Na found in 100 mL of 3% NaCl

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Salim R. Rezaie, MD

@srrezaie

3 years

Engaging the midline vallecular fold with laryngoscope blade tip during orotracheal intubation when using a standard geometry blade associated with improved laryngeal visualization

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Salim R. Rezaie, MD

@srrezaie

6 years

Spinal Immobilization in Trauma Pts #FOAMed #ACEP18 1 Does NOT Help Immobilize the Cervical Spine or Decr Rates of Spinal Cord Injury 2 Incr Difficulty of Airway Management & ICP 3 Can Cause Pressure Ulcers 4 Changes Physical Exam 5 Worsens Pulmonary Fxn

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Salim R. Rezaie, MD

@srrezaie

4 years

Decreasing Spread of Infection by Fist Bumping vs Handshaking... 1. Surface Area Fist Less Than Palm 2. Duration of Contact of Fist Less Than Palm 3. Transmission of Infection of Fist Less Than Palm #ACOEP19 #fistbump #FOAMed

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Salim R. Rezaie, MD

@srrezaie

4 years

COVID-19 Hypoxemia...a better way NC 6L/min + Surgical Mask (Goal SpO2 88 - 92%) --> HFNC + Surgical Mask + Prone --> Calculate ROX Score (Pulse Ox/FiO2/RR)...if <4.88 --> Intubation Another option would be CPAP + prone instead of HFNC Thoughts/Feedback?!? #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

6 years

ONE OF MY FAV TALKS & SLIDES AT #dasSMACC : "Everything" at the End of Life via @smaccteam @psirides #FOAMed

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Salim R. Rezaie, MD

@srrezaie

1 year

The loading dose of Levetiracetam (Keppra) in patients who are seizing is not 1000mg...It is... 60mg/kg (MAX 4500mg) Pts who are ≥75kg will be the MAX dose #FOAMed #FOAMcc #MedEd #MedTwitter #Keppra #Seizure

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Salim R. Rezaie, MD

@srrezaie

6 years

10 Ways to Improve: 1. Read more personal devp books 2. Get out of your comfort zone 3. Embrace mistakes & challenges 4. Ask for feedback 5. Learn from those that inspire you 6. Quit a bad habit 7. Get a mentor 8. Meditate 9. Be kind to others 10. Take breaks #FOAMed #MedEd

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Salim R. Rezaie, MD

@srrezaie

4 years

I worry that message "stay home for us" was taken too literally...Seeing delayed presentations of MI, stroke, burst appy, etc... #COVID19 didn't magically cure other illnesses...ppl are scared to come to ED...I worry this will increase burden of dz in long run...such a conundrum

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Salim R. Rezaie, MD

@srrezaie

6 years

Per #FOAMed feedback, CVC & IO access flow rates added to chart #FOAMed #postpubpeerreview

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Salim R. Rezaie, MD

@srrezaie

4 years

The VEINART Trial: VBG vs ABG In non-hypoxemic pts... -VBG is less painful compared to ABG -VBG is easier for the healthcare team compared to ABG -VBG provides useful information similar to ABG for physicians in regard to treatment decisions #FOAMed

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Salim R. Rezaie, MD

@srrezaie

5 years

Developing a Story/Message for Presentations: 1. Use Pen & Paper NOT Technology 2. Brainstorm & Give Yourself Time (Not Night Before) 3. Organize Your Talk (Mind Map) 4. Avoid Information Overload (Avoid List of Facts) 5. Craft a Story #smacc #presentationdesign #meded

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Salim R. Rezaie, MD

@srrezaie

5 years

3 Components to Every Great Presentation: 1. The Story - This Takes Time (Not the Night Before) 2. The Slides - Less is More (Pictures > Words) 3. The Delivery - Rehearse (Practice, Practice, Practice) #evolvED19 #MedEd #FOAMed

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Salim R. Rezaie, MD

@srrezaie

4 years

COVID-19 Hypoxemia: A Better and Still Safe Way...A Potential Workflow NIV/CPAP Risk of Aerosolization ROX Index to Predict Failure Awake Proning #COVID19FOAM Feedback and Thoughts Welcome

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Salim R. Rezaie, MD

@srrezaie

3 years

IMPORTANT PAPER --> The DIFOCCULT Trial: Time to Change from STEMI/NSTEMI to OMI/NOMI via @LeenAlblaihed -ACO missed in 28.2% of NSTEMI pts -ACO in NSTEMI similar to STEMI pts: -Measured myocardial damage -In-hospital & long-term mortality #FOAMed

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Salim R. Rezaie, MD

@srrezaie

4 years

Bedside Management of Acute PE via Mae West Massive PE: -Don't flood pt with fluids -Vasopressors: norepi + low dose vasopressin -Inotropes: Dobutamine or milrinone -Pulmonary vasodilators: Nebulized NTG or milrinone -Avoid intubation if possible #FOAMed #FOAMcc #HRreloaded

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Salim R. Rezaie, MD

@srrezaie

4 years

We give IV fluids to patients everyday...know what you are giving.... REBEL Review 70: Fluid Composition #FOAMed There is NOTHING normal about normal saline

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Salim R. Rezaie, MD

@srrezaie

4 years

Hypertriglyceridemic pancreatitis Tx: --> Insulin gtt 0.2U/kg/hr + D5 1/2NS + 20KCl --> Gemfibrozil 600mg PO BID --> Plasmapheresis considered, but not required #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

6 years

Conclusions From My Talk On: The Death of MONA in ACS at #ACOEP17

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Salim R. Rezaie, MD

@srrezaie

4 years

Thrombolysis in Acute Ischemic Stroke: Now we Have No Positive RCTs Re-Analysis of NINDS & ECASS-III Balancing for Baseline Differences Between Groups Both Question Validity of Results #FOAMed #FOAMcc #stroke #Alteplase

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Salim R. Rezaie, MD

@srrezaie

5 years

Equality is not enough... Equality is treating everyone the same. Equality aims to promote fairness, but it can only work if everyone starts from the same place and needs the same help Equity is giving everyone what they need to be successful. #FIX19

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Salim R. Rezaie, MD

@srrezaie

5 years

How I Resuscitate Before I Intubate for Hypotension Run fluids/blood Boom Sticks (ie Push Dose Pressors) Increase Pressure w/ norepinephrine drip #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

5 years

REBEL EM has been a work in progress over the past 5 1/2 years...Would not be possible without an amazing team which continues to contribute to the site and continue to help me grow as a person, leader, educator, and physician. Blessed to be in this #FOAMed space!!!

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Salim R. Rezaie, MD

@srrezaie

3 years

Spontaneous Bacterial Peritonitis via @PulmCrit @iBookCC -13% are asymptomatic!!! -No need to correct INR for paracentesis -Usual tx is ceftriaxone 2g NOT 1g IV qD #FOAMed

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Salim R. Rezaie, MD

@srrezaie

4 years

5 ECG Patterns You Must Know #FOAMed #STEMI #OMI #ECG #EKG 1st Diagonal of LAD Occlusion De Winter's T Waves Left Main Coronary Artery Stenosis Wellens' Syndrome Posterior Wall MI

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Salim R. Rezaie, MD

@srrezaie

3 years

Calcium in Exsanguinating Patients with Ricky Ditzel & Jeffrey Siegler via @emcrit #FOAMed #FOAMcc -Give calcium with 1st unit of blood in trauma (and TXA) -Consider giving 1g for every 2-4 products administered during large transfusion

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Salim R. Rezaie, MD

@srrezaie

3 years

IV Fluids - Compositions and Choices via @JPickosMed #FOAMed #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

3 years

Turns out 5-FU can cause coronary vasospasm which can mimic occlusion MI. Her 5-FU was stopped and she had no more recurrence of chest pain. Adding 5-FU induced coronary vasospasm to my ddx:

Coronary Vasospasm Secondary to 5-Fluorouracil and Its Management: Case Report

Although rare, 5-fluorouracil (5-FU) may lead to cardiotoxicity that presents with angina, elevated cardiac enzymes and electrocardiogram (ECG) changes. Coronary vasospasm related to 5-FU is a rare...

www.ncbi.nlm.nih.gov

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Salim R. Rezaie, MD

@srrezaie

6 years

REBEL EM Just Turned 5 Today!!! How Time Flies...Thank You to Those Who Have Supported us Over the Past 5 Years. #FOAMed #rebelEM

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Salim R. Rezaie, MD

@srrezaie

3 years

The KetaBAN Trial: Nebulized Ketamine for Analgesia in the ED -0.75mg/kg of nebulized ketamine was both efficacious and safe in control of acute pain in the ED compared to 1.0 and 1.5mg/kg #FOAMed PING @painfreeED

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Salim R. Rezaie, MD

@srrezaie

4 years

Not an Intensivist...frontline ED doc trying to do the best for my intubated #COVID19 pts...Use Vol-AC on ventilator (bc it's the mode I am most comfortable with)...using driving pressure to help with PEEP level determination...Feedback welcome #COVID19FOAM

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Salim R. Rezaie, MD

@srrezaie

4 years

The Magical Lewis Lead to Differentiate SVT-AC vs VT via @amalmattu at #ResusX20 -Better shows atrial activity -RA --> Suprasternal Notch -LA --> Rt 5th ICS next to sternum -LL --> Rt lower costal margin #FOAMed #ECG #EKG #FOAMcc

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Salim R. Rezaie, MD

@srrezaie

2 years

Tidal Volume on the ventilator is based off IDEAL BODY WEIGHT not Actual Body Weight Lung Size for a 250lb & 100lb pt of the same height are essentially the same (SEE IMAGE BELOW) #FOAMed #FOAMcc #tidalvolume

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Salim R. Rezaie, MD

@srrezaie

7 years

"You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome" Patch Adams #dasSMACC

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Salim R. Rezaie, MD

@srrezaie

10 months

CCB Toxicity High-dose Insulin Euglycemia Therapy (HIET) -Insulin Bolus 1U/kg; Infusion 1 to 10U/kg/hr -Ca: 2gCaCl OR 6gCaGluc IV -Aggressively replace Mg, K+, Phos -D20: 2.5mL/kg/hr; Titrate By 0.5mL/kg/hr Until Goal Glucose Achieved (≈200mg/dL) #FOAMed #FOAMcc #FOAMtox #HIET

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Salim R. Rezaie, MD

@srrezaie

3 years

This might be one of the funniest things I have read in a minute. I needed this today...so many truths...Freedom to not wear a mask at the Freedom Cafe!!! #wearyourmask #GetVaccinated

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