Lightnews — Scholar-powered news

@IM_Crit_ @imcrit.bsky.social · 10h

Patient required 2-3 l/m O2 via nasal cannula. Hemodynamics remained stable. A day later, he suffered massive intracranial hemorrhage and died...

Not every catheter-directed thrombolysis or suction thrombectomy is a success story!

#foamed #foamcc #meded #Medsky #emimcc #pulmsky

1 2

@IM_Crit_ @imcrit.bsky.social · 10h

After t-PA infusion started at 0.5 mg/hr, fibrinogen fell to <50 mg/dl for a day and PLTs (despite transfusion) remained <50k. HIT was (-) and no schistocytes were seen in blood smear

1 1

@IM_Crit_ @imcrit.bsky.social · 10h

Patient went directly to IR for catheter-directed thrombolysis after receiving PLT transfusion & being placed on a heparin drip. If you notice 👇, there is a catheter in the R pulmonary artery:

1 1

@IM_Crit_ @imcrit.bsky.social · 10h

Just heparin drip

t-PA/TNK

Catheter-directed thrombolysis
Suction thrombectomy

Surgery

1 1

@IM_Crit_ @imcrit.bsky.social · 10h

Side note: I have seen much worse RV hypokinesis without a RV occupant...!

Patient had PLT 40k likely due to chemotherapy / extensive metastatic disease

What would you do next?

1

@IM_Crit_ @imcrit.bsky.social · 10h

There was a R pulmonary artery thrombus and a right ventricular mass (thrombus). Troponin I and BNP were within normal limits. Lactate: OK

Time for echo:

1

@IM_Crit_ @imcrit.bsky.social · 10h

#PE stories:

How it started:

50 yo with solid cancer presented with dyspnea & bilateral leg edema. Hemodynamics: OK (BP: 155/70, HR: 80/min). O2 sat 97% on room air. US showed bilateral popliteal vein thrombosis. CT chest angio showed:

1 3

Reposted by @IM_Crit_

@IM_Crit_ @imcrit.bsky.social · 3d

Six surgeons general warn about RFK Jr.

#medsky

2 4 11

@IM_Crit_ @imcrit.bsky.social · 3d

1

@IM_Crit_ @imcrit.bsky.social · 3d

1

@IM_Crit_ @imcrit.bsky.social · 3d

Six surgeons general warn about RFK Jr.

#medsky

2 4 11

@IM_Crit_ @imcrit.bsky.social · 4d

ICU Snapshots:

Assessment/Plan (ICU Edition):
Day #1: Start Colace qd
Day #2: Change to Colace bid
Day #3: Add Senna
Day #4: Add Miralax
Day #5: The next intensivist comes on service

#medsky #foamed #foamcc #meded #emimcc

4 4

@IM_Crit_ @imcrit.bsky.social · 4d

Amazon is trying to get a piece of the pie, aka the multi-trillion dollar US health care industry

#Medsky #Healthcare

1 1

@IM_Crit_ @imcrit.bsky.social · 5d

🤔😳🫣

1

@IM_Crit_ @imcrit.bsky.social · 6d

Friendly reminder:

Science does not progress by popular vote

#meded #foamed #foamcc #Medsky

2

Reposted by @IM_Crit_