Lauren Westafer, DO, MPH, MS
@lwestafer.bsky.social
EM doc at BaystateEM | cofounder of FOAMpodcast |#impsci & #VTE researcher| addiction Med | 🏳️🌈she/her #LGBTQinMedicine
Totally agree. We can critique the individual studies but given there is at least a signal of harm with etomidate (and not with ketamine) across many studies, the only reason to defend routine etomidate is inertia and comfort of learned practice. I use ketamine unless some contraindication now
Time to abandon etomidate in RSI?
-Mounting evidence of harm vs ketamine:
2022 RCT(PMID 34904190) 8% incr mortality
2023 Meta(PMID 37127020) NNH = 31
2024 study(PMID 38368326) mod prob ⬇️ mortality w/ ketamine
-Ketamine appears to be better default agent
youtube.com/shorts/8bCPT...
#MedSky #EMIMCC
-Mounting evidence of harm vs ketamine:
2022 RCT(PMID 34904190) 8% incr mortality
2023 Meta(PMID 37127020) NNH = 31
2024 study(PMID 38368326) mod prob ⬇️ mortality w/ ketamine
-Ketamine appears to be better default agent
youtube.com/shorts/8bCPT...
#MedSky #EMIMCC
Etomidate vs Ketamine in RSI #criticalcare #emergencymedicine #resuscitation #airway
YouTube video by EMSwami
youtube.com
April 2, 2025 at 12:49 PM
Totally agree. We can critique the individual studies but given there is at least a signal of harm with etomidate (and not with ketamine) across many studies, the only reason to defend routine etomidate is inertia and comfort of learned practice. I use ketamine unless some contraindication now
Reposted by Lauren Westafer, DO, MPH, MS
RhD Immunoglobulin (e.g. RhoGAM) After First Trimester Abortion (spontaneous or induced) - I remember this debate in 2012 as a med student and now....many OB recommendations have changed! podcast is on spotify or wherever you listen foamcast.org/2025/03/22/r... #education #MedSky #EMSky #EMedSky
March 22, 2025 at 12:39 AM
RhD Immunoglobulin (e.g. RhoGAM) After First Trimester Abortion (spontaneous or induced) - I remember this debate in 2012 as a med student and now....many OB recommendations have changed! podcast is on spotify or wherever you listen foamcast.org/2025/03/22/r... #education #MedSky #EMSky #EMedSky
Reposted by Lauren Westafer, DO, MPH, MS
FOAMcast is baaaaaack. A major thought on asthma....we can and should do better for the patients we discharge from the ED... foamcast.org/2025/03/20/i... Listen on spotify, bit.ly/41CoxQF, or wherever you get your podcasts #education #MedSky #EMSky #EMedSky
March 20, 2025 at 1:19 PM
FOAMcast is baaaaaack. A major thought on asthma....we can and should do better for the patients we discharge from the ED... foamcast.org/2025/03/20/i... Listen on spotify, bit.ly/41CoxQF, or wherever you get your podcasts #education #MedSky #EMSky #EMedSky
Let's get the basics right! Updates in anticoagulation selection in hospitalized patients with PE... www.acepnow.com/article/anti... #education #MedSky #EMSky #EMedSky
Anticoagulant Selection Is Cornerstone of Pulmonary Embolism Treatment - ACEP Now
ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an...
www.acepnow.com
March 12, 2025 at 5:26 PM
Let's get the basics right! Updates in anticoagulation selection in hospitalized patients with PE... www.acepnow.com/article/anti... #education #MedSky #EMSky #EMedSky
Reposted by Lauren Westafer, DO, MPH, MS
D-dimer for Ruling out PE in High-Risk Patients?
thesgem.com/2025/03/sgem... @lwestafer.bsky.social #MedSky #MemeMonday
thesgem.com/2025/03/sgem... @lwestafer.bsky.social #MedSky #MemeMonday
March 3, 2025 at 12:35 PM
D-dimer for Ruling out PE in High-Risk Patients?
thesgem.com/2025/03/sgem... @lwestafer.bsky.social #MedSky #MemeMonday
thesgem.com/2025/03/sgem... @lwestafer.bsky.social #MedSky #MemeMonday
Reposted by Lauren Westafer, DO, MPH, MS
Now recruiting for Resident Editorial Board Fellowship Appointment! #education #MedSky #EMSky #EMedSky #BlueSky
February 27, 2025 at 3:57 PM
Now recruiting for Resident Editorial Board Fellowship Appointment! #education #MedSky #EMSky #EMedSky #BlueSky
Reposted by Lauren Westafer, DO, MPH, MS
Next up on the Skeptics' Guide to EM is this Hot Off the Press article on diagnosing pulmonary embolisms with @lwestafer.bsky.social #SGEMHOP #MedSky #EBM
pubmed.ncbi.nlm.nih.gov/39487597/
pubmed.ncbi.nlm.nih.gov/39487597/
Failure rate of D-dimer testing in patients with high clinical probability of pulmonary embolism: Ancillary analysis of three European studies - PubMed
In this study, ruling out PE in high-risk patients based on D-dimer below the age-adjusted threshold was safe, with no missed PE. However, the large CI of the primary endpoint precludes a definitive c...
pubmed.ncbi.nlm.nih.gov
February 28, 2025 at 1:48 PM
Next up on the Skeptics' Guide to EM is this Hot Off the Press article on diagnosing pulmonary embolisms with @lwestafer.bsky.social #SGEMHOP #MedSky #EBM
pubmed.ncbi.nlm.nih.gov/39487597/
pubmed.ncbi.nlm.nih.gov/39487597/
Reposted by Lauren Westafer, DO, MPH, MS
Do clinical decision rules actually help with diagnosis in medicine?
The latest #CJEMDebate explores the question with
@first10em.bsky.social @emlitofnote.bsky.social @lwestafer.bsky.social @reverendofdoubt.bsky.social and @paulatkinsonem.bsky.social. #medsky
link.springer.com/article/10.1...
The latest #CJEMDebate explores the question with
@first10em.bsky.social @emlitofnote.bsky.social @lwestafer.bsky.social @reverendofdoubt.bsky.social and @paulatkinsonem.bsky.social. #medsky
link.springer.com/article/10.1...
CJEM debate: clinical decision rules–thinking beyond the algorithm - Canadian Journal of Emergency Medicine
Canadian Journal of Emergency Medicine -
link.springer.com
February 5, 2025 at 8:23 PM
Do clinical decision rules actually help with diagnosis in medicine?
The latest #CJEMDebate explores the question with
@first10em.bsky.social @emlitofnote.bsky.social @lwestafer.bsky.social @reverendofdoubt.bsky.social and @paulatkinsonem.bsky.social. #medsky
link.springer.com/article/10.1...
The latest #CJEMDebate explores the question with
@first10em.bsky.social @emlitofnote.bsky.social @lwestafer.bsky.social @reverendofdoubt.bsky.social and @paulatkinsonem.bsky.social. #medsky
link.springer.com/article/10.1...
Reposted by Lauren Westafer, DO, MPH, MS
This is really interesting
What the qualitative studies says about EM providers and hospitalists is similar to what I used to hear
Practice needs to change to harm fewer patients, myths need to be busted
What the qualitative studies says about EM providers and hospitalists is similar to what I used to hear
Practice needs to change to harm fewer patients, myths need to be busted
In @annalsofem.bsky.social we published on the shocking rise in UFH use for PE www.annemergmed.com/article/S019.... We wanted to know why, so we conducted a qual study out in @jama.com and found some interesting things jamanetwork.com/journals/jam... #education #MedSky #EMSky #EMedSky #BlueSky
January 3, 2025 at 11:03 PM
This is really interesting
What the qualitative studies says about EM providers and hospitalists is similar to what I used to hear
Practice needs to change to harm fewer patients, myths need to be busted
What the qualitative studies says about EM providers and hospitalists is similar to what I used to hear
Practice needs to change to harm fewer patients, myths need to be busted
Question for radiologists (and others)...on CTPAs, if/when you use the term "filling defect" but don't specifically qualify PE yes or PE no, what does this mean/what is your certainty(%) that it is a PE? #MedSky #EMSky #EMedSky #radiology
January 31, 2025 at 1:17 PM
Question for radiologists (and others)...on CTPAs, if/when you use the term "filling defect" but don't specifically qualify PE yes or PE no, what does this mean/what is your certainty(%) that it is a PE? #MedSky #EMSky #EMedSky #radiology
You routinely ensuring your patients in the ED with asthma exacerbations have an ICS? It's time we get on board www.acepnow.com/article/inha... #education #MedSky #EMSky #EMedSky #BlueSky
Inhaled Corticosteroids An Underused Option for Asthma - ACEP Now
ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an...
www.acepnow.com
January 16, 2025 at 4:46 PM
You routinely ensuring your patients in the ED with asthma exacerbations have an ICS? It's time we get on board www.acepnow.com/article/inha... #education #MedSky #EMSky #EMedSky #BlueSky
In @annalsofem.bsky.social we published on the shocking rise in UFH use for PE www.annemergmed.com/article/S019.... We wanted to know why, so we conducted a qual study out in @jama.com and found some interesting things jamanetwork.com/journals/jam... #education #MedSky #EMSky #EMedSky #BlueSky
January 3, 2025 at 4:28 PM
In @annalsofem.bsky.social we published on the shocking rise in UFH use for PE www.annemergmed.com/article/S019.... We wanted to know why, so we conducted a qual study out in @jama.com and found some interesting things jamanetwork.com/journals/jam... #education #MedSky #EMSky #EMedSky #BlueSky
Reposted by Lauren Westafer, DO, MPH, MS
Does Andexanet Alpha Improve Outcomes Compared With Four-Factor Prothrombin Complex Concentrate for Reversal of Direct Oral Anticoagulants? www.annemergmed.com/article/S019... #education #MedSky #MedTwitter #EMSky #EMedSky #BlueSky
November 22, 2024 at 1:37 AM
Does Andexanet Alpha Improve Outcomes Compared With Four-Factor Prothrombin Complex Concentrate for Reversal of Direct Oral Anticoagulants? www.annemergmed.com/article/S019... #education #MedSky #MedTwitter #EMSky #EMedSky #BlueSky
Guidelines recommend alternatives to UFH in acute PE bc unpredictable pharmacokinetics & resource intensity. we looked at nearly 300K pts hospitalized w/acute PE & found out UFH use has increased! www.annemergmed.com/article/S019... @annalsofem.bsky.social #education #MedSky #EMSky #EMedSky #BlueSky
November 22, 2024 at 2:02 AM
Guidelines recommend alternatives to UFH in acute PE bc unpredictable pharmacokinetics & resource intensity. we looked at nearly 300K pts hospitalized w/acute PE & found out UFH use has increased! www.annemergmed.com/article/S019... @annalsofem.bsky.social #education #MedSky #EMSky #EMedSky #BlueSky