robbiemed / robbiemed is on Nostr

Following is not endorsement

Last Notes

2025-03-05 16:39:19

We in the US spend more on healthcare yet have discordant health outcomes relative to other countries.
Yet people are worked up about budget cuts.

2025-01-21 20:29:52

Chainsaw running on bench, because adjusting carb
Running chainsaw vibrates bench, causes phone to begin to slip
Grabs phone which is near blade, ends up with 3cm macerated lac
#ed #chainsaw

2025-01-21 17:11:33

Urolithiasis Pearls
- Presence or absence of hematuria alone cannot be used to diagnose or exclude nephrolithiasis
- Most stones ≤5 mm (70–98%) will pass spontaneously. Stones >5 mm have smaller chance (25–51%) of spontaneous passage & are more likely to need urologic intervention. (J Urol. 2015;194:1009)
- Send pts home w/ strainer, esp 1st-time stone formers for stone analysis
- Cx: Obstructed infected kidney (urologic emergency requiring urgent decompression), renal insufficiency, failed expulsion
Excerpt From
Pocket Notebook: Pocket Emergency Medicine, 4e
Erica Ashley Morse, MD
#em

2025-01-21 16:52:20

Prolonged #tourniquet use during #venipuncture can lead to significant alterations in the concentrations of various analytes due to hemoconcentration and the movement of analytes from surrounding tissues into the bloodstream. The literature indicates that even short-term venous stasis can cause clinically significant changes in several analytes.
**Duration and Impact:**
- 1 minute: Statistically significant changes can be observed in albumin, calcium, and potassium.[1] The AHA recommends that a tourniquet should not be applied for more than 1 minute to avoid significant increases in triglyceride levels.[1][2]
- 3 minutes: significant increases in alanine aminotransferase, total cholesterol, glucose, and potassium. Hemoconcentration effects are more evident[1][3]
**So**
- It’s recommended to keep tourniquet application to less than 1 minute.[2]
- Waiting for 5 minutes with the needle in situ after removing the tourniquet can help reduce hemostasis-induced variability.[4] But this is never going to happen.
Basically, tourniquet application should not exceed 1 minute if you want to minimize the risk of significant alterations in analyte concentrations.
**Rationalization**
[1] Lippi G, Salvagno GL, Montagnana M, Brocco G, Guidi GC. Influence of Short-Term Venous Stasis on Clinical Chemistry Testing. Clinical Chemistry and Laboratory Medicine. 2005;43(8):869-75. doi:10.1515/CCLM.2005.146.
[2] Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2011;123(20):2292-333. doi:10.1161/CIR.0b013e3182160726.
[3] Cengiz M, Ulker P, Meiselman HJ, Baskurt OK. Influence of Tourniquet Application on Venous Blood Sampling for Serum Chemistry, Hematological Parameters, Leukocyte Activation and Erythrocyte Mechanical Properties. Clinical Chemistry and Laboratory Medicine. 2009;47(6):769-76. doi:10.1515/CCLM.2009.157.
[4] Devi S, Pasanna RM, Nadiger N, et al. Variability of Human Fasted Venous Plasma Metabolomic Profiles With Tourniquet Induced Hemostasis. Scientific Reports. 2021;11(1):24458. doi:10.1038/s41598-021-03665-2.

2025-01-21 16:18:34

#olas #testflight link for iOS
https://testflight.apple.com/join/2FMVX2yM

2025-01-21 12:46:08

So fun to zap from iPadOS

2025-01-20 13:35:31

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- Natural Medicine Comprehensive Database
naturalmedicines.therapeuticresearch.com
- LactMed
ncbi.nlm.nih.gov/books/NBK501922

2025-01-01 16:27:23

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Thanks 🤜🤛

2024-12-30 18:22:46

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Love the “always a student” attitude but I don’t have the MD part yet 😐 afaict no other M1234 students on here 🤔

2024-12-18 11:39:51

Am I the only #medstudent on #nostr? Where is everyone?

2024-12-18 11:39:18

Last #virtual interview for #residency! It’s been a ride!

2024-04-26 13:04:34

Wrote an estimation tool to calculate the amount of sodium your patients are getting in their antibiotics, inspired by Frisbee at al.'s 2019 article.
https://nabxcalc.vercel.app/
#asknostr #hospitalist #AHRF #medicine

2024-04-25 21:54:59

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Feedback is welcome!
#medical #internalmed #antibiotics #calculator #asknostr

2024-04-25 21:54:12

I wrote an estimation tool to calculate the amount of sodium your patients are getting in their antibiotics, inspired by Frisbee at al.'s 2019 article.
https://nabxcalc.vercel.app/