
Pulmonary/Critical Care doc at @WeillCornell via @nyphospital & @BIDMC_IM & @BID_CMRs. Physiology 😍 Languages, travel. #MedEd. Views mine. 🏳️🌈🫁🫀🏥
New York, NY
Joined January 2019
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Joshua Davis (he/him) retweeted
As the tragic #CaliforniaWildfires continue, those with respiratory disease will be most impacted as exposure continues. Learn more about treatment protocols from the Chest Infection and Disaster Response Network: hubs.la/Q031VgTn0
#WildfireSmoke
Joshua Davis (he/him) retweeted
Excited to share our @JAMA_current CGS on SCCM’s 2024 guidelines on use of corticosteroids in sepsis, ARDS, and CAP!
📣learn about the nuanced evidence behind the rec for corticosteroid use.
As always it’s great to work with @AndyDavis @JoshDavisMD!
@WCMGIM @WCM_MedChiefs
This JAMA Clinical Guidelines Synopsis summarizes the 2024 Society of Critical Care Medicine guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia.
ja.ma/42bw8Y2
Joshua Davis (he/him) retweeted
1. Optimise patient position
Ear-to-sternal notch horizontal alignment with neck flexion never lets you down. Also called 'flextension' this is identical to the optimal direct laryngoscopy position
Joshua Davis (he/him) retweeted
The iGel is a great supraglottic airway device
But like other supraglottic airway devices (SAD) it's not foolproof
Here's how to maximise your success with the iGel - a thread 🧵
Joshua Davis (he/him) retweeted
Here’s another pulmonary physiology question that *everyone* who gives O2 to patients ought to know:
What is the primary mechanism by which supplemental oxygen can increase PaCO2 in someone with severe COPD?
1/
48%Hypoxic respiratory drive
21%Hypoxic vasoconstriction
22%Haldane effect
9%Something else / answers
23,074 votes • Final results Joshua Davis (he/him) retweeted
And what was the consequence of all that hyponatremia? All that rapid correction? 12 of osmotic demyelinating syndrome.
12 out of 22,858. 0.05%
If you divide by starting Na they found an incidence of:
0.3% with a Na < 120
0.015% with a Na > 120
**2.5% with a Na < 110**
7/10
Joshua Davis (he/him) retweeted
🚀Na over-correction (Na📈) as THE (only) cause of ODS/CPM: An absurd over-simplification.
Since 1980s, Na📈 has been portrayed as the main cause of CPM (so far as now the terms ODS and CPM are used synonymously).
However, finding the truth (if it exists) is more complicated.
🧵..
1/
Joshua Davis (he/him) retweeted
“this bronchoscopy could have been an induced sputum”
“this A-line could have been a cuff pressure”
“this intubation for ‘airway protection’ could have been a sternal rub”
“this swan could have been a POCUS”
“this consult could have been a google search”
Joshua Davis (he/him) retweeted
When you lose weight, where does the weight actually go? 🤔
Turns out, YOU EXHALE IT FROM YOUR LUNGS AS CO2 🤯
#MedTwitter #MedEd #NutritionMatters
🙏 Love this wisdom from @AvrahamCooperMD – at Durham, NC
Joshua Davis (he/him) retweeted
Medicine: gene therapy
.
.
Also medicine: sorry can’t send records fax machine not working
Joshua Davis (he/him) retweeted
Ascites is like carrying around a hot tub:
Huge energy bill!
1⃣Kilocalorie= energy to 🔥1L by 1°C
2⃣Ascites=Heating ~5-10L to 36°C 24hrs/day
3⃣Energy comes from body breakdown (sarcopenia)
If you⬇️ascites➡️the energy bill falls
Help patients. ⬇️the ascites!!! #livertwitter
Joshua Davis (he/him) retweeted
Here’s a quick video breaking down an emergency intubation recorded in a blunt trauma victim. The key to laryngoscopy is identifying the epiglottis!
#FOAMed
Joshua Davis (he/him) retweeted
How to differentiate jugular venous from carotid artery pulsations ⬇️
Via @fazalabul @grepmeded
#MedTwitter
Joshua Davis (he/him) retweeted
More monkeypox vaccine will be available tomorrow at 1 p.m. Including the appointments opening tomorrow, nearly 7,000 doses of monkeypox vaccines will have become available to New Yorkers since June 23. To get updates, text MONKEYPOX to 692692: on.nyc.gov/3NYBtqY
Joshua Davis (he/him) retweeted
Absent lung sliding is sensitive but nonspecific sign of pneumothorax. US lung point or X-ray are usually needed prior to chest tube placement. Normal BP in this patient made tension pneumothorax unlikely. Table lists causes of absent lung sliding. ncbi.nlm.nih.gov/pmc/article…






























