The framing for this has always seemed strange to me. Surgery has a 0% failure rate at preventing recurrent appendicitis (yes if done well) and antibiotics a 44% failure rate. Unless surgery is strongly contraindicated, appendectomy seems like the right choice.

Check out StEMIx this Nov from my colleagues @StanfordEMED. Register at StEMIx.live to join in. Content is going to be awesome.

Independence Day is a reminder that America is not the project of any one person. The single most powerful word in our democracy is the word ‘We.’ ‘We The People.’ ‘We Shall Overcome.’ ‘Yes We Can.’ America is owned by no one. It belongs to all citizens. And at this moment in history—when core democratic principles seem to be continuously under attack, when too many people around the world have become cynical and disengaged—now is precisely the time to ask ourselves tough questions about how we can build our democracies and make them work in meaningful and practical ways for ordinary people.

It is with heavy hearts that we share the passing of Dr. Samantha Garza. In honor of Sam's life, we invite you to donate in her memory to fund brain tumor research. Thank you to everyone who supported Sam throughout her battle. We love you forever, Sam. gofund.me/94b84c9b

You would expect international STEMI registries to drive quality improvement. Unfortunately, incorporation bias leads many to mistakenly believe STEMI is a solved problem—yet patients who are missed never even make it into these registries! Great editorial on this topic by @matt_bivens

When I’m the on call intensivist, I make it clear to my team that if we’re called to help with critically ill patients, having no available ICU beds is irrelevant Critical Care is a People, not a Place

Lasix is NOT nephrotoxic 🫘 Please retweet so we can end this myth once and for all 🦄 Rising creatinine is more often an indicator of inadequate Lasix dosing than excessive!! Lasix can only harm the kidneys if it decreases cardiac output by dropping preload to the point of reducing stroke volume... as someone who scans these patients regularly this is surprisingly rare! If a patient still has venous congestion (on Doppler), then Lasix is not driving the AKI. Instead, their AKI is from untreated congestion!!

Our article on Sonographic Lavage, using gastric ultrasound in GIB (authors.elsevier.com/a/1kQy4…) was chosen by Probing the Literature, ACEP’s journal club! I’ll be there as this month’s guest host! Hope you can make it!

Sometimes I wish I could give letter writers feedback on their LORs. I legit wonder what they are thinking sometimes.

The most important thing you can do for your team collectively is to understand what growth trajectory each person wants to be on at a given time and whether that matches the needs and opportunities of the team.

Finding ways to convey to our patients (and each other) that 1. we get it (competence) 2. we get them (empathy and compassion) #LoMaH #bestjobever #EMConf #GrandRounds #MedEd #IamHuman

Moving Expectations to mindsets... 🔥Expectations are easily proned to be disconfirmed. 💪🏾Mindsets or beliefs focus on way of seeing things and has more room for making the reality more true. #LoMaH #bestjobever #EMConf #GrandRounds

So excited! Dr. @AliaCrum, a leading expert on the stress-is-enhancing mindset, is speaking at this month’s @StanfordEMED #EMConf #GrandRounds🔥🌲 How can we begin shifting our mindsets and beliefs? #doctorsarehumanstoo #IamHuman #bestjobever #LoMaH #MedEd

This is big.

Living legend @MikeGisondi shares a powerful story.

“Doctors shouldn’t be involved in politics” 👋 ER doc here to say I’ll stop being involved in politics when thoughts/prayers are able to fix bullet holes

What an amazing time with some fantastic Ed Researchers from across the country. Badass humans and doctors. Such a privilege to be mentored by @StefSebok and @CoatesMedEd

What a privilege it was to attend this Grand Rounds today. Chief Moon has an important story to tell.