Lara Hayes, MD
@larahayes.bsky.social
Hospitalist | IM nerd, dog mom, lover of the outdoors, believer in the rights of all humans, striving to be better everyday | Views own, 🚫 advice
Reposted by Lara Hayes, MD
Just your regular reminder that ~40% of menstruating adolescents (and likely even higher proportion of adults) suffer from iron deficiency and yet we don’t universally screen.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Prevalence of Iron Deficiency and Iron-Deficiency Anemia in US Females Aged 12-21 Years, 2003-2020
This study examines prevalence of iron deficiency among females aged 12 to 21 years to inform future screening strategies for iron deficiency and iron-deficiency anemia.
jamanetwork.com
January 16, 2025 at 7:03 PM
Just your regular reminder that ~40% of menstruating adolescents (and likely even higher proportion of adults) suffer from iron deficiency and yet we don’t universally screen.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
So can we all just agree pumping is the absolute worst?
So grateful to be able to do it, but it just sucks 😭
So grateful to be able to do it, but it just sucks 😭
January 8, 2025 at 3:21 PM
So can we all just agree pumping is the absolute worst?
So grateful to be able to do it, but it just sucks 😭
So grateful to be able to do it, but it just sucks 😭
Want to improve my (basically non-existent) Spanish so I can have better convos with our awesome EVS lady.
What method do people like? Are we liking Babble or Duo-Lingo better?
What method do people like? Are we liking Babble or Duo-Lingo better?
January 5, 2025 at 2:51 PM
Want to improve my (basically non-existent) Spanish so I can have better convos with our awesome EVS lady.
What method do people like? Are we liking Babble or Duo-Lingo better?
What method do people like? Are we liking Babble or Duo-Lingo better?
Heard palliative care refer to it as “prolonging death” instead of “prolonging life” in GOC discussions and it was so powerful.
We should be honest about what our interventions really do in some cases.
We should be honest about what our interventions really do in some cases.
January 3, 2025 at 8:31 PM
Heard palliative care refer to it as “prolonging death” instead of “prolonging life” in GOC discussions and it was so powerful.
We should be honest about what our interventions really do in some cases.
We should be honest about what our interventions really do in some cases.
Reposted by Lara Hayes, MD
Reposted by Lara Hayes, MD
With a government shutdown looming, one thing that was in the package that has increased the quality of life of people on Medicare is telehealth. Without funding by December 31st telehealth will no longer be available for millions of Americans. That breaks my heart not only for me but for millions!💔
December 19, 2024 at 7:21 PM
With a government shutdown looming, one thing that was in the package that has increased the quality of life of people on Medicare is telehealth. Without funding by December 31st telehealth will no longer be available for millions of Americans. That breaks my heart not only for me but for millions!💔
Not my dental office automatically designating the hubby as “head of household” and calling him about my account…
I’m an employed grown woman in 2024…and the insurance is in my name. Also it’s my job to handle bills in our house.
Just lots of icks there.
I’m an employed grown woman in 2024…and the insurance is in my name. Also it’s my job to handle bills in our house.
Just lots of icks there.
December 20, 2024 at 12:46 AM
Not my dental office automatically designating the hubby as “head of household” and calling him about my account…
I’m an employed grown woman in 2024…and the insurance is in my name. Also it’s my job to handle bills in our house.
Just lots of icks there.
I’m an employed grown woman in 2024…and the insurance is in my name. Also it’s my job to handle bills in our house.
Just lots of icks there.
Reposted by Lara Hayes, MD
…cause insurance wouldn’t cover the anesthesia
December 17, 2024 at 9:34 PM
…cause insurance wouldn’t cover the anesthesia
The deaths prevented are in the MILLIONS. That doesn’t even factor in the disability and suffering prevented.
Modern miracles.
Modern miracles.
The number of deaths averted globally due to vaccination is absolutely staggering.
December 14, 2024 at 8:40 PM
The deaths prevented are in the MILLIONS. That doesn’t even factor in the disability and suffering prevented.
Modern miracles.
Modern miracles.
Reposted by Lara Hayes, MD
The last person to live an iron lung died this year at 78. He spent 70 years in that machine because of polio. Let’s please not do that again.
The lawyer helping Robert F. Kennedy Jr. pick federal health officials for the incoming Trump administration has petitioned the government to revoke its approval of the polio vaccine, which for decades has protected millions of people from a virus that can cause paralysis or death.
Kennedy’s Lawyer Has Asked the F.D.A. to Revoke Approval of the Polio Vaccine
Aaron Siri, who specializes in vaccine lawsuits, has been at Robert F. Kennedy Jr.’s side reviewing candidates for top jobs at the Department of Health and Human Services.
www.nytimes.com
December 13, 2024 at 2:46 PM
The last person to live an iron lung died this year at 78. He spent 70 years in that machine because of polio. Let’s please not do that again.
A modern miracle, saving millions of lives…this is what is at stake
The lawyer helping Robert F. Kennedy Jr. pick federal health officials for the incoming Trump administration has petitioned the government to revoke its approval of the polio vaccine, which for decades has protected millions of people from a virus that can cause paralysis or death.
Kennedy’s Lawyer Has Asked the F.D.A. to Revoke Approval of the Polio Vaccine
Aaron Siri, who specializes in vaccine lawsuits, has been at Robert F. Kennedy Jr.’s side reviewing candidates for top jobs at the Department of Health and Human Services.
www.nytimes.com
December 13, 2024 at 10:21 PM
A modern miracle, saving millions of lives…this is what is at stake
Reposted by Lara Hayes, MD
New office decor. I couldn’t resist.
December 12, 2024 at 3:40 PM
New office decor. I couldn’t resist.
Reposted by Lara Hayes, MD
Me to my wards team: hey guys, what does brat summer mean?
Medical student: ooh that’s a great question, why don’t you look it up and tell us about it on rounds tomorrow
Medical student: ooh that’s a great question, why don’t you look it up and tell us about it on rounds tomorrow
December 12, 2024 at 6:27 PM
Me to my wards team: hey guys, what does brat summer mean?
Medical student: ooh that’s a great question, why don’t you look it up and tell us about it on rounds tomorrow
Medical student: ooh that’s a great question, why don’t you look it up and tell us about it on rounds tomorrow
Reposted by Lara Hayes, MD
You guys aren't going to believe this but I just discovered my baby is a silly goose.
December 12, 2024 at 2:36 PM
You guys aren't going to believe this but I just discovered my baby is a silly goose.
Reposted by Lara Hayes, MD
Rant #5 Please don't tell me what the PaO2 is...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Over the years I've developed a number of "rants" (aka teaching) that seem to resonate with trainees on #ICUsky ward round.
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
November 25, 2024 at 9:16 PM
Rant #5 Please don't tell me what the PaO2 is...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.
What is the SpO2 I genially ask? In our target range? Well that's fine then.
Staff member shifting uneasily, "but the PaO2..."
Here we go...
Reposted by Lara Hayes, MD
How do you all handle determining when to call (as in end) an arrest?
Let’s say PEA, nothing obviously fixable, family unavailable/unprepared to say ‘stop.’
Obviously so much variability depending on situation, but do you have any guiding principles?
#emimcc
Let’s say PEA, nothing obviously fixable, family unavailable/unprepared to say ‘stop.’
Obviously so much variability depending on situation, but do you have any guiding principles?
#emimcc
December 9, 2024 at 1:44 AM
How do you all handle determining when to call (as in end) an arrest?
Let’s say PEA, nothing obviously fixable, family unavailable/unprepared to say ‘stop.’
Obviously so much variability depending on situation, but do you have any guiding principles?
#emimcc
Let’s say PEA, nothing obviously fixable, family unavailable/unprepared to say ‘stop.’
Obviously so much variability depending on situation, but do you have any guiding principles?
#emimcc
Reposted by Lara Hayes, MD
Are you taking care of patients with influenza in your hospital? Then you will know that many colleagues find oseltamivir treatment completely useless (or harmful) while others would never consider not using it. This is a new study you may be interested in:
December 8, 2024 at 11:41 AM
Are you taking care of patients with influenza in your hospital? Then you will know that many colleagues find oseltamivir treatment completely useless (or harmful) while others would never consider not using it. This is a new study you may be interested in:
This is the content we need!
A little girl asked if she could pet Twyla. I said, “Absolutely! She loves pets, especially butt scratches.” Then the little girl promptly turned around and pet Twyla with her butt. 🤣💀🥰
December 7, 2024 at 6:37 PM
This is the content we need!
Reposted by Lara Hayes, MD
"The medical system doesn't work without primary care doctors...The specialists can't do what the specialists do, their endoscopies, their knee replacements, all the things that make a lot of money for the hospital without the primary care doctors," Dr. Grinspoon said.
www.msn.com/en-us/health...
www.msn.com/en-us/health...
MSN
www.msn.com
December 7, 2024 at 12:36 PM
"The medical system doesn't work without primary care doctors...The specialists can't do what the specialists do, their endoscopies, their knee replacements, all the things that make a lot of money for the hospital without the primary care doctors," Dr. Grinspoon said.
www.msn.com/en-us/health...
www.msn.com/en-us/health...
Reposted by Lara Hayes, MD
Assuming we won’t ever get all HCWs to mask all the time, can we at least implement that if a patient shows up to an appt in a mask that their provider will then automatically mask for them without asking? Please?
December 6, 2024 at 5:12 PM
Assuming we won’t ever get all HCWs to mask all the time, can we at least implement that if a patient shows up to an appt in a mask that their provider will then automatically mask for them without asking? Please?
Reposted by Lara Hayes, MD
The other way to prevent NAGMA is to replete potassium with K-Citrate (PO) or K-Acetate (IV).
KCl causes hyperchloremic acidosis (like normal saline!), so giving tons of KCl will drive down the pH 😟
citrate or acetate are metabolized into bicarb, so they're alkalinizing and will *improve* pH 😛
KCl causes hyperchloremic acidosis (like normal saline!), so giving tons of KCl will drive down the pH 😟
citrate or acetate are metabolized into bicarb, so they're alkalinizing and will *improve* pH 😛
a little girl in a red jacket is looking up at something in the sky .
ALT: a little girl in a red jacket is looking up at something in the sky .
media.tenor.com
December 6, 2024 at 8:55 PM
The other way to prevent NAGMA is to replete potassium with K-Citrate (PO) or K-Acetate (IV).
KCl causes hyperchloremic acidosis (like normal saline!), so giving tons of KCl will drive down the pH 😟
citrate or acetate are metabolized into bicarb, so they're alkalinizing and will *improve* pH 😛
KCl causes hyperchloremic acidosis (like normal saline!), so giving tons of KCl will drive down the pH 😟
citrate or acetate are metabolized into bicarb, so they're alkalinizing and will *improve* pH 😛
Reposted by Lara Hayes, MD
PART 2: Towards the end of the DKA resuscitation when the gap is closing, a NAGMA often occurs.
This is a big problem because if you try to stop the insulin gtt while the patient's bicarb is <~18 mM that increases the risk of recurrent DKA.
Acidosis increases insulin resistance!
This is a big problem because if you try to stop the insulin gtt while the patient's bicarb is <~18 mM that increases the risk of recurrent DKA.
Acidosis increases insulin resistance!
December 6, 2024 at 8:55 PM
PART 2: Towards the end of the DKA resuscitation when the gap is closing, a NAGMA often occurs.
This is a big problem because if you try to stop the insulin gtt while the patient's bicarb is <~18 mM that increases the risk of recurrent DKA.
Acidosis increases insulin resistance!
This is a big problem because if you try to stop the insulin gtt while the patient's bicarb is <~18 mM that increases the risk of recurrent DKA.
Acidosis increases insulin resistance!
Reposted by Lara Hayes, MD
1/ On the 5th day of Pharmacy Advent, let’s tackle a clinical dogma: Beta-blockers in stimulant/cocaine use
Clinicians often hesitate to give BBs to pts w/ cocaine use d/t concerns over "unopposed α-receptor stimulation." Oldie but goodie, let’s dive in! 👇
#medsky #EMsky #pharmsky #HMsky #GPsky
Clinicians often hesitate to give BBs to pts w/ cocaine use d/t concerns over "unopposed α-receptor stimulation." Oldie but goodie, let’s dive in! 👇
#medsky #EMsky #pharmsky #HMsky #GPsky
December 5, 2024 at 9:30 PM