Jeffery Hill, MD MEd
drjeffy.bsky.social
Jeffery Hill, MD MEd
@drjeffy.bsky.social
EM physician interested in MedEd, training the next generation of EM docs who can practice EM anywhere, anytime, and take care of anything. Side projects include woodworking, cooking some good food here and there, and making things grow in the garden
Reposted by Jeffery Hill, MD MEd
Coordinating, consulting and managing an entire acute clinical service in real-time is fairly unique to EM.
Central to this is the emergency physician in charge (EPiC) role.
Following a busy 🌃 I'm resharing my mental model for the EPiC role.

🏥🚑🚑 🚑...
#EMedsky
www.stemlynsblog.org/an-epic-ment...
An EPiC mental model. St Emlyn's
Coordinating, consulting and managing an entire acute clinical service in real-time is fairly unique to emergency medicine. Are you EPIC?
www.stemlynsblog.org
December 15, 2024 at 7:37 AM
Reposted by Jeffery Hill, MD MEd
My troponin bumped from the mere headline of this case report.

"Simultaneous Acute Myocardial Infarction, Aortic Dissection, Pulmonary Embolism, and Pneumothorax."

#medsky #emedsky #emimcc #openaccess

pmc.ncbi.nlm.nih.gov/articles/PMC...
Simultaneous Acute Myocardial Infarction, Aortic Dissection, Pulmonary Embolism, and Pneumothorax
Chest pain is a frequently misdiagnosed presenting symptom, with a broad differential diagnosis that includes critical, time-sensitive cardiopulmonary conditions that necessitate rapid and accurate identification.
pmc.ncbi.nlm.nih.gov
December 8, 2024 at 2:52 PM
Reposted by Jeffery Hill, MD MEd
Systematic Review Snapshot Hot off the Press: Is Subcutaneous Insulin Administration Safe and Effective for the Treatment of Mild to Moderate Diabetic Ketoacidosis? www.annemergmed.com/article/S019... #education #MedSky #EMSky #EMedSky #BlueSky
December 9, 2024 at 4:28 PM
Reposted by Jeffery Hill, MD MEd
So after telling a decade of trainees that lidocaine with epi (adrenaline) is safe in digits, I've found an article that says "not so fast"
So if they have a history of vasculitis, or even Raynaud's, it can potentially cause necrosis.
So now I tell people to ask before using it in digits.
December 12, 2024 at 1:19 AM
Reposted by Jeffery Hill, MD MEd
Welcome @mgottliebmd.bsky.social to the #foamed sky community… if it was okay to have a favourite researcher… !
December 2, 2024 at 12:17 PM
Reposted by Jeffery Hill, MD MEd
For those going home to visit family this weekend:

• Samsung calls it Auto Motion Plus
• LG calls it TruMotion
• Sony calls it Motionflow
• Roku calls it Action Smoothing
• Google TV calls it Motion Enhancement
• Vizio calls it Smooth Motion Effect.
November 25, 2024 at 11:31 PM
Reposted by Jeffery Hill, MD MEd
My first skytorial:

Four pearls on the diagnosis of rhabdomyolysis!

When to suspect rhabdo includes:

- hyperthermia
- status epilepticus
- crush injury
- extreme exertion (marathon)
- found down
- compartment syndrone
- kidney injury of unknown etiology
a picture of a gorilla with a gif-finder.com watermark on the bottom
ALT: a picture of a gorilla with a gif-finder.com watermark on the bottom
media.tenor.com
November 23, 2024 at 9:17 PM
Reposted by Jeffery Hill, MD MEd
My fave rhabdo tip: AST > ALT, consider rhabdo. AST doesn’t only live in liver. #foamed #medsky #emsky
My first skytorial:

Four pearls on the diagnosis of rhabdomyolysis!

When to suspect rhabdo includes:

- hyperthermia
- status epilepticus
- crush injury
- extreme exertion (marathon)
- found down
- compartment syndrone
- kidney injury of unknown etiology
a picture of a gorilla with a gif-finder.com watermark on the bottom
ALT: a picture of a gorilla with a gif-finder.com watermark on the bottom
media.tenor.com
November 23, 2024 at 9:45 PM
Reposted by Jeffery Hill, MD MEd
This month's @annalsofem.bsky.social Journal Club wades into cefepime vs. pip/tazo.

Strong opinions on both sides – but the ultimate answer is we simply don't have strong enough evidence to rely upon for estimated harms in either direction .... #FOAMed #nephsky

www.annemergmed.com/article/S019...
DEFINE_ME
www.annemergmed.com
November 24, 2024 at 7:20 PM
Reposted by Jeffery Hill, MD MEd
Severe chest pain and dyspnea for the last three days.

#ECGSky #cardiosky #EPeeps
November 23, 2024 at 8:35 PM
Reposted by Jeffery Hill, MD MEd
Less is sometimes more! 💪🏻🔥

NSAIDs have a ceiling dose. Ketorolac 10 mg may be just as effective as 30 mg but side effects like bleeding are dose-related. #medsky #pharmsky #EMSky #SkyRx

pubmed.ncbi.nlm.nih.gov/27993418/
Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial - PubMed
Ketorolac has similar analgesic efficacy at intravenous doses of 10, 15, and 30 mg, showing that intravenous ketorolac administered at the analgesic ceiling dose (10 mg) provided effective pain relief...
pubmed.ncbi.nlm.nih.gov
November 23, 2024 at 1:21 PM
Reposted by Jeffery Hill, MD MEd
Seeing big Twitter accounts that stopped posting in 2023 suddenly come back now that this place is popular
November 23, 2024 at 2:22 AM
Lets chat about teaching EM residents to be efficient...

I think there are 5 rules that are helpful

1.) Don't have unreasonable expectations
2.) Be strategic with how you interrupt
3.) Work on micro skills
4.) Let them know what you’re thinking
5.) Residents attend the huddle

#EMedSky
a cartoon character says beep beep in a desert
ALT: a cartoon character says beep beep in a desert
media.tenor.com
November 22, 2024 at 4:26 AM
Reposted by Jeffery Hill, MD MEd
Honey, stop what you're doing, new hyponatremia research just dropped!

What's it say?

It looks like slow correction is associated with worse outcomes, like death and length of stay!

Was it just a small study?

No, it was a meta-analysis of almost 12,000 patients!

jamanetwork.com/journals/jam...
Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia
This systematic review and meta-analysis evaluates the association of sodium correction rates with mortality among hospitalized adults with severe hyponatremia.
jamanetwork.com
November 19, 2024 at 4:51 AM
Reposted by Jeffery Hill, MD MEd
This is the most important chart published in America this week.

(By @dylanlscott.bsky.social)
November 22, 2024 at 3:04 AM
Reposted by Jeffery Hill, MD MEd
Hey all:
I created a new starter pack for #MedEd enthusiasts! If you know of anyone missing, I’ll add you or them until we get to 150 - just reply to this message!

go.bsky.app/8hfHZr
November 21, 2024 at 12:49 PM
Who’s the most evil cartoon character ever created and why is it Peppermint Patty in Charlie Brown Thanksgiving?
a cartoon of charlie brown and peggy sitting at a table
ALT: a cartoon of charlie brown and peggy sitting at a table
media.tenor.com
November 21, 2024 at 1:40 PM
Reposted by Jeffery Hill, MD MEd
So as I am starting all over again here, I thought I’d look back on some of my previous work/content.

Let’s begin with a Plan A Block

The Interscalene Brachial Plexus Block

Useful for shoulder/Proximal humerus surgery/Pain

Check out the video

#AnSky #RASky

youtu.be/fX_uupfw-Lw?...
Interscalene Brachial Plexus Block
YouTube video by Dr Amit Pawa
youtu.be
November 16, 2024 at 1:09 PM
Reposted by Jeffery Hill, MD MEd
Welcome all the new #Medsky users! If you haven't already be sure to subscribe to @medsky.social! It's a tool for Medsky users to give themselves labels based off of their medical specialty, and there's over 280 to choose from!

Subscribe and pick up your label to show off your specialty pride!
November 16, 2024 at 12:05 AM
Also I think woodworking is pretty dope and wrote a book combining my interest in medicine and woodworking called ‘Workshop Wound Care’ available from lostartpress.com and French booksellers now too apparently? On its way to German booksellers once the translation is complete. #woodworking #EMedSky
Lost Art Press
Publishers of books on hand-tool woodworking. All our books are made in the USA.
lostartpress.com
November 15, 2024 at 4:32 AM
Hello Bluesky.

I’m an EM doc who loves MedEd, dabbles in research looking at the impact of boarding on resident education, and mostly looks to train great docs hi you would be happy to have care for you and your loved ones.

#EMedSky ?
November 15, 2024 at 4:29 AM