Roberto Cosentini, MD
@rob-cosentini.bsky.social
ED physician, innate passion for learning #bedsidepearls, #FOAMed.
Urban biker, dreaming climbing and sailing
Milan
easclubbergamo.wordpress.com
Urban biker, dreaming climbing and sailing
Milan
easclubbergamo.wordpress.com
STEMI is a failed paradigm
OMI should replace it
New OMI patterns are expected, as the more recent South African flag sign (1st LAD diagonal occlusion) or Aslanger pattern (is.gd/DzYfD8)
PMCardio App may help (no COI)
OMI should replace it
New OMI patterns are expected, as the more recent South African flag sign (1st LAD diagonal occlusion) or Aslanger pattern (is.gd/DzYfD8)
PMCardio App may help (no COI)
new @NUEMblog post:
STEMI to OMI: Rethinking who will benefit from PCI
STEMI to OMI: Rethinking who will benefit from PCI
April 22, 2025 at 9:10 PM
STEMI is a failed paradigm
OMI should replace it
New OMI patterns are expected, as the more recent South African flag sign (1st LAD diagonal occlusion) or Aslanger pattern (is.gd/DzYfD8)
PMCardio App may help (no COI)
OMI should replace it
New OMI patterns are expected, as the more recent South African flag sign (1st LAD diagonal occlusion) or Aslanger pattern (is.gd/DzYfD8)
PMCardio App may help (no COI)
Reposted by Roberto Cosentini, MD
What's the best maneuver for stopping peripheral vertigo?
Did you even know there were so many???
#medsky
www.evidencetriage.com/p/contortion...
Did you even know there were so many???
#medsky
www.evidencetriage.com/p/contortion...
Contortions To Stop The Gyrations
Network meta-analyses are all the rage, vertigo edition.
www.evidencetriage.com
April 22, 2025 at 8:14 PM
What's the best maneuver for stopping peripheral vertigo?
Did you even know there were so many???
#medsky
www.evidencetriage.com/p/contortion...
Did you even know there were so many???
#medsky
www.evidencetriage.com/p/contortion...
Drainage Course at #EASClub with dr Allegri
Chest Drainage #bedsidepearls
🚫 Never close the drainage tube during pt transport
🩸Haemothorax ➡️ 28-32 Fr tube
Chest Drainage #bedsidepearls
🚫 Never close the drainage tube during pt transport
🩸Haemothorax ➡️ 28-32 Fr tube
April 18, 2025 at 1:34 PM
Drainage Course at #EASClub with dr Allegri
Chest Drainage #bedsidepearls
🚫 Never close the drainage tube during pt transport
🩸Haemothorax ➡️ 28-32 Fr tube
Chest Drainage #bedsidepearls
🚫 Never close the drainage tube during pt transport
🩸Haemothorax ➡️ 28-32 Fr tube
#bedsidepearls in Chest trauma
🩻 Severity of chest wall injuries ➡️ RivScore
🫁 Severity of pulmonary contusion ⬆️ significantly when contusions are >20%
🩻 Severity of chest wall injuries ➡️ RivScore
🫁 Severity of pulmonary contusion ⬆️ significantly when contusions are >20%
April 15, 2025 at 10:03 AM
#bedsidepearls in Chest trauma
🩻 Severity of chest wall injuries ➡️ RivScore
🫁 Severity of pulmonary contusion ⬆️ significantly when contusions are >20%
🩻 Severity of chest wall injuries ➡️ RivScore
🫁 Severity of pulmonary contusion ⬆️ significantly when contusions are >20%
April 14, 2025 at 11:40 AM
April 11, 2025 at 7:08 AM
NIV Certification Eusem Course in Lisbon, April 10-11
⏱️ The golden hour of NIV influence prognosis
via @Patrick Plaisance
⏱️ The golden hour of NIV influence prognosis
via @Patrick Plaisance
April 10, 2025 at 8:53 AM
NIV Certification Eusem Course in Lisbon, April 10-11
⏱️ The golden hour of NIV influence prognosis
via @Patrick Plaisance
⏱️ The golden hour of NIV influence prognosis
via @Patrick Plaisance
Flying to Lisbon for our 2nd NIV Certification #EUSEM Course, April 10-11
Interactive Case scenarios to boost your competence on ARF patients to treat with
HFNC
CPAP
Bi-Level
Interactive Case scenarios to boost your competence on ARF patients to treat with
HFNC
CPAP
Bi-Level
April 9, 2025 at 10:00 AM
Flying to Lisbon for our 2nd NIV Certification #EUSEM Course, April 10-11
Interactive Case scenarios to boost your competence on ARF patients to treat with
HFNC
CPAP
Bi-Level
Interactive Case scenarios to boost your competence on ARF patients to treat with
HFNC
CPAP
Bi-Level
Reposted by Roberto Cosentini, MD
Folks are really good down here at avoiding unnecessary radiography in kids — the most unusual misalignment of practice I’ve had recently are plain c-spine x-rays in older adults.
If you care enough to order the test, you should care enough to order a test that actually answers your question ….
If you care enough to order the test, you should care enough to order a test that actually answers your question ….
March 21, 2025 at 8:54 PM
Folks are really good down here at avoiding unnecessary radiography in kids — the most unusual misalignment of practice I’ve had recently are plain c-spine x-rays in older adults.
If you care enough to order the test, you should care enough to order a test that actually answers your question ….
If you care enough to order the test, you should care enough to order a test that actually answers your question ….
Reposted by Roberto Cosentini, MD
Such fun to work together @rob-cosentini.bsky.social! And so cool to share ideas beyond medical knowledge.
March 14, 2025 at 1:57 PM
Such fun to work together @rob-cosentini.bsky.social! And so cool to share ideas beyond medical knowledge.
Reposted by Roberto Cosentini, MD
Pediatric front of neck access (the surgical tracheotomy)
An approach to the can't intubate can't oxygenate scenario in children #FOAMed
An approach to the can't intubate can't oxygenate scenario in children #FOAMed
Pediatric front of neck access (the surgical tracheotomy)
Case It is the scenario of nightmares: a young child with an airway obstruction. They came in with stridor, and although you were initially thinking severe croup, the story doesn’t quite fit, there is no response to medical therapy, and this patient is incredibly sick. There is significant hypoxemia despite a nonrebreather. You can’t wait for backup, so you proceed rapidly to RSI.
first10em.com
April 7, 2025 at 11:07 AM
Pediatric front of neck access (the surgical tracheotomy)
An approach to the can't intubate can't oxygenate scenario in children #FOAMed
An approach to the can't intubate can't oxygenate scenario in children #FOAMed
Chest pain at triage #bedsidepearls from MEU School Unimi at Albino
🫀Do ECG, always
🧪 Do troponin, unless a specific diagnosis can be excluded at triage (eg: PTX via Echo)
🫀Do ECG, always
🧪 Do troponin, unless a specific diagnosis can be excluded at triage (eg: PTX via Echo)
April 7, 2025 at 8:55 AM
Chest pain at triage #bedsidepearls from MEU School Unimi at Albino
🫀Do ECG, always
🧪 Do troponin, unless a specific diagnosis can be excluded at triage (eg: PTX via Echo)
🫀Do ECG, always
🧪 Do troponin, unless a specific diagnosis can be excluded at triage (eg: PTX via Echo)
Eating Disorders #bedsidepearls via @emcases.bsky.social
🧬 Genetic disorder, trigger by precipitating factor
⚖️ No weight threshold
➡️ Best follow ⬇️ over time
Adolescents:
🫀Bradycardia/ortho hypotension:
⚠️ severity signs ➡️ Admit 🏥
emergencymedicinecases.com/eating-disor...
🧬 Genetic disorder, trigger by precipitating factor
⚖️ No weight threshold
➡️ Best follow ⬇️ over time
Adolescents:
🫀Bradycardia/ortho hypotension:
⚠️ severity signs ➡️ Admit 🏥
emergencymedicinecases.com/eating-disor...
Eating Disorders - Common, Commonly Missed, Misunderstood | EM Cases
Recognition, management of eating disorders in emergency medicine; why eating disorders are missed, pitfalls in assessment and management on Emergency Medicine Cases podcast
emergencymedicinecases.com
April 6, 2025 at 9:28 PM
Eating Disorders #bedsidepearls via @emcases.bsky.social
🧬 Genetic disorder, trigger by precipitating factor
⚖️ No weight threshold
➡️ Best follow ⬇️ over time
Adolescents:
🫀Bradycardia/ortho hypotension:
⚠️ severity signs ➡️ Admit 🏥
emergencymedicinecases.com/eating-disor...
🧬 Genetic disorder, trigger by precipitating factor
⚖️ No weight threshold
➡️ Best follow ⬇️ over time
Adolescents:
🫀Bradycardia/ortho hypotension:
⚠️ severity signs ➡️ Admit 🏥
emergencymedicinecases.com/eating-disor...
Chest Trauma #bedsidepearls
1️⃣ Identify fatal lesions
ATOM-FC
2️⃣ Evaluate Severity
TTS & RibScore
3️⃣ Treat accordingly
🩸MTP
💉 Chest Tube
🔪 Emergency Thoracotomy
1️⃣ Identify fatal lesions
ATOM-FC
2️⃣ Evaluate Severity
TTS & RibScore
3️⃣ Treat accordingly
🩸MTP
💉 Chest Tube
🔪 Emergency Thoracotomy
April 5, 2025 at 8:54 PM
Chest Trauma #bedsidepearls
1️⃣ Identify fatal lesions
ATOM-FC
2️⃣ Evaluate Severity
TTS & RibScore
3️⃣ Treat accordingly
🩸MTP
💉 Chest Tube
🔪 Emergency Thoracotomy
1️⃣ Identify fatal lesions
ATOM-FC
2️⃣ Evaluate Severity
TTS & RibScore
3️⃣ Treat accordingly
🩸MTP
💉 Chest Tube
🔪 Emergency Thoracotomy
#bedsidepearls on Multiple Myeloma at #EASClubbergamo via Dr Alessio Marra
1️⃣ 🩺 Clinical
🩻 Thoracic vertebral lesions may manifest only with abdominal symptoms
🦴 Bone lesions may ensue when MM is otherwise asymptomatic
2️⃣ 🧠 Mental
⚠️ Don’t fix on 1st diagnosis
🎛️ Take control of your reactions
1️⃣ 🩺 Clinical
🩻 Thoracic vertebral lesions may manifest only with abdominal symptoms
🦴 Bone lesions may ensue when MM is otherwise asymptomatic
2️⃣ 🧠 Mental
⚠️ Don’t fix on 1st diagnosis
🎛️ Take control of your reactions
April 4, 2025 at 5:07 PM
#bedsidepearls on Multiple Myeloma at #EASClubbergamo via Dr Alessio Marra
1️⃣ 🩺 Clinical
🩻 Thoracic vertebral lesions may manifest only with abdominal symptoms
🦴 Bone lesions may ensue when MM is otherwise asymptomatic
2️⃣ 🧠 Mental
⚠️ Don’t fix on 1st diagnosis
🎛️ Take control of your reactions
1️⃣ 🩺 Clinical
🩻 Thoracic vertebral lesions may manifest only with abdominal symptoms
🦴 Bone lesions may ensue when MM is otherwise asymptomatic
2️⃣ 🧠 Mental
⚠️ Don’t fix on 1st diagnosis
🎛️ Take control of your reactions
How to incorporate #AI into daily clinical practice
⏱️ Closer than 6 months ago
🛣️ Still a long way to go
Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses | NEJM Catalyst catalyst.nejm.org/doi/full/10....
⏱️ Closer than 6 months ago
🛣️ Still a long way to go
Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses | NEJM Catalyst catalyst.nejm.org/doi/full/10....
Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses
One year after the deployment of ambient artificial intelligence scribes, The Permanente Medical Group in northern California reports rapid growth in physician usage, highly positive experiences am...
catalyst.nejm.org
April 3, 2025 at 12:53 PM
How to incorporate #AI into daily clinical practice
⏱️ Closer than 6 months ago
🛣️ Still a long way to go
Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses | NEJM Catalyst catalyst.nejm.org/doi/full/10....
⏱️ Closer than 6 months ago
🛣️ Still a long way to go
Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses | NEJM Catalyst catalyst.nejm.org/doi/full/10....
Reposted by Roberto Cosentini, MD
April 2, 2025 at 1:00 PM
Violence pathway at our #EASClubBergamo via Antonella Mangili & Renata Colombi
⚡️ Rising tension
🧠 Deliberate violence
💧 Loving contrition
🔁 Ripetitive
#bedsidepearls
⚡️ Rising tension
🧠 Deliberate violence
💧 Loving contrition
🔁 Ripetitive
#bedsidepearls
April 2, 2025 at 1:33 PM
Violence pathway at our #EASClubBergamo via Antonella Mangili & Renata Colombi
⚡️ Rising tension
🧠 Deliberate violence
💧 Loving contrition
🔁 Ripetitive
#bedsidepearls
⚡️ Rising tension
🧠 Deliberate violence
💧 Loving contrition
🔁 Ripetitive
#bedsidepearls
☠️ Methylene blue in methemoglobinemia
From clinical pharmacologist Pharmacy Joe —> pharmacyjoe.com/episode1009/
💉 1–2 mg/kg IV over 5 minutes of methylene blue immediately if levels indicate administration
⏱️ After treatment, MetHb levels on blood gas (ABG) are no longer reliable
#bedsidepearls
From clinical pharmacologist Pharmacy Joe —> pharmacyjoe.com/episode1009/
💉 1–2 mg/kg IV over 5 minutes of methylene blue immediately if levels indicate administration
⏱️ After treatment, MetHb levels on blood gas (ABG) are no longer reliable
#bedsidepearls
March 31, 2025 at 7:14 PM
☠️ Methylene blue in methemoglobinemia
From clinical pharmacologist Pharmacy Joe —> pharmacyjoe.com/episode1009/
💉 1–2 mg/kg IV over 5 minutes of methylene blue immediately if levels indicate administration
⏱️ After treatment, MetHb levels on blood gas (ABG) are no longer reliable
#bedsidepearls
From clinical pharmacologist Pharmacy Joe —> pharmacyjoe.com/episode1009/
💉 1–2 mg/kg IV over 5 minutes of methylene blue immediately if levels indicate administration
⏱️ After treatment, MetHb levels on blood gas (ABG) are no longer reliable
#bedsidepearls
My barbers shop in front of Colonne di San Lorenzo, downtown Milano
If this isn’t nice, what is?
If this isn’t nice, what is?
March 30, 2025 at 3:45 PM
My barbers shop in front of Colonne di San Lorenzo, downtown Milano
If this isn’t nice, what is?
If this isn’t nice, what is?
Leadership pearls via @roborman @stmuluspodcast —> t.ly/hqzHj
1/2
1️⃣ Listening is key to Lead
2️⃣ Prioritize. Not all problems need an urgent response
3️⃣ Vision + Patience + Respect are key to succeed
4️⃣ Be ready to judge, even if you don’t like it
1/2
1️⃣ Listening is key to Lead
2️⃣ Prioritize. Not all problems need an urgent response
3️⃣ Vision + Patience + Respect are key to succeed
4️⃣ Be ready to judge, even if you don’t like it
147. Your First Leadership Role? Start With These 8 Principles - Orman Physician Coaching
Leadership is hard. Here are eight ways to do it better (without losing your mind).
roborman.com
March 28, 2025 at 6:21 AM
Leadership pearls via @roborman @stmuluspodcast —> t.ly/hqzHj
1/2
1️⃣ Listening is key to Lead
2️⃣ Prioritize. Not all problems need an urgent response
3️⃣ Vision + Patience + Respect are key to succeed
4️⃣ Be ready to judge, even if you don’t like it
1/2
1️⃣ Listening is key to Lead
2️⃣ Prioritize. Not all problems need an urgent response
3️⃣ Vision + Patience + Respect are key to succeed
4️⃣ Be ready to judge, even if you don’t like it
Bi-monthly Simulation at #EAS Club Bergamo
☠️ Organophosphate intoxication of patient, paramedic and Team leader
🏁 Great challenge for our EM residents
🏥 Look at our group activities —> easclubbergamo.wordpress.com/attivita/
☠️ Organophosphate intoxication of patient, paramedic and Team leader
🏁 Great challenge for our EM residents
🏥 Look at our group activities —> easclubbergamo.wordpress.com/attivita/
March 26, 2025 at 6:26 PM
Bi-monthly Simulation at #EAS Club Bergamo
☠️ Organophosphate intoxication of patient, paramedic and Team leader
🏁 Great challenge for our EM residents
🏥 Look at our group activities —> easclubbergamo.wordpress.com/attivita/
☠️ Organophosphate intoxication of patient, paramedic and Team leader
🏁 Great challenge for our EM residents
🏥 Look at our group activities —> easclubbergamo.wordpress.com/attivita/
My two teaching mantras:
“You were not made to live like brutes, but to follow virtue and knowledge.”
Dante Alighieri, XIV century
“One should not teach thoughts, but teach how to think.”
Immanuel Kant, XVIII century
“You were not made to live like brutes, but to follow virtue and knowledge.”
Dante Alighieri, XIV century
“One should not teach thoughts, but teach how to think.”
Immanuel Kant, XVIII century
March 26, 2025 at 9:13 AM
My two teaching mantras:
“You were not made to live like brutes, but to follow virtue and knowledge.”
Dante Alighieri, XIV century
“One should not teach thoughts, but teach how to think.”
Immanuel Kant, XVIII century
“You were not made to live like brutes, but to follow virtue and knowledge.”
Dante Alighieri, XIV century
“One should not teach thoughts, but teach how to think.”
Immanuel Kant, XVIII century
Dyspnea #bedsidepearls
3️⃣ signs of respiratory distress:
# 1 tracheal tub, inspiratory
# 2 jugular retraction, inspiratory
# 3 supraclavicular retraction, inspiratory
3️⃣ signs of respiratory distress:
# 1 tracheal tub, inspiratory
# 2 jugular retraction, inspiratory
# 3 supraclavicular retraction, inspiratory
March 24, 2025 at 9:35 PM
Dyspnea #bedsidepearls
3️⃣ signs of respiratory distress:
# 1 tracheal tub, inspiratory
# 2 jugular retraction, inspiratory
# 3 supraclavicular retraction, inspiratory
3️⃣ signs of respiratory distress:
# 1 tracheal tub, inspiratory
# 2 jugular retraction, inspiratory
# 3 supraclavicular retraction, inspiratory