Emergency Physician | Educator, Clinician, Lifelong learner @UManitoba | Passionate about Resus, Trauma, and real-life EM cases | Based in Manitoba 🇨🇦Joined April 2015
Hello #MedTwitter!
I’m Negar (Nela), a US-IMG grad of @TehUofMed and current research fellow at @UWRadiology applying for Diagnostic Radiology for #Match2026.
In my free time, I love cuddling with
my cats or hiking in the beautiful scenery of Seattle🌲
Looking forward to…
Muscle relaxants in the elderly ⚠️
2023 Cochrane review: ↑ risk of dizziness, sedation & anticholinergic effects.
2015 cohort: users were 2.25× more likely to visit ED & 1.5× more likely to be hospitalized for falls/fractures.
👉 In >65, risks often outweigh benefits.
Refs:…
Endotracheal tube as chest tube: a back-up alternative in resource limited settings
"Although certainly not advocated as standard, the use of endotracheal tubes as CTs may be a suitable alternative or back-up solution in settings where commercial CTs are not readily available."…
🧵 CRP vs Procalcitonin – Inflammation vs Infection?
Both rise in systemic illness.
But they don’t speak the same language.
Let’s break down when to use CRP, when to trust Procalcitonin—and when both lie. 👇
@IhabFathiSulima@DrAkhilX@Janetbirdope@emcrit@andrewsuleh…
🚨 NIV vs HFNC in Multiple Rib Fracture🚨
New nationwide study compared outcomes & costs in adult trauma pts with ≥2 rib fractures, no prior intubation:
🔹 Mortality: NIV 11.4% vs HFNC 17.0% (p=0.007)
🔹 Tracheostomy: NIV 1.2% vs HFNC 3.1% (p=0.006)
🔹 Pulmonary complications:…
Avoiding unrecognised oesophageal intubation
The @RCoA & @dasairway have agreed to drop ‘no trace wrong place’
The message now is that we need to exclude oesophageal intubation by identifying SUSTAINED EXHALED CO2
This requires 4 elements
-CO2 rises & falls with respiration…
Head CT in Older Patients on Antithrombotics — Are We Overdoing It?
📊 New study: 5,948 pts ≥65 with head trauma (53% on AC/AP):
•13% had ICH
•No AC/AP ↑ ICH risk
•Risk ↑ with: high fall, GCS 14, scalp impact, vomiting, amnesia, skull/facial fracture
💡 Mechanism & exam…
Here's a video I made breaking down this incredible case of a 60-year-old man who presented to the ER with a muffled voice, difficulty breathing, and coughing up blood
#FOAMed
This recent validation study from Dr. Ohle found the Sudbury Vertigo Risk Score effectively identifies the risk of a serious diagnosis in patients with dizziness and can guide further investigation, consultation, and treatment decisions.
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