Me hyping myself up to try, again, to place an ultrasound–guided IV
Brett Biebelberg, MD
@bbiebelberg.bsky.social
IM PGY1 @ Penn, researching sepsis @MGH/BWH, gun violence prevention advocate, EMT, via Harvard. 🗣evidence-based medicine, QI, public health, humanity in medicine. Career changer & proponent of physician leadership. #medsky #emimcc #pccm 🫀🫁
This is intern year except every 2 weeks you go back to rolling a wooden box filled with patients you know nothing about, subspecialty services you have no experience in, new attending and senior resident preferences, and bathrooms you don’t know the codes for 😀
1/ Last October, 85 people ages 1-91 developed dizziness, drowsiness, anxiety, and/or memory distortion. Some went to the ED. They'd all recently eaten at a Wisconsin pizzeria. Local public health officials investigated. As reported in last week's CDC MMWR, they found
Case-control study in @jamanetworkopen.com suggests living in close proximity to a golf course substantially increases the risk of developing Parkinson's Disease, likely related to pesticide use.
Proximity to Golf Courses and Risk of Parkinson Disease
This case-control of older US adults examines risk of Parkinson Disease by proximity of residence to a golf course.
jamanetwork.com
It's that wonderful time of year when new residents are joining the ICU team! Here are a few of my favorite @criticalcaretime.bsky.social infographics to help you understand key concepts: ⚡️Undifferentiated shock 💉 Vasopressors 😮💨 The physiologically difficult airway & 🧪 Metabolic acidosis
ZODIAC trial: For ischemic stroke patients who are awaiting thrombectomy, flat positioning reduced the risk of neuroworsening or death Premature termination but seems reasonable Statistically robust results Best available evidence; should change practice pubmed.ncbi.nlm.nih.gov/40465238/ #EMIMCC
when perfusion falls, the most vulnerable tissue suffers first. so for someone with a chronic carotid artery stenosis, urosepsis can manifest with focal neuro symptoms.
a rabbit from the secret life of pets is angry and says `` i 'm sorry ... what ? ''
ALT: a rabbit from the secret life of pets is angry and says `` i 'm sorry ... what ? ''
media.tenor.com
My palliative care elective in med school was my most impactful rotation. I’m eager to rotate on PC as a resident. It felt like another world of medicine. A reprieve from the cog-in-the-wheel, task-rabbit medicine we practice. A version that prioritizes patients, dialogue, and bedside care #medsky
Spending 3 weeks with my palliative care colleagues is such a refreshing and validating experience. To watch and learn from these experts while navigating difficult EoL questions with such patient centeredness is incredible. If you're in training, please consider spending dedicated time with them.
Could it be that simple? Hanging a folding chair on the wall in patient rooms increased the patient-reported likelihood that physicians sat at the bedside, spent enough time, and checked for understanding. shmpublications.onlinelibrary.wiley.com/doi/10.1002/... @jhospmedicine.bsky.social #medsky
Wall‐mounted folding chairs to promote resident physician sitting at the hospital bedside
Click on the article title to read more.
shmpublications.onlinelibrary.wiley.com
A 25% reduction in research funding in the US would lower GDP by 3.8%— a decline similar in magnitude to that in the Great Recession. A 75% reduction in research funding would lower GDP 11% — a larger decline than in any recession since the Great Depression. www.nytimes.com/2025/04/30/b...
Takeaways from @nejm.org acute abdomen review: ➡️ Don’t withhold analgesia ➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability ➡️ Consult surgery ASAP ➡️ Beware of cognitive bias www.nejm.org/doi/full/10.... #medsky
Takeaways from @nejm.org acute abdomen review: ➡️ Don’t withhold analgesia ➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability ➡️ Consult surgery ASAP ➡️ Beware of cognitive bias www.nejm.org/doi/full/10.... #medsky
Wellness will be when I don't have to do a module on how to use hand sanitizer
I'm thrilled to have matched in internal medicine at Penn! @pennmedicine.bsky.social Endlessly grateful for my family, friends, and mentors on whose shoulders I stand. #Match2025
Cigna and Jefferson Health failed to reach a coverage agreement, meaning Cigna is now out-of-network for Jefferson patients. Was shocked to see that Cigna's reimbursement rates have only increased by 3% since 2020 vs. an inflation rate of 21% www.jeffersonhealth.org/about-us/new...
Important Update for Cigna Members: Jefferson Health Now Out of Network | Jefferson Health
Jefferson Health and Cigna have been unable to finalize a new contract. As a result, effective midnight on March 15, 2025, Jefferson Health will be considered out of network for Cigna commercial membe...
jeffersonhealth.org
Little Prayer by Danez Smith As seen on the subway, illuminated by rays of sunset
UpToDate, feeling pressure to remain relevant in the face of popular new generative AI tools like OpenEvidence, leans into AI-powered search, but stops short of rolling out any gen AI tools of its own.
Something I didn't appreciate until the residency process: It's wrong to assume the institution where someone trained was the "best" they could do There are so many other factors––proximity to loved ones, teaching quality, schedule, culture––that can outweigh prestige when deciding where to train
Do you decompress after leaving the hospital before you get home?
I’ve been wearing a mask to see every patient these days, since it seems like half of them knowingly or unknowingly have flu A. But before I walk into the room, I always pull my mask down for a second to show my face and flash a smile. I find this makes a big difference. #medsky
@uchicagomedicine.bsky.social we wear masks for all patient care when community respiratory virus prevalence is high bc we know hcw can spread before they even feel sick.
I’ve had 4 patients in just the last week who caught influenza during their hospital stay. Maybe we should be going back to universal masking in the hospital…