My OR/ICU satellite pharmacy whiteboard on vasoactive medication management in #cardiogenicshock. What's your approach? #medsky #emimcc #cardsky
Sara J. Hyland PharmD
@sarajpharmd.bsky.social
Periop and Emergency Medicine PharmD | Homesteader, cook, yogi, mama | Peaceful free-thinker trying to do some good✌ #FOAMed #MedSky #PharmSky https://scholar.google.com/citations?user=NDd3R3QAAAAJ&hl=en
Do you have experience and/or opinions regarding sugammadex use in the ICU or Emergency department? We'd be grateful if you took our practice survey here- t.co/GHiaYoGzqK #Medsky #PharmSky #EMIMCC #FOAMed
https://redcap.ohiohealth.com/surveys/?s=CY9RLM4T9JPDKF38
t.co
Do you have experience and/or opinions regarding sugammadex use in the ICU or Emergency department? We'd be grateful if you took our practice survey here- t.co/GHiaYoGzqK #Medsky #PharmSky #EMIMCC #FOAMed
https://redcap.ohiohealth.com/surveys/?s=CY9RLM4T9JPDKF38
t.co
VTE prophylaxis in foot & ankle surgery review- www.hmpgloballearningnetwork.com/site/podiatr... How can we best use limited data and tailor ppx to individual patient risk/benefit in this heterogenous surgical population? 🦶🔪💉💊 What's your approach? #Medsky #FOAMed #VTE #FAS #pharmsky
hmpgloballearningnetwork.com
Had a great time chatting with you guys about residual NMB and reversal strategies in the ICU! Thanks so much for the conversation and for highlighting this topic. #emimcc #medsky #pharmsky
Critical Concepts@critconcepts.bsky.social · last yr.The great @sarajpharmd.bsky.social tells us how to use sugammadex in the ICU, why we should, and how many of our patients may have occult residual paralysis. #medsky #emimcc icuscenarios.com/episode-90-s...
Sugammadex in the ICU: let's talk about a *real* conundrum Everyone always talks about the use of sugammadex for failed intubations (bad idea, lets move on) But we overlook something we *should* be talking about: when we should use sugammadex for pre-extubation paralysis reversal... #1/4 #EMIMCC
a woman speaking into a microphone with the words " it 's up for debate " below her
ALT: a woman speaking into a microphone with the words " it 's up for debate " below her
media.tenor.com
💔Pharmacotherapy of Acute #STEMI 💔 academic.oup.com/ajhp/advance-a… academic.oup.com/ajhp/advance-a��� After >3 years (and just in time for new AHA guidelines 😂), our team's 2-part comprehensive review of pharmacotherapy considerations across all phases of STEMI care is now fully published!
academic.oup.com
How can we best tailor VTE prophylaxis after elective THA/TKA to patient risk, to mitigate both thrombotic and bleeding/wound complications? #orthosky #medsky #pharmsky Our team at Grant examined our current risk-stratified VTE ppx tool in our recent publication here www.mdpi.com/2077-0383/14...
Risk-Stratified Venous Thromboembolism Chemoprophylaxis After Total Joint Arthroplasty: Evaluation of an Institutional Approach
Background/Objectives: The optimal venous thromboembolism (VTE) chemoprophylaxis approach after hip or knee total joint arthroplasty (TJA) remains controversial. This study aimed to characterize antit...
mdpi.com
I'm here for #FOAMEd and #medsky #pharmsky discussions 🤓💊🏥💉✌️ Migrating in process 🐦🦋 Below is linked some previous content, Will accumulate future content here⤵️
Sara J. Hyland PharmD@sarajpharmd.bsky.social · 6y agoOriginal #MedTweetorial and #FOAMed Content Index: 1) Volume Kinetics (I.e. "how to avoid killing your patients during 'fluid resuscitation'"):2) Patient-Centered Pain/Opioid Dosing Assessment Pearls: x.com/SaraJPharmD/st… x.com/SaraJPharmD/st…
point-of-care electrolyte analyzers cannot detect hemolysis! so point-of-care hyperkalemia may or may not be real. in this case, the hyperkalemia was wholly artifactual. think twice before unleashing therapy for hyperkalemia (the ECG is often the key) (more: emcrit.org/ibcc/hyperka...) #emimcc
One of the strongest motivators driving me through the past 6-12 months has been working with an incredible team to bring this publication into existence 💪#postoppain #opioidstewardship mdpi.com/2227-9032/9/3/…
Perioperative Pain Management and Opioid Stewardship: A Practical Guide
Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. The multitude of guidance publications, many different healthcare providers involved in executing them, evolution of surgical technique, and complexities of perioperative care transitions all represent challenges to process improvement. This review seeks to summarize and integrate key recommendations into a “roadmap” for institutional adoption of perioperative analgesic and opioid optimization strategies. We present a brief review of applicable statistics and definitions as impetus for prioritizing both analgesia and opioid exposure in surgical quality improvement. We then review recommended modalities at each phase of perioperative care. We showcase the value of interprofessional collaboration in implementing and sustaining perioperative performance measures related to pain management and analgesic exposure, including those from the patient perspective. Surgery centers across the globe should adopt an integrated, collaborative approach to the twin goals of optimal pain management and opioid stewardship across the care continuum.
mdpi.com
Any periop, emergency med, or critical care pharmacotherapy topics fair game. Also sometimes implementation science / practice research, lit interpretation, or plants. 🤓💊💉🔬🌱✌ x.com/SaraJPharmD/st…
Sara J. Hyland PharmD@sarajpharmd.bsky.social · 6y agoOriginal #MedTweetorial and #FOAMed Content Index: 1) Volume Kinetics (I.e. "how to avoid killing your patients during 'fluid resuscitation'"):2) Patient-Centered Pain/Opioid Dosing Assessment Pearls: x.com/SaraJPharmD/st… x.com/SaraJPharmD/st…
Reviewer #2: "This manuscript is far too long. It must be trimmed significantly to publish." Also Reviewer #2: "Discuss these additional subtopics and add these references." 😵 please send beer
I had to miss a quality committee mtg today and a nurse colleague told me "we will miss your voice of reason and big words!" and I have never felt so complemented 😅
Latest #EmergencyMedicinePharmacy topic discussion board- Pharmacotherapy of Acute #STEMI 💔 Special thx to PGY2 @emgpharmd on the assist 💪 #EMedPharmD and/or #PeriopClinicalPharmacist friends- What is your approach?
Yes, the world is still awaiting #JusticeforBre #JusticeforBreonnaTaylor How is it over 9 months later and we're still here? 😡😭 x.com/SaraJPharmD/st… apnews.com/article/breonn…
Sara J. Hyland PharmD@sarajpharmd.bsky.social · 6y agoSeriously how are we just now learning about this tragedy?? 😢 #JusticeforBre #JusticeforBreonnaTaylor x.com/RealSpikeCohen… …washingtonpost-com.cdn.ampproject.org/v/s/www.washin…
4) Stopping bup requires reinitiation after an opioid-free period subsequent to surgical pain recovery. This is logistically challenging, and incredibly painful and destabilizing for pts, likely increasing the risk for relapse. pubmed.ncbi.nlm.nih.gov/30500943/ pubmed.ncbi.nlm.nih.gov/29452378/
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pubmed.ncbi.nlm.nih.gov
Happy Holidays! I'm starting a #FOAMed gift exchange. My gift to #MedTwitter is- 🎁5 reasons to continue your patient's #buprenorphine perioperatively!🎁
YOU GUYS I had the BEST collaborative interaction re: periop management of a patient with opioid use disorder (OUD) last week. Started with a secure group chat:
Ortho ordering preop clinda then they see me giving them the look x.com/DickKingSmith/…
#Ohio #pharmacists - please join me & my colleagues @danjames36 @emargs11 at the @OhioSHP annual meeting tomorrow (Thurs 10/22 at 0900 EST) via Zoom to discuss collaborative treatment of refractory bleeding + factor product stewardship in cardiac surgery! oshp81stannualmeeting2020.sched.com
Original #MedTweetorial and #FOAMed Content Index: 1) Volume Kinetics (I.e. "how to avoid killing your patients during 'fluid resuscitation'"):2) Patient-Centered Pain/Opioid Dosing Assessment Pearls: x.com/SaraJPharmD/st… x.com/SaraJPharmD/st…
New @EAST_TRAUMA guidelines: In ongoing hemorrhage + c/w coagulopathy ➡ conditionally rec TEG/ROTEM > traditional coags to guide blood component transfusions in adult trauma patients, adult surgical patients, and the critically ill journals.lww.com/jtrauma/Abstra…
Normalize preop ancef in penicillin-allergic patients✌
#TwitteRx- This kind shout out from a neurologist colleague got me thinking: What are some of the "non-pharmacy" jobs you've done in your career to help a patient or a colleague? 👀 @GhanaboyPharmd @ChillaPharmD @EMPoisonPharmD @PharmD_intheED @trob_pharmd et al whatchu got?
I agree no one should suggest they are a physician when they are not. I support all HCPs in advancing their training to improve patient care, increase patient access to care, and/or to make more robust/efficient healthcare teams. We cool now? #medicineisateamsport
Plus expert case reviews (SSIs, readmissions, complications) and active involvement in continuous process improvement + cost savings initiatives! Is a PharmD missing from YOUR team? 🔨🔩💊 #medicineisateamsport #teamworkmakesthedreamwork