Joshua Madden, MD @josh_emncc

Midwest gent PennEM Chief Resident #NeuroEMScholars Incoming Penn Neurocritical Care fellow 25-27 #EM #EMNCC #NeuroCrit #Sim #MedEd #POCUS 📍Philly Joined September 2018

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Cliff Reid @cliffreid

10 months ago

🧵 Managing Challenging Behaviours in Resuscitation Teams: A Thread for Team Leaders (1/13) Every resuscitation team leader can face difficult team dynamics Here are 6 key challenging behaviours you'll encounter and how to manage them effectively in real-time 🚨

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Joshua Madden, MD @josh_emncc

4 months ago

Having non-EM physicians frequently ask me if the Pitt is a real representation of the ED, followed by man that’s crazy! Lets me know that non-EM docs have zero clue what we do or go through. The Pitt has opened up consultants minds and is changing consultation culture.

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Anthony DiGiorgio, DO, MHA @DrDiGiorgio

6 months ago

To be comfortable as an attending physician one must have spent a lot of time being uncomfortable as a trainee. Making training comfortable means a lot of discomfort when on your own.

CoffeeBlackMD @CoffeeBlackMD

6 months ago

To be comfortable as an attending physician one must have spent a lot of time being uncomfortable as a trainee. Making training comfortable means a lot of discomfort when on your own.

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Joshua Madden, MD @josh_emncc

6 months ago

Neuro resuscitation question: Is there ever a role for vasopressors in a patient with concerns for acute stroke needing intubation and sedation but subsequently becomes hypotensive to meet sedation goals? What if giving fluids and changing sedatives doesn’t help?

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Joshua Madden, MD @josh_emncc

9 months ago

“Don’t be afraid to re-invent yourself, it’s invigorating” -Walter Koroshetz, MD

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Joshua Madden, MD @josh_emncc

10 months ago

facs.org/media/vgfgjpfk… Neurotrauma is truly fascinating—from its complex pathophysiology to the vast landscape of research and the incredible collaboration across specialties! 🧠🚨🚑 #Neurotrauma #NCC #EMCC #TBI #trauma #NSGY #NeuroResearch #Collaboration”

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Dr.Pradeep Kallollimath @drpradeepck

10 months ago

Looks like SAH, but it’s not. A case of pseudo SAH : #MedTwitter #MedX #NeuroTwitter 🧵

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Joshua Madden, MD @josh_emncc

10 months ago

Saving a life with no patient history, labs, or prior imaging is a different challenge. It’s all about intuition, quick reflexes, and thin-slicing, while applying evidence-based medicine in real-time. #SavingALifeFromScratch #EMCrit #EM #Resus

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Joshua Madden, MD @josh_emncc

10 months ago

pubs.rsna.org/doi/epdf/10.11… Most case reports I see have two common lab findings, very similar to what I’ve seen. UDS: fentanyl + stimulant CK: elevated #CHANTERsyndrome

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Joshua Madden, MD @josh_emncc

10 months ago

Is there some crazy interaction with combined stimulant and opioid ingestion? So far, in every CHANTER syndrome case I’ve seen, the UDS is positive for both amphetamines or cocaine with fentanyl. Have you all seen CHANTER Syndrome? #neurorads #Neurology #NCC #neurocrit

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Joshua Madden, MD @josh_emncc

10 months ago

Are there places to check out lectures by some of our great NCC social media educators???👀 #NCC #NeuroCrit #stroke #TBI #ICUpharm

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Joshua Madden, MD @josh_emncc

11 months ago

If you’re intubating a pt with status asthmaticus and tachycardia tachycardia, which induction agent are you reaching for? Ketamine or Etomidate or Propofol? Why? What heart rate would make you lean away from ketamine?#EM #ICU #Pulmcrit #EMCrit

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Joshua Madden, MD @josh_emncc

11 months ago

pubmed.ncbi.nlm.nih.gov/34844423/ No benefit within 6h of stroke onset (functional outcome nor EVT treatment efficacy) Not to discount its utility, but do you think CTP will become obsolete regardless of time, as the field moves toward EVT in pts w/ LVO and large core infarct?

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Joshua Madden, MD @josh_emncc

11 months ago

“As an EM doc, I play a key role in stroke codes. As a neuro enthusiast, I’m often confused when neuro docs ask for CTP in patients <6h from stroke onset, especially since the literature doesn’t support it. Stroke docs, why CTP <6h?”

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Joshua Madden, MD @josh_emncc

11 months ago

New level of respect and admiration for neuroradiology. I’m currently spending elective time with @PennRadiology , learning and growing scan by scan. I thought we worked hard in the ED, but boy do these folks grind! #newfoundpatienceforradreports #NCC #neurorads #EMCC

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Joshua Madden, MD @josh_emncc

11 months ago

link.springer.com/article/10.100… I find this diagnosis both fascinating and alarming. I’m happy that the research on this phenomenon is steadily growing.