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https://t.co/H8tTISK4Eh @queenspm_r @SEAMOKingston @QueensUHealth @providence_care Awesome, @jesstrier!!! WOOTTTT @mjbeyak @acweyand Hey there! We Emerg docs take a yearly certification test to ensure that we intepret the blue dot correctly... and now you're telling me it's not worth it??! Wondering why things are changing with the AZ vaccine?Check out this clear and concise summary. Here is the Ontario COVID19 Science Advisory Table's guide for ED physicians seeing patients with symptoms following A-Z vaccine, published yesterday:
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https://t.co/SA029CWS3d @gurnseymom https://t.co/oQ4g6lY51M
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Quote tweeted this for you. 4-28 days is risk period. Very rare. Ontario COVID19 Science Advisory Table has a website with super useful science briefs: here is their summary for the vaccine-induced blood clot. (They say risk period is 4-28 days after shot)
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ERROR: type should be string, got "https://t.co/oQ4g6lY51M We need to take an airborne spread approach to minimizing COVID19 community spread in today's @globeandmail https://t.co/t9LfmaBFsv Southwestern Ontario (Guelph) reporting in with mandatory square dancing in gym class in the (cough) 1970s everywhere thread about #ygk covid outbreaks from @MOHKFLA presser there can never be enough of these OK I am HERE for the types of papers memes. see also syphilis and epididymitis... Thread regarding COVID19 in #ygk Thanks for this - I have also just donated. Helped me feel like I was doing something tangible to offset the horror of the news reports. Time for a plug: highly recommend the “Five Things to Know” series in @CMAJ (COI: I am an editor). Never recognized the treasure trove of info stored there... check it out! At 300 words, it’s easily digestible + high yield content. @AAMorra13 My best meme... Nice presentation to guide online teachers - 10 rules for slides. Canada can’t stand by while India’s medical system collapses https://t.co/4vCI9UEQYS I cannot amplify this enough. Interesting take on collecting diverse opinions - find people who disagree with you will help you make better decisions https://t.co/ENnj13uoQD @JHowardBrainMD Same! This man is a national treasure. I’m rapidly becoming @JillianHortonMD’s biggest fan. https://t.co/R3OEb6tIqC @MIHomeYGK I think you will need a new icon for that one... I regularly use a fax machine. In (checks notes) 2021. @HayleyManlove And we are thrilled to have you!!! @EnswellJones Look, Chris, *I’m* not judging you. But honestly? It kinda looks like Jeff is... @EnswellJones Are you sure you weren't eating chips? @Qemerg has always had this kind of support. It is one of the things I value most - the *unconditional* step up to take on shifts when someone has a crisis. No matter who, and no matter what. I'm just so constantly grateful for my colleagues. and Kingston. #ygk @JenniferA_Ma Awww, thanks! How awesome!! Thank you. An outstanding educator with massive influence - congratulations @sherbino!! Great to see an Emergency Medicine leader honoured with this. I love these so much. These TikToks are at the top of my pandemic survival kit. (Also Bill, I get you - hang in there!) @SchulichMedDent @daniellekelton @WesternUEmerg Awesome to see this, @daniellekelton!! @RichardLehman1 I’m so sorry. There are no words for this loss. Sending you strength and solace. Super protective cloth mask that raises money for CHEO. Great idea. @salut_galarneau Thank you @salut_galarneau @loleen_berdahl Enjoyed reading these and have subscribed. Thx for seeing inside my head! not...reassuring @loveovercovid Thanks for educating me! Awesome. @loveovercovid That's nice of you, thank you. But I don't need anything - feel free to make a donation instead to people who do, or just go and support a local business. Many people in our community struggling right now. @jezcarreiro Thanks for that. (I’m a freelance complainer too...haha) @swseanag @kmbrleyn Nice! Thanks to both of you! Very sad. Not unexpected and unfortunately necessary given yesterday but still. Another loss for #ygk in a year of losses. @Qemerg - interesting opportunity! Maybe you can hit up @film_md for tips... Amplifying this - thanks Eve. I just spent an hour with a garbage bag picking up some of the waste. As a #Queensu alumni + professor I'm generally pro-Queen's. But I'm angry about this desecration of our beloved #ygk waterfront. And as an ER doc I'm terrified of the 3rd wave and these gatherings. @Qemerg - resources This is chilling 👀 this thread. 100% agree Twitter thread with notes on regional LTC issues @jgordonboyd This happened to me last week. Had a *blissful* meeting free day and then realized it had not, in fact, been meeting free... Ouch. This is... not good great thread updating #ygk on our current status from presser with @MOHKFLA This is a thoughtful conversation about the role of men in ending violence against women. https://t.co/iWWAmIXaG7 @acweyand Honestly it should be mandatory after Daylight Savings... @DGlaucomflecken I wondered... but wasn’t sure. Now that you say that I totally recognize him. outstanding thread on heavy menstrual bleeding in adolescents He deserves all the kudos. He and his hard-working staff are the reason we are green right now. Yes. And both are amazing women with a record of high quality care for our community. I've just spent 5 minutes digesting this. What a story. @jmugele I may have heard this phrase aimed at me once or twice... I've learned to wear it proudly. Means you feel things strongly and are passionate about what you believe in. @DrDmytrash yeah. I remember - like it was yesterday even though 30 years have passed - a rotation where the attending clearly didn't like me and it was just awful. @EMResUBC looks great, gang - Nice to see a few familiar faces! The \"hanging out with...\" series is PURE GOLD"
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Also it reminds me to remember that med students are constantly trying to figure out and fit in with the rotation vibe - challenging, stressful and exhausting. @AAMorra13 and completely random bizarre Harlequin Romance novel covers And while we are at it - innovative ways to bring natural light into basement EDs exist - makes such a difference to patients and staff... @brittp_27 Is that the day where it's like 5 degrees and people are in flip flops and suntanning on the remaining snowbanks like it's a beach in Brazil? And obviously by “tales sins” I mean... actually I have no idea what I was trying to say there. Reasons?!? Quite a useful short article that unpacks the tales sins for zoom fatigue and offers some solutions. A good thread from a medical student on the positive clinical teaching habits she’s planning to adopt as a resident. @TabathaSouthey Same Tabatha. I've become pandemic Rapunzel. @QueensPostgrad @AAMorra13 Video in hug form. Nice work @joncluett The only possible answer to this is @EnswellJones
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If you aren't following him, you are missing out. Every Friday a new twitter story thread drops. I have laughed to the point of crying, gasping or both. Thank you. A little part of me died when I saw this. Today's required reading - an absolutely fabulous piece on how to move towards gender equity in Canadian medicine from the @CMAJ (plus why it's important)
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https://t.co/z57aANEwxO @DrMalaJoneja @jgordonboyd Mala. We will@always have time for *your* emails.”! @jgordonboyd I like this modification! @schuklenk Email hard for shift workers on different schedules - my colleague @RangLouise has a signature that reads in part “my schedule is probably not the same as yours” to reassure ppl when she emails weekends/evenings. New thought. “In these unprecedented times, I will only be able to respond to emails Wednesday between 9 and 11. I appreciate your understanding.” Hey Canadian EM physicians: Please consider taking this survey on gender equity in Canadian Emergency Medicine. It will help us see where we can focus our efforts to level the playing field. https://t.co/yfXNymBtOJ @itsaeuphemism Rob. I may have to disown you. Noooo please help and don’t let Come on Eileen best out the greatest song ever.... Vote! Vote! Vote! @DrPoorman Just finished reading it actually. Twitter book club? Message to voice mail recorders everywhere. I think we all know that these are “unprecedented times” and that there is a “covid19 pandemic.” Please feel free to *not* include this on your voicemail. @signindoc @AAMorra13 guilty as charged @AAMorra13 did you notice "male" under surgeon? Also applies to emergency physicians.... @AAMorra13 @adamcifu sunglasses emoji @adamcifu I would add that RCTs cannot reliably measure harm, particularly unexpected harms from an intervention, because they are not powered to detect them. They are powered for efficacy. We use the Vioxx example in class to talk about this. @HumanFact0rz @DrHarryThomas I actually think it should be "that's not unreasonable" Australia recommends, for both men and women, a max of only 7 Canadian-standard sized drinks a week. The guidelines in the Netherlands recommend cancelling happy hour altogether: Zero is best, they basically say, but if you choose to drink, stop after one. https://t.co/shCW8YJyHg Worth a listen this morning. Two thoughtful physicians who have been bright lights during this pandemic. Lots of familiar faces here!! Love this Love this and would love to try. It’s exhausting to pretend to be interested when you’re under stress as a learner. I’ll never forget the anesthetist who wrote “lacks intellectual curiosity” on my student eval bc I couldn’t answer any of his v specialized Qs + I ran away when he wanted to do more “teaching” @DavidClinkard Oh so much that @BuddingSprout @signindoc Ahhhh I deeply miss it. Moved around from Crave to KingstonCoffeeHouse to Balzacs. Super productive in coffee shops... the smell and background buzz. Sigh. @signindoc well... i miss sitting and working with a reusable mug of lovely espresso. I think thats environmentally ok? Short break but the #Berniememes are back. @deAdder The obituary is a masterpiece and paints a vivid and funny picture of a deeply loved woman. The affection and admiration you had for her shines through every part of this. and meals at restaurants And libraries I miss coffee shops so very deeply @Damonjdd1 Happy Birthday Mae!!! You have brought your family so much joy. I hope you are able to have some fun, even while locked down. 🎉🎂☃️ Small break from Bernie memes for a true Canadian legend. PSA: This is now just a Bernie meme stan account...
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Can't stop won't stop @ejblackmore @KingstonHSC kind of like this https://t.co/oKt9itGoUS hahaha #Qmed Bernie at City Hall. #YGK https://t.co/YFrW5GjUSP @VanessaGiuliano It was the only possible outlet for my HUGE joy at seeing the 2022s start clerkship! This is quite the read. The most entertaining thing so far today. And it's not a Gen Z pile on (title suggests that but worry not) @DanJMulder1 I feel you, Isaac's snowman. Me: trying to open hospital care program from home using 15 ultrasecure steps/passcodes etc etc etc
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sigh It’s day 689 in the “after time.” I’m trying to eat a salad with a plastic spoon by myself in an isolated corner of the hospital because, covid. I never noticed eating lunch with colleagues and cutlery. I realize this a minor thing but wow, I miss the before times. This is completely applicable to Ontario. Worth reading. OMG yes - come on #YGK, this is the 2021 distraction we need... naming our snowplow fleet @jgordonboyd @JAVanderlinden @QueensuDOM @QueensU_CNS Hey - read the abstract and that's pretty cool Gord! Congratulations to all of you. @MaryFernando_ @jonathanstea @jkwan_md @Billius27 @DennisKendel @Kidsdoc1Rick @AmyTanMD @KariSampsel @nilikm @IacovosMichael Thank you. We need to keep talking about this. Emergency physicians have been drawing attention to this for a very long time. ED overcrowding is dangerous and not caused by inappropriate use of the ED but by lack of inpatient beds. @CAEP_Docs @alandrummond2 @jkwan_md @NightShiftMD @maureentaylor31 @drgigiosler @MarciaJAnderson @nilikm @JillianHortonMD @SCBriand @DorisGrinspun @syramadad @HelenBranswell https://t.co/losCJ0n1ig @DrJenGunter @manitobahydro An actual lol at this thread. Thanks for sharing @elamin88 "the light at the end of the tunnel grows brighter every day" but "we must remain vigilant" @elamin88 ...my friends @elamin88 Everything about this is fingernails on the blackboard... the Cov-ed, the cliches, the fingerpointing.... @lysalomax We should start a series - @DeiselKain's son had similar thoughts... https://t.co/zsZKDeU2UB @lysalomax This is amazing. I love the random EEG insertions to the Bla Bla Bla. A paramedic legend and a salt of the earth, stand-up and all around good guy. Happy Retirement, Graham! Please, on behalf of Emerg staff and other holiday health workers... in your Dec meetings don’t assume that everyone there is about to have a “holiday break.” Many of us are gearing up for the busiest shifts of the year, and covid is surging. We’re anxious + we aren’t on holiday. @DavidClinkard @DavidBarbic @BCEmergMedNtwrk @CAEP_Docs @Providence_Hlth same tbh What’s that sound? Oh it’s the stampeding of ER, IM and ICU doctors towards the vaccine... sleeves up and ready, indeed. @Klodiana23 Thanks Klodiana... this was a task and a half, for sure. I’m relieved it worked out! And so happy that they found the course useful. @stuartkatherine Ha. I have unfinished business in New Zealand - time for another sabbatical I think!! I wish I lived in New Zealand.... This is just amazing and I am thrilled to see it. Congratulations to a rock star colleague, researcher and advocate for women around the world! @susanabartels
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https://t.co/ybIW355Hnp @drsaminaali I may have become a little teary.... @girlyratfish Quiet sunset on Lake Huron https://t.co/A1dUgtOulD Congratulations @DrAnneEllis!! Really well deserved. 🎉🙌🎉 Enjoyed this. Crayon bracket time. See below for rules. @DavidBarbic @CJEMonline @BCEmergMedNtwrk @CHEOSNews nice work, David and co!
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(I love the Just the Facts series) Oh... absolutely!! Nice one. @driveinsaturday @MIHomeYGK love it Obviously the lead plow Oh I think we need to step up here #ygk. @MIHomeYGK any thoughts on a campaign to name the Kingston fleet? Because this is just amazing. Another 15 for a total of 75 active cases. Blergh. @DrPoorman Can I fax you my response? @DrPoorman Do NOT say that it’s quiet here... sigh Nice thread here on trauma coagulapathy @Karen__Moffat @james_paulad ^^^ what she said! Oh this is really worrying Have not fainted since then. (I see quite a lot of blood in my job as an emergency physician). Just wish the doctor I’d been with that day had reassured me instead of laughing at me. Would’ve saved me months of significant worry that I wasn’t cut out for medicine. 2/2 Fainted on my very first day of med school after watching a patient with horrifying bleeding. Was terrified they’d kick me out if they found out about my “blood problem.” Exposed myself to blood whenever possible. Months later I discovered fainting can be from strong emotion. 1/2 31 years ago. I remember it vividly.
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Two female Deans of Engineering profile some of the successes of women in engineering since then in this article, and it’s inspiring to think about that on a somber day. Thoughtful piece on intimate partner violence and gender-based violence. https://t.co/Uus2hEOvbD I think that @andrewjtagg needs to see this... #dontforgetthebubbles yup. ouch. the direction here is...not good @PlanetinFocus @signindoc Soooo good Wow - take a look at this issue!! So many must read papers here for anyone interested in #meded
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Thanks @Jeff__Riddell for the tip. Nice thread on ASA. The British seem happy about this - I’m not a biologist but think they can be really destructive if unchecked... maybe @QUBS_Director @RKDanby have thoughts about reintroduction? https://t.co/05lT0BsZia Endorse! #CARL truths, #Qmed! 😬 @ETtube @First10EM @ASPphysician @SharkawyMD @EMCases @DavidJuurlink Septra + ACE/ARB/renal impairment can cause hyper K
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Beware! @VonAnneli A robust faculty development program should be focused on this - if we made it part of our routine I think it would help a lot. Also need step down strategies for older faculty (but that's a different thread) @VonAnneli This is a real problem that often goes unacknowledged. I started doing the airway teaching in our sim lab to try to keep my skills up. (and in a sign of how old I am, used it to learn VL when it arrived...). @SciencePharmer Hidden expert in the crowd! Agreed - this was great. Some familiar faces too! @RKDanby @QUBS_Director @AnneLougheed This is good news! Hang in there KFLA.... I endorse this methodology @TChanMD @movinmeat also what if (and I'm really just spitballing here, hypothetically) you had more than one calendar on the go... @TChanMD @movinmeat wh...what?
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you are officially my tech queen and I bow in your presence @DrAnneEllis I have doodle polls duking it out against each other for my offered availability. Maybe we need fewer meetings? @movinmeat i like the way you think Doodle Polls: miraculous tools for connecting at optimal times or the scourge of modern organizations? Discuss. @RVeldhoen @AKHallMD @Qemerg @dwmessenger @Damonjdd1 @chaplintim @RangLouise Did they by any chance involve the town of Lacombe, Alberta? @Qemerg grads know and love those tales... (some of them might even be true!!) @jen_crichton You *are* Yoda - so much wisdom to share that you may not even recognize. I’m sure you were totally inspiring. @Jodie_Pritch @CAEP_Docs Thanks Jodie! @mykkymcg @rajivthava @KrishanYadavMD Suspect they are less expensive than a lot of the tests we order without thinking - BNP, hs trop, X-ray series etc. Better to do a culture than spray antibiotics mindlessly at everyone with an abscess. @TheSGEM @KrishanYadavMD Aw thanks Ken! @tysonsavage_ Thank you - how are you?!? @KrishanYadavMD Thank you!! (And nice to hear from you - hope all is well!) That was fun!! @KariSampsel @AKHallMD @Qemerg @dwmessenger @Damonjdd1 @chaplintim @RangLouise omg so classic @KariSampsel @AKHallMD @Qemerg @dwmessenger @Damonjdd1 @chaplintim @RangLouise pretty sure he actually wanted to send in an action photo - swimming or biking! @robertohle @kovacsgj @jeff_what Same!! A well deserved acknowledgement of an oversized contribution to Canadian Emergency Medicine. Legendary!! Congratulations to both of you research rock stars!!! @TopsyFarms @wendyeforbes Noted and now on my list - thanks!! @wendyeforbes Second shoutout for @TopsyFarms who I had not heard about - thanks!! @CKWS_Shauna The pickle present?!? (I have never heard of this but... cool!) @CKWS_Shauna beautiful! (although I will need someone to explain the Santa Pickle ornament to me....)
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So many gorgeous things. @docguerin Ok just enjoyed browsing that - loving the custom crayons! Hey #YGK... anyone want to hit me up with your best "buy local" gift ideas? I need some inspiration for this season and amazon is not it. goodbye I am going to spend the next week practicing making lung cookies @sbuttemer CONGRATULATIONS!! We have been seeing this for years in the ED - so many patients who cannot get family doctors. It is a huge barrier for health. @MDaware if the borders ever open this could be your new house wine... https://t.co/wv3BhfqMsG Looking forward to this! @Dr2NisreenAlwan @Laconic_doc Princess Bride @WesternUEmerg @Mase911_ @watERmbrad @mikeclemente88 @aaronstone2015 Congratulations Mason! (and to your colleagues also) #frontlineworkers @choo_ek I am always here for you Esther. (although tbh your election is causing me to require my own emotional support Canadian...) posting without comment OK. Resetting today's intentions by thinking about how to be a helper - anyone have adult warm coats they can donate? @veroniac @AuforGA Ah that's the best thing I've read this morning. Thanks for posting - and congratulations @AuforGA!! @MDaware I endorse this plan @DrLindaDykes @Psynian @ShaunLintern @mancunianmedic @Trisha_the_doc @DLGDen Thank you for giving me the joy of #redscrubsman on a day when I needed a laugh and some distraction. Perfect! A 9 point version! Best thing on twitter this morning Looks like this might be really useful. Unfortunately there is a paywall. @MDaware @DrJenGunter All are welcome!! (Kingston is a lovely place to live and work if you’re interested in trying out Canadian Snickers bars) @murray_deem Omg I’m on my way over.... look at those! Great to see this and to see the work we’ve done at Queen’s showcased. Congrats to @LaurenMaggio on this! @queensu @Queens_UGME @JillianHortonMD - would you be willing to send a short message or record a short video to mark the occasion of our 3rd year medical students at Queen's starting their clinical learning? This "white coat" ceremony will happen in mid-January. Send me a DM if interested. Thx @picardonhealth - would you be willing to send a short message or record a short video to mark the occasion of our 3rd year medical students at Queen's starting their clinical learning? This "white coat" ceremony will happen in mid-January. Send me a DM if interested. Thx. @guygavrielkay Currently working through it - she is mesmerizing! I like this exercise: “what is a reasonable range of views?” @drpmacpherson @angiesalomon Here’s my opinion: the ED is no place for costumes. Period. If you feel the urge to celebrate Hallowe’en, feel free to wear some festive socks or a black and orange T-shirt underneath your scrubs. @alandrummond2 Oh Al. Good luck, and take care of yourself. Sad to hear this. Oh this is a very nice thread. #CARL 'Psychological PPE' is what Britain's health professionals urgently need now https://t.co/gYU42MsIbA Response from their publicity fail. Nice to see an acknowledgement and apology with concrete steps moving forward. Hoping they can move forward and earn the trust back (as they say). No. This is not and should not be a thing. Writing reference letters is part of the job of an academic. @shainadrummond @wearfigs @thestyleclique Was going to say exactly the same thing. Thank you. @FrannyCrawford1 ❤️ @Mimiblanc73 Oh - Thanks for that. @RobsonJulia Yes - dying in covid times means the loss of rituals and gatherings. Amplifies the sadness, somehow. Thanks Julia. @TabathaSouthey @uofg Thanks for that much needed smile, Tabatha. XO My Dad was a kind and lovely man. And so many other things. I will miss him forever. https://t.co/qAbn4ksN4V @AnnetteHay1 @MattCheungMD @CDNCancerTrials @CIHR_IRSC congratulations, Annette!! Awesome news. @BlairBigham @united @flySFO Congratulations!! @rojasfec @SciencePharmer We had a discussion in the classroom about pros/cons of guidelines. Main con = financial COI. To be clear - Did not endorse “shooting from the hip”! @SciencePharmer Agreed. Hope you found our discussion interesting. Same Loved reading this. Poignant and well written. Nice thread on a brand new RCT on intermittent fasting (“time restricted eating”) - worth a look Nice blog summary of evidence around exercise and falls prevention for older patients. @MCG_MedEd @ChrisFrankCOE #Qmed Love this one. Buckle up everyone...
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COVID-19 outbreak hits Western University as five students test positive https://t.co/lDP6UsIpgv Tbh I have never wondered this. But regardless, an interesting tweetorial. @MDaware @FutureDocs https://t.co/tYX3VCemu5 @MDaware @FutureDocs I’m just going to go ahead and start calling you Associate. Seems like a slam dunk tbh. A lovely start to the day - watching paediatricians talk about their job.
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@bob_connelly check it out! Chest tube drainage box thread - useful Read the article last week and these letters are also moving. Worth a few minutes.
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'You've given me new perspective': readers on Elliot Dallen's terminal illness articles https://t.co/bbkQX09qrD @Jeffmasuda @queensu @cityofkingston @MOHKFLA Thanks for writing this. Exactly echoes my feelings. “In the past week, students have descended en masse to the city. They have shut down our beach and they have treated our neighbourhood like a giant outdoor bar. They have... turned the entire University district into some kind of pandemic outbreak incubator.” Another senseless tragedy from our roads, which continue to not be safe for cyclists. Hey @mjbeyak I think this is what you we’re getting at. Interesting take!
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ERROR: type should be string, got " https://t.co/0fnCHqjh0O @mjbeyak As for me... my middle aged indignation expands to adapt to any occasion. If you need more, let me know! lol @mjbeyak Not sure, Mike. I know there was a brief attempt to enforce distancing that failed. I'm devastated as a neighbourhood user of an amazing resource now unavailable to me. Don't want to undermine public health + FTR was taken aback by the crowds at the pier the last few days. This is devastating. Understand the rationale but at the same time heartbroken. We’ve been loving the swimming in the morning and evening when there aren’t crowds. Our public health heroes are suddenly under attack. And it’s wrong https://t.co/YNffH8Kifd @MaggieHulbert I think it has to do with organization. And no, my inbox doesn’t have 8000 emails living free of files and labels, why do you ask?! On a meeting where we are discussing \"email hygiene\" and sadly this is me: https://t.co/NBBeXWL1B8 Clearing Ontario’s surgery backlog could take over a year and a half, study shows https://t.co/kO4QxIZiEY Sad news. If you haven’t seen his TED talk (discussed in this obituary) it’s well worth your time."
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https://t.co/jQ91GyCRwt As first female chair of neurosurgery, Gelareh Zadeh will steer training of the next generation of neurosurgeons https://t.co/ufzGPsZj3M Endorse this plan. Twice a year hospital have tremendous disruption with time stamps, screwed up shifts and record keeping... for what purpose, exactly? Most of you (smarter people than me) probably know this. But here's a PSA, just in case.
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*if you are screen sharing a document on zoom and someone texts you, and you open the window, everyone on your meeting can watch your text conversation*
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#awkward this is 100% truth @inkib Oh Ben - I don't know you but your tweet was on the top of my feed. I can't "like" it - feels too flippant for something this raw and profound. I so hope that you and your loved people can squeeze meaning and maybe even some joy into the time you have left. ☎️ Hello, cardiology? Paging
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@adribaran @adribaran @Damonjdd1 @EAEisenhauer @RangLouise @drgigiosler @jacindaardern @DrAnnieHuang @helenbevan @GalaBaranchuk @AcostaRaimondi @clara_clarais @lucreciamburgos @Lukazelian @Misosaliprandi @DrAnneEllis @DrGDigby @DrMalaJoneja @DrMarthaGulati @purviparwani @aracelilm @EstelaRolon1 @LuzCabral3 @ClaudiaAlmont17 @Mdelsueldo @MujerSIAC @james_paulad @QueensuDOM @paomorejon @ValeriaRoman @Marian_Carbajal Thank you Adrian! 🙏 @DrGDigby Good luck! I’m serious, let me know if you need anything. Happy to help. @andrewjtagg one for the (growing) LEGO file I felt this way too. It made me cringe. But there aren’t enough female full professors, so...
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I was supported and encouraged by many colleagues inside and outside my department and I’d like to pay it forward. Please reach out if you are thinking about applying or have questions. I was Obama’s Ebola tsar. US healthcare workers are dying at a shameful rate https://t.co/Jxlz6vEkd5 Decolonising dermatology: why black and brown skin need better treatment https://t.co/JmquFHjVnj @bleep_boop1 @alandrummond2 congratulations, good luck and hang in there!! Repeat after me: This is an emergency https://t.co/bssgpMOcZM This is a really interesting convo if you’re interested in research and medical students. Wow. Just read this new structured review on PE from @bmj_latest - this is an excellent summary. Oh, this is a must read. Thanks @hosaysaid for digging deep for the rest of us. @YoniFreedhoff Ha I was wondering the same thing... @kieranlquinn @AmolAVerma I wondered the same thing! This is so sad. And frightening. I love this so much. Thanks for sharing! @TamaraMcColl @SSHorg @AKHallMD @chaplintim @Brent_Thoma @petrosoniak @c_forristal @georgemastoras @drcaners @jameslhuffman @Adam_Szulewski @christadakin @UManitoba_Emerg @UManitobaCPD @um_research @UM_RadyFHS It looks great - congratulations!!! I wonder if COVID-19 has caused people to refrain from providing bystander cpr - delays in chain of survival due to fear of close contact. Part of the equation? A study about Canadian surgical training - and the ED was identified as a common location for gender- based harassment for trainees. @lysalomax Everyone needs a “kind thoughts for hard days at work” jar. How lovely!! Very nice work!
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Diagnosing acute aortic syndrome: a Canadian clinical practice guideline | CMAJ https://t.co/yUsf05IAlF @charlesweijer @Andrew_McRae_EM @UCalgaryEM @westernuepibio @SchulichMedDent @CAEP_Docs Congratulations, Andrew!! @DFisman @EAEisenhauer @janephilpott @QueensUHealth @hockings Omg - your mom is Sandra Fisman? She was one if my favourite profs at Western. I did a child psych rotation with her and loved every second of it. A good teacher can transform a rotation for a medical student. @robertohle @ScienceNorth @Northern_Heroes @CTVNews @CBCNews @cbcmarkus @CBCSudbury @SudburyStar @GreaterSudbury @Katie_s_allan @NickelBelt @HeartandStroke @Ilcor_org Love this!! @drsaminaali I get you, Hercules Mulligan. I get you. @drsaminaali Is he on your Zoom call? Amazing. @drsaminaali Huh. Is the *snake* um.... affectionate?!? @AlexandraMazur1 I’m really sorry to see this (and even sadder that you have to read emails like that). I’ve really appreciated your coverage of the Covid19 pandemic in Kingston and wanted to send you some online thanks for your hard work. Hang in there! This is a great animation. @robertohle @sarah_mcisaac @HSN_Sudbury Congratulations!!! What a great award - keep on inspiring us! @trishgreenhalgh I’m sorry you’re receiving these messages. Thanks for your efforts in researching + disseminating findings. Super useful. @AnnaBatchelor Shadow. @JonathanRose 😬😊 Same tbh @ChrisFrankCOE @queensu Does it need revitalizing? I love it as it is. Happy to think about it though... @kerstindewit Winston! 😍 @KariSampsel @emergmedottawa yay - congratulations!!! @OHSUEmergency @choo_ek @OHSU_CPREM Congratulations, Professor!! Hey #Qmed - step 3! A critical part of the critique which is often overlooked. your time wasting thread for today... I'm sure theres a lesson in here about cognitive bias but not quite sure how Awesome - I was just thinking that we needed a *new* virus to stop us from getting too complacent... 🦠 😬 yes - this this exactly this. @NeelaJan @Aidan_Baron I add dehydrated fruit sauce (applesauce, apple blueberry, whatever) then rehydrate with water and mix into oatmeal instead of milk. Applesauce dehydrates into practically weightless flakes! @AlisonKabaroff Look at you all fancy with your “science” and “measurements.” @lizrenzetti @NightShiftMD I’m sorry you’re receiving this kind of vile messaging. I love your column and think you’re amazing if that’s any help. @TeamUrology @siemensr @CanUrolAssoc Such great news - congratulations!! 😬 Buckle up. And wash hands / wear your mask!! @lysalomax @CMAJBlogs Actually as of yesterday, our own attending ED physician, Dr Eve Purdy!!! 🎉🥂👍
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@purdy_eve @docsibley @j_thePA Taken at a lawn ornament factory. Almost 26 years ago... https://t.co/LcF8GkSueT @mccusimano @AKatyukha @uoftobgyn @QueensUGME Ohhhh thanks!! What a lovely thing to read today. 🙏 @TamaraMcColl @Qemerg @purdy_eve Yes!!! (not a surprise of course) And a resident valedictory address from @Qemerg's own @purdy_eve - one of two residents selected for this huge honour! (she rocked it of course - with @Qemerg cheering on the sidelines) Every word of this:
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In the stay-at-home era, why have we so sorely neglected home care? https://t.co/mpltIJcGgj 8pm EST - very exciting!!! @MDaware @LandoAware I grew up with a miniature daschund named Heidi. Here she is (on my lap) with me and my brother and sister sometime in the 1970s. Loved that dog so much - I'm glad that you and your family have Lando. https://t.co/0DsYWT2YAh @MDaware @LandoAware tbh I'm really only here now for #Landotwitter @dr_lisa_lcalder Congratulations!!! We are in good hands. The most exciting news! Totally support this. Please don’t leave out the generalists who test and identify these cases. Emergency physicians and family doctors are frequently left out of these discussions. To the peril of the system, frankly. Queen's EM @Qemerg + @KingstonHSC nurses + support staff wanted to thank our #YGK community for your support. We raised $35K for the Lionheart COVID-19 Street Project, now matched by the Springer family! If you're financially secure, pls consider donating.
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https://t.co/JcSRXdPkLe @alandrummond2 Last night at #CAEPgrandrounds @RicharLisa said that it starts with formal antiracism training in organizations. She also recommended this book.
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https://t.co/o1B4bBnyzl Ugh and of course I mean advocating for others who are on the receiving end of racist acts. (I’m not advocating FOR racist acts obvi)
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Been a long day! @takhliqamir @CAEP_Docs @RicharLisa Finally there are clearly many things we can do as learners and as established physicians to work against structures that maintain or cause systematic discrimination. But I think the first step is to identify them. Again I defer to @RicharLisa for her thoughts @takhliqamir @CAEP_Docs In terms of advocating for witnessed acts against others that is harder to answer in a blanket fashion. I’m going to tag @RicharLisa for her thoughts. @takhliqamir @CAEP_Docs Student harassment reporting is confidential and protected and allows for debriefing at the very least. @takhliqamir @CAEP_Docs Hi - thanks for asking. I think that it’s often hard for students because they can feel (and sometimes sadly are) at risk of affecting evals (+ careers) if they speak out. First, all med schools have reporting structures for any kind of harassment, including racism. Also features @leifsok @DungeyPaul @dwmessenger @JanetvanVlymen Yay!! Such great news. So glad to hear this. 🎉👏🙌 Super excited to talk with these thoughtful people about advocacy next week - CAEP’s first National EM Grand Rounds. @MaddyLemke Adjust your post call expectations for yourself. You’re unlikely to write your NEJM paper or even organize your closets. Some sleep, some food, some exercise (a walk outside qualifies)... and you’re good! Groceries or laundry? You’re a post call hero now. @drsaminaali @yoga_junkie_ Yeah. Let’s go with that. “We have a province larger than France, but we have this dysfunctional messaging that’s treating Algoma the same way it’s treating Toronto the same way it’s treating Kingston”
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Favourite quote from this interview. @AngelaVarrin @ChrisFrankCOE @queensu Thank you! 🙏 @AnnetteHay1 @EAEisenhauer This is my fave so far! @yao_gordon Congratulations Dr. Yao!!! @Alison_Somer @QueensUGME Congratulations Dr. Bell!!!! Huge milestone. @MaddyLemke And hahaha thank you! I definitely enjoy the memes but glad to see that I’m more than just a meme... @MaddyLemke Thanks very much for your lovely thoughts - so appreciated!! @JennS_625 @queensu Least I could do to try to properly acknowledge a massive milestone. Congratulations to the class of 2020!! Hey #qmed @queensu - I’m here in front of Grant Hall for zoom graduation - celebrating Queens Medicine class of 2020!!! https://t.co/IgXuC8Sgxp @MaggieHulbert It makes me laugh now but I remember it spinning me into a bit of a crisis of self doubt. The judgement hung over me for months. @MaggieHulbert I also had a very bad anesthesia rotation as a clerk... hated every second, was grilled mercilessly about anesthetic drugs (about which I knew nothing)and then at the end I was told that I “lacked intellectual curiosity!” @eccucourse Oh. My. Goodness. @LGlaucomflecken I’m linking you with @drsaminaali - you and she are both husband lifesavers with middle of the night CPR.
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If anyone knows how to navigate next steps (like how to sleep again), she does.
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Also she’s worth knowing regardless!! An all round excellent human. @itsaeuphemism This is amazing @DrMalaJoneja I’m sorry to hear this Mala. Hope you are ok. @rachieks Same. Awful. @OpenResLeeds @wikimediauk Happy to send you a version. DM me. Ok 2020. That is ENOUGH. Seriously.
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Thank goodness you’re alright Hey #Qmed @Qemerg - any thoughts for @AcadMedJournal? (it doesn't really make up for everything - but it might help after today's thunder-snowsquall) @AudreyGruneberg Oh that’s so nice - Thanks!! Best of luck at Western. I loved it there. @ChuckWendig Oriented, not orientated. Petty and pedantic but I cannot, will not, let this go. @AudreyGruneberg @SchulichMedDent Congratulations!!! Super exciting. (I was in UWO, class of 1992). #purpleandproud @Dr_ChrisSimpson @adribaran my favourite is the "scar mediated V tach" one with junctional rhythm a close second @iDuchaine I’m sensing a theme @sarahleonard22 @alexsummers4 @JamieCSummers Also support @FrannyCrawford1 Me too! Um... I think @Dr_ChrisSimpson and @adribaran might enjoy this! @emlitofnote Wow that’s amazing! I worked in New Zealand for a year and loved it. Many ex-pat Americans working in EDs there. Congratulations!! A Mass Casualty In Slow Motion: Emergency Medicine During the COVID-19 Surge in New York City – emupdates https://t.co/k4G02ReHrt Reflections on “hallway medicine” from @purdy_eve @CMAJ
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Normalizing deviance – CMAJ Blogs https://t.co/StbQ71kTgd Letter to @TorontoStar from 19 ID doctors - COVID19 is droplet spread.
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https://t.co/1oF7jkSAbn @AnneLougheed this is indeed amazing @EricMTrautmann @sbarolo @shrewshrew Oh oh oh can we do corporate speak words next?!? “Learnings” (noun) is my personal fave. Next to “blue sky” (verb). John was a lovely, gentle and supportive colleague and a friend. My heart is breaking for his family. He will be so missed. @TabathaSouthey @FCanuckistan Yup Excellent. "excited" is not exactly how I spell "horrified" @ellkaydee It’s mostly just a horrific picture of school in the age of covid. @ellkaydee I’m sure that argument has be made - whether it’s a legitimate risk? Unknown. I always thought instruments were more a risk to the player if not cleaned. Not an area in which I have expertise More news about Quebec school reopening plans from this article: “...typical teaching strategies, such as group work, hands-on learning and guided reading, would not meet safety guidelines.”
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Just... wow. Music and art are critical and not known to have physical contact. I feel sure there are creative ways to teach distanced Phys Ed and drama also. This sounds completely horrible (other than the class sizes). “The way to avoid congregations of people in parks and on streets is not to punish them for being out-and-about, it’s to create more space.” @AudreyGruneberg @somegoodnews @queensu Right?! @ddale8 Oh I *loved* that album! Thanks for the reminder... will load it up on the playlist. One of the sad things about 2020 was not being able to celebrate graduations of all kinds. Losing that ritual was hard - this @somegoodnews episode was really lovely as a result. And so happy and surprised to see some @queensu grads at the end! https://t.co/Q9NZ4RBsEj @caycedomarula @QueensGenSurg @queensu @KingstonHSC @QueensUHealth @DeanOnCampus @epipatelmd Welcome! And nice to meet you at the security photo booth... @CampusSecurity @queensu Ok thanks. Phew.
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Might be good to have different language on the ticket: “is this bike abandoned” instead of “you are in violation of our policy.” Especially bc policy site you are told to check does not mention anything about annual cleanup. @rubyella1984 @queensu @CampusSecurity One of many ticketed on Friday I’m told. Not sure what’s up? @gordhunter @queensu I’ve heard the same from a few ppl now. Wondering if it’s some sort of spring clear out of abandoned bikes and we all just got hit with warnings? But surely there would be different language to communicate that? Thank you!!! @NurseStrider @queensu It was attached to my bike with a twist tie. Legitimately unclear what I did to violate the policy. According to the parking website they ticket and then impound your bike so would like to sort this out before my bike goes on an unplanned trip. Hey @queensu - got a ticket yesterday telling me I’m violating the university’s bike parking policy. Was parked here outside the new medical building. Totally unclear how I’m in violation?!? https://t.co/QS80L4ruMy @DavidJuurlink Yeah I get that. But we won’t be shaking hands with patients if/when we stop doing it societally as a cultural greeting habit. Was mostly just musing on how everything has changed. I miss my pre-covid life (medical and otherwise). @DavidJuurlink I used to shake hands with many patients when I met them. Always did with elderly patients. Felt like a warm gesture in the ED and a way to connect. Always washed hands before and after patient contact so did not seem as crazy as it does now in covid19 land. I miss it, actually. This is a great one pager. Great job!! 👏👏👏 Love this group so very much. Great great people. @kerstindewit 🤔 @jddneary @ericpaulimd Underrated tweet. @sbarolo @c_mckinley @AnnyckBC @AllostEricSite @CataPhD @teresamarx It has special meaning for Canadians...
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https://t.co/9oS7xWcQNg @sbarolo @c_mckinley @AnnyckBC @AllostEricSite @CataPhD @teresamarx MOIST (shudders) @AKHallMD @AcadMedJournal @Qemerg @elainevanmelle @drjfrank @Damonjdd1 @Jessica_V_Rich @sherbino @kweersin @GlenBandiera Nice job Andrew!! Best thing on twitter today! HT @purdy_eve Pleased to report that I have joined the editorial team @CMAJ. Super excited to support knowledge dissemination in Canada and beyond, and looking forward to working with @AndreasLaupacis and team! Well now that you put it like that... Yes yes yes A fun collaboration from #Qmed students. Talented and unstoppable even when 2020 happens.
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Stand (6ft) By Me - A Virtual Collab by Queen's Med Students and Friends - YouTube https://t.co/FMwEOpXgL3 @scottwakeham @Woodenheads @QueensUGME Socially distant graduation. The wooden heads stove is the best part of this masterpiece... A worthy champion! Also enjoyed the other medalists. Thanks for an enjoyable distraction. From a collection of publicly available details on health worker deaths in UK (caution low quality data) - Highlights the disproportionate death rates in Black, Asian and minority ethnic (BAME) HCWs that has been reported elsewhere. @GowerMD Ah I thought it was me because we took off our snow tires... Cathal Kelly is reliably excellent - and this piece particularly so. @jgordonboyd Saw this on the weekend: your pandemic alcoholic name = your first name plus your last name.... @purdy_eve @TheSGEM @alandrummond2 @bob_connelly @KFLAPH @MOHKFLA Agreed decision being made by thoughtful people in possession of community-based data. Not my call nor would I presume to second guess it. Love this idea @KingstonHSC @davidcarr333 @srrezaie @EMSwami @EMManchester @Rick_Pescatore @embouncebacks @amalmattu @emupdates @EmICUcanada @HedayatiMD @MDaware @richardbody @rob_cosentini @katplenk @jeremyfaust @LWestafer Worked 9/10ths of a shift the other day without realizing I’d forgotten to take it out @cliffreid Ghostbusters - originals and the remake @itsaeuphemism @smjoyceindy Rob. Did you vote zenith? @smjoyceindy It’s dilemmas like this that keep me going. @smjoyceindy Right? Also who in their right mind would vote for zenith when labyrinth is available! I have to say that voting on the #wordbracket match-ups is rapidly becoming the day's highlight. Highly recommend. @jesstrier @MCG_MedEd @Damonjdd1 Glass of wine is a nice touch @DoctorFitz And finally - anything by Atul Gawande: Being Mortal, the Checklist Manifesto. Complications... all excellent and thought provoking. He wrote a magazine piece about coaching that changed the way I think:
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https://t.co/s6puRZF7Ak @DoctorFitz Why? First one is amazing “biography of cancer”
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Next one an eloquent account of illness + grief but also love and grace in the face of a life cut short.
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Cutting for Stone is outstanding (medical) fiction.
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The last 2 are insightful/wry reflections on medical training. @DoctorFitz Emperor of All Maladies by Siddartha Mukerjee.
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When Breath Becomes Air by Paul Kalanithi
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Cutting for Stone by Abraham Verghese
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And a couple of training memoirs by women:
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A Not Entirely Benign Procedure by Perri Klass and
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This Won’t Hurt a Bit by Michelle Au @caycedomarula @QueensGenSurg @queensu Congratulations to both of you and looking forward to being your colleague! @TheSGEM @hotSahs @SarabSodhi @SAEMEBM @ffolliet @EMSwami @srrezaie @EMManchester @EMNerd_ @reverendofdoubt @PulmCrit @meganranney @AliRaja_MD @Rick_Pescatore Link to observational data -> decreased number of hair washes post cap wearing. Unpublished data; personal communication.
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Lol @hotSahs @TheSGEM @SarabSodhi @SAEMEBM @ffolliet @EMSwami @srrezaie @EMManchester @EMNerd_ @reverendofdoubt @PulmCrit @meganranney @AliRaja_MD @Rick_Pescatore Same - and also to reduce hairwashing burden.
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Observational level of evidence. @Eleytherius Same!!
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https://t.co/qpTqf60jls Having irrational envy of people with laptop processor capability that can change their zoom backdrop. Pandemic day who knows - this is what my life has become. @bob_connelly https://t.co/2E4jIhR0mb Hey @verified @Twitter please consider @bob_connelly - a neonatologist who disseminates information about neonatology, Pediatrics, child health and medical education. @verified @twitter please consider verifying @DrAnneEllis who is a tremendous source of high quality information on allergies and asthma @verified @Twitter please consider verifying Dr Kieran Moore @MOHKFLA - he is our Kingston Ontario chief of public health and full of useful / helpful information. @hclindsMD @QueensUGME Heather! ❤️
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Stay safe. Really proud and moved by the class of 2020 who created the most lovely “last class” today. You guys have handled this covid situation with grace and resilience. I know you will be great doctors and the world will be better for it. #Qmed @AAMorra13 @bob_connelly Accepted with gratitude. @AAMorra13 @bob_connelly Forgiven. I shall expect my apologetic CARL salute poem shortly ... @TheSGEM @EMNPKat @meganranney @AliRaja_MD @jeremyfaust @MDaware @thenntgroup @EddyLang1 I think we need the NNZ (number needed to zoom) @bob_connelly What about the gratuitous CARL slander?! Ouch. https://t.co/D5Ne0KqpjJ 💯this @DrJenGunter Checks out US blocks millions of N95 face masks headed for Canada https://t.co/AhQms1enag @AnneLougheed @jbaliamier @alecross1 @twusan @CathySantyr @FlyingVirg @JonathanRose Lol. Don’t usually pick up but needed something non covid related on my feed! @AnnetteHay1 @jpater45 @Limapda @james_paulad @DrGDigby @Scottyboy1976 I have 2 matches on your list Annette... @AnnetteHay1 @jpater45 @Limapda @james_paulad @DrGDigby @Scottyboy1976 Hahaha ok.
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Brooklyn 99
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Scrubs
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The West Wing
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Great British Baking Show
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Dr. Who
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The Crown
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6 shows 6 friends
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Tagging @purdy_eve @bob_connelly @AnneLougheed @dwmessenger @sikitula @lkd @leifsok Eddie Gizzard is my fave @EMCases Asked this am but no responses - has anyone tried this with other N95 types? @purdy_eve @dwmessenger @drjfrank ❤️ @mmurr27 @MurraysWhoTweet Not soon enough. Long time to ensure that’s it’s safe and works. Wash your hands and stay home. @MurraysWhoTweet Pedantic Murray of the day says “Epiglottis” with 2 Ts lol @MurraysWhoTweet Ah man! I’m on a zoom meeting so only dipping in and out of twitter. Go Murray’s, go!! @MurraysWhoTweet Wowww a question made for me but saw it too late lol Same tbh This is great for this type of N95 - anyone tried it with others? @jddneary I was just thinking the same thing! @MaddyLemke @halletjulie @ZuhaibMir This is amazing. If only I could have seen that instead of my slides!!! Medical education right now. https://t.co/mKA3W9OYIC @itsaeuphemism @bob_connelly I expect nothing less Love it.
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@itsaeuphemism @bob_connelly @963bigfm Ah that sucks. I’ve had a locked bike stolen and a locked bike stripped while parked at @KingstonHSC - it’s a slap in the face at the best of times and now... just brutal. Grrrrr @MaddyLemke @halletjulie @scottwakeham @erin_landau Wait wait wait you can play Catan online?!? @ellkaydee @bob_connelly @saraconns @luke_connelly @EGruenwoldt Yes yes yes this is the content we need rt now @Stella_Yiu @MDaware hey i wasn't saying i disagreed with the direction the account is taking!
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#loveitSeth @MDaware Are you an all penguin account now Seth @DrAprilBoyd1 Congratulations!! “The doubling time for studies rivals any coronavirus.”
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@RichardLehman1 returns with his (much welcomed) weekly blog focused on covid 19 and evidence updates. @HumanFact0rz @docpgb @petrosoniak @KariLynWhite @EmICUcanada @EMSwami @jbeckesmay @emupdates seems like there is lots of heterogeneity but CAS webinar panel yesterday said yes, absolutely. @drlauraduggan @doctimcook @doctimcook @drlauraduggan @georgemastoras Thanks for reviewing - much appreciated! @travellator2 Yes - there was disagreement about the role of front of neck access from panel. No disagreement that it creates lots of aerosol. CAS covid intubation panel not in agreement about anatomically difficult airway, see below about cric infection issues Some nice pearls here - including a question about using HFNC and covering or face with with NRB mask - instead of oxygen tubing, connect NRB to suction, removing aerosol. Love the outside the box thinking! @drrandywax Haha we should have a naming contest. @purdy_eve Also ogling your towers of equipment with envy/desire/covetousness 4) Many sample approaches and guidance from groups who have thought a lot about this and have lived experience. Use their work which is shared ++ on many platforms (including this webinar which will also be shared). OK we are wrapping up. Here are my key takeaways. 1) develop shared mental model with team. 2) practice (SIMULATION) and use aids to relieve cognitive load checklists etc 3) Standardized approach across institution for drugs and technique Some variation of opinion on panel about black and white nature of awake intubation being contraindicated. This is a difficult situation and decision. If anticipated very difficult airway may mean different decisions (i.e. front of neck access as initial attempt). First priority is to protect staff. Summary comments. These are physiologically difficult airways but not *usually* anatomically difficult airways. However - remember that awake techniques are contraindicated here. Anything that makes patients cough is BAD. @georgemastoras stressing need for open lines of communication and cross-disciplinary collaboration. Ottawa does not yet have dedicated intubation team but discussions ongoing. Comment from Vancouver - also has a dedicated team for intubation within hospital led by anesthesia. Vancouver has a tent outside the ED for crash intubations with no time to call anesthesia led team and ED does the crash tubes there Panel wrapping up. Now answering questions - Q who is intubating in your hospitals? Is there an intubation team?
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A - UK and Italy have convened institutional mobile intubation teams. All intubations done by dedicated team Airway collaboration is collecting anonymous data to try to ascertain hcw transmission information and learn more about PPE. https://t.co/fSeG8NQRLd apply mask over patients face, use a filter are the recommended extubation steps then some individual variability. (I don't do this routinely so may have missed some content here) Q about extubation. Panel suggesting avoid coughing during extubation. Nuanced individual practice for this (IV lidocaine mentioned). Deep extubation? This is not the time to start doing this. Extubate deep and replace with supraglottic? maybe if its your routine practice. Code blue in hospital - who is airway manager? SOme centres have modified on call so that in hospital airways have staff anesthesiologist (principle - standardized approach with staff protection and best airway manager to perform procedure) Cardiac arrest? First responders must have airborne precautions prior to initiation of BCLS/ACLS. Should be routine in centres with community spread. Another case - need to intubate a trauma. Approach as covid positive? Panel says yes - most centres have community spread. You may be able to scale down if good evidence that self isolated x 2 weeks and no symptoms. some ppl have recommended doff looking in a mirror. PANEL DISAGREES. Using a spotter is evidence-based method to reduce errors and contamination. Doff slowly with a spotter. Point again that doffing is the most risky part of this entire procedure. O2 sats will sink like a stone. BMV 2-person technique with careful gentle ventilation is most people's recommended step 2. Rescue supraglottic airway - use a later generation device with good seal. And PRACTICE it. retweeting bc out of thread. Failed 1st pass intubation? Here is recommended plan. https://t.co/t1IijOVTDt Failure to intubate on first attempt. Here is the recommended plan. https://t.co/DqUcArasc5 Flat capnograph = ETT is esophageal. Standardized drug protocol reduces cognitive load and allows a shared mental model for your team. (personal note - this is not the time to insist on your own personal signature cocktail for intubation) Intubate by protocol: here is recommended cocktail: https://t.co/9xYA5ngEra Recommend cognitive aids like checklists. STRONGLY recommend development or adoption of institutional checklist and then PRACTICE with them. Very helpful in reducing cognitive load. Recommend against cricoid pressure. Comment from anesthesiologist about risk of airway distortion. (note - I think ER MDs have mostly abandoned cricoid pressure for full stomach intubations for this reasons and others) Might have de-linked tweet about stripping down the tower - if you have a video laryngoscopy tower strip it down or the stuff on it will get contaminated. (Marie Kondo your tower) Check your video laryngoscope tower - strip it down so that components not contaminated. Nothing on it that is not part of covid intubation plan A Recommend large screen (left photo) instead of small screen (right photo) video laryngoscope tower. https://t.co/bXrl8embc8 In-situ sim must be done to train everyone on team. I'm going to stop tweeting it but it is being constantly stressed by everyone on panel. The standardized approach may be modified as the pandemic progresses in Canada. (personal comment - we are used to individual recipes and approaches to a/w management - we need to change that for this to protect the team and optimize success) Another mention of CRITICAL IMPORTANCE of standardized process with tight control. Decide on your approach and practice it. Recommended set-up in room from @doctimcook https://t.co/2P6QxRbBjH This is not the time to try new things on the fly. Predictability of your actions and your team essential for this - again the importance of simulation to create shared mental model. Point made that this is a great thing to start practicing now. Drill this during sims and with other intubated patients - CLAMP when you disconnect (i.e. switch from BMV to ventilator) Point about the circuit set-up - should be closed ("un-disconnected") as much as possible. Hepa filter next to patient. If disconnected then use a clamp and stop ventilation while circuit opened. Clamp beside every intubated patient? (I'm going to say YES!) Standardization and predictability = fundamental principles. Here is the set-up in England for Tim Cook. https://t.co/rIDcaOTFOR Standardized identical bins (A,B and C) shown - Ottawa. Recommend this approach to institutional standard setup. https://t.co/r6Mn5PE4YG Outside the room preparation. Standardized equipment and set-up and simulation *strongly recommended* by panel. (personal note - we have certainly benefitted from sim @Qemerg and @KingstonHSC ) Principles of PPE especially during shortages - neck protection (as example) may look different. Might be a shower if no neck covers available. Will evolve as shortages change https://t.co/MZGw2BgC12 High risk procedure. @drlauraduggan recommends optimal PPE - improved first pass success with providers who feel protected during procedure Now talking about drugs. Full paralysis using doses that are higher than what we are used to - optimize 1st pass success. Filter must go closest to patient to protect hcw in room Shout out to airway expert @kovacsgj as they mention the importance of Hepa filter attached to BMV in reducing risk of droplet spread @drlauraduggan says growing body of evidence about types of droplets from these oxygenation methods differing - stay tuned for evolving estimates @georgemastoras agrees that throwing out NIV and high flow O2 for all COVID pts is not a great idea. But should we use these devices to preoxygenate? Limited number of devices. Not sure thats a good way to pre-ox - thinks BMW with good seal better option If this pt decompensates do not start NIV but if already in place maintain - providers are wearing airborne PPE! Moving away from the idea that NIV and high flow O2 are dangerous. Agrees with intubation before decompensation. But also do not throw away other methods for maintaining oxygen support. Q to Tim Cook about optimal preoxygenation - how and what? https://t.co/pJIKHaxobv Q to panel - WHERE should this patient be intubated? (resp distress needing intubation). A: negative pressure room? Yes if available = optimal. Reality is rarely available for majority of patients. Should be done where providers can don PPE and where optimal preparation possible Need to find balance between intubation before it becomes crash and avoiding unnecessary intubation. Early airway management prior to decompensation is the underlying principle. May differ from site to site. No clear consensus out there. Varying FiO2 requirements wth intubation recommendations. Emerging literature suggesting that some pts do well without intubation even when ++ hypoxic Now moving on to case studies:
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1st one is Covid patient in resp distress. When to intubate? Q to panel. COVID pneumonic to remember steps. Importance of team members looking out for each other for PPE donning and DOFFING - most hazardous procedure and you must have a spotter. https://t.co/8fQkfBxFwg Video laryngoscopy has better 1st pass success rate. Note that video scopes have 2 kinds of blades - mac blade with hyperangulated. Recommended for intubation of COVID patient New techniques with airway management now since SARSv1. First point: 2 hand 2 operator BMV achieves better seal with less pressure. @drlauraduggan referencing this paper to talk about risk of AGMP and comparing different procedures. Level/quality of evdience in this syst review poor and includes observational studies. Note this is pre-Covid19 https://t.co/jvgjMKypvp Cannot talk about airway management without talking about PPE. Critical piece of the puzzle. This slide covering papers looking at intubation which seems reassuring that PPE works to protect airway managers. https://t.co/FR3U4YWisw Quite a few key papers quickly reviewed at start of webinar. This is an alarming stat but apparently early in outbreak - infective load may be increased in HCW and thus increased severity and mortality. Very worrying. https://t.co/41W01u7Jig First bit is a review of the worldwide stats and COVID19 epidemiology. @purdy_eve @georgemastoras Same!!! Thanks for taking time to do this. thanks @drlauraduggan for acknowledging information overload plus anxiety during preparation period. Goal today = slow down and focus on priorities for COVID a/w management "doing things safely" is the title of the webinar and focus of the conversation. Will be live tweeting this multi-disciplinary webinar on COVID intubation from Canadian Anesthesia Society. Featuring expertise from Canadian anesthesiologists, critical care and emergency medicine. Will thread tweets below. @drsaminaali @drhali85 @ELMorrisonMD @AlisonKabaroff @AishaMD_ @KathyReid5 I shall need a full report next BEEM course!! @drsaminaali @drhali85 @ELMorrisonMD @AlisonKabaroff @AishaMD_ @KathyReid5 I must hear more about “DJ!!” @meganranney @Twitter Yayyyyy! @WAMcCauley @drzzzombie @WesternUEmerg @western_ccfpem @SchulichMedDent Perry Cox is the *second* best doctor of all time. Bill - if you haven’t watched Scrubs your crown is a tiny bit tarnished... Oh I love this. And honestly - the team in the ED is the best. “As resilient as Gumby..” I hope so! Actually bought it at the sick kids peds conference. Cost about $5... ❤️👍 NOPE NOPE NOPE All I have to say is that I accept apologies from all you people who mocked my waist level stethoscope holster! @MeganAS24 @haileyahobbs @3dLimestone @ZuhaibMir This is outstanding. Thank you! The PPE worries keeps everyone up at night and this is a huge help. @CindyBolton4 it's missing "person talking while on mute while others on call uselessly shout YOU'RE MUTED" haha
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(Have been guilty of both these sins tbh) We wrote about our COVID19 preparation using translational simulation @KingstonHSC @Qemerg. Made possible by amazing shared resources around the world across many platforms. Unprecendented connection/cooperation within + btwn organizations to do this. "Work with." Honestly twitter - an edit button. Would it be so hard? ❤️ All these people. Honestly so lucky to worth with the @Qemerg group. Grateful every day. @MaggieHulbert @scottwakeham @MCG_MedEd @QueensUGME Aw. You guys are awesome. I'm so sad honestly about C3 - its one of my favourite times to teach. Will do my best to connect virtually. My kids tell me I should be able to do virtual Kahoot... so thats something! We can still crown the CARL king/queen on Friday. (Huge news) @scottwakeham @MCG_MedEd @QueensUGME Thanks all. Full credit to @MCG_MedEd - honestly I’ve been totally focused on ED response. Grateful to have the infrastructure to do some online shouting into the void. @HumanFact0rz @precordialthump @HawkmoonHEMS @symon_ben That is awesome... but did they add in weird non-Canadian vowels where they don't belong? If I see "apnoea" I won't know what to do!! @KingstonHSC 3D printed face shields March 23 version @DrCarolynSnider Welcome back!! The world needs you out of quarantine. @RichardLehman1 Not a GP but very interested in understanding factors associated with hcw infection. Inadequate PPE vs improper doffing technique vs inadvertent exposure to unrecognized covid pt? Informs our workplace decisions re: PPE focus. @WhistlingDixie4 @nhsuhcw Congratulations!!! The only good thing to come from covid19 is the return of @RichardLehman1's bmj blog. Thank you for coming out of retirement to guide us through the science! @dwayne_doctor Again - not my opinion, discussion in the webinar. Concern is delay to resus while all staff don PPE. Risk of infection >> chance of success was the point of discussion. @Bellevillain We’ve talked a lot about this. Most people in our group with healthy families are staying put but have in or out of house isolation plans if they get sick. Everyone has changed their on shift clothing and post shift decontamination procedure though. @CanEMDoc Tweet specifies in hospital. Delays to get PPE on providers will decrease chance of salvage and BMV known to be aerosol generating so risk increased. Opinion of webinar faculty not policy. Just watched this - great technology! To be clear - no official policy and acknowledgement that this will be different from centre to centre. Concern for risk to staff outweighing chance of recovery. This is new territory. @ZuhaibMir @epipatelmd @BZevin @QueensPeriopMed @KingstonHSC Point is that aerosol generated in intubation persists. There were many Qs I think on this topic. CAS website will post webinar later today/tomorrow for ppl to listen @ZuhaibMir @epipatelmd @BZevin @QueensPeriopMed @KingstonHSC N95 mask recommended in webinar for anyone entering a room up to 1 hr post intubation. That's for a standard neg pressure room - some newer rooms (ORs?) have more air exchanges/hr so institutional guidelines may vary. #CASPPE here is a link to @shannonlockhart protocl referenced during CAS webinar @brkster no but going to ask - tanks for reminder @garblisa This was not covered - they mostly talked about in hospital code blues. Take homes for applying to OOH arrest = shock low risk, passive oxygenation low risk and everything else (CPR, ventilation) increases risk to providers #CASPPE Protecting front line staff should be our highest priority. System will fall apart if front line staff unprotected. Acknowledgement of stress of this for front liners. Look out for each other.
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(thank you - this is v stressful!) #CASPPE summary comments: Concept of Enhanced airborne PPE for intubation. Intubation is the HIGHEST RISK AGMP. Doff with a buddy / coach to make sure you don;t contaminate. Shower afterwards. #CASPPE CAS wants ppl to know they are advocating for adequate PPE be made available for AGMP to keep front line people safe.
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(Thanks for that - the potential lack of PPE very worrisome) #CASPPE (they are answering written questions now if tweets feel disjointed) #CASPPE airborne (not intubating) precautions needed for 1 hr for anyone entering a room post intubation. #CASPPE If you do not have an anteroom, external contact layer comes off in room, wash hands in room then everything else comes off outside. #CASPPE do not waste N95 masks. Use them for AGMP and not for contact /droplet encounters #CASPPE recommend trying innovative ways to reduce entry/exit from rooms (pumps outside of rooms etc). *Patient should never wear N95 mask* regular mask for patient #CASPPE Q about adding N95 mask for patients with coughing/sneezing to contact/droplet? A = regular mask is ok as long as patient also has mask. Distance from patient also important. This is current recommendation. #CASPPE protected code blue recommendations "no CPR unless everyone in room has N95 mask" #CASPPE slides and recording of presentation will be online later today or tomorrow for people who missed it - CAS website #CASPPE Unwitnessed asystolic arrest in hospital of COVID patient they suggest *no resuscitation.* Outcomes dismal and risk to staff high. #CASPPE shock is ok if everyone has contact/droplet precautions. (My comment - consistent theme here is protection of staff during code blue. "Staff safety first") #CASPPE Q about CPR. What to do? Scenario for extubated covid pt with arrest - contact/droplet precautions for NRB mask/filter (passive oxygenation). Chest compressions are increased risk. "No chest compressions unless everyone in room has PPE" @momneph not yet but good idea. Webinar has much useful discussion #CASPPE note made that sensitivity of COVID19 test is low when pt is asymptomatic - false neg is legit problem. Intubation of all patients in centres with community transmission should use *at least* contact/droplet PPE. Shortages of PPE remain a major concern. #CASPPE coughing patient - is there a risk of airborne contamination? A: this is a droplet scenario. Contact/droplet precautions. Only AGMP requires airborne precautions. Intubation = high risk AGMP and they are recommending neck protection ("Enhanced airborne") #CASPPE Tips for tranfer vented patients: Tape connections to vent to reduce risk of leak. Esp important to tape filter to tube so if vent disconnects the filter is intact! #CASPPE transfer of pt to ICU setting is also high risk. ET tube then hepa (HEM) filter, waveform capnographer and then BMV. Also you need a clamp for ETT. **Note filter can clog - if disconnect from vent TUBE MUST BE CLAMPED #CASPPE how do you identify pts at high risk intubation? ABG actually very important. PaO2/FiO2 ratio predictive. Guidelines are coming out. #CASPPE sim team from Vancouver has published their sim protocol for practicing. Strongly recommend simulations in every centre for practicing. #CASPPE Q - How long after intubation do you leave your PPE on or need PPE for entering room? Confusion = how long airborne precautions in room afterwards. IPAC says ~1 hr to clear room (depends how many air exchanges/hr in the room) #CASPPE you ca tweak the airflow in your area to "negative" vs "positive" airflow in areas of hospital. This is a role for hospital engineers #CASPPE all centres are struggling with lack of neg pressure room spaces. Role for hospital engineers to tweak airflow patterns in existing rooms. Can safely intubate in non-negative pressure room but CLOSE DOOR, ENHANCED PPE and (possibly) PORTABLE FILTERS #CASPPE next best for intubation to neg pressure room = room with door. There are portable hepafilters available if you can't find neg pressure room #CASPPE Q about having to intubate in non-negative pressure area. Recommend preserving neg press rooms for high risk procedures (i.e. hold only for intubation) #CASPPE Q about "Magyvered" solutions for neck coverings etc. Recommendation is to think about doffing when you improvise coverings - make sure you can take it off without contaminating #CASPPE Q about reuseable masks (since N95 supply limited). Answer - do not reuse contaminated masks (i.e. post intubation). Might be able to reuse non-contaminated ones. Stay tuned and connect with local Inf control #CASPPE Q: Shoe covers - mandatory? Experience during SARS showed contamination putting on/removing. More important = long gown and wipeable shoes. #CASPPE There are other PPE arrangements that are also protective. (my thought - seems like layering + doffing coach is a theme for ensuring protection) #CASPPE they note availability of PPE is variable and will also evolve. Institution specific.They stress importance of doffing coach. #CASPPE need ++ practice to don and doff this PPE or contamination is significant risk. Using the coveralls they suggest for intubation is very difficult. #CASPPE they are recommending disposable coveralls for intubating. They also note evolving PPE for intubation - changing constantly. #CASPPE they also recommend showering immediately after intubation to remove contamination. #CASPPE slide below shows evolution of recommended PPE for intubation. https://t.co/9wg3VLI4Be #CASPPE Intubation plan for COVID pt. What is PPE? Glow gel sims have shown ++ neck contamination of both intubator and assistant. #CASPPE BMV has high likelihood of aerosol generation so if done, two hand seal with low volume slow ventilation. PPE mandatory #CASPPE BMV and Cric (front of neck access) also have ++ risk and are AGMP. (I suspect this is true even if paralyzed but not explicitly discussed) #CASPPE some heterogeneity about need for neck protection for intubation. Q about extubation = high risk? Has been designated as same as intubation (coughing ++ etc) #CASPPE different sites are taking different definitions fro AGMPs, this will continue to evolve as resources become limited. Intubating = highest risk (agreement universal about this) #CASPPE webinar identifying controversies about what is/is not AGMP https://t.co/Sv39ZSTAdp #CASPPE Case to begin - COVID pt on np needs IV start. @drlauraduggan starting with clarification of droplet transmission process. Concern that most infection occurs via droplets on surfaces. Routine precautions = contact/droplet #CASPPE Webinar starting - the Canadian Journal of Anesthesia is making all their covid resources free online. @purdy_eve *waving furiously* Am hanging out with anesthetists this afternoon - they are talking about PPE for COVID19 in this free webinar. Will attempt to live tweet for this who are interested. Using HT #CASPPE @drlauraduggan I can give it a try @karenerrichetti Forgot to tag!! @dwmessenger our dept head who has stepped up amazingly to prepare us. @karenerrichetti I’m an emergency physician in Canada. This week I was promoted to professor. Far more importantly, I’ve been constantly inspired by my hospital and by my entire ED team. Ppl are working together quickly and effectively. A new level of cooperation and mutual respect in our ED. @docguerin @cameacem Congratulations!! https://t.co/rTL82TIGYg Yay!!! So well deserved! @janephilpott Thank you! Looking forward to working with you at @queensu Overwhelmed soup and toast. Attention @oliveakingston @BellaBistro - do you use them? @CarolineBoveyRD Thank you! @Zoe_Saynor Wow - thanks! @CindyBolton4 Thanks Cindy. Thanks also to you for all your superhuman efforts during this pandemic. ❤️ @drjessigold Likewise! @MWEnergy @DrPalssonUNC Thanks! Virtual cupcakes welcomed. @joelwiens @TChanMD Wow- thanks for this message! Stay safe. @DrAnneEllis Thanks Anne! @corlettja ❤️ @gabouryDesign Nope. Emergency medicine 70% and EBM teaching/curriculum the rest. Thank you! @llgilmou Thank you!! @SuneelUpadhye Um. 2021?!? Thanks Suneel! @khursiah1010 Wow - thanks!! So... to say I’ve been overwhelmed by the response to this is a massive understatement. So many lovely messages. Thank you all. Now stay safe and keep supporting each other! Love this patient information video - aimed at families with children but relevant for all pts with viral symptoms.
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@SketchyEBM is awesome btw - many great epi resources Nice collection of remote teaching tips/resources from @TChanMD and @ALiEMteam https://t.co/PCMTNstRq0 @dwmessenger @Qemerg @Adam_Szulewski @KingstonHSC @QueensUHealth Adam! WOOT! Congratulations. I’ve seen a version where the free space is “you touched your face” @momneph Wow - thanks for that!! @EddyLang1 That gif tho!! Thx *Non covid post*
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The world is crappy right now but one piece of good news for me - officially been made a full professor today. 😁
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Looking forward to the day when I can focus again on academic work... @ejblackmore We need more virtual Zwift rides! Canadian physician friends - these brilliant Toronto epidemiologists have created an amazing resource. Suggest following/sharing. @drlauraduggan Suggest reaching out to your medical school (or ours, DM me for contacts) - lots of bright thoughtful clerks currently sidelined who would welcome a chance to help We’ve convened a small working group to look at this exact question. Heroes wearing PPE
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*thank you* @drsaminaali Same, friend. @DGlaucomflecken I think your current A++ twitter game is helping so much! ❤️🩺🦠 Hey @DrAnneEllis apparently adult epi pens on back order x1 month. Suggestions? This is an excellent initiative. Frontline health care workers will need to limit their travels to work and then home. It’s very hard to think of yourself as a risk to others - but that is the truth. A lot of them these days wear PPE This service is critical to keeping patients out of ED. Many people worked hard to get this up and running on short notice. Amazing!! @DrMalaJoneja Honestly don’t know. The university district is crawling with parties - crowds, loud music and open carry/drinking. We’ve planned for high volumes of drunk students in the ED. But it’s maddening that our time and resources are needed for this in the midst of a pandemic. @BenForestell Social distancing is critical rt now. Partying = opposite of social distancing. Devoting time, energy and staff to mop up drunk students in ED is an appalling use of resources that are already strained due to pandemic planning. The parties are *at best* deeply offensive. And the worst part? Likely to be repeated on Tuesday.
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*repeated*
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#ygk #Queensu It’s not just stupid. It’s tone deaf, selfish and unbelievably irresponsible. Hospital: everyone working overtime with pandemic planning
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City: schools closed, large gatherings cancelled, social distancing
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Students: huge parties everywhere with anticipated ++ ED visits Omg yes. The playlist! Get it up on Spotify ASAP @neoncloth This is God’s work you’re doing William. Boooobbbbbbb!!!! This is a PUBLIC SERVICE for your department (and mine).
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@bob_connelly
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Check out this poster of Africa by Toto I made on https://t.co/sBbPHbRMeU! https://t.co/jsVL52NBrk Endorse @rvanwylick @mjbeyak @KingstonHSC Pillows. And alcohol hand wash. @mjbeyak @KingstonHSC Haha yes it’s a special covid19 free area, VIPs only. Hope you are healed soon. #heforshe some ideas on being an orthopaedic surgery ally. https://t.co/uhDGdWZFzU Just a few of my brilliant female @Qemerg residents and colleagues. Too many others to mention or show. Posted in honour of #InternationalWomensDay2020 https://t.co/RgRojAD447 Oh this is so great - congratulations @CVarnerEmerg !! Very glad to read this! Cannot unsee this @bob_connelly @luke_connelly @saraconns @MLou88 Toto. Always and forever... @GenBureau @kevinfhlee @QueensuDOM Oh - great news. Congratulations to all 3 of you!! Very excited to welcome 4 women into our #Qmed @Qemerg program!! A far cry from the early 1990s when I was the only woman in a group of 15... the future is bright. worth watching for many reasons but particularly for the vietnamese coronavirus education song. @lisaculliton @NightShiftMD Indeed @EpiEllie I know! Here is some ice art. Winter can be gorgeous. https://t.co/wHNOviSnTL This is a great thread from the always thoughtful and brilliant @meganranney Yes. Also a reminder that doctors notes should not be required for people who call in sick. Means they have to go to a health care facility where they exposure health care workers and other pts to *get a piece of paper.* 2/2 most virus is picked up from surfaces where the particles have landed/come off people’s hands. That’s why washing your hands + not touching your face are the best way to stay well. Masks (+ addt’nal protective covers) are for health care workers caring for sick ppl. 1/2 Some clarity: masks stop you from breathing aerosolized virus. If you’re not a health care worker you’re unlikely to need one. People who are sick and coughing *should* wear a mask to stop their virus from going into the air. Even better - stay home. The Evolution of Schools of Thought in Medicine: Healthy Tensions | History of Medicine | JAMA | JAMA Network https://t.co/nImAYFAFMI @KariSampsel Oh saaammmmeeee Thisthisthisthis This article from Dec is chilling. The overwhelmingly young female clientele, the role of the medical profession in fuelling this obsession... and so much more.
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“An unaltered female face is aberrant” I also did this. Along with wondering why no one has gloves... 👍 @DrEricLevi RIGHT?!? Same thought. @DanJMulder1 @Sandy_NataschaS Um Yes. Keep symptomatic people out of ED unless very ill. Testing should be done elsewhere, keeping other patients and staff safe. @FrannyCrawford1 Also, actual solid food and wine! Yay!!! “We can reduce risk by regularly washing our hands, not going to work or school if we are sick, and getting the flu shot to reduce overcrowding at health-care facilities during the outbreak.”
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Evergreen advice, really. #AcademicChatter @purdy_eve @SocraticEM @emsimcases I’d add the winky emoji but I find it creepy tbh @purdy_eve @SocraticEM @emsimcases Great minds. @emcrit Have you read the Hilary Mantel series on Thomas Cromwell? The third in the trilogy (the Mirror and the Light) will be released in March - the first 2 *both* won the Booker Prize.
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(Wolf Hall and Bring up the Bodies). “The Undoing Project” by Michael Lewis is fantastic. Speaking of “teeing it up”, can’t wait to see the replies to this one. Then he did 500 pushups and offered to play for the Bruins tonight. That’s one of the reasons the IIHF pushes so hard for NHL players to participate in the Olympics: the revenue helps to pay for lower division men’s and women’s tournaments around the world. This tournament in Madrid, involving Australia, Croatia, Georgia, Iceland, Israel and Spain is one of 34 being held by the @IIHFHockey this season. Three events, the Olympics, Men’s Worlds and World Junior pay for the rest. The Olympic money was cut when NHL players didn’t go. There’s all kinds of speculation now about Assistant GM Craig Conroy. If he gets the job would his good friend and former linemate Jarome Iginla join the front office as well? Hard to imagine how I would have managed without the endless supply of helpful suggestions from @rayferrarotsn. I also declined the helpful suggestion by @rayferrarotsn at the Men’s World Championship to say that Hungary’s Bence Stipsicz (stip-shits) “dumped it in the corner.” Amazing story. *fixes the location of where I live from the the previous tweet. I do know where I live, I swear. Heading back home to Toronto after another NHL regular season for @TSN_Sports. Many thanks to our crews, in particular analysts @mike_p_johnson, @jamiemclennan29 and @djpoulin20. It’s a great team to be on. Next stop for TSN, the Men’s World Championship in Latvia/Finland. Richard won a USports national championship with the University of New Brunswick this season, last year he led the QMJHL in save percentage. In NYC, where @mike_p_johnson, @markhmasters and I will have the Leafs regular season finale from MSG tonight. This from @ethan_sears at @nypostsports: the Rangers, Islanders, Devils, Knicks and Nets are all in the playoffs for the first time in 29 years (1994). NYR won the Cup. https://t.co/o8HtH14XOM Pittsburgh and Toronto both lost in the “play-in” round in 2020, but the NHL considers those playoff appearances. Longest Active NHL Playoff Streaks Entering This Season:
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Years This Year
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Pittsburgh 16 ❌
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Nashville 8 ❌
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Washington 8 ❌
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Boston 6 ✅
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Toronto 6 ✅ Their Dad Keith is one of four players in history with 50 goals and 200 PIMs in the same season. (Gary Roberts, Brendan Shanahan and Kevin Stevens are the others). The young man has been found, will meet Marner and Matthews after the game. A postscript: the @MapleLeafs are working to locate this young fan. Ummm… https://t.co/WGHzgtSl4R Congratulations to VP Production Paul Graham, producer @CEdwardsTSN and everyone on our exceptional crew. Very proud to have been on this team for the last 28 years. I’ll add him to the list. Anyone seen Denis Lemieux of the Federal League Champion Charlestown Chiefs lately? https://t.co/G7nFg6CrWx It’s true. I never won one of those things with @rayferrarotsn. This sadly puts to an end one of the longest running gags at @tsn_sports, as it follows 14 straight nominations without a win. @tsnjamesduthie, @DarrenDreger and @rayferrarotsn will have to find new material. (@petermansbridge also offered to loan me one of the 14 he’s won.) Unfortunately @jamiemclennan29 is ineligible, he still has four games to serve from his five game suspension in the 2006 playoffs. If I was there (I’m in Tampa) I would have said how honoured I am to share this with everyone on our @TSN_Sports crew, led by VP Production Paul Graham, producer @CEdwardsTSN and analyst @mike_p_johnson who is an absolute joy to work with. I’m calling the game in Tampa tonight and have no idea who will be in goal for the Leafs. Good thing my @eliteprospects subscription is up to date 😂. Regina won the sixth game of the series 5-3, Connor Bedard had a goal and three assists, has 11-8-19 in the first six games. Game seven is Monday night. Happy birthday Melanie! 🎂🥳🎉♥️ So in addition to being in contention down the stretch, Nashville bolstered it’s draft position considerably, picking up a total of nine picks, including two firsts and three seconds as part of the haul for the players moved at the deadline. The @PredsNHL are a fascinating story, still in playoff contention despite moving key players (Ekholm, Granlund, Jeannot, Niederreiter) at the deadline. Their remaining schedule is tough (at Wpg, at Cgy, vs Min, vs Col) but if the Preds win out, they make the playoffs. #InclusionMatters The set was designed by Indigenous artist Jacob Alexis from the Alexis Nakota Sioux Nation. The card backs were written by Indigenous card collector Naim Cardinal. @UpperDeckSports worked closely with Indigenous communities to make them as authentic as possible. https://t.co/vQ0vfNWKMB Many thanks to my friend Dr. Janice Forsyth @janice_ubc for sending along these limited edition @UpperDeckSports “First Peoples Rookie Cards” celebrating Indigenous hockey players who never had a licensed trading card before. https://t.co/k3fVK3b4li In the end, this was a horrible, senseless tragedy that shattered Jonathan’s family and his community. #NewProfilePic https://t.co/QaMg3sgYOK Ex-cellent hat, @atrupar
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