Justin Morgenstern @First10EM Twitter profile

Last Seen Profiles

@gmoneyNFT

@teklitGH

@EunomieTeam

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@yujinstarboy

@Shiroyal305

@Cambo_64

@bokeplokalmalam

@EvaMarieOlsson1

@9_haku

@MumfordAsia

@WyedeanGeog

@atlautomotive

@stwmaniax

@bokeplokalmalam

@ResinOne1

@andrajoleno

@omgitstomie

@Halil1324608

@stwmaniax

@houseatreidess

@CentaurTheatre

@Inchcape_SS

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@CourageHabit

@litao0806

@9758898k

@mommy_feminist

@summerjam

@great_aliens

@KDHLRadio

@sa1_syam

@bokeplokalmalam

Justin Morgenstern

@First10EM

2 years

Multiple emergency departments in Toronto are on the verge of collapse tonight. There are no nurses. They are begging people with no nursing training to act as nurses. Care will be compromised. But they won't declare an official emergency (presumably to save face?)

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Justin Morgenstern

@First10EM

3 years

There is no way that someone who had set foot in a hospital in recent weeks would be talking about loosening COVID restrictions

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Justin Morgenstern

@First10EM

2 years

2 years without being sick (masks definitely work), and it took less than 5 days of daycare to take the whole family down

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Justin Morgenstern

@First10EM

3 years

It might be unpopular to say, but the rise of virtual care is resulting in A LOT of very bad medicine The physical exam may be old fashioned, but if you never perform one, your diagnosis will be wrong very often

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Justin Morgenstern

@First10EM

3 years

When you show up for your shift and you are so short staffed that the emergency department is no longer separating potential COVID patients from non-COVID patients... Abandoning IPAC principals... that is the current state of Ontario healthcare

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Justin Morgenstern

@First10EM

3 years

Which science averse group of doctors did more damage during this pandemic? The ivermectin group or The "it's not airborne" group

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Justin Morgenstern

@First10EM

4 years

About a month ago, @fordnation decided that the people of Ontario wanted a third wave We are now headed into that very predictable third wave I cannot comprehend why anyone would want to follow this path, and am incredibly frustrated to be forced along for the ride

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Justin Morgenstern

@First10EM

2 years

How is it possible that OHIP doesn't cover crutches for a patient with a broken leg who cannot bear weight? How is that universal health care? @OntariosDoctors @CAEP_Docs @fordnation @JustinTrudeau @OntarioHealthOH

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Justin Morgenstern

@First10EM

3 years

Sadly, the Ontario government's refusal to use the basic tools available means that we are firmly back into exponential COVID growth @fordnation seems to be committed to a 4th wave - which I guess is completely on brand

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Justin Morgenstern

@First10EM

4 years

It is high time that we broke this horrible research cycle: Researchers: We don't know if this will be safe in pregnant women, so we will exclude them Clinicians: Pregnant women were excluded from the research, so we don't know if its safe and will exclude them

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Justin Morgenstern

@First10EM

3 years

I can't imagine anyone has ever told a construction worker removing asbestos that they shouldn't wear an N95 because "we don't think you are going to take it off properly"

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Justin Morgenstern

@First10EM

2 years

We can literally test for COVID in your breath, but there are still many in medicine who deny that COVID is airborne??

Eric Feigl-Ding

@DrEricDing

2 years

New—FDA grants emergency use authorization to the first #COVID19 “breathalyzer” test that can detect #SARSCoV2 in a breath sample, within 3 minutes—with 91% of positive samples correctly and 99% of negative samples correctly.

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Justin Morgenstern

@First10EM

3 years

COVID is spread by asymptomatic individuals We are telling asymptomatic COVID positive healthcare workers to work What is the scientific basis for this decision? Is this going to improve staffing issues, or make them worse? @COVIDSciOntario @ASPphysician @NathanStall

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Justin Morgenstern

@First10EM

2 years

This algorithm on contrast and CTs from the IBCC @PulmCrit is brilliant

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Justin Morgenstern

@First10EM

3 years

Regular use of N99 respirators results in "a dramatic fall of up to 100% in hospital-acquired coronavirus infections" COVID is airborne It is unbelievably irresponsible that medical organizations continue to deny this

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Justin Morgenstern

@First10EM

2 years

@DGlaucomflecken Why are you making them stay in clinic an hour after you left?

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Justin Morgenstern

@First10EM

4 years

CDC guidance updated to state that inhaled aerosols are the main way that COVID-19 spreads @arcandandrew @JoanFC

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Justin Morgenstern

@First10EM

3 years

So far, in every meeting I have had with my hospital about the airborne nature of COVID, the people on the other side of the table refuse to talk about data They state guidelines or experts say its droplet spread, but won't look at studies Science is easy.. if you engage

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Justin Morgenstern

@First10EM

3 years

The evidence suggests N95s are better than surgical masks I kept hearing the opposite, but after finally reading the evidence myself, it is clear that N95s are the better option #FOAMed

The evidence suggests N95s are better than surgical masks - First10EM

This deep dive covers all the available science, and the evidence suggests N95s are better than surgical masks.

first10em.com

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Justin Morgenstern

@First10EM

4 years

0 beds in our ICU Critically ill patients stuck in our ED But saw long lines for the mall on the way to work today Completely dropped the ball on this one York Region @YorkRegionGovt @PublicHealthON

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Justin Morgenstern

@First10EM

6 years

Ever since I learned about confirmation bias, I’ve been seeing it everywhere

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Justin Morgenstern

@First10EM

3 years

We are currently at a very dangerous point on the curve in Ontario Some voices will demand that we open up early. We listened to these voices at the end of the second wave, even as @COVIDSciOntario predicted a third wave if we did. The result was a lot of unnecessary death.

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Justin Morgenstern

@First10EM

3 years

I promise to stop tweeting about the airborne transmission of COVID as soon as the medical community embraces scientific reasoning... Unfortunately, considering our progress with thrombolytics in stroke, that might be a while

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Justin Morgenstern

@First10EM

1 year

There is a lot of data on how horrible it is for medical outcomes to keep inpatients boarded in the ED I don't see enough discussion of how inhumane it is. EDs are not designed to allow patients to sleep. No one would want a loved one to spend 24 hours in an ED We need better

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Justin Morgenstern

@First10EM

3 years

National Post: Plexiglass dividers may do more harm than good, Ontario science table director says. (Droplet precautions don't work against an airborne disease)

Plexiglass dividers may do more harm than good, Ontario science table director says

nationalpost.com

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Justin Morgenstern

@First10EM

3 years

No one has stepped up to explain why hospitals continue to act under droplet precautions when the science so clearly says that COVID is airborne Is the IPAC community just not on twitter, or does everyone actually agree this is airborne now, but are just embarrassed to admit it?

Justin Morgenstern

@First10EM

3 years

When it comes to the transmission of COVID, medicine has become far too much like politics: people expressing strong, black and white opinions, often with very little to support them, and spending their time vilifying the other side. We need to do better...

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Justin Morgenstern

@First10EM

4 years

COVID-19 is spread by aerosols: an evidence review We have been ignoring this science for far too long. Time to make COVID management evidence based. #FOAMed

COVID-19 is spread by aerosols (airborne): an evidence review - First10EM

COVID-19 is spread by aerosols - a review of the available science.

first10em.com

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Justin Morgenstern

@First10EM

3 years

This is why healthcare workers were so upset about the constant talk of omicron being 'mild' We knew this was coming, and yet again, no one wanted to listen to scientific expertise

TO Paramedic Union

@416TPSUnit

3 years

#CodeRed No units available in the City at 18:38 hours tonight.

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Justin Morgenstern

@First10EM

4 years

Hydroxychloroquine routinely used among admitted patients in Italy We are still struggling to figure out why the mortality rate was so much higher in Italy This is not going to be a miracle drug

Roberto Cosentini

@rob_cosentini

4 years

1. The evidence of HCQ is weak (100 pts all over the world) 2. We treated all our #COVID19 1.000 admitted pts with HCQ, no miracles yet.

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Justin Morgenstern

@First10EM

3 years

@DFisman @COVIDSciOntario The very first conversation I had when joining @COVIDSciOntario was about aerosols - there was clear agreement that they play a major role The first meeting I attended was about ventilation to control aerosols Yet no publication has ever emerged This is a massive failure

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Justin Morgenstern

@First10EM

9 months

No beds Critically ill patients in hallways Hours of EMS offload delay Emergency medicine in Ontario is incredibly unsafe right now

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Justin Morgenstern

@First10EM

4 years

I'm up to 8,000 words on the topic, and have a splitting headache How about we all just agree that the science supports aerosol transmission of COVID-19 so I can call it quits for the evening? Anyone?

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Justin Morgenstern

@First10EM

4 years

Important message from the Public Health Agency of Canada: 1) COVID is spread by aerosols 2) Coughing, sneezing, and shouting create aerosols 3) Ventilation is important We are so far behind on this science Time to finally get our guidance right

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Justin Morgenstern

@First10EM

3 years

When it comes to the transmission of COVID, medicine has become far too much like politics: people expressing strong, black and white opinions, often with very little to support them, and spending their time vilifying the other side. We need to do better...

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Justin Morgenstern

@First10EM

2 years

New rule: hospital administrator on duty must come down and personally meet any admitted patient waiting more than 1 hour for a bed in the ED Ensure that we remember it is human being, not just a statistic, lying there in that chaotic hallway (Stolen from this month's EM:RAP)

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Justin Morgenstern

@First10EM

3 years

Any pharmacy offering symptomatic COVID testing immediately loses my business for all other transactions Is that worth the trade off?

Nathan Stall

@NathanStall

3 years

“Absolutely ridiculous...it just does not seem like a good idea.” #Ontario pharmacies will soon test symptomatic people for #COVID19 . Without capacity limits and ventilation standards, this seems like a surefire way to infect others and cause outbreaks.

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Justin Morgenstern

@First10EM

1 year

Emergency Airway Management Part 1: Optimizing the basics

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Justin Morgenstern

@First10EM

4 years

3 normal ultrasounds 1 normal CT The appendicitis that was pretty obvious on day 1 was finally officially diagnosed on a 4th ultrasound 3 days later We often put too much weight in radiology reports and not enough weight in clinical assessment

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Justin Morgenstern

@First10EM

6 years

Calcium channel blockers are better for SVT Strong work by team @FOAMpodcast (as I always feel when I read things that fit with my preconceived notions) #FOAMed

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Justin Morgenstern

@First10EM

9 months

Happy New Year! To celebrate, why not spend some time reading the top 10 posts on First10EM in 2023? Number 1: Don’t prescribe tramadol #FOAMed

Don't prescribe tramadol - First10EM

Tramadol is a bad drug. It is unpredictable, with essentially no pain relief for some patients and much too high doses for others.

first10em.com

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Justin Morgenstern

@First10EM

5 years

Don't prescribe tramadol My conclusions after reviewing the literature #FOAMed

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Justin Morgenstern

@First10EM

3 years

After fighting all year to get people to accept the science on airborne spread, only to be denied because of @WHO recommendations, it is quite amazing to hear that the @WHO "has always recognized the importance of airborne transmission"

Soumya Swaminathan

@doctorsoumya

3 years

WHO has always recognized the importance of airborne transmission in certain situations & settings and provided appropriate guidance. We need to focus on all prevention methods, incl good ventilation, recognizing that some measures are more relevant depending on context.

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Justin Morgenstern

@First10EM

3 years

The science is clear COVID is airborne So where is the advocacy from @ACEPNow @CMA_Docs @SAEMonline @OntariosDoctors @CAEP_Docs @WHO @GovCanHealth to protect healthcare workers, patients, and all of society?? Science denialism is a bad look in medicine

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Justin Morgenstern

@First10EM

3 years

This is an excellent document if you want a summary of the evidence that clearly shows COVID is airborne There is better evidence that COVID is airborne than there is for measles

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Justin Morgenstern

@First10EM

6 years

Paramedic 2 quick summary If 1000 people treated with epi: 246 extra ROSC 158 extra admissions 8 extra survivors (5 with bad neuro outcomes, 3 with good neuro outcomes) What those numbers means is a value question, not a science question #FOAMed

Paramedic 2: Epinephrine harms/helps in out of hospital cardiac arrest - First10EM

Should we be using epinephrine in cardiac arrest? This post breaks down the recent PARAMEDIC 2 trial. Short answer, probably not.

first10em.com

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Justin Morgenstern

@First10EM

4 years

Seriously?? We took a holiday from vaccinating?? Who the hell is in charge??

David Carr

@davidcarr333

4 years

@jkwan_md No vaccinations on the weekend or holidays. No need to update your vaccine data till the 30th. Early closures of vaccine clinics on Dec 24th with reopening on the 29th? Not sure now is the time to take 4.5 days off. Covid is not on holiday.

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Justin Morgenstern

@First10EM

3 years

Finally, @GovCanHealth clearly states that COVID is airborne (although without using the word)

Statement from the Chief Public Health Officer of Canada on November 12, 2021

/CNW/ - Since the outset of the pandemic, we have learned a lot about the SARS-CoV-2 virus that causes COVID-19. Most importantly, we have learned how the...

www.newswire.ca

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Justin Morgenstern

@First10EM

3 years

Again: Caring for patients is not a right, it is a privilege If you choose to remain unvaccinated, you lose that privilege

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Justin Morgenstern

@First10EM

5 years

No reason to choose tramadol over morphine - my article in EMNews #FOAMed

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Justin Morgenstern

@First10EM

4 years

Coats don’t work

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Justin Morgenstern

@First10EM

3 years

I think the science is very clear: COVID is spread by airborne transmission. It looks almost identical to the prototypical airborne infection tuberculosis. It should be treated with the same precautions...

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Justin Morgenstern

@First10EM

4 years

I am not American, but this is a shockingly strong statement by @NEJM "Our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs."

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Justin Morgenstern

@First10EM

3 years

Based on the responses, everyone in the world seems to think this is obvious... except those running the pandemic response in Canada

Justin Morgenstern

@First10EM

3 years

The evidence suggests N95s are better than surgical masks I kept hearing the opposite, but after finally reading the evidence myself, it is clear that N95s are the better option #FOAMed

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Justin Morgenstern

@First10EM

4 years

I'm an ER doc. My psychologist was paid for by my hospital while in New Zealand. It's not a red flag. It's a sign I recognize the extreme stress of this job, and the need to stay as healthy as possible to provide the best quality care to my patients.

Anand Swaminathan MD MPH 🏳️‍🌈🇺🇦

@EMSwami

4 years

I'm an ER doc. I've never suffered from depression but, last 4 months have been incredibly hard. I started seeing a psychologist for the 1st time It feels selfish to take an hour once a week to talk about myself But i've already learned a lot

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Justin Morgenstern

@First10EM

5 years

An update on peripheral vasopressors No bad outcomes in more than 14,000 patients - clearly this is not as dangerous as we we told #FOAMed

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Justin Morgenstern

@First10EM

3 years

First major political party in Ontario to follow the science and formally recognize that COVID is airborne - I hope everyone follows suit, but this demonstrates far better leadership than our current government

Steven Del Duca

@StevenDelDuca

3 years

No more delays, @fordnation . Cases are rising. We need strong vaccine mandates, improved ventilation because COVID-19 is airborne, and stronger public health measures that support businesses and workers. #onpoli Our @OntLiberal plan:

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Justin Morgenstern

@First10EM

4 years

People in Canada often like to think we are well ahead of America on issues of race With Kamala Harris as the new VP, it's time to reflect hard on the fact we have never elected anyone other than a white man to run this country Racism is real in Canada

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Justin Morgenstern

@First10EM

4 years

I hate lockdowns You know what I hate more than lockdowns? People dying

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Justin Morgenstern

@First10EM

5 years

The multitude of alerts in the emergency department boggles my mind My EMR thinks it's essential to flag a low acetaminophen level OH MY GOD - WE CAN'T FIND ANY ACETAMINOPHEN!!!! Thanks. That was really helpful computer

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Justin Morgenstern

@First10EM

3 years

I don't know why news agencies keep running this nonsense "I had to take tests and quarantine after travelling during the pandemic" is not a news story @CBCNews

saskatchewan potato utility

@birlios

3 years

I am so freaking bored of seeing this same story. You left the country during a pandemic and you came back during a pandemic and there were a series of minor inconveniences along the way. This isn't news.

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Justin Morgenstern

@First10EM

4 years

Why is @UnityHealthTO denying the vaccine to pregnant healthcare workers?? The risk from COVID is probably higher than the risk from the vaccine You are going to force pregnant nurses to work in the ICU without the protection of a vaccine? Let them choose! @BogochIsaac

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Justin Morgenstern

@First10EM

10 months

You would think that hospitals should care at least as much about sleep as an airline Why can't we give patients eye masks and ear plugs like I get with my flights? At a bare minimum. Why are hospitals designed to be such inhumane places?

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Justin Morgenstern

@First10EM

5 years

Overnight, sent home 12 patients with the presumptive diagnosis of COVID but no testing because of restrictions We won't flatten the curve like this @PublicHealthON

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Justin Morgenstern

@First10EM

5 years

I had never heard of using TXA for angioedema until I heard this great episode of the @iBookCC @PulmCrit @adamdavidthomas I've now seen excellent results in 3 patients (for what my anecdotal evidence is worth) #FOAMed

Angioedema

CONTENTS Rapid reference 🚀 Overview Diagnosis of angioedema Histamine-mediated vs bradykinin-mediated angioedema Airway management Histamine-mediated angioedema Bradykinin-mediated angioedema...

emcrit.org

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Justin Morgenstern

@First10EM

9 months

PPIs should not be prescribed for upper GI bleeds (pre-endoscopy)

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Justin Morgenstern

@First10EM

6 years

I can't think of another critical care or emergency conference that I've been to where the opening pannel is 100% female #SMACC What an incredible start to the conference @smaccteam

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Justin Morgenstern

@First10EM

1 year

Don’t prescribe tramadol

Don't prescribe tramadol - First10EM

Tramadol is a bad drug. It is unpredictable, with essentially no pain relief for some patients and much too high doses for others.

first10em.com

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Justin Morgenstern

@First10EM

4 years

Good to see this information catch up with the science

COVID-19 is spread by aerosols (airborne): an evidence review - First10EM

COVID-19 is spread by aerosols - a review of the available science.

first10em.com

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Justin Morgenstern

@First10EM

6 years

BP 85/50 —> bolus —> BP 65/40 —> bolus —> even worse Time to review this post on the crashing RV failure patient #FOAMed

Pulmonary hypertension and right ventricular failure - First10EM

An emergency medicine and critical care guide to the resuscitation of right ventricular failure in the setting of severe pulmonary hypertension.

first10em.com

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Justin Morgenstern

@First10EM

6 years

I have worked in emergency medicine for almost 10 years in Canada. I have never seen a single patient with a gun injury. This is possible. #fix18 @meganranney

Justin Morgenstern

@First10EM

6 years

Science is not about advocating for one side or the other. It is a quest for the truth. We absolutely need gun violence research. This is not politics, it’s health. @MeaganRanney @ERdisasterdoc @feminemtweets #FIX18

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Justin Morgenstern

@First10EM

3 years

It is now very clear that all Ontario hospitals need to update their PPE policies @ONThealth @PublicHealthON @OntariosDoctors @UnityHealthTO @UHN @Sunnybrook @MSHospital @NYGH_News @TOPublicHealth @OttawaHealth @CAEP_Docs

Canada's CPHO

@CPHO_Canada

3 years

1/4 Since the outset of the pandemic, we’ve learned a lot about the #SARSCoV2 virus that causes #COVID19 . Importantly, we’ve learned how the virus can linger in fine aerosols and remain suspended in the air we breathe.

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Justin Morgenstern

@First10EM

3 years

Again - I would kindly invite anyone recommending against N95s to engage with me on the science This has been a pandemic of anti-science dogma as much as it has been a pandemic of a virus Lets use this science to keep our HCWs and patients safe

Justin Morgenstern

@First10EM

3 years

The evidence suggests N95s are better than surgical masks I kept hearing the opposite, but after finally reading the evidence myself, it is clear that N95s are the better option #FOAMed

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Justin Morgenstern

@First10EM

3 years

It is absolutely impossible to control an infectious disease when the public health officials in charge of controlling its spread will not publicly acknowledge its route of spread

Justin Morgenstern

@First10EM

3 years

COVID numbers are rising rapidly in Ontario Once again, urgent action is needed One of the most important things we can do is to finally acknowledge science and state clearly for everyone that COVID is airborne @PublicHealthON @COVIDSciOntario @TOPublicHealth @COVIDSciOntario

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Justin Morgenstern

@First10EM

4 years

Favourite pearls about diagnostics in emergency medicine? @broomedocs @LWestafer @EMSwami @_NMay @srrezaie @TheSGEM @EMManchester @PulmCrit @davidcarr333 My number 1 overlooked lesson is that pretest probability REALLY matters

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Justin Morgenstern

@First10EM

2 years

Every emergency department should review the impacts of the Canadian Association of Radiologists Guidance on Contrast-Associated Acute Kidney Injury We should not be delaying urgent imaging to wait for a creatinine

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Justin Morgenstern

@First10EM

3 years

COVID has clearly demonstrated how poorly medicine, as a whole, understands science This ongoing fiasco should prompt significant reassessments in all areas of medicine I might suggest: Stress tests tPa in stroke adenosine Urine drug screens "Clearing" psych pts The word quiet

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Justin Morgenstern

@First10EM

3 years

When your government doesn't understand how COVID is spread, you end up with disasters exactly like the one we are facing now

David Fisman

@DFisman

3 years

No words @jljcolorado @kprather88

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Justin Morgenstern

@First10EM

5 years

We need to drastically rethink hospitals. When I am sick, I want a dark quiet room. I want a good night’s sleep. And I want something to entertain me/ distract me during the day. I don’t want beeping, alarms, middle of the night BP checks, 5 am blood draws, and hours of tedium.

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Justin Morgenstern

@First10EM

3 years

From one of the smartest infectious disease docs in Canada: "We have come to learn over the past 18 months that virus-containing aerosols are a dominant method of COVID-19 transmission" But our hospitals deny this and refuse to protect our patients

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Justin Morgenstern

@First10EM

3 years

Washed my hands, paused to talk to nurse, and started to put on gloves to see a patient - subsequently got thoroughly scolded by IPAC for not washing my hands again before putting on the gloves. I really have lost all faith in IPAC

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Justin Morgenstern

@First10EM

5 years

Have you ever portrayed a bad stereotype while teaching? The mean surgeon during a sim session? I know I have, but this is an awful reinforcement of the hidden curriculum. I'll try to be better. @SocraticEM #smacc

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Justin Morgenstern

@First10EM

2 years

This was the basis for my first ever EM:RAP recording. Now more than 7 years old, but perhaps the post I use most often on shift: Palliative resuscitation for dyspneic patients

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Justin Morgenstern

@First10EM

3 years

Why does every 'improvement' in a hospital seem to make the emergency department less efficient? You used to be able to do that in one click? Don't worry, with our upgrade it will now be 5!

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Justin Morgenstern

@First10EM

6 years

Dislodged tracheostomies can be really scary - as I was reminded on shift last night. Really glad I had recently reviewed this topic #FOAMed

Respiratory distress in the patient with a tracheostomy (update) - First10EM

A summary of the emergency medicine approach to respiratory distress in the patient with a tracheostomy

first10em.com

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Justin Morgenstern

@First10EM

5 years

CRASH 3: TXA is no wonder drug No change in primary outcome, no change in mortality, no change in disability. I won't be using TXA. #FOAMed

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Justin Morgenstern

@First10EM

5 years

Disagree entirely. We are humans as well as doctors - I will always start my phone calls with "Hi, how's your day going?" Although the response is, sadly, still mostly "what do you want?'

Rhea Liang

@LiangRhea

5 years

Advice to young docs when calling the on call surgeon. We expect to be called. You can skip 'how is your day?' or 'is this a good time?' or 'I'm really sorry to bother you but...' If I answer the phone- just talk. And *especially* don't say 'sorry did I wake you?' at 3pm.😳

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Justin Morgenstern

@First10EM

5 years

Trauma patient - leg/abdo symptoms only. Never chest pain, shortness of breath, diaphoresis, nausea, vomiting, dizziness. Lowest BP 95/65, highest HR 65, normal sats. No cardiac history. Normal bedside echo to my eye. What do you make of this ECG?

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Justin Morgenstern

@First10EM

3 years

Just a reminder that smallpox was endemic until we decided to do something about it Endemic is not a happy ending for COVID

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Justin Morgenstern

@First10EM

3 years

85% of expired COVID viral load is found in aerosols <5um So why does my hospital insist only droplets matter? Why are vulnerable patients kept 6 feet from COVID patients? Why do we act like a threadbare curtain will protect against COVID transmission?

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Justin Morgenstern

@First10EM

3 years

The reason that I have to get fit tested for an N95 every 2 years was SARS SARS-CoV-2 rolled along, and they insist I no longer have to wear that N95 Insanity

Kimberly Prather, Ph.D.

@kprather88

3 years

The amount of resistance to accepting SARS-CoV-2 is airborne is especially surprising given it was well accepted that SARS-1 was airborne. They believed in the precautionary principle back then--so they stomped it out.

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Justin Morgenstern

@First10EM

4 years

We should test all admitted patients We can't expose our staff without appropriate PPE, only to find out days later that the patient was actually positive. These are not "surprises" anymore. Many many atypical presentations.

Justin Morgenstern

@First10EM

4 years

In 201 asymptomatic woman presenting for delivery in NYC, 29 (14%) were positive for COVID (plus false negatives due to 70% sensitivity)

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Justin Morgenstern

@First10EM

3 years

@KashPrime Yeah. I thought the answer was pretty obvious Just like the comparison, because the airborne group is still not acknowledged as wrong in many hospitals

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Justin Morgenstern

@First10EM

1 year

After spending a lot of time with the literature, I am relatively convinced that the current enthusiasm for balanced transfusion, whether 1:1:1 or 1:1:2, is misguided, and we will use less FFP and platelets in the future

Massive hemorrhage: a very deep dive - First10EM

A deep dive into all of the available evidence around current massive hemorrhage protocols in emergency medicine.

first10em.com

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Justin Morgenstern

@First10EM

5 years

Tamiflu doesn’t work A new RCT claims it does, but really just provides us with an excellent lesson in the importance of blinding and placebo #FOAMed

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Justin Morgenstern

@First10EM

3 years

COVID is clearly airborne I've been saying this for a long time () Here is a new paper in the Lancet that explains the science Congrats @DFisman @trishgreenhalgh Thread follows...

COVID-19 is spread by aerosols (airborne): an evidence review - First10EM

COVID-19 is spread by aerosols - a review of the available science.

first10em.com

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Justin Morgenstern

@First10EM

2 years

The now infamous but not very helpful N95 trial (Loeb 2022) Too many sources of bias to be really helpful. #FOAMed

The now infamous but not very helpful N95 trial (Loeb 2022) - First10EM

A critical appraisal of the N95 RCT Loeb 2022. Short answer- this trial had too many flaws to allow us to draw valid conclusions.

first10em.com

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Justin Morgenstern

@First10EM

3 years

@Mrhockey1231 @GovCanHealth Yes - continuing to suggest non-airborne PPE for a disease you are clearly stating is airborne is absolutely nonsensical and dangerous @GovCanHealth

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Justin Morgenstern

@First10EM

3 years

If anyone has brought a CO2 detector into the arena for a @Raptors game, I would love to know the numbers. Anyone have good data on ventilation from other NBA arenas at full capacity?

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Justin Morgenstern

@First10EM

3 years

Also - if ventilation is so important, why haven't we suggested measurements for mass gatherings indoors in Ontario @COVIDSciOntario @NathanStall @DFisman

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Justin Morgenstern

@First10EM

3 years

COVID-19 spreads through the air. Here's what you can do about it this winter

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