Jace Mullen @_JaceMullen Twitter profile

Last Seen Profiles

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Jace Mullen

@_JaceMullen

7 months

Paramedic school never taught me how to respond when a gangster responds to you treating them with dignity and kindness by offering their services as a hit man.

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Jace Mullen

@_JaceMullen

7 months

Anyways Harm Reduction works. Support your local harm reduction center!

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Jace Mullen

@_JaceMullen

7 months

@DanMeisels I’m so glad I never worked anywhere that cared about getting signatures. Sometimes I would remember

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Jace Mullen

@_JaceMullen

7 months

Obsessed with our new cric kit. Everything you need, nothing you don’t. Love how it’s packaged with everything visable and in order for a Scalpel-Finger-Bougie cric.

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Jace Mullen

@_JaceMullen

7 months

Not to start a fight but I’m about to start a fight I’m just an observer here but since moving to a sorta-in-hospital setting it sure seems that the more cringy nursey stickers and stuff you own the worse you are your job

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Jace Mullen

@_JaceMullen

11 months

Paramedic pay should, at a minimum, allow for paramedics to live in their service area. That’s it, that’s the tweet

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Jace Mullen

@_JaceMullen

2 months

If I had to do compressions and defibrillation in order to achieve it, was the return do circulation really spontaneous?

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Jace Mullen

@_JaceMullen

4 months

Having someone you've never met trust you to take their baby, parent, or loved one from them during an emergency is the closest thing to sacred I've ever experienced. It's an honor worth reflecting on sometimes.

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Jace Mullen

@_JaceMullen

7 months

This is how I want to be remembered Putting ketchup on my flight bowl of hash browns like god intended

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Jace Mullen

@_JaceMullen

4 months

US healthcare is a religion. Paramedics, having taken a monastic vow of poverty in service of the sick and injured, are amongst the holiest of its clerics.

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Jace Mullen

@_JaceMullen

5 months

Come work with me! We have an open medic position at my base -Good medicine -Really great high performing coworkers -we do everything: RW, FW, and CCT ground -Unique missions profile (ECMO to backcountry SAR calls) -Colorado is rad

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Jace Mullen

@_JaceMullen

2 months

Getting gaslit by the ER staff because my stroke patient with their face melting off was actually just a TIA and had no defects by the time I got to the ER

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Jace Mullen

@_JaceMullen

6 months

Harm Reduction is to EMS as fire prevention is to the fire service. We’re some of the only people in medicine that get 1-on-1 time with patients even after we’re done with what we need to do. That last bit of time on the ride in is valuable, don’t let it go to waste.

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Jace Mullen

@_JaceMullen

6 months

Bubbles are such a pro move for pediatric 911 calls. We know they chill out the kiddo but if you hand them to a parent you include them in their kids care, giving them some semblance of control back which chills them out—a chill parent makes for a chill kid.

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Jace Mullen

@_JaceMullen

3 months

I don’t know who needs to hear this but if they don’t respond to painful stimulus you’re done, you have the data you need. You don’t need to keep hurting them harder or longer you can move on it’s going to be okay. (This tweet sponsored by the anti-sternal rub club)

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Jace Mullen

@_JaceMullen

1 year

The award for the most ✨aesthetic✨blood pressure goes to…

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Jace Mullen

@_JaceMullen

8 months

Remember when EMT school made it sound like everyone you’d run on having chest pain would have their own bottle of nitro? Turns out that was a lie

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Jace Mullen

@_JaceMullen

8 months

When she’s a freak in the sheets but she’s also

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Jace Mullen

@_JaceMullen

4 months

Wanna be a resuscitationist? Cool, start learning how ALL of your equipment works. How to troubleshoot it, its limitations, and how to maximize it. No excuses, be an expert in every piece of equipment you use.

Chelsea || FP-C, CCP-C 🚁🚑

@bassoonapillar

4 months

We can prevent harm to our patients by being familiar with how our equipment functions and operates.

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Jace Mullen

@_JaceMullen

11 months

Once again doing unholy things in a public bathroom

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Jace Mullen

@_JaceMullen

9 months

So stoked to work for a program that takes our hearing seriously. New custom molded hearing protection now standard PPE for our whole program. This absolutely should be industry standard.

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Jace Mullen

@_JaceMullen

6 months

I am so grateful to have come up as a paramedic in a system where we all wanted to run calls. If you pissed if dispatch they sent you to the slowest posts and people would fight tooth and nail to get out if it. Running calls is fun as hell just let me take care of sick people

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Jace Mullen

@_JaceMullen

6 months

This is the most chaotic assembly of gear I’ve ever seen under the guise of a first aid kit. Or “I mean the paramedics do this how hard could it be?”

ECGs

@EcgsOnly

6 months

Mobile mini-crash cart 🚗 You never know what can happen on the road 😐

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Jace Mullen

@_JaceMullen

1 year

With hyper-angulated VL we are taught things like the Kovsc’s Sign* or the 50/50 rule**. w/ HAVL visualization of cords is rarely the issue, rather it’s tube delivery. Simply, the worse your view, the more success you should find with tube delivery. But why…? 🧵

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Jace Mullen

@_JaceMullen

7 months

Hey Paramedics: you’re also not immune from needing clinical rationale for any test or procedures you do in the back of the ambulance

Casey Parker

@broomedocs

7 months

This is awesome

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Jace Mullen

@_JaceMullen

6 months

I’ve been doing this since @critconcepts wrote about it in must have been 2014? It’s incredible that I still get sideways looks when I do it. I consider a BVM with airway adjuncts to be married. They go together in sickness, that’s for sure.

armyemdoc

@armyemdoc

6 months

Your first intubation attempt failed. You have to bag the patient back up before you go to plan B. This is what your patient should look like... It's far easier to bag when you've double-barreled their nose and placed an OPA. #emergency #emergencymedicine #foam #foamed …

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Jace Mullen

@_JaceMullen

9 months

Everyone thinks they’re the cool one until the Blackhawk with the hoist team shows up

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Jace Mullen

@_JaceMullen

11 months

Time to see if I still know how to be a real paramedic…it’s been a minute

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Jace Mullen

@_JaceMullen

6 months

You know you’re in for a hard transport when the sending attending has the same UpToDate page pulled up in the background while giving report as you were reading on the way there

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Jace Mullen

@_JaceMullen

6 months

US Paramedicine doesn’t have a codified philosophical or theoretical framework. It feels at times like it’s ad hoc because it IS ad hoc. It’s easy to forget how young of a field it is, and how very recently people actually started to care about it. Maybe they still don’t.

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Jace Mullen

@_JaceMullen

8 months

As a general rule, I don’t trust anyone who feels like they need to embroider the word “leader” onto their scrubs or wear a “leadership” badge buddy. You are management, we the managed will determine if you’re a leader. You don’t get to just call yourself a leader.

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Jace Mullen

@_JaceMullen

8 months

You know what’s really cool? Taking good care of people

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Jace Mullen

@_JaceMullen

6 months

My favorite thing about paramedics is how we all want to practice at the tops of our scope… With the exception of foleys They are in most of our scopes and yet are broadly ignored

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Jace Mullen

@_JaceMullen

6 months

Goodmorning to everyone working a bonus 13-hour shift today and only to people working a 13-hour shift today!

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Jace Mullen

@_JaceMullen

6 months

I see a lot of unnecessary panic in the peri-intubation period surrounding a misunderstanding of SpO2, and specifically pulse-ox lag. I was going to write a neat tweetorial but then I found this that’s both quicker and better than anything I could do:

Pulse Ox Lag

Folks put a lot of stock in the pulse oximeter, as they should, because the pulse ox is an awesome feat of engineering and patient safety. But the pulse ox lags. Here, the inestimable Dr. Jonas Pol…

emupdates.com

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Jace Mullen

@_JaceMullen

1 year

A habit I have gotten in which I wish I had used more as a ground medic is making little “cheat sheets” on my way to calls. I have expected doses and volumes of any meds I might need (always RSI meds). Peds I add normal vitals, equipment sizes (if you don’t use @Handtevy )

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Jace Mullen

@_JaceMullen

6 months

If you approach every low acuity call with the mindset of training for the high acuity patient, you will perform when it matters. If you blow off the "BS calls" don't be surprised when you can't perform on the sick patient. It's all practice and there's no substitute for reps

bay-lee

@crtsbly

6 months

@_JaceMullen 1000% agree! Nothing can substitute repetition on both high and low acuity calls.

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Jace Mullen

@_JaceMullen

1 year

Difficult airway prediction tools don't have a place in EMS. Either they need RSI/DSI or they don't. There's not some scenario where "well we'd tube them but since their mouth opening sucks..." Approach every airway as you would a difficult one and you wont even miss LEMONS

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Jace Mullen

@_JaceMullen

6 months

Anyways, being prepared to respond to emergencies is cool. But packing stuff to do "hero shit" but nothing to respond to the likely life-threats is misguided. The basic stuff saves lives not the hero shit: BLS airway management, bleeding control, and a cell-phone.

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Jace Mullen

@_JaceMullen

3 months

No matter who you are or where you are this will always be a constant: Bring a patient in to the ED on NIV who looks chill: ED will always take off the mask and then be shocked that the patient looked good because of the positive pressure. Weird, we didn’t do it just for fun

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Jace Mullen

@_JaceMullen

1 year

You might me in a Colorado EMS lounge when they have Oreos by the roll available

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Jace Mullen

@_JaceMullen

1 year

“Scene calls aren’t dick measuring contests” Oh really, then why do SAM splints have rulers on them?

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Jace Mullen

@_JaceMullen

8 months

I have an EMS joke but no one gives a shit about it

Paul Wischmeyer MD,EDIC,FCCM⎪ #NutritionMatters 💪

@Paul_Wischmeyer

8 months

Anyone have any good jokes? 😂 #MedTwitter

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Jace Mullen

@_JaceMullen

3 months

Putting on a tourniquet: “Hey man this is about to fucking suck, hopefully I’ll be able to give you something for the pain here in a minute but I can’t promise that right now”

Nicole Trauma Llama APRN, CNS

@TraumaSoapBoxes

3 months

Remembering the ENT resident who told my kid years ago that getting the inside of her nose cauterized for repeat epistaxis (nosebleeds) wouldn’t hurt Y’all… be honest. Things we do hurt. They suck. They’re not fun. Don’t gaslight. Don’t fib. Be trustworthy

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Jace Mullen

@_JaceMullen

1 year

I’d like to take a second to apologize to all the EM and crit care docs for the right sided EJs I placed in patients you probably wanted to line. I didn’t know better then but now that I do know better I will probably still do it again, but only if I have to.

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Jace Mullen

@_JaceMullen

1 year

Since starting to fly I don’t feel like a “real paramedic” anymore (buy me a beer and I’ll tell you what that means to me). While this job is profoundly difficult, it doesn’t use like 90% of the hardest skills of being a medic. The “paramedic” stuff in HEMS is the easy stuff

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Jace Mullen

@_JaceMullen

5 months

The number of OB nurses on any given floor that are pregnant at any given time defies nature

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Jace Mullen

@_JaceMullen

7 months

As a paramedic I think I understand how hospitals works and then I learn that nurses at Level IV NICUs don’t all have to have NRP or STABLE and I realize I’m just a prehospital gremlin

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Jace Mullen

@_JaceMullen

1 year

🧵 We talk about the stress curve, we know that there is "optimal stress" where we perform best. Too little pressure, we get bored; too much stress we perform poorly. We talk about this mostly in our personal practices. But as a flight medic I also apply this to groups.

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Jace Mullen

@_JaceMullen

1 year

Coming in with the unfiltered opinions none of you asked for: Neonatal Resuscitation Program (NRP) should be required for all paramedics just like ACLS and PALS essentially are. It’s not “PALS but smaller”. It’s a fundamentally different approach.

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Jace Mullen

@_JaceMullen

4 months

It should surprise no one that taking a critically ill patient and then flying them to 14,000’ in an unpressurized cabin can make things REALLY hard.

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Jace Mullen

@_JaceMullen

1 year

It blows my mind how ICUs (you know the place with all the intubated patients) sort sorta don’t use? ETCO2? Like some patients seem to have to sometimes but by-and-large it’s not used. Babes, it’s almost 2023. We’re living in the future.

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Jace Mullen

@_JaceMullen

1 month

Next time you get to the point in a code where someone gets bored enough to try to do bicarb: Tel them to grab some graham crackers, crush them up and sprinkle them on the patient. Since they wanna do something with no benefit because “it won’t hurt them” (Bicarb does)

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Jace Mullen

@_JaceMullen

6 months

Did you know that you can just order a custom flight suit nametag?

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Jace Mullen

@_JaceMullen

3 months

ARE YOU FUCKING KIDDING ME Figs flight suit coming to a HEMS-influencer near you

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Jace Mullen

@_JaceMullen

2 months

You can’t human factors or system design your way out of people needing baseline competence. Systems that attempt to end up incredibly fragile and difficult to work within.

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Jace Mullen

@_JaceMullen

9 months

Remember most End Tidal Nasal Cannulas provide what is effectively only blow-by oxygenation maxing out around 8 lpm. The prongs are for sampling not oxygen delivery and thus it is not appropriate for pre-oxygenation or ap-ox. I made a gif to demonstrate:

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Jace Mullen

@_JaceMullen

10 months

After four days in a row of delivering a new Advanced Airway Course to my program all over Colorado I am EXHAUSTED! So grateful to all the airway educators who have taught me how to teach these skills. They showed me how to make this feel like playing more than learning!

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Jace Mullen

@_JaceMullen

8 months

Say it with me: ETT cuffs don't need 10 ml of air! Use cuff manometry and aim for 20-30 cmH2O as a starting point. This tweet sponsored by the 9ml of air I recently took out of a very uncomfortable patient's ETT cuff.

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Jace Mullen

@_JaceMullen

3 months

Holy fuck this is one of the most thoughtful, earnest, and true threads I’ve read on here in a long time. Not just valuable for paramedics grappling with med schools but a great peak into the psyche of EMS for those that want to know how our weird little brains work.

Dr Aidan Baron

@Aidan_Baron

3 months

I end up speaking to paramedic friends and collages every few months about doing medicine. Is it worth it? What’s the process like? “Should I do it?” And my answer is essentially these three things I’ve discovered and learned from others 1/ 🧵

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Jace Mullen

@_JaceMullen

4 months

The cool thing about flight suits is that they don't trigger the "I love a man in uniform" response but they also manage to let the cold knives of winter wind assault you but you'll also sweat more than you thought possible in summer.

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Jace Mullen

@_JaceMullen

2 months

Yo dawg I heard you like VL… #PAC24

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Jace Mullen

@_JaceMullen

6 months

Respirtory.

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Jace Mullen

@_JaceMullen

1 year

Surgery time! Turning one of the best airway mannequins in the world into a SALAD capable mannequin! @jducanto @7SIGMAMPLS @intubatiem

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Jace Mullen

@_JaceMullen

2 months

Have we considered bottling whatever alleged magic is in a IV started in a hospital versus the field? Maybe then they could just pour that elixir onto a field line instead of pulling it reflexively

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Jace Mullen

@_JaceMullen

1 year

The best medics I know consult base more than the rest. They present the case, and present a plan or look for guidance of the best of two+ options or ask for creatively solving a problem outside of protocols. The best docs collaborate.

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Jace Mullen

@_JaceMullen

2 months

It’s a borderline holy event here at #PAC24 @jducanto and the making of the goo

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Jace Mullen

@_JaceMullen

7 months

The biggest thing that moving to HEMS has highlighted for me is that the medicine—the acute resuscitation of the critically ill—is the easy part of being a paramedic. It’s everything else that is fucking hard. Dispo’s and the “maybe sick” patients are far more cognitively taxing

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Jace Mullen

@_JaceMullen

6 months

The past tense of "troubleshoot" is "troubleshat" As in: "We just troubleshat our way through that transport"

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Jace Mullen

@_JaceMullen

4 months

US EMS risk management follows the abstinence only model, with similar results. We have to, as a profession, learn to accept and manage risk. It’s not enough to simply say “we just won’t accept any”

Chris Root

@ChrisRootMD

4 months

Photographic demonstration of the difference in safety culture between US and UK EMS from @DrDougKupas . The UK paramedics are the ones in green helmets, the US paramedics are the ones with no gear at all. #NAMESP2024

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Jace Mullen

@_JaceMullen

29 days

If I get auto-peded due to Alabama’s hostile pedestrian infrastructure someone make sure the medic only gets a donut if he doesn’t goose the tube #CCTMC24

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Jace Mullen

@_JaceMullen

10 months

Colorado: In order to be “primary provider” on an air ambulance a Paramedic needs 3 years/4000 hours experience in an ER or ICU. Considering the scope of most medics in ERs in Colorado, does this sound misguided to anyone else? How did this end up as law?

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Jace Mullen

@_JaceMullen

28 days

“It’s essential to be able to perform effective CPR in flight. The only way to do that is mechanical CPR” @DarrenBraude #CCTMC2024

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Jace Mullen

@_JaceMullen

4 months

@KurteL10 I tell my new partners that yeah, we have a fast helicopter, bags full of blood and other tools of resuscitation, but the most important thing we bring with us is that we “bring the calm”. “Bring the calm” is almost like a mantra at this point

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Jace Mullen

@_JaceMullen

9 months

Also now that I’m a licensed paramedic we can all agree the the “certification vs. licensure” argument against paramedic pay has always been a dumb semantic argument. “Nurses are licensed, paramedics are certified so how could we pay paramedics more” You can, it’s all made up

Jace Mullen

@_JaceMullen

9 months

I want to issue a formal shoutout to whoever it was at the Colorado EMS office who correctly decided that a Philosophy degree is “health sciences related” for the purpose of converting from a certified to a licensed paramedic.

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Jace Mullen

@_JaceMullen

7 months

Best costume of the year right here!

Dan M.

@DanMeisels

7 months

@_JaceMullen @emergcasey i love spooky season! 🎃 and Twitter.. and photoshop.. 😂

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Jace Mullen

@_JaceMullen

9 months

Good morning say it back

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Jace Mullen

@_JaceMullen

1 year

Paramedics have no role in the HEMS environment and certainly not in managing critical ICU patients.

Áine Yore, MD 🏳️‍⚧️🇮🇪

@AineYoreMD

1 year

“Thrombolysis is a proven, effective treatment for acute ischemic stroke.”

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Jace Mullen

@_JaceMullen

5 months

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Jace Mullen

@_JaceMullen

6 months

#twinning

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Jace Mullen

@_JaceMullen

1 month

On “Airway Monogomy”: If you use a bougie whenever you’re using Standard Geo laryngosocopy, you will become so much more facile with it than if you only pull it out when you’ve already looked in an airway and got scared. Start every airway like you would a difficult one.

Jace Mullen

@_JaceMullen

1 month

“In summary, the bougie as an aid in the first intubation attempt was associated with increased success. These data suggest that bougie should probably be used first and not as a rescue device.”

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Jace Mullen

@_JaceMullen

7 months

I so badly want to be a cool FOAMed POCUS dude but I just simply don't work for a program that does it. Also I'm not convinced the places doing it locally are doing it well.

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Jace Mullen

@_JaceMullen

11 months

Made a thing. Pretty stoked with how it turned out. Mostly hand tools, based on the vernacular welsh form.

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Jace Mullen

@_JaceMullen

1 year

If you’re in healthcare but you’ve never worked in the field maybe tonight is the night to keep your “hot takes” to yourself. This is the stuff that paramedics do best. Good luck to the crew and ED staff out there. Thoughts with the family and the teams.

Nicole Trauma Llama APRN, CNS

@TraumaSoapBoxes

1 year

I’m here to tell you everything you learned on TV about what happens when someone codes is false

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Jace Mullen

@_JaceMullen

1 year

Small nuance but as one who spent years on twitter dot com banging the “paramedics are experts at Paramedicine” drum (before it was cool) I’ve shifted from the descriptive to the normative. Paramedics *should* be experts in paramedicine.

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Jace Mullen

@_JaceMullen

11 months

It's funny how the people who are less good at this job inexplicably "hate these stupid QA flags". And the people who are good at their job are willing to engage with the CQI process...

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Jace Mullen

@_JaceMullen

1 year

@jtrebach Yo I once had to make the firefighters go get my patient because she tried to clean her urine off the floor with bleach and oopsie made chloramine gas. So, yeah, don't do that either

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Jace Mullen

@_JaceMullen

1 year

Prehospital seizure patients rarely come with IVs. I like IM Midaz as first line and then get a line for any additional midaz.

RockyMtnEM

@RockyMtnEM

1 year

No IV with patient in status? That’s ok! Use IM or IN midazolam. #RMWC23

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Jace Mullen

@_JaceMullen

1 year

What’s old is new again

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Jace Mullen

@_JaceMullen

4 months

I need this in my house more than anything This is rad, Claire!

Claire Zagorski, MSc, LP

@clairezagorski

4 months

YALL look at this! Thank you so much @CatsVaxnNatSec ! 🥹💕🥰

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Jace Mullen

@_JaceMullen

1 year

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Jace Mullen

@_JaceMullen

8 months

Lifehack: You don’t want your INR and your hemoglobin to be the same number

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Jace Mullen

@_JaceMullen

4 months

Love this. There are far, far, fewer true BVM masters than there are who think bag-mask ventilation can’t be hard because it’s “BLS”

Eric Jaeger, JD, NRP, EMS IC (He/Him)

@EricJaegerTNG

4 months

@JamesHa43064357 @NAEMSP @ACEPNow I use the phrase Core Airway Skills rather than BLS Airway Skills. They are the skills that will keep the pt alive. And the reality is they’re not that basic; there are key microskills that must be mastered to ensure effective oxygenation and ventilation.

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Jace Mullen

@_JaceMullen

4 months

Woke up horrified because I had a nightmare that I flew a patient in to the ICU and when I tried to give report they were just like "nah you have to take care of them for the rest of your shift" What is wrong with my brain

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Jace Mullen

@_JaceMullen

2 months

The best fucking group of nerds in the world getting together to play airway What more could a boy ask for?

Andrew Merelman

@amerelman

2 months

Awesome weekend learning and teaching airway with an incredible group of friends #PAC24 @_JaceMullen @le_chadd @ChrisRootMD @jstgeorgemd @Luca_Uenlue @ResusOnTheRoad @jducanto @ProtectedAirway

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Jace Mullen

@_JaceMullen

7 months

Very excited that we’re replacing the old buddy lite warmers with new QinFlow Warrior warmers. These kick ass and keep the blood WARM even at very high transfusion rates. Would love to hear any pearls or pitfalls from people currently using these!

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Jace Mullen

@_JaceMullen

5 months

She let me hit because of my browned butter sea salt chocolate chip cookies

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Jace Mullen

@_JaceMullen

2 months

Im a professional and I take my job seriously. But also it’s amazing how effective a “mindset of play” can be at cultivating creative and effective solutions to problems in a resuscitation. Bonus points for fostering high levels of team effectiveness.

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Jace Mullen

@_JaceMullen

4 months

Enjoy this progression of my mustache freezing while I got COLD in the National Ice Core Lab freezer! I was a test subject looking at ALS trauma care in an arctic environment. Bonus picture of why I am not MRI compatible right now Denver-area medics should enroll!

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Jace Mullen

@_JaceMullen

9 months

@olsonplanner I’m never leaving this site

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