Andrew T (@agtischer) header
Andrew T (@agtischer) profile picture

Skier, Med Student, Firefighter/Paramedic

Duluth, MN
Joined June 2017
Pre-hospital placement of a large-calibre central venous catheter can be a life-saving measure. The insertion site attempted most frequently was the right subclavian vein using a landmark-guided technique. #anaesthesia #MedTwitter doi.org/10.1111/anae.16778
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I don’t believe the “40% of med students don’t plan to practice” stat…but even if I did, here’s some more relevant stats. - the government has cut RVU reimbursement year over year, while inflation has only increased…in the past few years alone we took a double digit pay cut because of government @MedicareGov reimbursement when adjusted for inflation - private equity has taken over healthcare, fairly unchecked. This results in bad patient care, unstable healthcare markets and poor working conditions for physicians… -healthcare administrators have grown 3800% versus physician #s growing 200% since the 70s. This represents declining physician autonomy and an overwhelming administrative burden…much of which is created by government programs like CMS “Quality Measures” which are less about care quality and more about gamesmanship and documentation burden - insurance companies have a chokehold on the finances of healthcare…and their lobby dollars fund the congressmen who help keep them in power and allow them to continue to squeeze physicians and patients both How ‘bout you work on some of those issues, Congressman…and get back to the med students after you do?
#1 reason for MD shortage is Med schools admitting students who aren’t going to practice. Only 60% of med students today plan on practicing clinical medicine. Med Schools need to focus on admitting students who want take care of patients, not just get their MD.
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A little nod to #JohnHinds and #HonorableIntentions at the end of @ChrisRootMD’s lecture today. Amazing stuff as always! @DocJohnsMum #CCTMC2024
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“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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Stop taking your cardiac arrest patients off the vent. Free up your resources. But if you’re going to do it you need to have thought about it before hand or you’re going to have a bad time. #CCTMC2024
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At my first session of #esowave2024 and already have technology FOMO. ESO did a pilot with CAPCE of awarding continuing education credit for clinicians looking up the HDE outcomes for their patients. Incredibly well received…. This is how adults learn.
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Want to know the secret to saving dramatically more patients from cardiac arrest? Its not Epi, DSED, ECMO, POCUS or Heads-up CPR… 1. Train most of the public how to perform CPR (eg require it in high school), and 2. Make AEDs (defibrillators) widely available.
Replying to @Aidan_Baron
I think regardless of what it shows, much like ECLS it’s small fry compared to focussing on resuscitating the right people, training everybody in the population in CPR & AED, and expanding public access defibrillator availability.
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Teenage male comes to ED via ambulance after MVC (car crash). Vitals are stable. #FAST exam done immediately after arrival is shown below. For students/residents: What do you see in this ultrasound clip? And what would your next step be? #MedEd #POCUS #FASTexam #FOAMus
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Great presentation on initiation of CPR in rural vs urban environments by @agtischer and @mo_cares . @PCRF and @ESO supported many early career researchers at this year's @EMSWorldOFCL conference.
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Rural vs Urban Settings in Treatment Initiation in Cardiac Arrest (RUSTIC) Great work by @agtischer and team! Excited to see more of their work on urban/rural disparities in cardiac arrest care. #EMSWorldExpo2023
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A critically ill pt found down on the floor is a common occurrence for #EMS providers, but not a typical part of the day for hospital-based anesthesia providers. @jducanto and I break down the management of the true “floor airway” in @anesthesianews: anesthesiologynews.com/Revie… – at New Mexico, USA
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"We don't want CPR delayed to get Narcan. We don't want respirations delayed for Narcan. Narcan is a great tool, but it's not going to work if that heart isn't pumping anyway." - Andrew King, paramedic with Buchanan County EMS newspressnow.com/news/local_…
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Andrew T retweeted
In the spirit of accelerating EMS research and care, we are proud to kick off our 2023 ESO/@pcrfatucla Research Forum! Check out a few behind-the-scenes photos from the three-day workshop and extensive research happening at the ESO headquarters in Austin, TX.
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Just in case anyone still thinks ketamine elevates ICP “Ketamine was associated with a reduction in ICP….If these findings are reproduced.., ketamine may warrant consideration as a treatment for intracranial hypertension in children with severe TBI” journals.lww.com/ccmjournal/…
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Seven & a half years ago John Hinds knocked everyone's socks off with Crack the Chest Get Crucified in Chicago Remembering John & his family at Christmas Always reminded to keep our intentions honourable Your inspiration is immortal mate @DocJohnsMum litfl.com/crack-the-chest-ge…
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Early career years are intimidating—there's so much that feels out of your control. Here are the career principles I wish I knew when I was starting out:
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Here’s why I think you should use a bougie on every intubation airmedicaljournal.com/articl… Full: drive.google.com/file/d/19KB…
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After 40+ years in EMS, Ive finally started to compile a collection of short stories. Something I wrote a few yrs ago & has been sitting on a dusty hard drive. Burnout was strong in our profession pre 2020. For many, COVID has just thrown gas on the fire fltdoc1.medium.com/requiem-f…
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