iiinova — where your digital self keeps evolving

Rick Pescatore @rickpescatore.bsky.social · 13/04/2025

My grandfather wasn’t forgetful. He was irritable. Suspicious. Harsh in a way that felt new. We didn’t call it dementia. We called it life—just the toll of a hard-working man who’d been knocked around by time. But it was dementia. We just didn’t know it.

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Rick Pescatore @rickpescatore.bsky.social · 12/04/2025

Some patients come in screaming. Some bleeding. Some unconscious. But the ones I couldn’t stop thinking about were the ones who whispered. Who came in again and again, afraid to eat, exhausted, and unheard.

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Rick Pescatore @rickpescatore.bsky.social · 04/04/2025

“ETCO₂ is 35.” No pulse. No rhythm. An hour down. But everyone hesitates. Capnography says keep going. The clinical picture says stop. So… what are we actually following? 🧵 on the tool that’s everywhere but rarely helps: capnography. via @emnews00.bsky.social

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Rick Pescatore @rickpescatore.bsky.social · 28/03/2025

Medicine doesn’t need another guideline. It needs a revolution in ho We’ve mistaken statistical elegance for clinical progress—and in doing so, left the most vulnerable behind.

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Rick Pescatore @rickpescatore.bsky.social · 09/03/2025

EM has always been about thresholds—the doorway between life and death, between stability and chaos. But today, we stand at a new threshold. One we didn’t sign up for but one we can’t ignore. Emergency medicine is changing. The question is whether we change with it. 🧵

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Rick Pescatore @rickpescatore.bsky.social · 04/03/2025

⚛️ The Quantum Revolution in Medicine & the Role of Physicians We’re entering an era where quantum mechanics meets biology, diagnostics, and therapeutics. What does this mean for medicine—and how should physicians prepare? Let’s talk quantum computing, entanglement, and medical decision-making. 🧵👇

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Rick Pescatore @rickpescatore.bsky.social · 07/02/2025

A new study suggests the alpha angle on capnography may predict COPD readmission risk. Interesting idea, but could this be EMS’s capno-enthusiasm bleeding into the ED? I’ve rarely seen it influence decision-making in real practice. Worth a closer look or just academic curiosity? t.co/pESMMctTUx

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Rick Pescatore @rickpescatore.bsky.social · 06/02/2025

A great ER doctor sees beyond vitals and chief complaints—beyond what’s obvious. They recognize the quiet panic, the unspoken fears, the weight of exhaustion. The best medicine isn’t just treating disease; it’s understanding the human experience that comes with it.

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Rick Pescatore @rickpescatore.bsky.social · 06/02/2025

It’s 5 AM. The house is dark, the dogs are snoring in bed with Mom, and I’m grinding away on my business. But my tuxedo cat? He’s right here, posted up like a loyal cofounder. Some partners just get it.

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Rick Pescatore @rickpescatore.bsky.social · 05/02/2025

EBM shaped modern EM, legitimizing our field and improving care. But our rigid, dichotomous application of it now holds us back. We mastered the science—now we must embrace the art. EM must evolve beyond checkboxes and P-values, using evidence to guide-not dictate-in a world of clinical uncertainty.

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Rick Pescatore @rickpescatore.bsky.social · 01/02/2025

🚨 We talk a lot about the acute side of medicine—stabilizing, resuscitating, reacting. But what about the long game? The brain-gut axis isn’t just a buzzword; it’s central to how patients recover, adapt, and experience severe illness. Acute care should include setting patients up for real recovery.

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