Roberto Cosentini, MD @rob-cosentini.bsky.social · 22/04/2025STEMI is a failed paradigm OMI should replace it New OMI patterns are expected, as the more recent South African flag sign (1st LAD diagonal occlusion) or Aslanger pattern (is.gd/DzYfD8) PMCardio App may help (no COI) 133
Reposted by Roberto Cosentini, MDRyan Radecki MD MS @www.evidencetriage.com · 22/04/2025What's the best maneuver for stopping peripheral vertigo? Did you even know there were so many??? #medsky www.evidencetriage.com/p/contortion...evidencetriage.comContortions To Stop The GyrationsNetwork meta-analyses are all the rage, vertigo edition. 031
Roberto Cosentini, MD @rob-cosentini.bsky.social · 18/04/2025Drainage Course at #EASClub with dr Allegri Chest Drainage #bedsidepearls 🚫 Never close the drainage tube during pt transport 🩸Haemothorax ➡️ 28-32 Fr tube 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 15/04/2025#bedsidepearls in Chest trauma 🩻 Severity of chest wall injuries ➡️ RivScore 🫁 Severity of pulmonary contusion ⬆️ significantly when contusions are >20% 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 14/04/2025#bedsidepearls via #EASBergamo #whiteboard 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 11/04/2025Brnchodilation during #NIV At 2nd NIV EUSEM Certification Course, Lisbon April, 10-11 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 10/04/2025#NIV Indications at 2nd NIV Certification Eusem Course in Lisbon @Paolo Groff @Rodolfo Ferrari @Patrick Plaisance 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 10/04/2025NIV Certification Eusem Course in Lisbon, April 10-11 ⏱️ The golden hour of NIV influence prognosis via @Patrick Plaisance 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 09/04/2025Flying to Lisbon for our 2nd NIV Certification #EUSEM Course, April 10-11 Interactive Case scenarios to boost your competence on ARF patients to treat with HFNC CPAP Bi-Level 000
Reposted by Roberto Cosentini, MDRyan Radecki MD MS @www.evidencetriage.com · 21/03/2025Folks are really good down here at avoiding unnecessary radiography in kids — the most unusual misalignment of practice I’ve had recently are plain c-spine x-rays in older adults. If you care enough to order the test, you should care enough to order a test that actually answers your question …. 041
Reposted by Roberto Cosentini, MDMarco Garrone @marcogarrone.bsky.social · 14/03/2025Such fun to work together @rob-cosentini.bsky.social! And so cool to share ideas beyond medical knowledge. 011
Reposted by Roberto Cosentini, MDJustin Morgenstern @first10em.bsky.social · 07/04/2025Pediatric front of neck access (the surgical tracheotomy) An approach to the can't intubate can't oxygenate scenario in children #FOAMedfirst10em.comPediatric front of neck access (the surgical tracheotomy)Case It is the scenario of nightmares: a young child with an airway obstruction. They came in with stridor, and although you were initially thinking severe croup, the story doesn’t quite fit, there is no response to medical therapy, and this patient is incredibly sick. There is significant hypoxemia despite a nonrebreather. You can’t wait for backup, so you proceed rapidly to RSI. 0209
Roberto Cosentini, MD @rob-cosentini.bsky.social · 07/04/2025Chest pain at triage #bedsidepearls from MEU School Unimi at Albino 🫀Do ECG, always 🧪 Do troponin, unless a specific diagnosis can be excluded at triage (eg: PTX via Echo) 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 06/04/2025Eating Disorders #bedsidepearls via @emcases.bsky.social 🧬 Genetic disorder, trigger by precipitating factor ⚖️ No weight threshold ➡️ Best follow ⬇️ over time Adolescents: 🫀Bradycardia/ortho hypotension: ⚠️ severity signs ➡️ Admit 🏥 emergencymedicinecases.com/eating-disor...emergencymedicinecases.comEating Disorders - Common, Commonly Missed, Misunderstood | EM CasesRecognition, management of eating disorders in emergency medicine; why eating disorders are missed, pitfalls in assessment and management on Emergency Medicine Cases podcast 011
Roberto Cosentini, MD @rob-cosentini.bsky.social · 05/04/2025Chest Trauma #bedsidepearls 1️⃣ Identify fatal lesions ATOM-FC 2️⃣ Evaluate Severity TTS & RibScore 3️⃣ Treat accordingly 🩸MTP 💉 Chest Tube 🔪 Emergency Thoracotomy 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 04/04/2025#bedsidepearls on Multiple Myeloma at #EASClubbergamo via Dr Alessio Marra 1️⃣ 🩺 Clinical 🩻 Thoracic vertebral lesions may manifest only with abdominal symptoms 🦴 Bone lesions may ensue when MM is otherwise asymptomatic 2️⃣ 🧠 Mental ⚠️ Don’t fix on 1st diagnosis 🎛️ Take control of your reactions 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 03/04/2025How to incorporate #AI into daily clinical practice ⏱️ Closer than 6 months ago 🛣️ Still a long way to go Ambient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million Uses | NEJM Catalyst catalyst.nejm.org/doi/full/10....catalyst.nejm.orgAmbient Artificial Intelligence Scribes: Learnings after 1 Year and over 2.5 Million UsesOne year after the deployment of ambient artificial intelligence scribes, The Permanente Medical Group in northern California reports rapid growth in physician usage, highly positive experiences am... 041
Reposted by Roberto Cosentini, MDEMCrit Blog and Podcast @emcrit.bsky.social · 02/04/2025EMCrit Q&A - Episode 001 Industry involvement? Vasopressor choices in PE and more... emcrit.org/qa1 011
Roberto Cosentini, MD @rob-cosentini.bsky.social · 02/04/2025Violence pathway at our #EASClubBergamo via Antonella Mangili & Renata Colombi ⚡️ Rising tension 🧠 Deliberate violence 💧 Loving contrition 🔁 Ripetitive #bedsidepearls 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 31/03/2025☠️ Methylene blue in methemoglobinemia From clinical pharmacologist Pharmacy Joe —> pharmacyjoe.com/episode1009/ 💉 1–2 mg/kg IV over 5 minutes of methylene blue immediately if levels indicate administration ⏱️ After treatment, MetHb levels on blood gas (ABG) are no longer reliable #bedsidepearls 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 30/03/2025My barbers shop in front of Colonne di San Lorenzo, downtown Milano If this isn’t nice, what is? 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 28/03/2025Leadership pearls via @roborman @stmuluspodcast —> t.ly/hqzHj 1/2 1️⃣ Listening is key to Lead 2️⃣ Prioritize. Not all problems need an urgent response 3️⃣ Vision + Patience + Respect are key to succeed 4️⃣ Be ready to judge, even if you don’t like itroborman.com147. Your First Leadership Role? Start With These 8 Principles - Orman Physician CoachingLeadership is hard. Here are eight ways to do it better (without losing your mind). 101
Roberto Cosentini, MD @rob-cosentini.bsky.social · 26/03/2025Bi-monthly Simulation at #EAS Club Bergamo ☠️ Organophosphate intoxication of patient, paramedic and Team leader 🏁 Great challenge for our EM residents 🏥 Look at our group activities —> easclubbergamo.wordpress.com/attivita/ 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 26/03/2025My two teaching mantras: “You were not made to live like brutes, but to follow virtue and knowledge.” Dante Alighieri, XIV century “One should not teach thoughts, but teach how to think.” Immanuel Kant, XVIII century 020
Roberto Cosentini, MD @rob-cosentini.bsky.social · 24/03/2025Dyspnea #bedsidepearls 3️⃣ signs of respiratory distress: # 1 tracheal tub, inspiratory # 2 jugular retraction, inspiratory # 3 supraclavicular retraction, inspiratory 000
Reposted by Roberto Cosentini, MDRyan Radecki MD MS @www.evidencetriage.com · 24/03/2025If you provide the 95% CI, you don't need to supply a p-value with it.media.tenor.coma monkey with goggles and headphones says i have spokenALT: a monkey with goggles and headphones says i have spoken 0143
Roberto Cosentini, MD @rob-cosentini.bsky.social · 23/03/2025Day 1 of AI Master in Clinical Medicine at University of Torino via Prof. Gaetano de Ferrari 📊 Data is the most valuable resource 🤖 ChatGPT spreading is supersonic 🫀AI proved effective in cardiology 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 22/03/20252nd day of AI Master in Clinical Medicine at University of Torino via Prof. Gaetano de Ferrari AI Anatomy AI application in clinical medicine AI and images AI may outperform clinicians at interpretation of images (see picture 3) 000
Reposted by Roberto Cosentini, MDKen Milne MD @thesgem.bsky.social · 21/03/2025Interesting article on biases in RCTs based on methodological quality. jamanetwork.com/journals/jam... #MedSkyjamanetwork.comEmpirical Evidence of BiasObjective. —To determine if inadequate approaches to randomized controlled trial design and execution are associated with evidence of bias in estimating treatment effects.Design. —An observa... 021
Reposted by Roberto Cosentini, MDRyan Radecki MD MS @www.evidencetriage.com · 21/03/2025Stop ordering abdominal x-rays in children with constipation! No! No! #medsky www.evidencetriage.com/p/cant-stop-...evidencetriage.comCan't Stop The (Pediatric) Waste1 in 5 visits for selected conditions received unnecessary tests. 174
Roberto Cosentini, MD @rob-cosentini.bsky.social · 20/03/2025#bedsidepearls at #EASClubBergamo Fever & sore throat: 🦻 Listen to voice & sounds 🥔 Hot potato voice or noisy inspiratory breathing ➡️ upper airway obstruction 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 19/03/2025Massive Transfusion at #EASClubBergamo via PGY5 Alberto Comi & Dr Eugenia Belotti 🩸 Balanced Transfusion 1:1:1 (Italy 4:1:1) ➡️ Shock Index >1 ➡️ No SBP & HR > 120 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 17/03/2025#bedsidepearls via our Residents at #EASBergamo Inspired by Amal Mattu’s #whiteboard 1/2 🥾 Mountain hiking + hypotension + nausea and vomiting ➡️ If symptoms persist, consider snake bite or anaphylaxis 💊 Obtain cultures before first dose of antibiotics 100
Roberto Cosentini, MD @rob-cosentini.bsky.social · 17/03/2025#bedsidepearls at EAS Bergamo via our EM residents Inspired by Amal Mattu and his weekly #whiteboard 000
Reposted by Roberto Cosentini, MDRyan Radecki MD MS @www.evidencetriage.com · 16/03/2025Never hurts to pull together more data sets in which COVID-19 vaccines are shown to be safe – another look at (lack of) risk for fetal outcomes in pregnancy. #medsky medicineminute.substack.com/p/covid-19-v...medicineminute.substack.comCOVID-19 Vaccines Safe in PregnancyMore data unable to find fetal risks due to maternal exposure. 05721
Roberto Cosentini, MD @rob-cosentini.bsky.social · 13/03/2025‘The Great Presenter’ 2nd ed. via @marcogarrone.bsky.social & me at EAS Club Bergamo How to be an unforgettable presenter 8️⃣0️⃣% Know your audience Focus on 1 key message Transform the audience 2️⃣0️⃣% Slide shaping Privileged to grow with Marco & the super enthusiastic group of participants 110
Roberto Cosentini, MD @rob-cosentini.bsky.social · 11/03/2025#TheGreatPresenter How to change your audience via @marcogarrone.bsky.social Garrone at EAS Club Bergamo easclubbergamo.wordpress.com 010
Reposted by Roberto Cosentini, MDStellaIn @stellain.bsky.social · 14/02/2025EAS Congress #Bergamo @rob-cosentini.bsky.social 011
Roberto Cosentini, MD @rob-cosentini.bsky.social · 13/02/2025Acute dyspnea workshop at 1st EAS Conference Bergamo Patient trajectory and early support with Stella Ingrassia @davidcarr333.bsky.social 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 10/02/2025🗓️ 4 days to our 1st EAS Conference in Bergamo Thrilled to host @davidcarr333.bsky.social in person, Tim Harris online and other brilliant colleagues from Italy Ready to learn with fun 021
Roberto Cosentini, MD @rob-cosentini.bsky.social · 12/12/2024INDUCTION 2nd edition EAS Club Bergamo_t.ly/71SPb 🔎 NIV in Neuromuscular D via Dr Valentina Rosti 🫧 Beware secretions (pseudobulbar —> worse prognosis) ⚠️ Don’t wait for ⬆️ pCO2 ⏱️ Prepare Early Staff & Equipment 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 12/12/2024INDUCTION 2nd edition EAS Club Bergamo_t.ly/71SPb 🔎 How to Use Non-Invasive Ventilation via Dr Valentina Rosti 👺Facial mask for NIV ⛑️ Helmet > mask for CPAP ➡️ Rise time 🚅 Fast if high RR or pt obstructed 🐢 Slow if lower RR & pt restricted 010
Roberto Cosentini, MD @rob-cosentini.bsky.social · 12/12/2024INDUCTION 2nd edition EAS Club Bergamo_https://t.ly/71SPb 🔎 How to Identify Respiratory distress 👨🦼 Body position 🟣 Look for Cyanosis 👤🦶Head-to-toe Muscle Recruitment evaluation 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 12/12/2024INDUCTION 2nd edition EAS Club Bergamo_https://t.ly/71SPb ➡️ Lung ultrasound in the ED via Dr Gloria Suma ✅ Interstitial_More sensitive than C-xray ⏱️ Early Detection 🖥️ Monitoring evolution 000
Roberto Cosentini, MD @rob-cosentini.bsky.social · 12/12/2024INDUCTION 2nd edition EAS Club Bergamo_https://t.ly/71SPb ➡️ Procedural Sedation via dr Mauro Belotti 000
Reposted by Roberto Cosentini, MDSt Emlyn's podcast and blog @stemlyns.bsky.social · 04/12/2024Learn about the possible utility of ECMO in trauma in this podcast with Chris Bishop at Tactical Trauma 2024stemlynsblog.orgPodcast – ECMO in Trauma with Chris Bishop at Tactical Trauma 24In this podcast, Liz Crowe discusses the effect bad behaviour has on teams and ultimately patient safety. 085
Roberto Cosentini, MD @rob-cosentini.bsky.social · 11/12/2024INDUCTION 2nd edition EAS Club Bergamo (t.ly/71SPb) EM Mindset via @andreaduca00 ➡️ Identify patient trajectory: 🐇 Hare. Rapidly fatal —> Treat 🐿️ Squirrel. Potentially fatal —> Treat & Investigate 🐢 Turtle. Time to investigate 010