Author | Lightnews

Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Jonathan Howard @joho.bsky.social · 2d

"The risk of myocarditis after COVID-19 infection is approximately 42 times higher than the risk after COVID-19 vaccination"

Of course, COVID's harms are not limited to myocarditis

The incidence of myocarditis and pericarditis has been documented in adolescents after COVID-19 vaccinations. This study aims to assess the risk of myopericarditis in adolescents following COVID-19 vaccination, using a meta-analysis of the published cases. We performed a comprehensive literature search of the following databases on July 5, 2023: MEDLINE, EMBASE, PubMed, and the Cochrane Library. We performed a meta-analysis using a random-effects model to estimate the incidence of myopericarditis per million of administered COVID-19 vaccine doses or COVID-19 infections. A total of 33 studies were included in the meta-analysis. The incidence of myopericarditis per million COVID-19 infections (1583.9 cases, 95% CI 751.8-2713.8) was approximately 42 times higher than that for COVID-19 vaccine administrations (37.6 cases, 95% CI 24.2-53.8). The risk of myopericarditis after COVID-19 vaccination was particularly high among the 16-19 age group (39.5 cases per million, 95% CI 25.8-56.0), males (43.1 cases per million, 95% CI 21.6-71.9), and those who received the second dose (47.7 cases per million, 95% CI 22.2-82.2). There were no significant differences in the incidence of myopericarditis per million COVID-19 vaccine administrations between Europe, the Western Pacific, and the Americas (p = 0.51). Adolescents faced a potential risk of myopericarditis after COVID-19 vaccination, but this risk is less harmful than that of myopericarditis following COVID-19 infection

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

The Lancet Countdown on Health and Climate Change @lancetcountdown.bsky.social · 1d

🚨 JUST PUBLISHED 🚨

⚠️ The 2025 @lancetcountdown.bsky.social report reveals climate change inaction is costing lives and livelihoods, and harming the economy.

❤️‍🩹 Protecting people’s health demands all hands on deck.

Read more: www.lancetcountdown.org/2025-report/ #LancetClimate25

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Simone Gherardi @drghem.bsky.social · 2d

emcrit.org/pulmcrit/202... #EMIMCC Some @pulmcrit.bsky.social 's highlights about aha vs erc cardiac arrest guidelines #Emcritters

PulmCrit - 2025 AHA & ESICM guidelines on post-arrest care

The ESICM and AHA both just released new guidelines on post-arrest care. It's always interesting when two professionals produce "evidence-based"

emcrit.org

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Josh Trebach, MD @jtrebach.bsky.social · Sep 22

hi, medical toxicologist that knows a lot about Tylenol here👋 Claiming that tylenol use in pregnancy causes autism is fearmongering

here's what you need to know 🧵

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

josh farkas 💊 @pulmcrit.bsky.social · Sep 22

proposal:

all types of bradykinin-mediated angioedema involve a common vicious spiral 👇

tranexamic acid or aminocaproic acid should be universally effective in blocking this cycle & aborting attacks

there's no need for super-expensive drugs (icatibant et al.)

thoughts? criticism? #EMIMCC

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

SAEM Academy of Emergency Medicine Pharmacists @saemaemp.bsky.social · Sep 22

Don't forget to submit your didactic session to present at SAEM26 Annual Conference! Deadline is 10/2/25! buff.ly/nwLK5Mo
#SAEM #AEMP #AEMPlify #EMRx

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

REBEL EM @rebel-em.bsky.social · Sep 18

🚨 New Post Alert!
Syncope is common in the ED—but which decision rule do you trust?
⚡ San Francisco Syncope Rule = fast but fallible
🧩 Canadian Syncope Risk Score = comprehensive but complex
🩺 Neither replaces clinical judgment
👉 Read here: https://wp.me/pdrP8b-5pF
#FOAMed #EMIMCC #MedSky

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

josh farkas 💊 @pulmcrit.bsky.social · Sep 17

cosign this 😁

four-factor PCC had clotting factors & *also* endogenous anticoagulants (protein C & S, antithrombin III)

that’s why PCC doesn’t cause as much thrombosis: it’s rebuilding the coagulation cascade rather than purely functioning as a pro-thrombotic

(& Adnexanet alfa price is insane)

Anand Swaminathan @emswami.bsky.social · Sep 17

Time to Ditch Andexanet Alfa?
-ANNEXA-1: No mortality benefit, incr VTE
-Real world data: Rech 2025 (PMID:40700941) no improved outcomes, 9% incr VTE w/ andexanet alfa (NNH = 11)

Mounting evidence that andexanet offers no benefit while increasing complications

youtube.com/shorts/7DGcv...
#EMIMCC

Andexanet Alfa + Thrombembolism #emergencymedicine #criticalcare

YouTube video by EMSwami

youtube.com

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

SAEM Academy of Emergency Medicine Pharmacists @saemaemp.bsky.social · Aug 20

AEMP is seeking new practitioners to present the YIR at AEMP 2026 at SAEM Congress next year! Apply today! #AEMP #AEMPlify #EMRx

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

SAEM Academy of Emergency Medicine Pharmacists @saemaemp.bsky.social · Aug 21

The submission portal for SAEM Congress is now open. Submit your didactic session proposal today! #SAEMonline #AEMPlify

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

St. Luke's Treasure Valley PGY1 and PGY2 EM Pharmacy Residencies @slhsrxresidency.bsky.social · Aug 24

🚑 The first EM Pharmacy Pearl for the year is out by PGY2 EM Resident, Jonathan!

#rxsky
#pharmsky
#pgy2em

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

REBEL EM @rebel-em.bsky.social · Aug 25

🚨 New Post Alert!
Syncope is common in the ED—but which decision rule do you trust?
⚡ San Francisco Syncope Rule = fast but fallible
🧩 Canadian Syncope Risk Score = comprehensive but complex
🩺 Neither replaces clinical judgment
👉 Read here: https://wp.me/pdrP8b-5pF
#FOAMed #EMIMCC #MedSky

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

SAEM Academy of Emergency Medicine Pharmacists @saemaemp.bsky.social · Aug 24

💉National Immunization Awareness Month!💉

Together, we can help raise awareness about the importance of vaccination. Many patients express interest in receiving vaccines when they are offered in the ER, creating a valuable opportunity for engagement with EM pharmacists!

SAEM August theme

National Immunization Awareness Month

buff.ly

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Megan A Rech, PharmD, MSc @meganarech.bsky.social · Aug 18

📣Have you heard of antiamyloid therapies for Alzheimer’s disease? They cause ADEs called ARIAs that are non-specific, typically require MRI, & can mimic stroke

⛔ Concomitant thrombolytics/anticoagulants are contraindicated

Learn more in our JAMA IM Clinical Insight 👇

JAMA Internal Medicine @jamainternalmed.com · Aug 17

Antiamyloid therapies for #Alzheimer disease slow cognitive decline but pose serious adverse effects like amyloid-related imaging abnormalities.

ja.ma/3V32mjt

JAMA Internal Medicine presents: "New Frontier, New Challenges—Recognizing and Managing Adverse Effects of Antiamyloid Therapies" by Megan A. Rech, et al. Published online June 23, 2025.

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Neurocritical Care @neurocritcarej.bsky.social · Jul 28

Burman et al: Effect of Ketamine Analgosedation on Neurological Outcome in patients with Severe Traumatic Brain Injury: A Randomized Controlled Pilot Study

Link: link.springer.com/ar...

@neurocritical #neurocritcare

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

josh farkas 💊 @pulmcrit.bsky.social · Aug 11

Myth busting: Antibiotics don't reduce mortality in variceal hemorrhage!

I updated the IBCC & explained what happened here emcrit.org/ibcc/gib/#va...

We probably don't need antibiotics at all🤦‍♂️

Nice illustration of how meta-analyses can be fragile (even Cochrane) emcrit.org/pulmcrit/meta/ #EMIMCC

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

SAEM Academy of Emergency Medicine Pharmacists @saemaemp.bsky.social · Aug 12

Donate to the SAEMF Challenge to give back to EM! Not only will your donation help advance EM practices and research, but it'll HELP AEMP MOVE UP THE LEADERBOARD in this SAEM competition! See link for more details or scan QR code to go to the donations page buff.ly/qvUCT8C
buff.ly/masr25D

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

REBEL EM @rebel-em.bsky.social · Aug 6

🚨 NEW POST: MDCalc Wars 🛑💥
Are you using PERC and Wells correctly?

✅ Start with Wells to guide next steps
🚫 Don’t use PERC in moderate/high-risk
🧪 Use high-sensitivity D-dimer!

👉 Read now: https://wp.me/pdrP8b-5oN
#FOAMed #EMIMCC #MEDSky

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

sccmcriticalcare.bsky.social @sccmcriticalcare.bsky.social · Aug 6

Gain insight into best practices for retaining highly skilled pharmacists in the ICU and the importance of reducing burnout in pharmacy teams in the latest SCCM Podcast. Listen now: sccm.org/pod544
#SCCM

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

SAEM Academy of Emergency Medicine Pharmacists @saemaemp.bsky.social · Jul 24

Welcome to AEMP's Pulse Dose! Weekly pharmacy pearls to upgrade your EM practice!
This week's topic: Local anesthetic systemic toxicity, or "LAST". Don't be the LAST to know!
#AEMP #SAEM #AEMPPulseDose #RxPearls #LAST

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Aimee Mishler, PharmD, BCEMP, FAWM @empharm.bsky.social · Jul 30

📣 Hot off the press!
MTP review and update for the pharmacist!
#rxsky
#pharmsky

pubmed.ncbi.nlm.nih.gov/40580496/

Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Anand Swaminathan @emswami.bsky.social · Jun 5

In patients with undifferentiated shock, always get a Rapid US for Shock + Hypotension (RUSH exam) to differentiate etiologies

Avoid diagnostic closure, particularly when the answer appears simple

youtube.com/shorts/MUptk...
#EMIMCC

RUSH Exam + Tamponade #emergencymedicine #criticalcare #resuscitation

YouTube video by EMSwami

youtube.com

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Anand Swaminathan @emswami.bsky.social · Jun 13

Ketamine in status epilepticus?
PMID:39674935 ketamine > no drug after midaz failed(flawed study)
PMID:40186980 midaz/ket > midaz. But, kids seized 34 min prior to meds, very low rate of sz break w/ midaz

Consider ketamine after 2 doses BZD fail but evidence weak
youtube.com/shorts/arX6s...
#EMIMCC

Ketamine in Status Epilepticus #criticalcare #emergencymedicine

YouTube video by EMSwami

youtube.com

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Anand Swaminathan @emswami.bsky.social · Jun 25

Hypokalemia big killer in DKA
-All DKA patients total body K down
-Some w/ serum hyperK due to acidosis shifting K
-K < 3.5: replete prior insulin
-K 3.5-5.5: start insulin + K repletion simultaneously
-Skip bolus: no faster DKA resolution but incr risk hypoK

youtube.com/shorts/pTnt8...
#EMIMCC

Hypokalemia in DKA #criticalcare #emergencymedicine

YouTube video by EMSwami

youtube.com

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Reposted by Aimee Mishler, PharmD, BCEMP, FAWM

Anand Swaminathan @emswami.bsky.social · Jun 28

Massive Hemorrhage Protocol: More than just giving products
-Control bleeding: tourniquet extremity hemorrhage, pelvic binders, balloon tamponade
-Early transfusion
-TXA, AC reversal (PCC or FFP) + Ca

Don't forget to get consultants mobilized for definitive care

youtube.com/shorts/AIV4o...
#EMIMCC

Massive Hemorrhage Protocol #criticalcare #emergencymedicine #trauma

YouTube video by EMSwami

youtube.com

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