Brandon Somwaru, DO
@brandonsomwaru.bsky.social
Intensivist, emergency physician, human
Automatic ID consult
"My husband isn't here because we're getting a bearded dragon and he went to a reptile expo in New Jersey"
January 12, 2026 at 12:38 PM
Automatic ID consult
Reposted by Brandon Somwaru, DO
16 million people are losing their healthcare and hospitals are already closing because of it but it’s a win because one of the bottom tier fast food restaurants is going to start selling the same Mexican Cokes that you can already get at literally every store
July 20, 2025 at 2:24 AM
16 million people are losing their healthcare and hospitals are already closing because of it but it’s a win because one of the bottom tier fast food restaurants is going to start selling the same Mexican Cokes that you can already get at literally every store
Reposted by Brandon Somwaru, DO
Protecting his stock portfolio while ripping away health care from 17 million Americans.
This is Washington at its worst.
We need to ban Congressional stock trading.
This is Washington at its worst.
We need to ban Congressional stock trading.
July 3, 2025 at 5:36 PM
Protecting his stock portfolio while ripping away health care from 17 million Americans.
This is Washington at its worst.
We need to ban Congressional stock trading.
This is Washington at its worst.
We need to ban Congressional stock trading.
Reposted by Brandon Somwaru, DO
For decades, Sec. Kennedy has spread lies about vaccines. Now, his misinformation will lead to preventable illness & death.
Firing independent experts is a dangerous move that makes it harder for Americans to access vaccines that are safe, effective & essential to saving lives.
Firing independent experts is a dangerous move that makes it harder for Americans to access vaccines that are safe, effective & essential to saving lives.
June 9, 2025 at 11:07 PM
For decades, Sec. Kennedy has spread lies about vaccines. Now, his misinformation will lead to preventable illness & death.
Firing independent experts is a dangerous move that makes it harder for Americans to access vaccines that are safe, effective & essential to saving lives.
Firing independent experts is a dangerous move that makes it harder for Americans to access vaccines that are safe, effective & essential to saving lives.
Reposted by Brandon Somwaru, DO
Just a reminder that LDL does in fact *cause* heart disease. Here is a summary of the evidence for that:
academic.oup.com/eurheartj/ar...
academic.oup.com/eurheartj/ar...
It is really dangerous when people deny this.
academic.oup.com/eurheartj/ar...
academic.oup.com/eurheartj/ar...
It is really dangerous when people deny this.
Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Co...
AbstractAims. To appraise the clinical and genetic evidence that low-density lipoproteins (LDLs) cause atherosclerotic cardiovascular disease (ASCVD).Metho
academic.oup.com
June 1, 2025 at 2:10 AM
Just a reminder that LDL does in fact *cause* heart disease. Here is a summary of the evidence for that:
academic.oup.com/eurheartj/ar...
academic.oup.com/eurheartj/ar...
It is really dangerous when people deny this.
academic.oup.com/eurheartj/ar...
academic.oup.com/eurheartj/ar...
It is really dangerous when people deny this.
Reposted by Brandon Somwaru, DO
If you ask medical intensivists which types of admissions scare us the most, I would guess the most common answer would be pregnant patients (followed by status asthmaticus, which is a separate conversation). Pursuing any policy that increases risk of severe disease in pregnant people is insane.
This is absolutely terrible. Not only are pregnant women immunosuppressed but their physiology also puts them at increased risk for more severe disease. Shameful.
Is flu next? Also pregnant women are immunosuppressed and have always been on the list of high risk. This is beyond comprehension
May 27, 2025 at 5:26 PM
If you ask medical intensivists which types of admissions scare us the most, I would guess the most common answer would be pregnant patients (followed by status asthmaticus, which is a separate conversation). Pursuing any policy that increases risk of severe disease in pregnant people is insane.
Reposted by Brandon Somwaru, DO
Loop diuretics work if the plasma concentration is above a threshold
The best way to achieve a high plasma level is a *bolus*
A continuous infusion will achieve a *lower* peak serum level than a bolus
If a big bolus fails to work, a continuous gtt will *also* fail
more emcrit.org/ibcc/diurese...
The best way to achieve a high plasma level is a *bolus*
A continuous infusion will achieve a *lower* peak serum level than a bolus
If a big bolus fails to work, a continuous gtt will *also* fail
more emcrit.org/ibcc/diurese...
May 27, 2025 at 5:42 PM
Loop diuretics work if the plasma concentration is above a threshold
The best way to achieve a high plasma level is a *bolus*
A continuous infusion will achieve a *lower* peak serum level than a bolus
If a big bolus fails to work, a continuous gtt will *also* fail
more emcrit.org/ibcc/diurese...
The best way to achieve a high plasma level is a *bolus*
A continuous infusion will achieve a *lower* peak serum level than a bolus
If a big bolus fails to work, a continuous gtt will *also* fail
more emcrit.org/ibcc/diurese...
Reposted by Brandon Somwaru, DO
ACOG is deeply disappointed by HHS’s move to drop COVID-19 vaccine recommendations in pregnancy. The science is clear: COVID-19 remains dangerous in pregnancy and vaccination protects both patients and newborns. The vaccine is safe and protects families. Read our full statement: buff.ly/OGue7sO
May 27, 2025 at 6:34 PM
ACOG is deeply disappointed by HHS’s move to drop COVID-19 vaccine recommendations in pregnancy. The science is clear: COVID-19 remains dangerous in pregnancy and vaccination protects both patients and newborns. The vaccine is safe and protects families. Read our full statement: buff.ly/OGue7sO
Reposted by Brandon Somwaru, DO
We should be investing in rural communities and making them better places to build a life & raise a family - not shutting down rural hospitals by choking off their funding.
Saving rural hospitals is one more reason to call your Representative and speak out against this GOP attempt to cut Medicaid.
Saving rural hospitals is one more reason to call your Representative and speak out against this GOP attempt to cut Medicaid.
Hundreds of rural hospitals are at risk of closing, threatening critical care
Hospital officials told CBS News the closure was driven by the same factors that have closed other rural hospitals: low reimbursement rates.
www.cbsnews.com
May 21, 2025 at 5:16 PM
We should be investing in rural communities and making them better places to build a life & raise a family - not shutting down rural hospitals by choking off their funding.
Saving rural hospitals is one more reason to call your Representative and speak out against this GOP attempt to cut Medicaid.
Saving rural hospitals is one more reason to call your Representative and speak out against this GOP attempt to cut Medicaid.
23.4% is a personal favorite but don’t forget to:
-Elevate HOB >30 degrees
-Keep head midline
-Avoid fentanyl
-Consider paralysis
-Advocate for definitive therapy
-Elevate HOB >30 degrees
-Keep head midline
-Avoid fentanyl
-Consider paralysis
-Advocate for definitive therapy
Options for Reducing ICP in the ED
1) Hypervent: Drop PCO2 ➡️ cerebral vasoconstriction ➡️ ⬇️ ICP. Target PaCO2 = 30 mm Hg
2) Hypertonic saline: Avoids fluid shift issues you see w/ mannitol + more rapid onset: 250 cc of 3% OR 30 cc of 23.4% OR 2-3 amps of NaHCO3
youtube.com/shorts/oycmq...
#EMIMCC
1) Hypervent: Drop PCO2 ➡️ cerebral vasoconstriction ➡️ ⬇️ ICP. Target PaCO2 = 30 mm Hg
2) Hypertonic saline: Avoids fluid shift issues you see w/ mannitol + more rapid onset: 250 cc of 3% OR 30 cc of 23.4% OR 2-3 amps of NaHCO3
youtube.com/shorts/oycmq...
#EMIMCC
Dropping ICP # #criticalcare #emergencymedicine #intubation
YouTube video by EMSwami
youtube.com
May 21, 2025 at 3:28 PM
23.4% is a personal favorite but don’t forget to:
-Elevate HOB >30 degrees
-Keep head midline
-Avoid fentanyl
-Consider paralysis
-Advocate for definitive therapy
-Elevate HOB >30 degrees
-Keep head midline
-Avoid fentanyl
-Consider paralysis
-Advocate for definitive therapy
Reposted by Brandon Somwaru, DO
Any time I see a doctor say they had to leave medicine to “tell patients the truth”
they sounds like a grifter who’s going to
1) say some ableist, eugenicist BS about how you can prevent all your ailments with one easy hack your MD won’t tell you
2) sell useless, expensive supplements 💰
they sounds like a grifter who’s going to
1) say some ableist, eugenicist BS about how you can prevent all your ailments with one easy hack your MD won’t tell you
2) sell useless, expensive supplements 💰
a man in a suit is sitting at a table with dr.squatch products
Alt: a man in a suit is sitting at a table with supplement products
media.tenor.com
May 12, 2025 at 12:51 AM
Any time I see a doctor say they had to leave medicine to “tell patients the truth”
they sounds like a grifter who’s going to
1) say some ableist, eugenicist BS about how you can prevent all your ailments with one easy hack your MD won’t tell you
2) sell useless, expensive supplements 💰
they sounds like a grifter who’s going to
1) say some ableist, eugenicist BS about how you can prevent all your ailments with one easy hack your MD won’t tell you
2) sell useless, expensive supplements 💰
Reposted by Brandon Somwaru, DO
One threatening letter and suddenly NEJM is the mouthpiece of the administration’s vaccine policy (giving it the sheen of scientific authenticity).
After years of publishing articles about social justice, NEJM caved to authoritarianism in a hot minute.
After years of publishing articles about social justice, NEJM caved to authoritarianism in a hot minute.
Dr. Makary and Dr. Prasad publish a new framework for COVID-19 vaccines that they announced via an @nejm.org editorial, rather than following @fda.gov's usual process and publishing a draft guidance for comment.
www.nejm.org/doi/full/10.... 1/2
www.nejm.org/doi/full/10.... 1/2
An Evidence-Based Approach to Covid-19 Vaccination | NEJM
This article from the FDA compares broad U.S. recommendations on Covid vaccination with those from other countries and announces the adoption of an evidence-based approach to such recommendations.
www.nejm.org
May 21, 2025 at 11:37 AM
One threatening letter and suddenly NEJM is the mouthpiece of the administration’s vaccine policy (giving it the sheen of scientific authenticity).
After years of publishing articles about social justice, NEJM caved to authoritarianism in a hot minute.
After years of publishing articles about social justice, NEJM caved to authoritarianism in a hot minute.
Opened my run bag looking for BandAids and found IV start kits, a tourniquet, C-collars, my Butterfly, a lac tray, a laryngoscope, ET tubes, a bougie, a BVM, lido, epi, bicarb, D50, calcium, TXA, Narcan, saline flushes, a cautery pen & curettes… but no BandAids
Prepared? Yes. Practical? Not at all
Prepared? Yes. Practical? Not at all
May 21, 2025 at 2:28 PM
Opened my run bag looking for BandAids and found IV start kits, a tourniquet, C-collars, my Butterfly, a lac tray, a laryngoscope, ET tubes, a bougie, a BVM, lido, epi, bicarb, D50, calcium, TXA, Narcan, saline flushes, a cautery pen & curettes… but no BandAids
Prepared? Yes. Practical? Not at all
Prepared? Yes. Practical? Not at all
Reposted by Brandon Somwaru, DO
These are the striking winners of our 2025 Scientist At Work photo competition, taking viewers on a voyage of discovery that includes the Arctic and Antarctic circles, and a shot from atop a Greek mountain
Read the full stories of these images: https://go.nature.com/3SGnT0e
Read the full stories of these images: https://go.nature.com/3SGnT0e
May 19, 2025 at 7:56 AM
These are the striking winners of our 2025 Scientist At Work photo competition, taking viewers on a voyage of discovery that includes the Arctic and Antarctic circles, and a shot from atop a Greek mountain
Read the full stories of these images: https://go.nature.com/3SGnT0e
Read the full stories of these images: https://go.nature.com/3SGnT0e
Methylene blue seems to be much more effective when targeting patients with true vasoplegia (widen pulse pressure / - passive leg raise / not fluid responsive / evolemic on POCUS) as opposed to those with non-vasoplegic refractory shock where we feel the need to “throw the kitchen sink”
May 16, 2025 at 1:38 PM
Methylene blue seems to be much more effective when targeting patients with true vasoplegia (widen pulse pressure / - passive leg raise / not fluid responsive / evolemic on POCUS) as opposed to those with non-vasoplegic refractory shock where we feel the need to “throw the kitchen sink”
Reposted by Brandon Somwaru, DO
I’d like to dedicate the DOJs ongoing investigation into Medicare fraud committed by Unitedhealth Group to one of the health insurance industries staunchest defenders
May 15, 2025 at 11:26 PM
I’d like to dedicate the DOJs ongoing investigation into Medicare fraud committed by Unitedhealth Group to one of the health insurance industries staunchest defenders
Reposted by Brandon Somwaru, DO
"The [FDA] said it will conduct a scientific review of the children’s products by late October with the aim of removing them from the market."
When you're so bad at faking a politically-motivated "scientific review" that you announce the conclusion you're planning to reach five months in advance.
When you're so bad at faking a politically-motivated "scientific review" that you announce the conclusion you're planning to reach five months in advance.
U.S. health regulators have announced plans to phase out fluoride-containing supplements sometimes used to strengthen children’s teeth.
FDA and RFK Jr. aim to remove ingestible fluoride products used to protect kids' teeth
U.S. health officials say they plan to phase out ingestible fluoride supplements used to strengthen children’s teeth, citing possible health risks.
bit.ly
May 13, 2025 at 11:22 PM
"The [FDA] said it will conduct a scientific review of the children’s products by late October with the aim of removing them from the market."
When you're so bad at faking a politically-motivated "scientific review" that you announce the conclusion you're planning to reach five months in advance.
When you're so bad at faking a politically-motivated "scientific review" that you announce the conclusion you're planning to reach five months in advance.
Reposted by Brandon Somwaru, DO
See this? It's called a non-inferiority trial. It compares the new vaccine with the current vaccines to see if the new vaccine does better. This new vaccine did.
Placebo-controlled trials are not needed to test most new vaccines. Demanding them will only reduce vaccine access. Which is the point.
Placebo-controlled trials are not needed to test most new vaccines. Demanding them will only reduce vaccine access. Which is the point.
May 11, 2025 at 9:08 PM
See this? It's called a non-inferiority trial. It compares the new vaccine with the current vaccines to see if the new vaccine does better. This new vaccine did.
Placebo-controlled trials are not needed to test most new vaccines. Demanding them will only reduce vaccine access. Which is the point.
Placebo-controlled trials are not needed to test most new vaccines. Demanding them will only reduce vaccine access. Which is the point.
Reposted by Brandon Somwaru, DO
Disclosures: I received a 747 from Novo Nordisk but I pinky promise it does not affect my clinical or research practices
May 12, 2025 at 2:27 PM
Disclosures: I received a 747 from Novo Nordisk but I pinky promise it does not affect my clinical or research practices
Reposted by Brandon Somwaru, DO
I’m fascinated by scientific breakthroughs that were universally hailed in the moment, like pasteurization, that are now vilified by some people. Is this a uniquely American thing? Anybody written a book about why/how this happens? Like the psychology behind it. I’d love to learn more.
May 11, 2025 at 3:06 AM
I’m fascinated by scientific breakthroughs that were universally hailed in the moment, like pasteurization, that are now vilified by some people. Is this a uniquely American thing? Anybody written a book about why/how this happens? Like the psychology behind it. I’d love to learn more.
Reposted by Brandon Somwaru, DO
Amazing. UHC shareholders are suing because after the CEO shooting, the company was “no longer willing” to use “aggressive, anti-consumer tactics” to generate the profits they were promised.
A gift from the content gods.
A gift from the content gods.
Hey @glaucomflecken.bsky.social I'm not sure how to process this. Can Jimothy help?
www.nbcnews.com/business/bus...
www.nbcnews.com/business/bus...
UnitedHealthcare sued by shareholders over reaction to CEO's killing
The group of investors alleged that the company misled them by not adjusting its forecast after Brian Thompson's killing.
www.nbcnews.com
May 8, 2025 at 11:28 PM
Amazing. UHC shareholders are suing because after the CEO shooting, the company was “no longer willing” to use “aggressive, anti-consumer tactics” to generate the profits they were promised.
A gift from the content gods.
A gift from the content gods.
Reposted by Brandon Somwaru, DO
Bill Gates accused Elon Musk at least twice in the past week of “killing” children in the world’s poorest countries by cutting foreign aid under the Trump administration.
Bill Gates Accuses Elon Musk of ‘Killing Children’ by Cutting Foreign Aid
www.nytimes.com
May 8, 2025 at 6:49 PM
Bill Gates accused Elon Musk at least twice in the past week of “killing” children in the world’s poorest countries by cutting foreign aid under the Trump administration.
Reposted by Brandon Somwaru, DO
As clearly unscientific as this is, it reveals the belief system underpinning the entire eugenics-aligned American wellness movement, which is that good and trustworthy people CAN'T get sick or harbor disease.
So, if you're sick, guess you're not good or trustworthy.
So, if you're sick, guess you're not good or trustworthy.
“When it comes to .. raw milk, I want to be free to form a relationship with a local farmer, look him in the eyes, pet his cow, and then decide if I feel safe to drink the milk from his farm.”
— Casey Means, Trump’s latest surgeon-general nominee.
www.wsj.com/politics/pol...
— Casey Means, Trump’s latest surgeon-general nominee.
www.wsj.com/politics/pol...
Trump Picks a ‘MAHA’ Movement Leader for Surgeon General
The president said he would nominate Dr. Casey Means, a California doctor and wellness influencer, to be the next surgeon general.
www.wsj.com
May 8, 2025 at 2:05 PM
As clearly unscientific as this is, it reveals the belief system underpinning the entire eugenics-aligned American wellness movement, which is that good and trustworthy people CAN'T get sick or harbor disease.
So, if you're sick, guess you're not good or trustworthy.
So, if you're sick, guess you're not good or trustworthy.
Reposted by Brandon Somwaru, DO
RFK Jr and Statistics:
May 5, 2025 at 4:06 PM
RFK Jr and Statistics:
Evil, cruel, and unforgivable
The White House is increasingly seeking to deport immigrants who came to the U.S. decades ago and have established a life, career and family in the country.
Listen to one family's story on "The Daily."
Listen to one family's story on "The Daily."
Family Separation 2.0
Her father had lived in the United States for decades. He was sent back to Brazil as part of President Trump’s deportation operation.
www.nytimes.com
May 3, 2025 at 4:13 AM
Evil, cruel, and unforgivable