#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.

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P Mimi Poinsett MD @yayayarndiva
RT @JHospMedicine: Countdown...10 minutes to #jhmchat see you soon to discuss practice changing articles in hospital medicine! https://t.co/UKK00DIYIK
Michael Sinha MD, JD, MPH @DrSinhaEsq
@MLB @TMobile #HRDerby #HRDerby2016 @Giancarlo818 or... @SHMLive @JHospMedicine @FutureDocs @mahoneyr #JHMChat Decisions, decisions...
J Hospital Medicine @JHospMedicine
Welcome to #JHMChat tonight! for now lets introduce yourselves and dont forget to use the #JHMChat hashtag in your tweets.
J Hospital Medicine @JHospMedicine
Special welcome to @mahoneyr who is tonight's #JHMChat discussant for Intravenous BP control in hospitalized patients
Robert J. Mahoney, MD @mahoneyr
No CME for baseball. We'll keep you posted. #jhmchat @DrSinhaEsq @MLB @TMobile @Giancarlo818 @SHMLive @JHospMedicine @FutureDocs
Robert J. Mahoney, MD @mahoneyr
Evening, all, from seasonably warm St. Louis, Missouri. #jhmchat
Daniel Wolfson @WolfsonD
#jhmchat Glad to be joining chat with @mahoneyr @FutureDocs https://t.co/m68Bw8HMaZ
Society of Hospital Medicine @SocietyHospMed
And our fourth #JHMChat (our first w/ a chance at #CME) is live! Join the conversation now w/ @JHospMedicine! https://t.co/Fm4hOJOX7U
J Hospital Medicine @JHospMedicine
RT @SHMLive: And our fourth #JHMChat (our first w/ a chance at #CME) is live! Join the conversation now w/ @JHospMedicine! https://t.co/Fm4hOJOX7U
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Special welcome to @mahoneyr who is tonight's #JHMChat discussant for Intravenous BP control in hospitalized patients
Tony Breu @tony_breu
@JHospMedicine Here from VA Boston #JHMChat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Edgar Lerma, Chicago-based Nephrologist; Curator of #Nephpearls #JHMChat https://t.co/X7NRcm1zV6
J Hospital Medicine @JHospMedicine
@tony_breu thx for joining #jhmchat
John Ryan @JJRyanMD
. John Ryan here @UofUHealthCare @JHospMedicine #JHMChat
James Legan MD @jimmie_vanagon
RT @DrSinhaEsq: Tonight @ 9pm ET: @FutureDocs & others on #jhmchat, CME available here: https://t.co/GeLuJT1Hrb #hcsm #hcldr #foamed https://t.co/Ijm4j5cDIb
J Hospital Medicine @JHospMedicine
@WolfsonD great to have you! #jhmchat
roscoeoz @rwh3
@JHospMedicine #JHMChat Ross White at Ryde Hospital, Sydney, Australia
Malvinder Parmar @wittykidney
Malvinder Parmar, no COI details per pinned tweet #JHMChat
J Hospital Medicine @JHospMedicine
Chicagoans in house #jhmchat @FutureDocs https://t.co/o5YJYrATso
Charlie M. Wray @WrayCharles
Happy to be joining in from warm (and not foggy) SF #JHMchat
Tony Breu @tony_breu
@JJRyanMD That makes two former VA Boston chief residents! #JHMchat
Chris Moriates, MD @ChrisMoriates
Chris Moriates joining from #ATX, new @dellmedschool. @costsofcare. Happy to be here #jhmchat
Edward Lew @elewmd
@JHospMedicine #jhmchat thanks for putting this on! joining from bay area, CA
VC @doctorvec
Victor Collier hospitalist and medical educator myrtle beach #jhmchat
J Hospital Medicine @JHospMedicine
@rwh3 great to have you from Australia! #jhmchat
J Hospital Medicine @JHospMedicine
RT @elewMD: @JHospMedicine #jhmchat thanks for putting this on! joining from bay area, CA
J Hospital Medicine @JHospMedicine
T1 up in a moment #JHMChat -welcome #CMEchat #hscm #meded #nephrology #cardiology communities remember to tag tweets #JHMChat tonight
Shoshana Herzig @ShaniHerzig
looking forward to an exciting #JHMchat from balmy Boston
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: T1 up in a moment #JHMChat -welcome #CMEchat #hscm #meded #nephrology #cardiology communities remember to tag tweets #JHMChat tonight
Robert J. Mahoney, MD @mahoneyr
Disclaimer: my tweets are probably my own. My typos are definitely my own. #jhmchat
J Hospital Medicine @JHospMedicine
Tonight's #JHMChat article is As-needed intravenous antihypertensive therapy and blood pressure control https://t.co/TWqTSjf6t8
J Hospital Medicine @JHospMedicine
T1: Do you ever order blood pressure medicine for inpatients “as needed”? Why or why not? #JHMChat @mahoneyr pls start off:)
DinasarapuMD,MPH,FHM @dcsreddy
#jhmchat I am in. Feels exciting.
James Legan MD @jimmie_vanagon
Hello all, internist from #BigSkyCountry thank you all for the #JHMchat https://t.co/nHfxFqvnRX
J Hospital Medicine @JHospMedicine
@MDaware @JJRyanMD @UofUHealthCare @NorthwesternEM thx Seth remember to use #jhmchat
J Hospital Medicine @JHospMedicine
RT @jimmie_vanagon: Hello all, internist from #BigSkyCountry thank you all for the #JHMchat https://t.co/nHfxFqvnRX
hospitalist @hospitalist2
#jhmchat hello from texas
Robert J. Mahoney, MD @mahoneyr
T1 Depends on how you define "as needed". Generally includes evidence of target organ damage, not just treating numbers. #jhmchat
Shannon K. Martin @shannonmartinmd
Hello from another Chicagoan! Shannon Martin, hospitalist from @UChicagoMed #jhmchat
J Hospital Medicine @JHospMedicine
RT @mahoneyr: Disclaimer: my tweets are probably my own. My typos are definitely my own. #jhmchat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Evolution of antihypertensive therapy #JHMChat #Nephpearls https://t.co/LlLS4m1ra0 https://t.co/Wi3mLqOHVz
Society of Hospital Medicine @SocietyHospMed
Our first topic of discussion about #bloodpressure mgmt for hospitalized patients is live on #JHMChat! Jump in! https://t.co/SRFg1hSPWP
J Hospital Medicine @JHospMedicine
And welcome to our next guest on #jhmchat! September edition https://t.co/J07oiI9zvQ
J Hospital Medicine @JHospMedicine
RT @SHMLive: Our first topic of discussion about #bloodpressure mgmt for hospitalized patients is live on #JHMChat! Jump in! https://t.co/SRFg1hSPWP
Rebecca Jaffe, MD @RJmdphilly
Joining from philly. Bowing out of toddler bed time so hoping this is as scintillating! #jhmchat
J Hospital Medicine @JHospMedicine
RT @edgarvlermamd: Evolution of antihypertensive therapy #JHMChat #Nephpearls https://t.co/LlLS4m1ra0 https://t.co/Wi3mLqOHVz
Seth Trueger @MDaware
@JHospMedicine ack sorry, will try that too :) #jhmchat
Chris Moriates, MD @ChrisMoriates
@JHospMedicine @mahoneyr I *USED* to do this. As resident, it is easy way to avoid "extra pages" by putting in lots of "PRN orders" #jhmchat
Tony Breu @tony_breu
@mahoneyr Right, and it’s hard to write a “PRN acute ischemic stroke” order #JHMchat
Robert J. Mahoney, MD @mahoneyr
T1 In tonight's article, many orders for IV hydralazine were triggered solely by BP numbers. #jhmchat
J Hospital Medicine @JHospMedicine
Thx Chris! Funny not to be in the room w you during #jhmchat :) https://t.co/EoSGJzvxnQ
Amit Kumar Pahwa @pahwa
very rarely. 1st step is it real. 2nd step is there damage. if no to either then I let it ride. #jhmchat
J Hospital Medicine @JHospMedicine
RT @ChrisMoriates: @JHospMedicine @mahoneyr I *USED* to do this. As resident, it is easy way to avoid "extra pages" by putting in lots of "PRN orders" #jhmchat
Charlie M. Wray @WrayCharles
recall being told once as trainee "always put PRN anti-HTN meds on at night. Keeps nurses off your back". still use this tactic #jhmchat
Chi Chu @cdchu
RT @ChrisMoriates: @JHospMedicine @mahoneyr I *USED* to do this. As resident, it is easy way to avoid "extra pages" by putting in lots of "PRN orders" #jhmchat
Robert J. Mahoney, MD @mahoneyr
I'm not sure residents are the only ones trying to avoid extra pages. @ChrisMoriates @JHospMedicine #jhmchat
Society of Hospital Medicine @SocietyHospMed
Thanks for joining us for #JHMChat - don't forget to include the hashtag in your tweets to be an active part of the conversation!
Edward Lew @elewmd
.@mahoneyr #jhmchat This is key. We do same in ED, but still will get others hounding us on how "high" BP is. Can imagine u get paged a lot
J Hospital Medicine @JHospMedicine
RT @mahoneyr: T1 In tonight's article, many orders for IV hydralazine were triggered solely by BP numbers. #jhmchat
Seth Trueger @MDaware
@mahoneyr T1 agreed! asymptomatic elev BP isn't an acute problem. I don't treat it with IV antiBP meds #jhmchat
J Hospital Medicine @JHospMedicine
RT @Pahwa: very rarely. 1st step is it real. 2nd step is there damage. if no to either then I let it ride. #jhmchat
Robert J. Mahoney, MD @mahoneyr
I think that order would lead to quite a few clarification calls @tony_breu #jhmchat
VC @doctorvec
95% of patients at my institution have IV prn anti-HTN. The 5% that don't are on my service #jhmchat
Tony Breu @tony_breu
@mahoneyr With the average SBP just above what some consider “urgent”. #JHMchat
J Hospital Medicine @JHospMedicine
Hold this thought T3 will touch on signout #jhmchat https://t.co/ZXZpyN7vnT
Liam Farrell @drlfarrell
@JHospMedicine Hi from ireland; columnist, ex-family doc. @am here; 'The night + the light + the half-light..." #jhmchat
Edward Lew @elewmd
@mahoneyr @ChrisMoriates @JHospMedicine #jhmchat, true, i see admission orders from attendings
J Hospital Medicine @JHospMedicine
RT @doctorvec: 95% of patients at my institution have IV prn anti-HTN. The 5% that don't are on my service #jhmchat
Malvinder Parmar @wittykidney
@SHMLive @JHospMedicine @mahoneyr no, adjust dose of meds or add meds round-the-clock to achieve target BP, whatever your goal is #JHMChat
Amit Kumar Pahwa @pahwa
as in anything with HVC it takes education of a lot of people - doctors, nurses, and patients #jhmchat
Chris Moriates, MD @ChrisMoriates
RT @Pahwa: as in anything with HVC it takes education of a lot of people - doctors, nurses, and patients #jhmchat
J Hospital Medicine @JHospMedicine
POLL #JHMChat: at what systolic BP would you order as needed BP meds for inpatients? H/t @mahoneyr
Seth Trueger @MDaware
@WrayCharles that's a terrible reason #jhmchat
Chris Moriates, MD @ChrisMoriates
RT @Pahwa as in anything with HVC it takes education of a lot of people - doctors, nurses, and patients #jhmchat
J Hospital Medicine @JHospMedicine
RT @Pahwa: as in anything with HVC it takes education of a lot of people - doctors, nurses, and patients #jhmchat
Seth Trueger @MDaware
RT @JHospMedicine: POLL #JHMChat: at what systolic BP would you order as needed BP meds for inpatients? H/t @mahoneyr
Seth Trueger @MDaware
RT @Pahwa: as in anything with HVC it takes education of a lot of people - doctors, nurses, and patients #jhmchat
Chris Moriates, MD @ChrisMoriates
#trickquestion #jhmchat https://t.co/z2iNuPEjqL
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Chicagoans in house #jhmchat @FutureDocs https://t.co/o5YJYrATso
Charlie M. Wray @WrayCharles
Agree @Pahwa, ?? the use of PRN anit-HTN is new to docs - how long will it take to diffuse to other staff #jhmchat https://t.co/cuWczB4XJj
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: T1: Do you ever order blood pressure medicine for inpatients “as needed”? Why or why not? #JHMChat @mahoneyr pls start off:)
Vinny Arora MD MAPP @FutureDocs
RT @mahoneyr: T1 In tonight's article, many orders for IV hydralazine were triggered solely by BP numbers. #jhmchat
Seth Trueger @MDaware
GOLD MEDAL #jhmchat https://t.co/Z45Rj7ltOW
John P Erwin III MD✭ @HeartOTXHeartMD
John Erwin @TAMHSC_COM @bswhealth Good evening! #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: POLL #JHMChat: at what systolic BP would you order as needed BP meds for inpatients? H/t @mahoneyr
Chi Chu @cdchu
RT @WrayCharles: recall being told once as trainee "always put PRN anti-HTN meds on at night. Keeps nurses off your back". still use this tactic #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @edgarvlermamd: Evolution of antihypertensive therapy #JHMChat #Nephpearls https://t.co/LlLS4m1ra0 https://t.co/Wi3mLqOHVz
Vinny Arora MD MAPP @FutureDocs
RT @WrayCharles: Agree @Pahwa, ?? the use of PRN anit-HTN is new to docs - how long will it take to diffuse to other staff #jhmchat https://t.co/cuWczB4XJj
John P Erwin III MD✭ @HeartOTXHeartMD
RT @JHospMedicine: Tonight's #JHMChat article is As-needed intravenous antihypertensive therapy and blood pressure control https://t.co/TWqTSjf6t8
John Ryan @JJRyanMD
T1 I find the prn IV hydralazine order can make it very hard to get people on an oral regimen because no one gives time to kick in #JHMChat
James Legan MD @jimmie_vanagon
@mahoneyr @FutureDocs Thanks for the opportunity! I am an out patient internist, but will lurk &learn #jhmchat
Robert J. Mahoney, MD @mahoneyr
Ran out of charts #jhmchat https://t.co/GASemMv8k1
Seth Trueger @MDaware
agreed: it's an uphill battle to not Rx. but also an opportunity for education #jhmchat https://t.co/OzL77EKpr9
Liam Farrell @drlfarrell
@JHospMedicine T1 So many variables here; usly BP non-urgent, but if patient unstable for other reasons.... #jhmchat
J Hospital Medicine @JHospMedicine
Keep the conversation going on T2, T3 up in a moment #JHMChat
Society of Hospital Medicine @SocietyHospMed
Don't miss out! Our 4th #JHMChat is live now with a chance to claim #CME credit! Follow along & join the convo w/ @JHospMedicine.
J Hospital Medicine @JHospMedicine
RT @JJRyanMD: T1 I find the prn IV hydralazine order can make it very hard to get people on an oral regimen because no one gives time to kick in #JHMChat
Nick van Terheyden @drnic1
RT @JHospMedicine: POLL #JHMChat: at what systolic BP would you order as needed BP meds for inpatients? H/t @mahoneyr
Charlie M. Wray @WrayCharles
Evidence may suggest not to order, repeat phone calls from worried nurse pushes doc to place order #jhmchat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Keep the conversation going on T2, T3 up in a moment #JHMChat
Shoshana Herzig @ShaniHerzig
@WrayCharles Exactly #jhmchat
Amit Kumar Pahwa @pahwa
it's not just BP, we have to teach housestaff to be comfortable with the uncomfortable #jhmchat #julyeffect
Rebecca Jaffe, MD @RJmdphilly
@JJRyanMD and can lead to stacking doses: escalating orals with frequent PRNs = badness waiting to happen #jhmchat
J Hospital Medicine @JHospMedicine
T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Agents for management of hypertensive urgency ca. 2011 #JHMChat #Nephpearls https://t.co/DkHmWUdAPV https://t.co/rzjhMOEBKK
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Agents for management of hypertensive emergencies ca. 2011 #JHMChat #Nephpearls https://t.co/DkHmWUdAPV https://t.co/9LA23yIFXe
Daniel Wolfson @WolfsonD
#JHMChat Don't get it,if the pat was not being treated prior to admission why start them now if not chief complaint https://t.co/6igacIjVJr
Malvinder Parmar @wittykidney
What are the various factors that make one use 'prn' meds to lower BP? #JHMChat
Seth Trueger @MDaware
RT @Pahwa: it's not just BP, we have to teach housestaff to be comfortable with the uncomfortable #jhmchat #julyeffect
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat
James Legan MD @jimmie_vanagon
@drlfarrell @JHospMedicine yes, would agree, look at whole patient and decide how best to treat BP elevation #jhmchat
Robert J. Mahoney, MD @mahoneyr
Food for thought #jhmchat https://t.co/NBgq4qzw0g
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat
Seth Trueger @MDaware
@edgarvlermamd note those are for *emergencies* not asx elev BP #jhmchat
Loc Queen 💋 @drcockymd
RT @JHospMedicine: T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat
Vinny Arora MD MAPP @FutureDocs
Agree! One of reasons I picked this article for tonight's #jhmchat https://t.co/qNuVdTcdFl
Seth Trueger @MDaware
no. #jhmchat https://t.co/fqvLGTwN7I
Seth Trueger @MDaware
@JHospMedicine but there are plenty of harms. #jhmchat
Vinny Arora MD MAPP @FutureDocs
It's got to be about more than treating numbers #jhmchat https://t.co/flDU110Mmr
Seth Trueger @MDaware
RT @WrayCharles: Evidence may suggest not to order, repeat phone calls from worried nurse pushes doc to place order #jhmchat
Loc Queen 💋 @drcockymd
RT @doctorvec: 95% of patients at my institution have IV prn anti-HTN. The 5% that don't are on my service #jhmchat
Society of Hospital Medicine @SocietyHospMed
RT @FutureDocs: Agree! One of reasons I picked this article for tonight's #jhmchat https://t.co/qNuVdTcdFl
Edward Lew @elewmd
@JHospMedicine #jhmchat not medically. Can help decide floor/tele/stepdown bed though
Society of Hospital Medicine @SocietyHospMed
RT @mahoneyr: Food for thought #jhmchat https://t.co/NBgq4qzw0g
Rebecca Jaffe, MD @RJmdphilly
@WrayCharles what I hear from the housestaff every time. And confusion over attending expectations. #jhmchat
VC @doctorvec
I have never found any data to support treatment of asymptomatic BP. Maybe harm. #jhmchat
Seth Trueger @MDaware
RT @FutureDocs: Agree! One of reasons I picked this article for tonight's #jhmchat https://t.co/qNuVdTcdFl
Liam Farrell @drlfarrell
@jimmie_vanagon @JHospMedicine T1 In family practice, rarely get vexed about single BP measurements #jhmchat
Grace Farris MD @gracefarris
RT @mahoneyr: Food for thought #jhmchat https://t.co/NBgq4qzw0g
J Hospital Medicine @JHospMedicine
RT @MDaware: no. #jhmchat https://t.co/fqvLGTwN7I
J Hospital Medicine @JHospMedicine
RT @jimmie_vanagon: @drlfarrell @JHospMedicine yes, would agree, look at whole patient and decide how best to treat BP elevation #jhmchat
Robert J. Mahoney, MD @mahoneyr
T2 So far, it sounds like the only benefit is reduced calls to providers. #jhmchat
James Legan MD @jimmie_vanagon
RT @drlfarrell: @jimmie_vanagon @JHospMedicine T1 In family practice, rarely get vexed about single BP measurements #jhmchat
J Hospital Medicine @JHospMedicine
RT @drlfarrell: @jimmie_vanagon @JHospMedicine T1 In family practice, rarely get vexed about single BP measurements #jhmchat
Seth Trueger @MDaware
RT @doctorvec: I have never found any data to support treatment of asymptomatic BP. Maybe harm. #jhmchat
J Hospital Medicine @JHospMedicine
RT @Pahwa: it's not just BP, we have to teach housestaff to be comfortable with the uncomfortable #jhmchat #julyeffect
Sonia giagnoni @giagnoni_sonia
RT @edgarvlermamd: Evolution of antihypertensive therapy #JHMChat #Nephpearls https://t.co/LlLS4m1ra0 https://t.co/Wi3mLqOHVz
Avendaño Murillo MD @dr_josemurillo
RT @edgarvlermamd: Agents for management of hypertensive urgency ca. 2011 #JHMChat #Nephpearls https://t.co/DkHmWUdAPV https://t.co/rzjhMOEBKK
Avendaño Murillo MD @dr_josemurillo
RT @edgarvlermamd: Agents for management of hypertensive emergencies ca. 2011 #JHMChat #Nephpearls https://t.co/DkHmWUdAPV https://t.co/9LA23yIFXe
John P Erwin III MD✭ @HeartOTXHeartMD
@wittykidney 1) Dogma 2) Fear 3) Pager fatigue 4) #CHF 5) Angina #JHMChat
J Hospital Medicine @JHospMedicine
RT @mahoneyr: T2 So far, it sounds like the only benefit is reduced calls to providers. #jhmchat
Seth Trueger @MDaware
RT @mahoneyr: T2 So far, it sounds like the only benefit is reduced calls to providers. #jhmchat
Grace Farris MD @gracefarris
RT @FutureDocs: Agree! One of reasons I picked this article for tonight's #jhmchat https://t.co/qNuVdTcdFl
Tony Breu @tony_breu
@FutureDocs @WrayCharles One thing I point out to them: HTN is NOT a rapid response criteria. For a reason #JHMchat
Edward Lew @elewmd
.@doctorvec #jhmchat ACEP guidelines support no emergent tx of asymptomatic BP
Rebecca Jaffe, MD @RJmdphilly
RT @JHospMedicine: T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat
Liam Farrell @drlfarrell
Are you sure about that? RT @doctorvec: I have never found any data to support treatment of asymptomatic BP. Maybe harm. #jhmchat
Charlie M. Wray @WrayCharles
8 years on & this info still hasn't disseminated down to practitioners like it should. old habits die hard #jhmchat https://t.co/7CwQ2BcysN
Society of Hospital Medicine @SocietyHospMed
RT @mahoneyr: T2 So far, it sounds like the only benefit is reduced calls to providers. #jhmchat
J Hospital Medicine @JHospMedicine
RT @mahoneyr: Food for thought #jhmchat https://t.co/NBgq4qzw0g
Seth Trueger @MDaware
plenty of harms though- including RNs & MDs wasting time #jhmchat https://t.co/2QlKGoq8i6
Chris Moriates, MD @ChrisMoriates
@mahoneyr Well to be fair, of course theres always *risk* of badness-stroke, MI, etc. The issue: is risk at the moment>risk of meds #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @mahoneyr: Food for thought #jhmchat https://t.co/NBgq4qzw0g
Malvinder Parmar @wittykidney
@JHospMedicine many, Calm nurses, other providers Doing something Getting to the number in everyone's head And... #JHMChat
Charlie M. Wray @WrayCharles
Numbers are easy, patients are hard... #jhmchat https://t.co/0B4omko3p3
Grace Farris MD @gracefarris
RT @tony_breu: @FutureDocs @WrayCharles One thing I point out to them: HTN is NOT a rapid response criteria. For a reason #JHMchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @FutureDocs: It's got to be about more than treating numbers #jhmchat https://t.co/flDU110Mmr
Society of Hospital Medicine @SocietyHospMed
RT @WrayCharles: 8 years on & this info still hasn't disseminated down to practitioners like it should. old habits die hard #jhmchat https://t.co/7CwQ2BcysN
Chris Moriates, MD @ChrisMoriates
RT @WrayCharles: Numbers are easy, patients are hard... #jhmchat https://t.co/0B4omko3p3
J Hospital Medicine @JHospMedicine
Why we having #jhmchat ! https://t.co/HCeoXrRG5i
Liam Farrell @drlfarrell
@doctorvec Long-term raised BP has significant effects, unless things have changed++ since I retired #jhmchat
Amit Kumar Pahwa @pahwa
t2 less paging for NHO SBP>180 :-) #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @WrayCharles: Numbers are easy, patients are hard... #jhmchat https://t.co/0B4omko3p3
VC @doctorvec
Long-term yes. Short term in hospitalized patients not so sure. #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @JHospMedicine: Why we having #jhmchat ! https://t.co/HCeoXrRG5i
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Why we having #jhmchat ! https://t.co/HCeoXrRG5i
Edgar V. Lerma 🇵🇭 @edgarvlermamd
Lowering BP in ICH #JHMChat #Nephpearls https://t.co/hutF9CzQqO https://t.co/OexxmidVIW
Charlie M. Wray @WrayCharles
RT @JHospMedicine: Why we having #jhmchat ! https://t.co/HCeoXrRG5i
James Legan MD @jimmie_vanagon
RT @WrayCharles: Numbers are easy, patients are hard... #jhmchat https://t.co/0B4omko3p3
John Ryan @JJRyanMD
T2 No. Next question. #JHMChat
J Hospital Medicine @JHospMedicine
T3: Lipari et al found ONLY HALF of pts had BP regimen adjusted after getting as-needed BP meds. How can we improve this? #JHMChat
Amit Kumar Pahwa @pahwa
@tony_breu but you do forget that any concern by nursing or patient can be a reason for RRT #jhmchat
Edward Lew @elewmd
@drlfarrell @doctorvec #jhmchat sure, but needing IV meds prn in hospital for asymptomatic HTN? That is diff story
Vinny Arora MD MAPP @FutureDocs
RT @tony_breu: @FutureDocs @WrayCharles One thing I point out to them: HTN is NOT a rapid response criteria. For a reason #JHMchat
Robert J. Mahoney, MD @mahoneyr
Less info about hydralazine. Remember SL nifedipine? Here are some references regarding the harms. @MDaware #JHMchat https://t.co/h4EyYb4yr2
John P Erwin III MD✭ @HeartOTXHeartMD
RT @JHospMedicine: T3: Lipari et al found ONLY HALF of pts had BP regimen adjusted after getting as-needed BP meds. How can we improve this? #JHMChat
Rebecca Jaffe, MD @RJmdphilly
These are important. #jhmchat sounds like we're preaching to the choir. So why does this persist? A good start... https://t.co/IQY0X6os59
Michael Sinha MD, JD, MPH @DrSinhaEsq
T1: Dialysis complicates everything -- prefer IV PRNs for a patient who missed 2-3 dialysis sessions. Can still "box" residual fxn. #JHMChat
Tony Breu @tony_breu
@Pahwa Absolutely. And this is where education and a conversation can/should occur. Takes time. #JHMchat
Chris Moriates, MD @ChrisMoriates
True dat. #pagerPTSD #jhmchat https://t.co/svMu3iFI7K
Vinny Arora MD MAPP @FutureDocs
fascinated that the answers to T2 were no benefit but we all admit to doing this or knowing others do #jhmchat #need2change
Seth Trueger @MDaware
@ChrisMoriates @mahoneyr maybe not, actually. see @Atzema in @AnnalsofEM https://t.co/3jhni8FGhJ #jhmchat https://t.co/9vP6tSxkTm
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: T3: Lipari et al found ONLY HALF of pts had BP regimen adjusted after getting as-needed BP meds. How can we improve this? #JHMChat
Amit Kumar Pahwa @pahwa
t3: this is what really gets me and i push with the housestaff, they wouldn't do this if vanc trough was 5 #JHMChat
Robert J. Mahoney, MD @mahoneyr
Is this one of those things that "everbody else" does? @FutureDocs #jhmchat
Tony Breu @tony_breu
@JHospMedicine Not sure we need to adjust. Surely some of the patients had reason for acute HTN (e.g. pain). #JHMchat
Bill Dailey, MD MSMI @docdailey
@mahoneyr #jhmchat https://t.co/wRerrUbvlP
Liam Farrell @drlfarrell
accepted RT @elewMD: @doctorvec #jhmchat sure, but needing IV meds prn in hospital for asymptomatic HTN? That is diff story
Vinny Arora MD MAPP @FutureDocs
RT @RJmdphilly: These are important. #jhmchat sounds like we're preaching to the choir. So why does this persist? A good start... https://t.co/IQY0X6os59
Madhu S. MD @thinkalot
RT @MDaware: no. #jhmchat https://t.co/fqvLGTwN7I
Malvinder Parmar @wittykidney
@elewMD @drlfarrell @doctorvec hospitals has protocols & don't allow IV meds to lower BP in unmonitored setting, so r u monitoring #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T3: Lipari et al found ONLY HALF of pts had BP regimen adjusted after getting as-needed BP meds. How can we improve this? #JHMChat
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @FutureDocs: fascinated that the answers to T2 were no benefit but we all admit to doing this or knowing others do #jhmchat #need2change
Edward Lew @elewmd
@edgarvlermamd #jhmchat what's hypertensive "urgency?"
Vinny Arora MD MAPP @FutureDocs
Clearly:) #jhmchat https://t.co/u6cotyqg1P
Charlie M. Wray @WrayCharles
In essence treating a "problem" now, creates a PROBLEM later. My suggestion, stop treating the "problem" #jhmchat https://t.co/Ft2hCXUscM
Robert J. Mahoney, MD @mahoneyr
Yeah yeah yeah. I have lots of N=1 experience w/gravity. Not so much with BP management. @docdailey #jhmchat
Amit Kumar Pahwa @pahwa
@mahoneyr @MDaware don't tell @HopkinsMedicine housestaff about this - they love nifedipine #jhmchat
Seth Trueger @MDaware
hypothesis: social media community selects contrarians & nihilists (ping @dmark123w10) #jhmchat https://t.co/ZSZYAdbC9U
Grace Farris MD @gracefarris
One of the @BIDMChealth geriatricians recommends a glass of milk for nocturnal htn in hospitalized pts #jhmchat @FutureDocs @tony_breu
Carlos del Rio @carlosdelrio7
RT @mahoneyr: Disclaimer: my tweets are probably my own. My typos are definitely my own. #jhmchat
James Legan MD @jimmie_vanagon
RT @FutureDocs: fascinated that the answers to T2 were no benefit but we all admit to doing this or knowing others do #jhmchat #need2change
Vinny Arora MD MAPP @FutureDocs
RT @MDaware: hypothesis: social media community selects contrarians & nihilists (ping @dmark123w10) #jhmchat https://t.co/ZSZYAdbC9U
Jorge A Rodriguez MD @translatedmed
T3: Potential role for EHR/IT intervention to monitor for IV PRN meds and suggest adjustment for standing medications. #jhmchat
Chi Chu @cdchu
@wittykidney @elewMD @drlfarrell @doctorvec often they are ok with PO hydralazine off cardiac monitor.. #jhmchat
VC @doctorvec
I only adjust if evidence of poor control at home #jhmchat
Amit Kumar Pahwa @pahwa
@elewMD @edgarvlermamd when you are getting paged about someone's BP #JHMChat
Seth Trueger @MDaware
suppressing anti-IV-hydralazine rant for #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
@RJmdphilly @wittykidney Always a long lag between evidence and standard practice #deadlygap #jhmchat
J Hospital Medicine @JHospMedicine
RT @doctorvec: I only adjust if evidence of poor control at home #jhmchat
Chris Moriates, MD @ChrisMoriates
Fair. But 1% risk is still a risk. I will see more than 100 patients with severe HTN in hosp over time. #jhmchat https://t.co/UKNXDHyaw7
Seth Trueger @MDaware
MOA: distracts patient & RN long enough to repeat BP, regress to mean #jhmchat https://t.co/1BjdPBhMWn
Malvinder Parmar @wittykidney
@DrSinhaEsq Volume is the problem here, remove fluids & BP settles, no need for IV meds #jhmchat
J Hospital Medicine @JHospMedicine
RT @gracefarris: One of the @BIDMChealth geriatricians recommends a glass of milk for nocturnal htn in hospitalized pts #jhmchat @FutureDocs @tony_breu
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@DrSinhaEsq Hypertension in ESRD: Pathogenesis from @UpToDate #JHMChat #Nephpearls https://t.co/oGufhOz5Dm
J. Brian Byrd, MD, MS 🐦 @thebyrdlab
Brian Byrd, hypertension specialist & cardiologist, Ann Arbor. No relevant COI. #jhmchat
Robert J. Mahoney, MD @mahoneyr
It would be nice to have some evidence that it made a difference. Or at least some targets to shoot for. @docdailey #jhmchat
Amit Kumar Pahwa @pahwa
@gracefarris @BIDMChealth @FutureDocs @tony_breu is it from this guy? #JHMchat https://t.co/C8ZV6AaPnY
Seth Trueger @MDaware
best definition I've ever heard #jhmchat https://t.co/iMM5rtslWl
Charlie M. Wray @WrayCharles
Another solution: question the "diagnosis" of HTN urgency via @iona_heath https://t.co/2ycFc7r37H #jhmchat https://t.co/G1ArqJfK7t
Carlos del Rio @carlosdelrio7
#jhmchat how do we decrease the number of pages residents get so they can focus more on patient care and education?
Robert J. Mahoney, MD @mahoneyr
This. Always underestimated. @tony_breu @JHospMedicine #jhmchat
John Ryan @JJRyanMD
RT @gracefarris: One of the @BIDMChealth geriatricians recommends a glass of milk for nocturnal htn in hospitalized pts #jhmchat @FutureDocs @tony_breu
Vinny Arora MD MAPP @FutureDocs
I usually recommend a good nights #sleep - reduce interruptions since sleep loss Assoc w Inc BP #jhmchat https://t.co/aVQiSry3Xs
John P Erwin III MD✭ @HeartOTXHeartMD
One of my all-time favorite references! #parachutes #gravity #jhmchat https://t.co/lD6BoZfQRa
J. Brian Byrd, MD, MS 🐦 @thebyrdlab
UMich has had an interest in this topic even before this publication. See also https://t.co/zoCYsGk2x9 #jhmchat
Malvinder Parmar @wittykidney
@tony_breu @JHospMedicine agree "situational hypertension" should be controlled by controlling underlying issue #jhmchat
Robert J. Mahoney, MD @mahoneyr
More food for thought. #JHMChat https://t.co/62aSGEgJ8F
Vinny Arora MD MAPP @FutureDocs
RT @WrayCharles: Another solution: question the "diagnosis" of HTN urgency via @iona_heath https://t.co/2ycFc7r37H #jhmchat https://t.co/G1ArqJfK7t
Seth Trueger @MDaware
@ChrisMoriates @mahoneyr @Atzema @AnnalsofEM only if you compare to an appropriate control group… #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @translatedmed: T3: Potential role for EHR/IT intervention to monitor for IV PRN meds and suggest adjustment for standing medications. #jhmchat
Vinny Arora MD MAPP @FutureDocs
Welcome to #jhmchat on as needed meds to control BP in hospitalized patients https://t.co/5CYLoIGlzr
Malvinder Parmar @wittykidney
@WrayCharles @JHospMedicine This PROBLEM is caused by us - focusing on numbers #jhmchat
Seth Trueger @MDaware
RT @mahoneyr: More food for thought. #JHMChat https://t.co/62aSGEgJ8F
Robert J. Mahoney, MD @mahoneyr
Wouldn't it be nice to have an A1c for blood pressure? Maybe proteinuria? @doctorvec #jhmchat
Charlie M. Wray @WrayCharles
Or just make the hospital more "hospitable" and EBM shown decreased BPs https://t.co/T7OZQFATIf #jhmchat #SIESTA #lessismore
KP San Diego FMR @kpsdfmr
RT @mahoneyr: More food for thought. #JHMChat https://t.co/62aSGEgJ8F
Society of Hospital Medicine @SocietyHospMed
RT @mahoneyr: More food for thought. #JHMChat https://t.co/62aSGEgJ8F
Amit Kumar Pahwa @pahwa
@mahoneyr is this a slide a deck? #jhmchat
Edward Lew @elewmd
@wittykidney @drlfarrell @doctorvec #jhmchat i guess the Q is, why give anything to acute lower BP if asymptomatic? monitor or no monitor
Michael Sinha MD, JD, MPH @DrSinhaEsq
Assuming you can get the excess fluid off quickly enough, yes. #JHMChat https://t.co/HmtM6Rrrzu
J Hospital Medicine @JHospMedicine
RT @tony_breu: @JHospMedicine Not sure we need to adjust. Surely some of the patients had reason for acute HTN (e.g. pain). #JHMchat
J Hospital Medicine @JHospMedicine
RT @wittykidney: @WrayCharles @JHospMedicine This PROBLEM is caused by us - focusing on numbers #jhmchat
Tony Breu @tony_breu
@wittykidney @JHospMedicine Gets to the fact that large # of doses were given at night. No “time” to asses. #JHMchat
Santosy @msantosian
I take inpatient HTN in context (ESRD, s/p hip fx repair, rebounding AKI for x # of reasons, pain, withdrawal), Rx accordingly. #JHMChat
J Hospital Medicine @JHospMedicine
Thx remember to index #jhmchat https://t.co/Rn2TusV6TB
Shoshana Herzig @ShaniHerzig
@tony_breu @wittykidney @JHospMedicine And no knowledge of the patient by x-covering residents. #jhmchat
J Hospital Medicine @JHospMedicine
RT @DrSinhaEsq: Assuming you can get the excess fluid off quickly enough, yes. #JHMChat https://t.co/HmtM6Rrrzu
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@DrSinhaEsq Also need to consider dialyzability of antihypertensives #JHMChat #Nephpearls https://t.co/4MkJnheiro https://t.co/ANTzOCnT6W
John P Erwin III MD✭ @HeartOTXHeartMD
RT @JHospMedicine: Thx remember to index #jhmchat https://t.co/Rn2TusV6TB
Seth Trueger @MDaware
proposed solution #jhmchat @wittykidney @WrayCharles @JHospMedicine https://t.co/5cQ8m0oqzJ
J Hospital Medicine @JHospMedicine
RT @FutureDocs: Welcome to #jhmchat on as needed meds to control BP in hospitalized patients https://t.co/5CYLoIGlzr
Edward Lew @elewmd
@Pahwa @edgarvlermamd #jhmchat love it
JP Arroyo @anblog84
RT @thebyrdlab: UMich has had an interest in this topic even before this publication. See also https://t.co/zoCYsGk2x9 #jhmchat
J Hospital Medicine @JHospMedicine
RT @MDaware: proposed solution #jhmchat @wittykidney @WrayCharles @JHospMedicine https://t.co/5cQ8m0oqzJ
Michael Sinha MD, JD, MPH @DrSinhaEsq
Absolutely agree. One of the most important things I learned on the renal service in Residency. #JHMChat https://t.co/tOuNLiwR1H
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @edgarvlermamd: @DrSinhaEsq Also need to consider dialyzability of antihypertensives #JHMChat #Nephpearls https://t.co/4MkJnheiro https://t.co/ANTzOCnT6W
VC @doctorvec
What about orthostasis. How often do we check standing BP in hospitalized patients?#jhmchat
Chris Moriates, MD @ChrisMoriates
I always worry when new anti-HTNs started in hosp during acute illness/stressor, how pt will tolerate once under normal conditions. #jhmchat
Robert J. Mahoney, MD @mahoneyr
Have you watched while patients get orthostatics checked in the hospital? Whole thing takes 30 seconds. #notorthostatic @doctorvec #jhmchat
Michael Sinha MD, JD, MPH @DrSinhaEsq
@edgarvlermamd at the ready with tables upon tables! Great contributions! #JHMChat
Malvinder Parmar @wittykidney
@mahoneyr then, why do nurses from LTCs or other places send pt to ED, when BP is high but pt asymptomatic but now anxious #JHMChat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @doctorvec: What about orthostasis. How often do we check standing BP in hospitalized patients?#jhmchat
Santosy @msantosian
Sorry, forgot to introduce myself. Michael Santos, Hospitalist, recent grad from PSHMC IM! #JHMChat
Chi Chu @cdchu
@ChrisMoriates exactly - if we intensify regimen should pt get discharged on it, ask in f/u how often such regimens get cut back #jhmchat
J Hospital Medicine @JHospMedicine
RT @ChrisMoriates: I always worry when new anti-HTNs started in hosp during acute illness/stressor, how pt will tolerate once under normal conditions. #jhmchat
James Legan MD @jimmie_vanagon
@JHospMedicine yes& s an out patient tools like this may help put risks/benefits of BP reduction in context #jhmchat https://t.co/rzE3womRPc
Amit Kumar Pahwa @pahwa
@doctorvec how often are BP's even taken correctly in hospital setting. #JHMChat
hospitalist @hospitalist2
#jhmchat i think we are checking vitals too often. it makes patients who are already nervous in hospital, hysterical if their BP is high
Shannon K. Martin @shannonmartinmd
T3 multidisciplinary education critical - PRNs for BP common ? on gen med consults, tension bt EBM and surgeon pref for clear recs #jhmchat
Rebecca Jaffe, MD @RJmdphilly
@JeffIMchiefs from #jhmchat you guys should join the next one! https://t.co/zfyOVV2Xgo
Chi Chu @cdchu
@ChrisMoriates and figuring if htn is from acute stressor vs just poor baseline control #jhmchat
Amit Kumar Pahwa @pahwa
@ChrisMoriates Or just the fact we have now added to their list of meds #polypharmacy #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @ShannonMartinMD: T3 multidisciplinary education critical - PRNs for BP common ? on gen med consults, tension bt EBM and surgeon pref for clear recs #jhmchat
Robert J. Mahoney, MD @mahoneyr
BP poll so far. Not enough chars to put #JHMchat in so you'll have to find it in my profile if you want to vote. https://t.co/D3qQLPQC0e
John P Erwin III MD✭ @HeartOTXHeartMD
RT @hospitalist2: #jhmchat i think we are checking vitals too often. it makes patients who are already nervous in hospital, hysterical if their BP is high
Malvinder Parmar @wittykidney
@elewMD @drlfarrell @doctorvec yes, but If 1 is giving IV meds, this ASYMPTOMATIC pt would require high cost care without benefit #JHMChat
Seth Trueger @MDaware
3-night admission triggers Medicare SNF payment #jhmchat https://t.co/SPH8AdlbfG
Eduardo Viteri @etwiteri
RT @WrayCharles: Numbers are easy, patients are hard... #jhmchat https://t.co/0B4omko3p3
Vinny Arora MD MAPP @FutureDocs
We are working to reduce unnecessary nighttime vital checks through #SIESTA #choosingwisely #jhmchat https://t.co/teufMjIzYh
Charlie M. Wray @WrayCharles
RT @ShannonMartinMD: T3 multidisciplinary education critical - PRNs for BP common ? on gen med consults, tension bt EBM and surgeon pref for clear recs #jhmchat
Edward Lew @elewmd
@wittykidney @mahoneyr #jhmchat good question. ED sees all the time. Fear and not well educated in HTN
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@wittykidney @mahoneyr Ever heard of liticaphobia #JHMChat https://t.co/CnVZ4t2nmG
Chris Moriates, MD @ChrisMoriates
Yes, who knows? But that means should not be answered by me in that moment. Must encourage appropriate f/u. #jhmchat https://t.co/AYuHEu1Jpm
John P Erwin III MD✭ @HeartOTXHeartMD
RT @mahoneyr: BP poll so far. Not enough chars to put #JHMchat in so you'll have to find it in my profile if you want to vote. https://t.co/D3qQLPQC0e
Seth Trueger @MDaware
my rule: only give IV BP meds if considering gtt. #jhmchat https://t.co/VsuHjHCGQw
John P Erwin III MD✭ @HeartOTXHeartMD
RT @FutureDocs: We are working to reduce unnecessary nighttime vital checks through #SIESTA #choosingwisely #jhmchat https://t.co/teufMjIzYh
J Hospital Medicine @JHospMedicine
RT @mahoneyr: BP poll so far. Not enough chars to put #JHMchat in so you'll have to find it in my profile if you want to vote. https://t.co/D3qQLPQC0e
Beth RN BSN @bveltrop72
RT @hospitalist2: #jhmchat i think we are checking vitals too often. it makes patients who are already nervous in hospital, hysterical if their BP is high
Eduardo Viteri @etwiteri
RT @mahoneyr: Food for thought #jhmchat https://t.co/NBgq4qzw0g
J Hospital Medicine @JHospMedicine
RT @ShannonMartinMD: T3 multidisciplinary education critical - PRNs for BP common ? on gen med consults, tension bt EBM and surgeon pref for clear recs #jhmchat
Malvinder Parmar @wittykidney
@doctorvec and, How often do you consider 'pseudohypertension' especially in elderly, & Osler maneuver #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @FutureDocs: We are working to reduce unnecessary nighttime vital checks through #SIESTA #choosingwisely #jhmchat https://t.co/teufMjIzYh
J Hospital Medicine @JHospMedicine
T4: In Lipari study, more as-needed BP meds given at NIGHT. How can we improve protocols/handoffs to reduce their use? #JHMChat
Madhu S. MD @thinkalot
RT @mahoneyr: More food for thought. #JHMChat https://t.co/62aSGEgJ8F
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: T4: In Lipari study, more as-needed BP meds given at NIGHT. How can we improve protocols/handoffs to reduce their use? #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: T4: In Lipari study, more as-needed BP meds given at NIGHT. How can we improve protocols/handoffs to reduce their use? #JHMChat
Robert J. Mahoney, MD @mahoneyr
Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat
Seth Trueger @MDaware
T4: educate doctors, nurses, patients. #jhmchat https://t.co/W3WurXN5fL
James Legan MD @jimmie_vanagon
RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat
Tony Breu @tony_breu
@JHospMedicine Never seen contingency like this: “For severe asymptomatic HTN, please provide reassurance.” #JHMchat
John P Erwin III MD✭ @HeartOTXHeartMD
T4: #CPAP for #OSA & quit waking up patients at night for vitals #jhmchat https://t.co/L31hUjNnlu
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@Pahwa @elewMD Hypertensive Urgency: Useful diagnosis ⁉️❓#JHMChat #Nephpearls https://t.co/FkvqvxPMsU https://t.co/9i0QCXvX8S
Malvinder Parmar @wittykidney
@hospitalist2 pt at nursing home where BP may be checked 1/month - gets in to acute care, - everybody starts jumping to lower BP #JHMChat
Amit Kumar Pahwa @pahwa
@JHospMedicine this is a hard one because you don't want to say if BP > 180 don't do anything; less vital checks at night #jhmchat
Robert J. Mahoney, MD @mahoneyr
How many people giving IV BP meds consider this guideline? #JHMchat https://t.co/jMYHGvXdSA
Seth Trueger @MDaware
@mahoneyr @FutureDocs if they're potentially sick (eg why else admit for UT!?) makes sense. but… #jhmchat
Charlie M. Wray @WrayCharles
such an interesting finding! staffing usually cross-over, fewer tests (stressors) at night, more sleep, etc #jhmchat https://t.co/1538Rrf85r
Loc Queen 💋 @drcockymd
RT @FutureDocs: We are working to reduce unnecessary nighttime vital checks through #SIESTA #choosingwisely #jhmchat https://t.co/teufMjIzYh
Sam @samwain
RT @ChrisMoriates: Fair. But 1% risk is still a risk. I will see more than 100 patients with severe HTN in hosp over time. #jhmchat https://t.co/UKNXDHyaw7
J Hospital Medicine @JHospMedicine
RT @WrayCharles: such an interesting finding! staffing usually cross-over, fewer tests (stressors) at night, more sleep, etc #jhmchat https://t.co/1538Rrf85r
VC @doctorvec
RT @tony_breu: @JHospMedicine Never seen contingency like this: “For severe asymptomatic HTN, please provide reassurance.” #JHMchat
Ell Kennedy @luckyell
RT @MDaware: proposed solution #jhmchat @wittykidney @WrayCharles @JHospMedicine https://t.co/5cQ8m0oqzJ
Robert J. Mahoney, MD @mahoneyr
T4 Consider this while building your order sets. "Notify MD if" should mean "MD should do something if" #jhmchat
James Legan MD @jimmie_vanagon
RT @wittykidney: @hospitalist2 pt at nursing home where BP may be checked 1/month - gets in to acute care, - everybody starts jumping to lower BP #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @mahoneyr: How many people giving IV BP meds consider this guideline? #JHMchat https://t.co/jMYHGvXdSA
J Hospital Medicine @JHospMedicine
True - indexing #jhmchat https://t.co/hyp5DJW3yw
John Ryan @JJRyanMD
When I worked in Ireland, BP meds had to be written at bedside- I think they were prescribed less #jhmchat #anecdote https://t.co/f3Tf0r3Pdr
Seth Trueger @MDaware
@WrayCharles @JHospMedicine but staff who knows patient less? #jhmchat
J Hospital Medicine @JHospMedicine
RT @JJRyanMD: When I worked in Ireland, BP meds had to be written at bedside- I think they were prescribed less #jhmchat #anecdote https://t.co/f3Tf0r3Pdr
Christina Thielst @cthielst
RT @mahoneyr: How many people giving IV BP meds consider this guideline? #JHMchat https://t.co/jMYHGvXdSA
Charlie M. Wray @WrayCharles
argues that telling patients to "relax" may not be the answer #jhmchat https://t.co/82EHutkN1X
Aelaf Worku @DrAelaf
2 aspects to this: lit supporting majority of hypertensive urgency due to nonadherence and ER workflow. Which priority wins? #JHMChat
Susan Woolner @susanwoolner
RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat
Seth Trueger @MDaware
*raises hand* #jhmchat https://t.co/dkXAeNAbgI
mandy @mandajane79
RT @FutureDocs: We are working to reduce unnecessary nighttime vital checks through #SIESTA #choosingwisely #jhmchat https://t.co/teufMjIzYh
J Hospital Medicine @JHospMedicine
RT @DrAelaf: 2 aspects to this: lit supporting majority of hypertensive urgency due to nonadherence and ER workflow. Which priority wins? #JHMChat
Seth Trueger @MDaware
@mahoneyr even better: JNCVII on HTN urgency… #jhmchat
J Hospital Medicine @JHospMedicine
RT @mahoneyr: T4 Consider this while building your order sets. "Notify MD if" should mean "MD should do something if" #jhmchat
Amit Kumar Pahwa @pahwa
t4 if you feel the patient would not benefit from an IV dose overnight then should be in signout like we often do with narcotics #jhmchat
J Hospital Medicine @JHospMedicine
RT @mahoneyr: How many people giving IV BP meds consider this guideline? #JHMchat https://t.co/jMYHGvXdSA
Luis Saldana @lsaldanamd
RT @mahoneyr: More food for thought. #JHMChat https://t.co/62aSGEgJ8F
J Hospital Medicine @JHospMedicine
RT @HeartOTXHeartMD: T4: #CPAP for #OSA & quit waking up patients at night for vitals #jhmchat https://t.co/L31hUjNnlu
J Hospital Medicine @JHospMedicine
RT @tony_breu: @JHospMedicine Never seen contingency like this: “For severe asymptomatic HTN, please provide reassurance.” #JHMchat
Malvinder Parmar @wittykidney
@Pahwa @JHospMedicine and, gets stroke #jhmchat
J Hospital Medicine @JHospMedicine
RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat
J Hospital Medicine @JHospMedicine
RT @hospitalist2: #jhmchat i think we are checking vitals too often. it makes patients who are already nervous in hospital, hysterical if their BP is high
Charlie M. Wray @WrayCharles
I believe this is called the opposite of a "nudge". Speed-bump? #jhmchat https://t.co/LGtr1egaLi
Ji Baang @jbaang
@JHospMedicine wish we had "don't check BP when pt sleeping" in our ordering system. Sleeping pt almost always a good thing. #jhmchat
Rebecca Jaffe, MD @RJmdphilly
@Pahwa list of "do nots" could get out of hand? #jhmchat
Robert J. Mahoney, MD @mahoneyr
You mean, this? @MDaware #JHMChat https://t.co/MGNSyz21Wx
Seth Trueger @MDaware
bumping for #jhmchat https://t.co/DNjMYIvP5P
John Ryan @JJRyanMD
. @MDaware @mahoneyr I don't know the difference between urgency and emergency #truth #jhmChat #jhmConfessional
Seth Trueger @MDaware
yes THIS #jhmchat https://t.co/Z6S8d7NXTe
Robert J. Mahoney, MD @mahoneyr
First step is to differentiate urgency from emergency. Then treat emergency in appropriate venue. @translatedmed #jhmchat
Malvinder Parmar @wittykidney
@mahoneyr pre-printed order sheets often available, and the habit of ticking check boxes let one keep doing that may be futile #jhmchat
Society of Hospital Medicine @SocietyHospMed
When this #JHMChat is done, follow these instructions to claim your #CME if you haven't already pre-registered! https://t.co/rymSXjil0o
J Hospital Medicine @JHospMedicine
RT @jbaang: @JHospMedicine wish we had "don't check BP when pt sleeping" in our ordering system. Sleeping pt almost always a good thing. #jhmchat
Rebecca Jaffe, MD @RJmdphilly
@WrayCharles @JHospMedicine and for resident teams, unclear expectations by day *attending* #jhmchat
Seth Trueger @MDaware
@mahoneyr and, there's *negative evidence* that doing so doesn't help #jhmchat
John Ryan @JJRyanMD
RT @WrayCharles: I believe this is called the opposite of a "nudge". Speed-bump? #jhmchat https://t.co/LGtr1egaLi
Amit Kumar Pahwa @pahwa
@rjmdphilly very true but often we don’t put in do nots unless it happened overnight and we don’t want it to happen again #jhmchat
Seth Trueger @MDaware
RT @mahoneyr: You mean, this? @MDaware #JHMChat https://t.co/MGNSyz21Wx
J Hospital Medicine @JHospMedicine
Reminding myself in my excitement to discuss sleep to index #jhmchat! https://t.co/RjtPXldM5s
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@HeartOTXHeartMD @JHospMedicine HIPARCO: Effect of CPAP on BP in OSA #JHMChat #Nephpearls https://t.co/qeSL6hTekh https://t.co/qVoPrMDthk
Tony Breu @tony_breu
@JJRyanMD @MDaware @mahoneyr Urgency doesn’t exist. #JHMchat
Seth Trueger @MDaware
this is how we get MOC #jhmchat https://t.co/SYeG4Ntqpd
J Hospital Medicine @JHospMedicine
Sounds like #choosingwisely rec in the making? #jhmchat https://t.co/2wTswE9iZO
Piyush Kumar @drpiyushkr
RT @mahoneyr: You mean, this? @MDaware #JHMChat https://t.co/MGNSyz21Wx
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Reminding myself in my excitement to discuss sleep to index #jhmchat! https://t.co/RjtPXldM5s
Robert J. Mahoney, MD @mahoneyr
"Urgency" is variably defined in literature as > 160/100 or > 180/110. Depends on whom you ask @JJRyanMD @MDaware #jhmchat
Malvinder Parmar @wittykidney
@WrayCharles agree withdrawal of Ativan in many has caused difficult to control BP. A major issue, but not given much attention #JHMChat
Beth RN BSN @bveltrop72
RT @HeartOTXHeartMD: T4: #CPAP for #OSA & quit waking up patients at night for vitals #jhmchat https://t.co/L31hUjNnlu
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Sounds like #choosingwisely rec in the making? #jhmchat https://t.co/2wTswE9iZO
Vinny Arora MD MAPP @FutureDocs
RT @jbaang: @JHospMedicine wish we had "don't check BP when pt sleeping" in our ordering system. Sleeping pt almost always a good thing. #jhmchat
Seth Trueger @MDaware
hypertensive emergency: AoD, CVA, APE, eclampsia, ICH, SAH… hypertensive urgency: just a number. #jhmchat https://t.co/SYeG4Ntqpd
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @edgarvlermamd: @Pahwa @elewMD Hypertensive Urgency: Useful diagnosis ⁉️❓#JHMChat #Nephpearls https://t.co/FkvqvxPMsU https://t.co/9i0QCXvX8S
Vinny Arora MD MAPP @FutureDocs
RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @SHMLive: When this #JHMChat is done, follow these instructions to claim your #CME if you haven't already pre-registered! https://t.co/rymSXjil0o
J Hospital Medicine @JHospMedicine
RT @mahoneyr: "Urgency" is variably defined in literature as > 160/100 or > 180/110. Depends on whom you ask @JJRyanMD @MDaware #jhmchat
Rebecca Jaffe, MD @RJmdphilly
@Pahwa once burned twice shy. How to prevent the first time? #jhmchat
Aelaf Worku @DrAelaf
@MDaware waiting for oral antihtn meds to kick in is operationally costly when the presumed etiology is nonadherence. #JHMchat
J Hospital Medicine @JHospMedicine
RT @SHMLive: When this #JHMChat is done, follow these instructions to claim your #CME if you haven't already pre-registered! https://t.co/rymSXjil0o
Seth Trueger @MDaware
@DrAelaf begging the question #jhmchat
J Hospital Medicine @JHospMedicine
RT @wittykidney: @mahoneyr pre-printed order sheets often available, and the habit of ticking check boxes let one keep doing that may be futile #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @edgarvlermamd: @HeartOTXHeartMD @JHospMedicine HIPARCO: Effect of CPAP on BP in OSA #JHMChat #Nephpearls https://t.co/qeSL6hTekh https://t.co/qVoPrMDthk
J Hospital Medicine @JHospMedicine
RT @mahoneyr: First step is to differentiate urgency from emergency. Then treat emergency in appropriate venue. @translatedmed #jhmchat
Tony Breu @tony_breu
@mahoneyr @JJRyanMD @MDaware “Urgency” is defined by the provider looking at the value. It’s still asymptomatic HTN. #JHMchat
Malvinder Parmar @wittykidney
@mahoneyr @MDaware I think this image should be given to all HCPs, and possibly posted in EDs. #jhmchat
John Ryan @JJRyanMD
RT @tony_breu: @JJRyanMD @MDaware @mahoneyr Urgency doesn’t exist. #JHMchat
John Ryan @JJRyanMD
RT @mahoneyr: "Urgency" is variably defined in literature as > 160/100 or > 180/110. Depends on whom you ask @JJRyanMD @MDaware #jhmchat
Ji Baang @jbaang
@mahoneyr @FutureDocs when my wife was a pt the night time and early hour vitals were very "eye opening". Let us sleep! #jhmchat
Costs of Care @CostsofCare
RT @jbaang: @JHospMedicine wish we had "don't check BP when pt sleeping" in our ordering system. Sleeping pt almost always a good thing. #jhmchat
Seth Trueger @MDaware
@doctorvec @mahoneyr @JJRyanMD no. #jhmchat
J Hospital Medicine @JHospMedicine
RT @mahoneyr: You mean, this? @MDaware #JHMChat https://t.co/MGNSyz21Wx
Robert J. Mahoney, MD @mahoneyr
Ugh. This is actually something worse. @RebeccaEBerger @ChrisMoriates @JHospMedicine #jhmchat
Edgar V. Lerma 🇵🇭 @edgarvlermamd
@mahoneyr @JJRyanMD @MDaware Hypertensive Urgency: Useful diagnosis ⁉️❓#JHMChat https://t.co/Fkvqvy7nRu https://t.co/mDVoHjqdDW
J Hospital Medicine @JHospMedicine
RT @WrayCharles: I believe this is called the opposite of a "nudge". Speed-bump? #jhmchat https://t.co/LGtr1egaLi
Shannon K. Martin @shannonmartinmd
@RJmdphilly @WrayCharles @JHospMedicine fear of monday AM quarterback attending can absolutely drive resident overnight behavior! #jhmchat
John Ryan @JJRyanMD
RT @MDaware: hypertensive emergency: AoD, CVA, APE, eclampsia, ICH, SAH… hypertensive urgency: just a number. #jhmchat https://t.co/SYeG4Ntqpd
J Hospital Medicine @JHospMedicine
RT @Pahwa: t4 if you feel the patient would not benefit from an IV dose overnight then should be in signout like we often do with narcotics #jhmchat
John Ryan @JJRyanMD
RT @edgarvlermamd: @mahoneyr @JJRyanMD @MDaware Hypertensive Urgency: Useful diagnosis ⁉️❓#JHMChat https://t.co/Fkvqvy7nRu https://t.co/mDVoHjqdDW
Seth Trueger @MDaware
@wittykidney @mahoneyr and wherever it is hospitalists are when we call for admission #jhmchat
J Hospital Medicine @JHospMedicine
RT @ShannonMartinMD: @RJmdphilly @WrayCharles @JHospMedicine fear of monday AM quarterback attending can absolutely drive resident overnight behavior! #jhmchat
Joshua Hollabaugh @_hollabaugh_
RT @jbaang: @JHospMedicine wish we had "don't check BP when pt sleeping" in our ordering system. Sleeping pt almost always a good thing. #jhmchat
James Legan MD @jimmie_vanagon
@DrAelaf @MDaware & how best to change nonadherence to adherence for long term BP control? #jhmchat
VC @doctorvec
I believe there are two categories of HTN in the hospital: 1) asymptomatic HTN 2) HTN emergency. They are treated very differently. #jhmchat
(((S. Baker-Good.))) @brainsneedsleep
RT @JHospMedicine: Reminding myself in my excitement to discuss sleep to index #jhmchat! https://t.co/RjtPXldM5s
Society of Hospital Medicine @SocietyHospMed
Here's the link to claim your #CME after tonight's #JHMChat w/ @JHospMedicine: https://t.co/RpnSHpUwTQ
Seth Trueger @MDaware
https://t.co/4AgVRGNa8r #jhmchat https://t.co/MFQ2QFEUvq
John Ryan @JJRyanMD
RT @MDaware: this is how we get MOC #jhmchat https://t.co/SYeG4Ntqpd
Robert J. Mahoney, MD @mahoneyr
#JHMchat fun fact: the half life of amlodipine is 30-50 hours.
(((S. Baker-Good.))) @brainsneedsleep
RT @FutureDocs: We are working to reduce unnecessary nighttime vital checks through #SIESTA #choosingwisely #jhmchat https://t.co/teufMjIzYh
John P Erwin III MD✭ @HeartOTXHeartMD
@edgarvlermamd @JHospMedicine Even an absence of a nocturnal dip in #BP assoc w increased risk of #stroke , #MI, & #death #jhmchat
Seth Trueger @MDaware
@jimmie_vanagon @DrAelaf if the problem is nonadherance, oral dosing in the ED just fixed the problem. #jhmchat
Tony Breu @tony_breu
Agree. Language matters. “Urgency” suggests we must act. NOW! #JHMchat https://t.co/94HzB9pUWs
Enlightened24 @enlightened24
RT @FutureDocs: Agree! One of reasons I picked this article for tonight's #jhmchat https://t.co/qNuVdTcdFl
J Hospital Medicine @JHospMedicine
Time flies on #JHMChat 5 min left! pls share closing thoughts on how to spread lessons learned on treating BP in hospital pts
Edward Lew @elewmd
@jimmie_vanagon @DrAelaf @MDaware #jhmchat primary care
J Hospital Medicine @JHospMedicine
RT @SHMLive: Here's the link to claim your #CME after tonight's #JHMChat w/ @JHospMedicine: https://t.co/RpnSHpUwTQ
Santosy @msantosian
@mahoneyr @JHospMedicine #jhmchat Its a fair point, we used to have Comm. to RN nursing order but they got rid of it. Now I order "q_W/A"
Guy Youngblood @smashweaselmd
RT @WrayCharles: Evidence may suggest not to order, repeat phone calls from worried nurse pushes doc to place order #jhmchat
Seth Trueger @MDaware
TIL there's no #icd10 for hypertensive urgency #impressed #jhmchat @HeartOTXHeartMD @tony_breu @JJRyanMD @mahoneyr https://t.co/wjPuysNIqG
J Hospital Medicine @JHospMedicine
RT @tony_breu: Agree. Language matters. “Urgency” suggests we must act. NOW! #JHMchat https://t.co/94HzB9pUWs
J Hospital Medicine @JHospMedicine
RT @mahoneyr: #JHMchat fun fact: the half life of amlodipine is 30-50 hours.
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Time flies on #JHMChat 5 min left! pls share closing thoughts on how to spread lessons learned on treating BP in hospital pts
John Ryan @JJRyanMD
RT @MDaware: TIL there's no #icd10 for hypertensive urgency #impressed #jhmchat @HeartOTXHeartMD @tony_breu @JJRyanMD @mahoneyr https://t.co/wjPuysNIqG
Enlightened24 @enlightened24
RT @JHospMedicine: Spread the word @JHospMedicine now offers #cme for #tweetchats #jhmchat Pre-register to get! #hcsm https://t.co/o2wMtUTaB9
Robert J. Mahoney, MD @mahoneyr
The N on our poll is too small to draw any conclusions.Poll remains open for a while. #jhmchat https://t.co/3OKsJ01HXa
James Legan MD @jimmie_vanagon
@elewMD @DrAelaf @MDaware &having a hospitalist system that keep us (out patient grunts) in the loop very helpful :) #jhmchat UR appreciated
John P Erwin III MD✭ @HeartOTXHeartMD
RT @mahoneyr: The N on our poll is too small to draw any conclusions.Poll remains open for a while. #jhmchat https://t.co/3OKsJ01HXa
J Hospital Medicine @JHospMedicine
RT @mahoneyr: The N on our poll is too small to draw any conclusions.Poll remains open for a while. #jhmchat https://t.co/3OKsJ01HXa
VC @doctorvec
I am giving the new interns a talk on HTN in the hospital tomorrow. Some useful info tonight. #jhmchat
J Hospital Medicine @JHospMedicine
Reminder to log in here to get your #CME credit for #JHMChat! THANK YOU! https://t.co/j51W8XLLIN
J Hospital Medicine @JHospMedicine
Special thanks to our guest @mahoneyr & partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - #CME edition!
Robert J. Mahoney, MD @mahoneyr
Thanks, #JHMchat, for a spectacular evening. And have a great week!
John Ryan @JJRyanMD
RT @JHospMedicine: Special thanks to our guest @mahoneyr & partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - #CME edition!
Gopi Dandamudi @gopi_gdanda1
RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat
John P Erwin III MD✭ @HeartOTXHeartMD
RT @MDaware: this is how we get MOC #jhmchat https://t.co/SYeG4Ntqpd
John P Erwin III MD✭ @HeartOTXHeartMD
RT @MDaware: hypertensive emergency: AoD, CVA, APE, eclampsia, ICH, SAH… hypertensive urgency: just a number. #jhmchat https://t.co/SYeG4Ntqpd
Amit Kumar Pahwa @pahwa
@JHospMedicine I got it! Best CME EVER! #JHMchat
Society of Hospital Medicine @SocietyHospMed
Thanks to all for another amazingly engaging #JHMChat! Where did the last hour go?! https://t.co/yOSM5Jg2R6
Malvinder Parmar @wittykidney
@JHospMedicine Don't treat numbers - pay attention to symptoms Assess "Situational HTN" & deal If need to lower, not over 30% #JHMChat
Chris Moriates, MD @ChrisMoriates
Congrats @JHospMedicine @FutureDocs @SHMLive @mahoneyr @CostsofCare on a tremendous #jhmchat. so much learning + connecting
J Hospital Medicine @JHospMedicine
JOIN us for next #JHMChat Monday Sept 12th 9p ET w @ShaniHerzigon how hospitalists can curb #opioidepidemic @SHMLive
Santosy @msantosian
RT @JHospMedicine: Special thanks to our guest @mahoneyr & partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - #CME edition!
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Reminder to log in here to get your #CME credit for #JHMChat! THANK YOU! https://t.co/j51W8XLLIN
Robert J. Mahoney, MD @mahoneyr
RT @SHMLive: Thanks to all for another amazingly engaging #JHMChat! Where did the last hour go?! https://t.co/yOSM5Jg2R6
J Hospital Medicine @JHospMedicine
Awesome! #jhmchat #cme check! https://t.co/J4xcjo5tbS
Ji Baang @jbaang
@JHospMedicine If BP not an issue less checking could lead to less intervention with little to no harm. Maybe even good. #jhmchat
J Hospital Medicine @JHospMedicine
RT @ChrisMoriates: Congrats @JHospMedicine @FutureDocs @SHMLive @mahoneyr @CostsofCare on a tremendous #jhmchat. so much learning + connecting
Rebecca Jaffe, MD @RJmdphilly
IMO best thoughts: interprof HTN educ, care redesign for rest, no admissions for HTN urg, focus on night time root causes #jhmchat
J Hospital Medicine @JHospMedicine
RT @SHMLive: Thanks to all for another amazingly engaging #JHMChat! Where did the last hour go?! https://t.co/yOSM5Jg2R6
Chris Moriates, MD @ChrisMoriates
THIS is what it is all about. Great job #Jhmchat @FutureDocs @mahoneyr https://t.co/vByTjohFHO
Seth Trueger @MDaware
RT @RJmdphilly: IMO best thoughts: interprof HTN educ, care redesign for rest, no admissions for HTN urg, focus on night time root causes #jhmchat
Seth Trueger @MDaware
RT @jbaang: @JHospMedicine If BP not an issue less checking could lead to less intervention with little to no harm. Maybe even good. #jhmchat
J Hospital Medicine @JHospMedicine
Thanks to @FutureDocs and @SHMLive for another amazing #JHMChat. Next one.....soon! ://twitter.com/JHospMedicine/status/752684068072984577
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Awesome! #jhmchat #cme check! https://t.co/J4xcjo5tbS
Megan Ranney MD MPH @meganranney
RT @mahoneyr: The N on our poll is too small to draw any conclusions.Poll remains open for a while. #jhmchat https://t.co/3OKsJ01HXa
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: JOIN us for next #JHMChat Monday Sept 12th 9p ET w @ShaniHerzigon how hospitalists can curb #opioidepidemic @SHMLive
Seth Trueger @MDaware
endorse. #jhmchat https://t.co/0dxjlLmqcx
Vinny Arora MD MAPP @FutureDocs
RT @ChrisMoriates: Congrats @JHospMedicine @FutureDocs @SHMLive @mahoneyr @CostsofCare on a tremendous #jhmchat. so much learning + connecting
Society of Hospital Medicine @SocietyHospMed
RT @ChrisMoriates: Congrats @JHospMedicine @FutureDocs @SHMLive @mahoneyr @CostsofCare on a tremendous #jhmchat. so much learning + connecting
Vinny Arora MD MAPP @FutureDocs
RT @ChrisMoriates: THIS is what it is all about. Great job #Jhmchat @FutureDocs @mahoneyr https://t.co/vByTjohFHO
Ji Baang @jbaang
This I can't miss... #jhmchat https://t.co/xRI2ByJHYG
kirk murphy @kirkmurphy
RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat
Seth Trueger @MDaware
RT @tony_breu: Agree. Language matters. “Urgency” suggests we must act. NOW! #JHMchat https://t.co/94HzB9pUWs
Society of Hospital Medicine @SocietyHospMed
RT @ChrisMoriates: THIS is what it is all about. Great job #Jhmchat @FutureDocs @mahoneyr https://t.co/vByTjohFHO
Seth Trueger @MDaware
RT @doctorvec: I believe there are two categories of HTN in the hospital: 1) asymptomatic HTN 2) HTN emergency. They are treated very differently. #jhmchat
Vinny Arora MD MAPP @FutureDocs
I need to take a screen capture of this tweet #jhmchat for my next talk! Cc @MDaware @SHMLive https://t.co/kfkCgVtdI8
Vinny Arora MD MAPP @FutureDocs
RT @ChrisMoriates: THIS is what it is all about. Great job #Jhmchat @FutureDocs @mahoneyr https://t.co/vByTjohFHO
Megan Ranney MD MPH @meganranney
RT @tony_breu: Agree. Language matters. “Urgency” suggests we must act. NOW! #JHMchat https://t.co/94HzB9pUWs
Tony Breu @tony_breu
This should be a great one. #JHMchat https://t.co/RYlcTHpqdw
James Legan MD @jimmie_vanagon
@elewMD @DrAelaf @MDaware Thanks all for the #jhmchat great to have the #cme opportunity, much appreciated @mahoneyr & @FutureDocs
J Hospital Medicine @JHospMedicine
RT @tony_breu: This should be a great one. #JHMchat https://t.co/RYlcTHpqdw
J Hospital Medicine @JHospMedicine
RT @jbaang: This I can't miss... #jhmchat https://t.co/xRI2ByJHYG
Society of Hospital Medicine @SocietyHospMed
RT @FutureDocs: I need to take a screen capture of this tweet #jhmchat for my next talk! Cc @MDaware @SHMLive https://t.co/kfkCgVtdI8
Mohammed Hassan @a_9b
RT @edgarvlermamd: Evolution of antihypertensive therapy #JHMChat #Nephpearls https://t.co/LlLS4m1ra0 https://t.co/Wi3mLqOHVz
J Hospital Medicine @JHospMedicine
RT @jimmie_vanagon: @elewMD @DrAelaf @MDaware Thanks all for the #jhmchat great to have the #cme opportunity, much appreciated @mahoneyr & @FutureDocs
Shannon K. Martin @shannonmartinmd
Thx @JHospMedicine @mahoneyr @FutureDocs for fun #jhmchat! Will be sure to bring this up in next 2 weeks on service for great discussion!
J Hospital Medicine @JHospMedicine
RT @ShannonMartinMD: Thx @JHospMedicine @mahoneyr @FutureDocs for fun #jhmchat! Will be sure to bring this up in next 2 weeks on service for great discussion!
Society of Hospital Medicine @SocietyHospMed
RT @ShannonMartinMD: Thx @JHospMedicine @mahoneyr @FutureDocs for fun #jhmchat! Will be sure to bring this up in next 2 weeks on service for great discussion!
John P Erwin III MD✭ @HeartOTXHeartMD
RT @jbaang: This I can't miss... #jhmchat https://t.co/xRI2ByJHYG
Moath Bin Homaid @m_humaid
RT @mahoneyr: You mean, this? @MDaware #JHMChat https://t.co/MGNSyz21Wx
conciergedoc @DrFerdowsi
RT @MDaware: hypertensive emergency: AoD, CVA, APE, eclampsia, ICH, SAH… hypertensive urgency: just a number. #jhmchat https://t.co/SYeG4Ntqpd
#JHMChat content from Twitter.