#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Pierrette 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 @DrSinhaEsq @MLB @TMobile #HRDerby #HRDerby2016 @Giancarlo818 or... @SHMLive @JHospMedicine @FutureDocs @mahoneyr #JHMChat Decisions, decisions... |
 | Journal of Hospital Medicine @JHospMedicine Welcome to #JHMChat tonight! for now lets introduce yourselves and dont forget to use the #JHMChat hashtag in your tweets. |
| Journal of 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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine @tony_breu thx for joining #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @WolfsonD great to have you! #jhmchat |
 | Malvinder Parmar @wittykidney Malvinder Parmar, no COI details per pinned tweet #JHMChat |
 | Charlie M. Wray, DO, MS @WrayCharles Happy to be joining in from warm (and not foggy) SF #JHMchat |
| Journal of Hospital Medicine @JHospMedicine Chicagoans in house #jhmchat @FutureDocs https://t.co/o5YJYrATso |
| 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 |
| Journal of Hospital Medicine @JHospMedicine @rwh3 great to have you from Australia! #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @elewMD: @JHospMedicine #jhmchat thanks for putting this on! joining from bay area, CA |
| Journal of Hospital Medicine @JHospMedicine T1 up in a moment #JHMChat -welcome #CMEchat #hscm #meded #nephrology #cardiology communities remember to tag tweets #JHMChat tonight |
 | Shoshana Herzig, MD, MPH @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 |
| Journal of Hospital Medicine @JHospMedicine Tonight's #JHMChat article is As-needed intravenous antihypertensive therapy and blood pressure control https://t.co/TWqTSjf6t8 |
| Journal of Hospital Medicine @JHospMedicine T1: Do you ever order blood pressure medicine for inpatients “as needed”? Why or why not? #JHMChat @mahoneyr pls start off:) |
 | Dr. Chandrasekhar Dinasarapu @Dcsreddy #jhmchat I am in. Feels exciting. |
| Journal of Hospital Medicine @JHospMedicine @MDaware @JJRyanMD @UofUHealthCare @NorthwesternEM thx Seth remember to use #jhmchat |
 | 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 MD MS @ShannonMartinMD Hello from another Chicagoan! Shannon Martin, hospitalist from @UChicagoMed #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @mahoneyr: Disclaimer: 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 |
| Journal of Hospital Medicine @JHospMedicine And welcome to our next guest on #jhmchat! September edition https://t.co/J07oiI9zvQ |
| Journal of 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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine Thx Chris! Funny not to be in the room w you during #jhmchat :) https://t.co/EoSGJzvxnQ |
 | Amit Pahwa @Pahwa very rarely. 1st step is it real. 2nd step is there damage. if no to either then I let it ride. #jhmchat |
| Journal of 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, DO, MS @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 |
| Journal of 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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine Hold this thought T3 will touch on signout #jhmchat https://t.co/ZXZpyN7vnT |
| edward lew @elewMD @mahoneyr @ChrisMoriates @JHospMedicine #jhmchat, true, i see admission orders from attendings |
| Journal of 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 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 |
| Journal of 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 |
| Journal of 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: 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, DO, MS @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 @DrSinhaEsq RT @JHospMedicine: T1: 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 FACC @HeartOTXHeartMD John Erwin @TAMHSC_COM @bswhealth Good evening! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: POLL #JHMChat: 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 FACC @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 FACC @HeartOTXHeartMD RT @JHospMedicine: Tonight's #JHMChat article is As-needed intravenous antihypertensive therapy and blood pressure control https://t.co/TWqTSjf6t8 |
| 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 |
| Journal of 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. |
 | Ñick van Terheyden, MD -Dr Ñiçk 🇺🇸🇬🇧🇮🇪🇳🇬🌍 @drnic1 RT @JHospMedicine: POLL #JHMChat: POLL #JHMChat: at what systolic BP would you order as needed BP meds for inpatients? H/t @mahoneyr |
| Charlie M. Wray, DO, MS @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, MD, MPH @ShaniHerzig @WrayCharles Exactly #jhmchat |
| Amit 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 |
| Journal of 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: 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: T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat |
| Robert J. Mahoney, MD @mahoneyr Food for thought #jhmchat https://t.co/NBgq4qzw0g |
| Michael Sinha @DrSinhaEsq RT @JHospMedicine: T2: 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 |
 | PRN Pain @DrCockyMD RT @JHospMedicine: T2: 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 |
| PRN Pain @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 |
| VC @doctorvec I have never found any data to support treatment of asymptomatic BP. Maybe harm. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @WrayCharles what I hear from the housestaff every time. And confusion over attending expectations. #jhmchat |
| Seth Trueger @MDaware RT @FutureDocs: Agree! One of reasons I picked this article for tonight's #jhmchat https://t.co/qNuVdTcdFl |
| Journal of Hospital Medicine @JHospMedicine RT @MDaware: no. #jhmchat https://t.co/fqvLGTwN7I |
| Robert J. Mahoney, MD @mahoneyr T2 So far, it sounds like the only benefit is reduced calls to providers. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @drlfarrell: |
| Seth Trueger @MDaware RT @doctorvec: I have never found any data to support treatment of asymptomatic BP. Maybe harm. #jhmchat |
| Journal of 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 FACC @HeartOTXHeartMD @wittykidney 1) Dogma 2) Fear 3) Pager fatigue 4) #CHF 5) Angina #JHMChat |
| Journal of 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 |
| 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: T2: Are there any benefits to giving one-time BP med doses to patients with high BP and no symptoms? #JHMChat |
| Charlie M. Wray, DO, MS @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 |
| Journal of 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 FACC @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, DO, MS @WrayCharles Numbers are easy, patients are hard... #jhmchat https://t.co/0B4omko3p3 |
| John P Erwin III MD FACC @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 |
| Journal of Hospital Medicine @JHospMedicine Why we having #jhmchat ! https://t.co/HCeoXrRG5i |
| Amit Pahwa @Pahwa t2 less paging for NHO SBP>180 :-) #jhmchat |
| John P Erwin III MD FACC @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 FACC @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, DO, MS @WrayCharles RT @JHospMedicine: Why we having #jhmchat ! https://t.co/HCeoXrRG5i |
| Journal of 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 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: @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 FACC @HeartOTXHeartMD RT @JHospMedicine: T3: 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 @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 @DrSinhaEsq RT @JHospMedicine: T3: 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 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 |
 | Docdailey @docdailey @mahoneyr #jhmchat https://t.co/wRerrUbvlP |
| 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 |
 | Madhusree⚕️ Singh, 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: 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 |
| edward lew @elewMD @edgarvlermamd #jhmchat what's hypertensive "urgency?" |
| Michael Sinha @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 |
| Vinny Arora MD MAPP @FutureDocs Clearly:) #jhmchat https://t.co/u6cotyqg1P |
| Charlie M. Wray, DO, MS @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 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 |
 | Carlos del Rio @CarlosdelRio7 RT @mahoneyr: Disclaimer: Disclaimer: my tweets are probably my own. My typos are definitely my own. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @MDaware: hypothesis: 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 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 FACC @HeartOTXHeartMD @RJmdphilly @wittykidney Always a long lag between evidence and standard practice #deadlygap #jhmchat |
| Journal of 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 |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd @DrSinhaEsq Hypertension in ESRD: Pathogenesis from @UpToDate #JHMChat #Nephpearls https://t.co/oGufhOz5Dm |
 | J. Brian Byrd Lab @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 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, DO, MS @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 |
| 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 FACC @HeartOTXHeartMD One of my all-time favorite references! #parachutes #gravity #jhmchat https://t.co/lD6BoZfQRa |
| J. Brian Byrd Lab @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: 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 FACC @HeartOTXHeartMD RT @translatedmed: T3: 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, DO, MS @WrayCharles Or just make the hospital more "hospitable" and EBM shown decreased BPs https://t.co/T7OZQFATIf #jhmchat #SIESTA #lessismore |
 | KP San Diego FM Residency Program @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 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 @DrSinhaEsq Assuming you can get the excess fluid off quickly enough, yes. #JHMChat https://t.co/HmtM6Rrrzu |
| Journal of 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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine Thx remember to index #jhmchat https://t.co/Rn2TusV6TB |
| Shoshana Herzig, MD, MPH @ShaniHerzig @tony_breu @wittykidney @JHospMedicine And no knowledge of the patient by x-covering residents. #jhmchat |
| Journal of 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 FACC @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 |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: Welcome to #jhmchat on as needed meds to control BP in hospitalized patients https://t.co/5CYLoIGlzr |
 | JP Arroyo @anblog84 RT @thebyrdlab: UMich has had an interest in this topic even before this publication. See also https://t.co/zoCYsGk2x9 #jhmchat |
| edward lew @elewMD @Pahwa @edgarvlermamd #jhmchat love it |
| Journal of Hospital Medicine @JHospMedicine RT @MDaware: proposed solution #jhmchat @wittykidney @WrayCharles @JHospMedicine https://t.co/5cQ8m0oqzJ |
| Michael Sinha @DrSinhaEsq Absolutely agree. One of the most important things I learned on the renal service in Residency. #JHMChat https://t.co/tOuNLiwR1H |
| Michael Sinha @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 @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 FACC @HeartOTXHeartMD RT @doctorvec: What about orthostasis. How often do we check standing BP in hospitalized patients?#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 |
| Journal of 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 |
| Amit 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 MD MS @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 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 FACC @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, DO, MS @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 FACC @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 FACC @HeartOTXHeartMD RT @FutureDocs: We are working to reduce unnecessary nighttime vital checks through #SIESTA #choosingwisely #jhmchat https://t.co/teufMjIzYh |
| Journal of 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 |
| Eduardo Viteri @etwiteri RT @mahoneyr: Food for thought #jhmchat https://t.co/NBgq4qzw0g |
| Journal of 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 |
| Journal of 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 |
| Madhusree⚕️ Singh, MD @thinkalot RT @mahoneyr: More food for thought. #JHMChat https://t.co/62aSGEgJ8F |
| Michael Sinha @DrSinhaEsq RT @JHospMedicine: T4: 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 |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T4: T4: In Lipari study, more as-needed BP meds given at NIGHT. How can we improve protocols/handoffs to reduce their use? #JHMChat |
| Seth Trueger @MDaware T4: educate doctors, nurses, patients. #jhmchat https://t.co/W3WurXN5fL |
| Tony Breu @tony_breu @JHospMedicine Never seen contingency like this: “For severe asymptomatic HTN, please provide reassurance.” #JHMchat |
| John P Erwin III MD FACC @HeartOTXHeartMD T4: #CPAP for #OSA & quit waking up patients at night for vitals #jhmchat https://t.co/L31hUjNnlu |
| 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 |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd @Pahwa @elewMD Hypertensive Urgency: Useful diagnosis ⁉️❓#JHMChat #Nephpearls https://t.co/FkvqvxPMsU https://t.co/9i0QCXvX8S |
| Amit 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, DO, MS @WrayCharles such an interesting finding! staffing usually cross-over, fewer tests (stressors) at night, more sleep, etc #jhmchat https://t.co/1538Rrf85r |
| PRN Pain @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 |
| Journal of 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: @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 |
| Society of Hospital Medicine @SocietyHospMed RT @mahoneyr: How many people giving IV BP meds consider this guideline? #JHMchat https://t.co/jMYHGvXdSA |
| Journal of Hospital Medicine @JHospMedicine True - indexing #jhmchat https://t.co/hyp5DJW3yw |
| Seth Trueger @MDaware @WrayCharles @JHospMedicine but staff who knows patient less? #jhmchat |
 | Christina Thielst @Cthielst RT @mahoneyr: How many people giving IV BP meds consider this guideline? #JHMchat https://t.co/jMYHGvXdSA |
| Charlie M. Wray, DO, MS @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, CPXP @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 |
| Journal of Hospital Medicine @JHospMedicine RT @DrAelaf: 2 aspects to this: 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 |
| Journal of 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 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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine RT @HeartOTXHeartMD: T4: T4: #CPAP for #OSA & quit waking up patients at night for vitals #jhmchat https://t.co/L31hUjNnlu |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: @JHospMedicine Never seen contingency like this: @JHospMedicine Never seen contingency like this: “For severe asymptomatic HTN, please provide reassurance.” #JHMchat |
| Malvinder Parmar @wittykidney @Pahwa @JHospMedicine and, gets stroke #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat |
| Journal of 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, DO, MS @WrayCharles I believe this is called the opposite of a "nudge". Speed-bump? #jhmchat https://t.co/LGtr1egaLi |
 | Jihoon 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 |
| 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 |
| Journal of 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 |
| 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 |
| 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 |
| Amit 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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine Sounds like #choosingwisely rec in the making? #jhmchat https://t.co/2wTswE9iZO |
| 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 |
| 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 @DrSinhaEsq RT @edgarvlermamd: @Pahwa @elewMD Hypertensive Urgency: @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 FACC @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 |
| Journal of 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 |
| Journal of 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 |
| Journal of 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 |
| Seth Trueger @MDaware @DrAelaf begging the question #jhmchat |
| John P Erwin III MD FACC @HeartOTXHeartMD RT @edgarvlermamd: @HeartOTXHeartMD @JHospMedicine HIPARCO: @HeartOTXHeartMD @JHospMedicine HIPARCO: Effect of CPAP on BP in OSA #JHMChat #Nephpearls https://t.co/qeSL6hTekh https://t.co/qVoPrMDthk |
| Journal of 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 |
| Jihoon 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 |
| Journal of 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 |
| Journal of 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 MD MS @ShannonMartinMD @RJmdphilly @WrayCharles @JHospMedicine fear of monday AM quarterback attending can absolutely drive resident overnight behavior! #jhmchat |
| Journal of 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 |
| Seth Trueger @MDaware @wittykidney @mahoneyr and wherever it is hospitalists are when we call for admission #jhmchat |
| Journal of 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 |
| 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-Goodwin @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 |
| Robert J. Mahoney, MD @mahoneyr #JHMchat fun fact: the half life of amlodipine is 30-50 hours. |
| S. Baker-Goodwin @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 FACC @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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Here's the link to claim your #CME after tonight's #JHMChat w/ @JHospMedicine: Here's the link to claim your #CME after tonight's #JHMChat w/ @JHospMedicine: https://t.co/RpnSHpUwTQ |
 | smashweaselMD @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 |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: Agree. Language matters. “Urgency” suggests we must act. NOW! #JHMchat https://t.co/94HzB9pUWs |
| Journal of Hospital Medicine @JHospMedicine RT @mahoneyr: #JHMchat fun fact: #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 |
| 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 |
| John P Erwin III MD FACC @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 |
| Journal of 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 |
| Journal of Hospital Medicine @JHospMedicine Reminder to log in here to get your #CME credit for #JHMChat! THANK YOU! https://t.co/j51W8XLLIN |
| Journal of 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! |
 | Gopi Dandamudi @GDandamudiMD RT @mahoneyr: Why do we wake up patients for vitals? Is there something actionable there? @FutureDocs #jhmchat |
| John P Erwin III MD FACC @HeartOTXHeartMD RT @MDaware: this is how we get MOC #jhmchat https://t.co/SYeG4Ntqpd |
| John P Erwin III MD FACC @HeartOTXHeartMD RT @MDaware: hypertensive emergency: hypertensive emergency: AoD, CVA, APE, eclampsia, ICH, SAH… hypertensive urgency: just a number. #jhmchat https://t.co/SYeG4Ntqpd |
| Amit 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 |
| Journal of Hospital Medicine @JHospMedicine JOIN us for next #JHMChat Monday Sept 12th 9p ET w @ShaniHerzigon how hospitalists can curb #opioidepidemic @SHMLive |
| 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 |
| Journal of Hospital Medicine @JHospMedicine Awesome! #jhmchat #cme check! https://t.co/J4xcjo5tbS |
| Jihoon Baang @jbaang @JHospMedicine If BP not an issue less checking could lead to less intervention with little to no harm. Maybe even good. #jhmchat |
| Journal of 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 |
| Journal of 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: 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 |
| Journal of 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 |
| Jihoon 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: 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 |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: This should be a great one. #JHMchat https://t.co/RYlcTHpqdw |
| Journal of 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 |
| Shannon K. Martin MD MS @ShannonMartinMD Thx @JHospMedicine @mahoneyr @FutureDocs for fun #jhmchat! Will be sure to bring this up in next 2 weeks on service for great discussion! |
| Journal of 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 FACC @HeartOTXHeartMD RT @jbaang: This I can't miss... #jhmchat https://t.co/xRI2ByJHYG |
 | Sahba Ferdowsi DO (conciergedoc) @DrFerdowsi RT @MDaware: hypertensive emergency: hypertensive emergency: AoD, CVA, APE, eclampsia, ICH, SAH… hypertensive urgency: just a number. #jhmchat https://t.co/SYeG4Ntqpd |
#JHMChat content from Twitter.