Lara Hayes, MD

Discover five facts about WHO and its global impact ⬇️

Prevalence of Iron Deficiency and Iron-Deficiency Anemia in US Females Aged 12-21 Years, 2003-2020 This study examines prevalence of iron deficiency among females aged 12 to 21 years to inform future screening strategies for iron deficiency and iron-deficiency anemia.

Just your regular reminder that ~40% of menstruating adolescents (and likely even higher proportion of adults) suffer from iron deficiency and yet we don’t universally screen.

jamanetwork.com/journals/jam...

So can we all just agree pumping is the absolute worst?

So grateful to be able to do it, but it just sucks 😭

Want to improve my (basically non-existent) Spanish so I can have better convos with our awesome EVS lady.

What method do people like? Are we liking Babble or Duo-Lingo better?

Heard palliative care refer to it as “prolonging death” instead of “prolonging life” in GOC discussions and it was so powerful.

We should be honest about what our interventions really do in some cases.

Surprisingly a lot of my patients using drugs in the hospital have it brought it my their mothers. Just very sad when you think about it :(

A banner that reads “900 AMERICANS WENT BANKRUPT TODAY DUE TO PERSONAL MEDICAL BILLS”

With a government shutdown looming, one thing that was in the package that has increased the quality of life of people on Medicare is telehealth. Without funding by December 31st telehealth will no longer be available for millions of Americans. That breaks my heart not only for me but for millions!💔

Not my dental office automatically designating the hubby as “head of household” and calling him about my account…

I’m an employed grown woman in 2024…and the insurance is in my name. Also it’s my job to handle bills in our house.

Just lots of icks there.

lain @user000000 this year felt like being awake during surgery

…cause insurance wouldn’t cover the anesthesia

The deaths prevented are in the MILLIONS. That doesn’t even factor in the disability and suffering prevented.

Modern miracles.

The last person to live an iron lung died this year at 78. He spent 70 years in that machine because of polio. Let’s please not do that again.

A modern miracle, saving millions of lives…this is what is at stake

New office decor. I couldn’t resist.

I do not miss the oppressive, unshakeable feeling of impending doom…even if nothing was wrong

Me to my wards team: hey guys, what does brat summer mean?

Medical student: ooh that’s a great question, why don’t you look it up and tell us about it on rounds tomorrow

You guys aren't going to believe this but I just discovered my baby is a silly goose.

Rant #5 Please don't tell me what the PaO2 is...

Less experienced critical care staff members are frequently exercised by arterial blood gas PaO2 readings.

What is the SpO2 I genially ask? In our target range? Well that's fine then.

Staff member shifting uneasily, "but the PaO2..."

Here we go...

Well now this is going to bother me…

How do you all handle determining when to call (as in end) an arrest?

Let’s say PEA, nothing obviously fixable, family unavailable/unprepared to say ‘stop.’

Obviously so much variability depending on situation, but do you have any guiding principles?

#emimcc

Are you taking care of patients with influenza in your hospital? Then you will know that many colleagues find oseltamivir treatment completely useless (or harmful) while others would never consider not using it. This is a new study you may be interested in:

Hey #medsky here are your generalists 👇- the big picture people - we are up to 109! #GIMsky #MedEd #GPsky #hospitalist #MedEd

This is the content we need!

"The medical system doesn't work without primary care doctors...The specialists can't do what the specialists do, their endoscopies, their knee replacements, all the things that make a lot of money for the hospital without the primary care doctors," Dr. Grinspoon said.

www.msn.com/en-us/health...

Assuming we won’t ever get all HCWs to mask all the time, can we at least implement that if a patient shows up to an appt in a mask that their provider will then automatically mask for them without asking? Please?

a little girl in a red jacket is looking up at something in the sky . ALT: a little girl in a red jacket is looking up at something in the sky .

The other way to prevent NAGMA is to replete potassium with K-Citrate (PO) or K-Acetate (IV).

KCl causes hyperchloremic acidosis (like normal saline!), so giving tons of KCl will drive down the pH 😟

citrate or acetate are metabolized into bicarb, so they're alkalinizing and will *improve* pH 😛

PART 2: Towards the end of the DKA resuscitation when the gap is closing, a NAGMA often occurs.

This is a big problem because if you try to stop the insulin gtt while the patient's bicarb is <~18 mM that increases the risk of recurrent DKA.

Acidosis increases insulin resistance!

1/ On the 5th day of Pharmacy Advent, let’s tackle a clinical dogma: Beta-blockers in stimulant/cocaine use

Clinicians often hesitate to give BBs to pts w/ cocaine use d/t concerns over "unopposed α-receptor stimulation." Oldie but goodie, let’s dive in! 👇

#medsky #EMsky #pharmsky #HMsky #GPsky

I'd like to talk about mistakes and how we can learn from them. We don't like to talk about our mistakes in medicine, and that leads to a culture where mistakes are hidden, seen as a source of shame, and any potential lessons are lost. #MedSky #EMIMCC #MedEd #EMSky

In retrospect, maybe it was a bad idea to make it so that the people in charge of giving you access to healthcare get a ton of money if they don't give you access to healthcare.