You're working in the ED when a 30 y.o male presents 30 minutes after envenomation to the right index finger by his pet snake (left). He has a picture of culprit (right) , and it is definitely NOT from America. A 🧵on U.S. exotic envenomation management. (shared with consent)

@ColeLightfoot Fair, two things can be true

@ColeLightfoot in terms of where the supply that’s killing people is actually coming from. I highly doubt CAN made that fentanyl, but maybe. precursors for production are from (or were, some scheduling caused less of this) china and production in Mexico. Just providing some clarity

@ColeLightfoot It is not 43 lbs of pure fentanyl, to reiterate, so it’s also much less than your are implying

@ColeLightfoot The "2mg" claim is misleading, they weigh total seized product, not purity. DEA data shows ~1% purity, so it's likely ~194g of fentanyl mixed with filler. A drop in the bucket compared to total seizures (27,000 lb), primarily from Mexico. Likely sourced there, arriving via CAN.

@AmSidlak No

RT @NatRevDrugDisc: FDA approves new non-opioid pain drug The FDA has approved Vertex’s suzetrigine, an oral inhib…

Just got a photo "memory" of the snacks I brought in for my STD topic discussion during PGY-2 (TEN YEARS AGO GOOD LORD)

I have worked in healthcare for a decade. I still don't know where the cockles of the heart are and I am now too afraid to ask.

RT @darbysaxbe: By suspending all grant funding overnight is a huge waste of taxpayer money and a completely inefficient use of federal res…

@pricklyresearch I really hope it’s nothing, but shifts behind opaque walls with gag orders, is concerning. My point was that our education system is meh, and propped up by good post grad research. I doubt this will lead to more research funding, and that’s troubling. Hope it’s nothing.

@zacroBID @pricklyresearch Very normal stuff happening.

Today, for the first time in 2 years, I’m pain-free from workout injuries. The injuries are probably still there, but I can’t feel them, and that’s worth celebrating. #Mid30s

@Forensic_Lady22 Thank you, always nice to know I am not shouting into the void! Though my audience already knows this stuff, that's why he need to go on Rogan 😂

RT @thereal_truther: Dr. Paul Offit from today's Roundtable on Vaccines: "The problem is not only that we've largely eliminated these dise…

HOW DOES METHOCARBAMOL WORK?!?!?! NO BODY KNOWS AND WE JUST KEEP GIVING IT AND GIVING IT