Matt Sztajnkrycer
@NoobieMatt
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Forged @tamingthesru | Professor & PD @MayoClinicEM EMS Fellowship | Toxicologist @MNpoisoncenter | CME Editor @AnnalsofEM | 💔Avenger Brass 5/27/24 ❤️🩹7/1/24
Rochester, MN
Joined January 2016
Hey @emresidents - Looking for a challenging fellowship? Unique care environments? The opportunity to be part of an awesome team? . Check us out! Accepting applications now.
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Based on my ED shift today, the post-Christmas COVID surge is well underway. I am exhausted. And it is only January 3rd.
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You have no idea how hard this silly thing is until you have your chest cracked and 4 chest tubes.
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Not all heroes wear capes. An enormous number of lives saved by this little critter.
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Little things make me happy. Guy comes in with presyncope. Brother died of “heart thing” at age 16. Get an ECG. Seen it many times in books but in nearly 25 years in ED, first time in real life. Ran to show residents. Teaching rounds. It’s gonna be a great day.
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At the tattoo parlor yesterday, I was struck by how much everyone:.1. really enjoyed their job.2. came by and "up-sold" the work of their colleagues.3. genuinely wanted to learn what other were doing in terms of techniques.Why is this not happening in the ER?.
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A word about that photo. Yes, I am not doing very well at all. Yes, they are saving my life. My wife took photo and video of my resus. She said that she knew I would want it if I lived. Boy, did I marry the most wonderful woman ever!!!!.
Train your folks to work as a high-performing team under pressure. Empower them to always push forward, to innovate, and to bring back lessons learned. Thank them for their awesome work and for all that they do. Because one day it might be your life they save. ❤️❤️❤️
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@pallbro I was in charge of continuity planning for staffing the ED in the setting of escalating clinical staff mortality. Just typing this brings back visceral emotions of how bleak that time was.
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We had a young medic quit because he couldn’t save a life at his first code. He did everything like ACLS said he should, and the patient still died. Sometimes we do need to train for failure.
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For all of you posting your so-called healthy foods, I see your recipe and raise it with a Hershey’s Sliced Chocolate Creme Cake and Nutella sandwich. The signature food of those who just don’t care anymore.
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Reflecting on July 1st -. My first day on IM as an MS3, the old team kept saying my patient had a cabbage and I couldn’t figure out why everyone was so fixated on her diet. For all med students and interns starting today - the learning curve is steep but you will do just fine.
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An unexpected vaccine side-effect - I had the best night's sleep I have had in the past 9 months.
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Train your folks to work as a high-performing team under pressure. Empower them to always push forward, to innovate, and to bring back lessons learned. Thank them for their awesome work and for all that they do. Because one day it might be your life they save. ❤️❤️❤️
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“CONCLUSIONS: Female physicians are not inferior to male physicians in performing emergency endotracheal intubation.”. Really American Journal of Emergency Medicine? Really?!!!. Ping @LauraWalkerMD @Raukar_Neha @darakass.
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The one guy I was SURE had COVID today did not. The guy I would not have predicted to have COVID based upon complaint and demeanor did. Medicine is hard. And COVID is making a mockery of my clinical gestalt.
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My grade school principal put me in special ed and told me (age 9) that I wouldn’t even succeed as a janitor. I later worked as a janitor and was actually very good at it. And I learned never to disparage hard working folks like janitors.
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Toxicologists: “All things are poison and nothing is without poison. Solely the dose determines that a thing is not a poison.”. Also toxicologists: Give your hemodynamically unstable CCB OD patient a 1000U IV insulin bolus followed by 100U/hr. It’ll be fine.
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I vividly remember this scene from watching MASH as a boy. Sad then. Somehow sadder now.
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@HarvardBiz This is crazy! Would you ever say this about a father? I can’t believe you would even publish something this out of step with reality.
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CC: CP.H: Very concerning.P: Looks like a STEMI.#ECG below. There are certain patterns every @emresidents should recognize as an advanced #EKG reader. This is one of them. Ping @mayoclinicemres @EM_RESUS @smithECGBlog @MedCrisis . #FOAMed #FOAMems .
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Wound up in the cath lab today. Things looked really good! No stents needed. Grafts are all open despite what the CTA said. The right atrial pressures are already improved with med management. Still unanswered questions but some very good news for once!. Back to CV rehab!
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I can think of many adjectives to describe this horrific event, but “boisterous” is not one of them.
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I am amazed/dismayed by the number of people I have seen this weekend with HR 60-70s, RR 16-20 (for real), Sats 97-100%, no risk factors, no LE pain/swelling, no CP - dyspnea with normal VS as only complaint - who had multiple segmental PEs. This world is scary.
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I asked a medical student with a previous career in Nursing how the training differed. His response: .Nursing emphasized patient safety and medication awareness, and focused on the patient. Medicine emphasizes diagnosis and the system. Kudos to Nursing. We have much to learn.
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@DrEricDing @SouthwestAir There are few things as frustrating to me as sick folks being required to get a doctor’s note or be fired. Many have no choice but to go to the ER. Under federal law, on arrival each is required to get a medical screening evaluation. It stresses an already broken system.
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@VFXpapa The benign sounding complaint was due to an abnormal, potentially lethal, heart rhythm (the change in the middle). The kind an AED is designed to detect and shock.
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Guys, someone finally blocked me! . I feel like I have reached a new level on Twitter!. Haven’t got a clue why, but happy nonetheless.
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Still one of the most terrifying videos of all time!. Not all seizures are neurological. Ping @mayoclinicemres @MayoPharmRes @MayoClinicCV @mayoneurores @TamingtheSRU .
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One of the surgeons discussing institutional knee-jerk responses - "Just because one person crapped their pants, now we all need to wear diapers.". A brilliant assessment.
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I’m back! What’d I miss?. Also I would not wish ICU delirium on my worst enemy.
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Today marked one of the greatest moments of my career - an academic lifetime in the making. We interviewed our first applicants for the @MayoClinicEM EMS fellowship! . And we had the opportunity to see the new fellow EMS response vehicle. #DreamsDoComeTrue
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Happy Holidays from 564. Stay safe and warm and socially distanced!
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I cannot stop watching this. All day long. For the last 3 days. I cannot look away.
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This is Homer. He was my bestest friend and work confidant. And a really good boy. He gave us 11 great years. I will miss him terribly.
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As I read this, I can’t help but wonder about the culpability of TJC/JHACO and their 5th vital sign campaign. Where is their accountability for this nightmare?
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@Caulimovirus As hilarious as this truly is, there is one sentence in there that starkly highlights the reality of the world today, and why this pandemic won’t go away. “I trust bros before lab coats.”. What we should be asking is how this came to pass.
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It was a beautiful Friday afternoon. Your locker was open, papers strewn everywhere. I picked them up and told a teacher I would let you know. You put a shotgun in your mouth that night. I never saw it coming. #shouldhavebeenabetterfriend. #ShareAStoryInOneTweet.
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I’m back!. Took 7.5 months and a near-death experience, but I am home!. (Ignore the puffy eyes - the lasix hasn’t kicked in yet)
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4 weeks ago today!. Thank you for all your support during this crazy, unexpected trip!!!
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@AlanHawxbyMD So, I'm no lawyer, but:.1. A federal public health emergency declaration actually nullifies some aspects of HIPAA.2. Nothing ever makes you exempt from ALL regulations.
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For those following my progress…. I started getting really SOB last week. ECG showed significant changes. Echo shows EF down and severe TR. CTA shows 2 of my 3 grafts have likely failed. That being said, I have an awesome team with a great plan. Sometimes hiccups happen.
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Missed esophageal intubation. In the OR/PACU. At a world class institution. In 2022.
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A man, his dog, his walker, and his supplemental protein shake.
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In Flanders fields the poppies blow.Between the crosses, row on row,. That mark our place; and in the sky. The larks, still bravely singing, fly.Scarce heard amid the guns below. #LestWeForget
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Happy Canada Day!. See you all by the 4th!. Be good and be kind.
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@KK_medicine I always wanted to name a daughter Francisella Tularensis. It sounds so Roaring 20s fun!.
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Reading a book on medical care in WW1. 20000 casualties in a single battle. 1000+ critical patients in 24 hours. I bitch when my pod opens and I get 8-10 patients in the first hour. In a highly resourced environment. Without mud and stench and artillery fire. I am not worthy.
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I was unable to take a selfie during the moment of truth, but apparently this vaccine is triumphant over both COVID and dragons!. #Science
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That sad, sad moment when you return to your station after multiple resuscitations only to remember that you had treated yourself to an ice cream sandwich right before the pager went off.
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That awkward moment when you get called out while lecturing in a Hawaiian shirt. And have no other shirt to change into…. 🤷♂️🤦
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I have always felt the word "Blessed" was overused. But I am truly blessed. I should be dead. Now, I get to live, to hopefully better myself as a husband, father, & friend. Despite the flak this site gets, without it I would not have met all you awesome folks. Thank you!
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Hey @US_FDA . Please give the US this simple, SAFE and effective patient-controlled, non-opioid analgesic!. It has nearly 50 years of safety data at this point. Ping @armyemdoc
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I am excited to announce our new @MayoClinicEM ACGME-accredited EMS fellowship. One year, fully-funded, take home EMS vehicle. Air and specialty team opportunities. Contact me if interested. Ping @emresidents @NAEMSP @ACEPNow @aaeminfo.
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I am excited to announce our new @MayoClinicEM EMS fellowship. One year, fully-funded, take home EMS vehicle. Full disclosure: Under initial ACGME review - notification 9/13. Contact me if interested. Please RT. Ping @emresidents @ACEPNow @NAEMSP.
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@DrZedZha Genuine question - From an ED standpoint, if you wanted them admitted, why did you not directly admit them? It would save you and your patient the nightmare of a modern ED visit, and decrease the strain on an already over-taxed system.
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This is Homer. Since rescuing him a decade ago, he has been my faithful companion and work confidant. He has an expanding paratracheal cancer. Last night, we thought today would be his last. Soon, but not today. I am truly grateful for each extra moment I get with him.
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Strange feeling - today I am as old as my Dad when he died. He spent his adult life chasing a retirement that never came. Take nothing for granted. Enjoy the life you have.
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Welp. how’s your day starting out?. PS: The brown stuff on the handle is poop - not mine!
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The morning of the day I had my STEMI, I randomly thought to myself “Two more weeks and I will have outlived my dad.”. It’s been 2 weeks. Despite my best efforts I made it. Here’s to you Dad! . Miss you every day.
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@LaurenKuwikMD I spend my entire life hiding the fact that I am a doc. Why would I want anyone to know. If there is an emergency, I am cool revealing my secret identity. But the rest of the time.
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Last fall, a couple of back to back experiences knocked me for a loop personally and then professionally. Frazzled, I gained 30 lbs and felt miserable. Today I got back on the bike figuratively and literally. Am I fixed? Hell no. Am I on the mend?
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A little good news amongst of sea of heartbreak and despair. Introducing Unit 564, the new EMS Fellowship physician response vehicle. It’s finally here! And it is awesome!!!. Ping @MayoClinicEM @anulukemd @csrussi
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It’s happening! It’s actually happening!. On my way to @TacTrauma #TacTrauma24 to get my learning on!!!
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It has been about 3 months since EPIC. Prior to roll-out, I was madly working at improving my echo skills. Since roll-out, I have not touched a probe. I simply don’t have the cognitive bandwidth. Exhausted, I just click buttons. EMR 1, Professional Growth 0.
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The latest… I must confess I tried to give the the surgeon the benefit of the doubt, but this is a hard read. “The medical examiner found that William died because … Shaknovsky dissected his inferior vena cava. ”. Ping @medmalreviewer
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Blast from the past - my father-in-law’s appy bill. Six days in-patient for uncomplicated surgery. Things have become a bit more expensive since 1950.
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