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This is something you are going to have to come to terms with if you want to have any kind of long term career in the medical field. All of us will die eventually. There will be many patients who die before they should have. If you are struggling with a older patient it only gets harder when...

I’ve also changed what I carry over the years, generally carrying less and less. ICUs/PICU/NICU: flashlight, drug reference cards, pens, sharpie, personal cell, +\- work cell. ED: flashlight, drug reference cards, pens, sharpies, shears, personal cell, usually work cell, +/- 2nd work cell, +/-...

I’m mostly deterred by the not wanting to die in a crash over some patient that would have had the same outcome in a ground ambulance bit; and the part where I would have to take a pay cut.

Have you ever actually surveyed your group to see how they prefer to learn?

I feel for you and your wife. I think too often clinicians dismiss the one in a million ( or 10,000) as not being possible due to their statistical unlikelihood. Unfortunately that means that the rare person with that actual disease struggles to get diagnosed and treated because all of their...

It’s not that I didn’t find the humor, rather its frustrating when there are people who consider themselves healthcare professionals who are quick to dismiss the possibility of serious illness in cases where a benign eitiology is far more likely (although not certain). I doubt that was your...

Hit a bit of a sore spot for me. I had a teen recently almost die from lupus nephritis after a long series of failure to diagnose, predominantly because they thought she was whining and seeking attention.

Previously healthy teens can certainly with life threatening disease. I’ve had many teens with strokes, PE, myocarditis, structural heart disease, and kidney disease who initially presented with either loss of consciousness or altered mental status during activity and no other prior history...

Are you a child?

What are your differential diagnosis?

yeah... try to justify that MDM in court

Do you have a of a bit better description of the syncopal event? Did the patient suddenly lose consciousness, did she lose consciousness shortly after racking a bar after heavy squats, slowly become more and more lightheaded throughout her workout, and so on? Did she have any preceding...

Not specific locally but rather most departments. Care about improved patient safety and follow actual science.

We do a full sign out of all of our hearts and complex patients at the bedside going to and coming back from surgery. Nursing to anesthesia, perfusionist to ECMO specialist, and medicine to surgery (and vice versa when they return). It has been a huge piece of how we keep our intra op codes and...

No, that was the shortened version.

Apparently MDAs don’t like when you end your 20 minute handoff with the words good luck.

1: That is a non-scholarly opinion/article. 2: While an extremely rare antecedent to GBS there is some theory that a vaccination may precipitate it. You cannot simply lump all “rare diseases” together and expect a similar clinical presentation, outcome, or risk stratification.

I already have, my first bachelors was in human and cellular biology. To be clear on the science, mRNA does not enter the nucleous or or mitochondria, and therefore does not alter DNA. It is transcribed by ribosomes in the ER. Just so I have a clear understanding, you don’t have a scientific...

Sorry. For clarity my intent is not to offer any medical advice. I do want to prevent any kind of misinformation being presented to readers of this thread, particularly those who do not often follow the site, who may take away some idea that there is some a current practice recommendation...

That doesn’t explain any pathophysiology what so ever. The current general convention is that the risk of Covid infection is greater than that of immunization in those with immunosuppression with the mRNA vaccines. Even given that concern that only would apply to vitiligo if you are on an...