MediMike

Ok, all of the above replies have settled some of MY unease. I couldn't believe that you have more of a responsibility, be it legal or ethical to ENSURE follow up with a specialist outside of providing the timely referral. Once you have done that it seems to be out of your hands? Never having worked outpatient it's a different world to me.

Stairs. Throw down blankets and do crunches, pushups. Will bring resistance bands to work. Actually have a gym at the hospital (empty at night) but it's closed due to COVID

??? I'm failing to see where you went wrong here. Not attempting to validate but if you provided a timely referral to an appropriate specialist with the proper documentation I'm unsure as to the issue.

Fundamentals of Critical Care from SCCM isn't terrible, broad overview of stuff. Marino's is good for theory and general knowledge. Fischman's is the Tintinelli's/Rosen's of Pulm if you're doing that. I believe there is an EMRA guide to mechanical ventilation written by a wonderful woman Jenelle Badulak, there is also 'The Ventilator Book" or something along those lines.

I'd have to oe I'd probably die. Not from boredom but from my wife murdering me. Honestly, my job is pretty niche and a fantastic fit for me so I'd probably keep at it.

Agreed. If you're vaccinated. My concern, again, isn't the individuals who are vaccinated, it's those who aren't. We're getting there, heard hopeful herd immunity levels around October 21st if we keep vaccinating on schedule.

And in happier news... "Promisingly, the data showed that after 21 days, just a single dose of the Pfizer/BioNtech vaccine was 72 percent effective at preventing not just covid-19 but SARS-CoV-2 infection itself; the vaccine was 86 percent effective in decreasing infection seven days after the second dose." News story on the pre-print (I know I know) of the SIREN trial, serially tested asymptomatic HCW who received the vaccine as well as those who received the vaccine AND had confirmed prior infection. 72% ain't perfect but it's better than nothing for sure! https://brief19

Sorry to hear about your friend's kiddo, sounds terrible. To my knowledge though there has been no association between the meningococcal vaccine and GBS. In fact I think per the CDC the only confirmed cases of GBS due to vaccination were the 1979s swine flu vaccine. I hadn't heard about the FL OB/Gyn, but what sound like petechiae, thrombocytopenia and a CVA go hand in hand with TTP in my mind. Curious what the "emergent surgery" was, unless he had a spontaneous ICH or hemorrhagic conversion.

Which COVID vaccine death are you referring to? You believe you have found one which is reputable and actually due to the vaccine? Moderna or Pfizer? And what was the cause of death?

https://skepticalinquirer.org/2018/11/diving-into-the-vaers-dumpster-fake-news-about-vaccine-injuries/

Thoughts on the IVCD? RBBB morphology w/o a slurred S in 6 but evident in I, really difficult to see an actual width of the complex on the phone screen. Possible RAE? Any chance this individual has a hx of connective tissue dz, pHTN?

It's interesting to see how the U.S. approach to healthcare has evolved outside of the remainder of our allies. CPR in other countires isn't a guaranteed thing, you essentially need to qualify for it. Worked with an attending a few years ago who approached it along the following lines: "Performing CPR is a medical procedure which has benefit for some people, and none for others. CPR is not going to benefit you so I am not offering this procedure." Some folks didn't agree with his approach but I was pretty well on board in certain situations.

I've been in similar situations fairly regularly this last year man, I get it. I will honor the patient's and family's wishes in the acute setting to the point of arrest, at which point any reversible causes are quickly addressed and the code called. CPR ain't designed to fix CA, or sepsis, or most of the things that end up killing 90yos. The lactate of 1.7 makes absolutely no sense to me. Whatever the underlying etiology, be it septic shock leading to myocardial dysfunction (most likely in my mind) or myxedema (did you happen to get a reflex FT4? Sick euthyroid will commonly give those T

Nice try dude, but you're grasping at straws and I'm pretty disappointed in you. Especially since you have yet to answer anyone's request for these horrible costs that come with masking. We do have evidence that our current vaccines can eradicate the diseases they were built for and reduce the spread and transmission of said diseases. We know this by the eradication and near eradication of a large number of them. Because they've been studied for years. How long has this vaccine been studied? Chagrined at my argument? At least I have one man. You can keep your disappointment in

Oof. That extra $50k is pretty significant. The smaller class sizes are nice though, easy to get lost in a larger cohort. Shorter programs aren't necessarily better. While PANCE pass rates are important the vast majority of programs out there are 27 months (unless things have changed), and I'm curious how they cut out 3 months of instruction without losing important didactic and clinical time. Passing the PANCE isn't everything.