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MediMike

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Everything posted by MediMike

  1. Great questions man, I can speak to some of this but not all as I am a cog in the machine rather than the driver Procedures: I hate to use the phrase "ample" but it's true. There will be minimum standards, and they are probably established already I simply don't have the information in front of me. Anecdotally I had three intubations in a single shift the other day, central lines are around enough that I lean on the PICC nurses because I'm a little tired of them. Institutionally our group is a fan of arterial lines. We have several interventional pulmonologists in our physician group
  2. It is! Starting salary will be a little over double the stipend. In general we don't hire anyone with less than 3-5 years of ICU experience. Let me know if you have any questions regarding the remainder of the benefits etc!
  3. Yikes. "Purge"? Edit; and shouldn't it be "...purge FROM our specialty societies..."? I mean, if you're going to be a fanatic at least use proper form
  4. Ended up down a Twitter hole (I'm actually regretting furthering my social media, there are a lot of idiots out there) and found a post detailing the new ACEP work group formed to deal with the supposed massive surplus of ED docs they are expecting by 2030. Ideas involved making all residencies 4 years, increasing resident pay to help slow down the for profit residency growth, and ensure that all APPs undergo "a standardized credentialing and certification process by the ABEM." This was of course followed by a number of ridiculous "ban them from the main ED" and "boo hiss APPs" comme
  5. Hey! @ventana! What's the deal? What did you find out regarding diagnosis? Can't just leave us hanging here.
  6. That's pretty awesome. Found it funny that they use the term "Critical Care APPs", was this posting looking for CC coverage for boarding patients? Or is that simply the term they use for ED APPs?
  7. Networking with individual clinicians will likely provide you a better foot in the door, but you may want to get some experience in a high volume center prior to going rural/frontier right off the bat. Likely @EMEDPA or @ohiovolffemtp could speak a little more to this. Also consider a residency, that would prepare you to be working some of these rural places solo. Join SEMPA. Join your state org and ask around.
  8. Whidbey as in Whidbey Island? (Not trying to dox you, just don't see many PNWers on here) Honestly if you're only doing two days a week and your schedule isn't full on those days it sounds like the clinic will likely do fine without you, so that should assuage your guilt somewhat. Others on here are always quick to point out that they would fire you in a heartbeat with no regrets if necessary so you should feel the same...I've never managed to develop that attitude. Regardless you need to ensure your own future, happiness and well being before worrying about others (i.e. the company).
  9. I thought atypical Wenkebach had a shortening PR interval?
  10. First, let me point out the the slippery slope argument is literally a logical fallacy. How is it discrimination? If you are unable to obtain a vaccination due to an underlying condition there would likely be workarounds. (I say likely as this is all theoretical). The government says I can't walk around with my genitals hanging out and that's a lot lower risk to most people than COVID, I'm assuming you have no issue with my junk being forced to be tucked in my pants? Or are you more of the true anarchist type? Where do you draw the line for government overreach? The shuttering of es
  11. I mean, you're not wrong. You're equating placing folks at risk of a disease in a pandemic with being gay but whatever. If you're ok with that then I really don't see what your argument is here? The current administration has come out and said they are not encouraging or supporting any type of required vaccine credentialing/database/requirements? Are you arguing against state government? Hopefully you're just as upset with DeSantis not allowing businesses to require proof of vaccination.
  12. Would you be opposed to businesses making the rule that they would require evidence of vaccination prior to entering?
  13. CHB w/ a junctional escape is possible!
  14. Evening folks! My group has established a new CC APP Fellowship which will be accepting applications. To my knowledge it's the only one in the PacNW. Happy to (try) and answer any questions you may have! https://www.chifranciscan.org/about-us/residencies/critical-care-app.html
  15. I agree with @UGoLong in that it appears to be a 2dT1 in the beginning, bit seems to transition to a 3dAVB later in the strip. Doesn't seem to be any further dropped beats, lose any P wave association. I'm counting about 14 P waves and 9 QRS complexes, atrial rate is around 93 and ventricular about 65. Would love to sit down with some calipers. ...and that's my life now. Dreaming about calipers.
  16. That's a silly statement man and you know it. You rely on the "village" to design and enforce laws against drunk driving so no one plows into your family when you're out on the road, to regulate the safety of the medicine/food/booze/guns that you buy, to keep the roads paved and in good repair to get you to work. All of that is "the village". Unless you live completely off of the grid and inna compound in the woods not receiving fire, law enforcement or military protection...you rely on others. You know this, ya ain't no Grizzly Adams. Unless you in fact are, in which case hat
  17. So is travel, going to the movie theater, eating out in restaurants...the list goes on. What involuntary thing are you being required to do which would necessitate receiving a vaccine? Edit: The context of that quote is actually pretty interesting. Here's a breakdown by a guy from the Brookings Institute. Essentially it is referring to a dispute between a family governing American land from afar and attempts to tax that land for defense. Franklin was pro government taxation in the interests of the common good. As usual we've screwed up the meaning. https://www.npr.org/2015/03
  18. I've got privileges. The credentialing process was ridiculous, reading a grainy printed out powerpoint followed by a 10 Q quiz. Old job has several online modules and then a visit to the OR where you had to bag multiple patients under anesthesia supervision. Pretty shocked you don't have it, especially in IR. Nothing takes the edge off a patient while that Trialysis rams its way in like 50 and 2!
  19. There ya go. Let your own post do the talking. If you don't mean what you typed don't type, or type something different? Encouraging this culture of showing up to work regardless of being sick, or because you have some inherent guilt about taking time off is exactly why there is such a burnout culture prevalent in this field. It isn't a lack of work ethic, it's a healthy approach to self care and patient care. Thanks. (See what I did there with the "thanks"? It was really passive, but aggressive at the same time, if only there was a word for that...)
  20. Funny, I saw that and immediately thought the same. Wonder if that section of bowel just lined up perfectly behind the diaphragm and is giving the appearance of free air?
  21. Pretty broad brush to be painting with partner. Taking time off isn't a sign of a poor work ethic. You must never take PTO? And any healthcare provider who doesn't call sick when they are symptomatic is putting their patients and coworkers at risk. That's not work ethic, that's irresponsible. To the OP, I glazed over a lot of your post, new it was a hot piece as there were so many responses so fast and I was eager to get to the drama, but agree with what I've seen. Courthouse/Personal pastor wedding, forget about a fancy ring/dress etc. Also don't pressure anything to meet your timeli
  22. Are you regularly using a hyperangulated blade without the stylet?
  23. Hey folks! Curious as to who is still doing direct laryngoscopy in the unit vs direct. Since I left being a medic years ago I let my direct skills lapse a fair amount, still get in practice time on manikins while teaching, but pretty much use a hyperangulated Glidescope while in house. If you're using video, what are you using?
  24. Ken Milne from the Skeptic's Guide to Emergency Medicine did the original review I believe! He's a good man, supports APCs, I did a podcast with him a couple months ago. Does great evidence based medicine literature review
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