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Dang...I take 2 weeks off and I can't find my a** with both hands my first day back....it depends on the level you're operating at. If the level you leave off at is 'ok', then there isn't much skill to degrade. If you operate at a pretty sophisticated level, the degradation curve can be pretty...

A patient with illness requiring inopressor that preclude routine PIV access in the ER needs a central line. If the u/s is coming out in that situation, somebody ought to be prepping the neck.

yeah...totally get that. It's a problem. When the distinction between competency, assessment skills and distracted decision making v. being fragile and weak isn't appreciated, it always defaults to "I'm weak". It just that patients suffer for it to one extent or another....and no one sees the...

That's an automatic go home IMHO...maybe even the next day off....no way anyone can concentrate on another call after something like that. Has nothing to do with being devastated or not. The acute psychological assault goes on for hours and is too distracting for any meaningful focus. Oh...and...

"I want American Airlines to take full responsibility for Kevin's death." Full responsibility. 14 year old's don't up and arrest. Something really bad caused that. That this just didn't go to settlement says a lot about what AA believes about what happened. The family is surely going to be...

Here's a really good review that everyone at any level should read: https://www.ncbi.nlm.nih.gov/books/NBK470384/

everyone should have their pupils examined in the physical exam, regardless of cc.

Maybe 2News Sunrise didn't know they'd been scooped, nor is it a bad thing that we don't depend on PBS for direction on this topic...stopped at 3... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904026/ https://www.annemergmed.com/article/S0196-0644(21)00152-9/abstract...

35? Gawd I'm old.....🧐 ...used the 1 and 2.....but I'm still kicking 'a' in the CT/V OR so watch the 'boomer' cracks.... OK...so there were variants in the 60's... https://emsmuseum.org/collections/archives/defibrillators/lifepak/

...so the HR doesn't wind up so much.

just sounds like cool mist treatment for croup, the goal being reduction of swelling. Only reason to do that in the PH setting, to my mind, is if racemic epi would not be available, and then just cold air would be just as effective (or not).

ETCO2 correlates directly with cardiac output. We use blood pressure as a surrogate for cardiac output, so you can say ETCO2 correlates directly with blood pressure. The less blood going through the lungs, the less CO2 is expired via the mouth and nose. Doesn't matter what the reason for that...

Well, if there would be a difference in where you would decide to bring the patient, like a trauma center v. IR neuro intervention v. cath lab/cardiac intervention center, it'd be important. If all of those things are accessible at the same place, you're correct...don't waste a lot of time...

Did you let them know? That's the kind of thing they'd really want to be aware of. Prolly be really appreciative....

Guess you're back to looking at earlobes...

this thread ought to be entered for the oddest/creepiest category....

There was a United Ambulance in Marin county, prolly late 60's through the 1990's, maybe early 2000's. Subsidiary of SF ambulance and sister service of Acme-Western in Alameda County. I think they morphed into St. Joseph's Ambulance and then just disappeared when the patriarch of the whole...

8 % (your data) of the total state and federal prison population constitutes a 'system' designed to generate revenue and capitalize off of cheap labor, which in turn provides incentive to keep them full by way of a revolving door mechanism rife with frivolous arrests, prosecutions and...

So you're saying that the 'prison system' (which one exactly?) makes meaningfully more than $43000/year off of an inmate pressing license plates or maintaining irrigation ditches? Sounds like the script came in the morning mail...