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Paramedic -> MD here (surgery). I think Emergency Medicine as a field has a lot of problems. Burn out is high, compensation is trending down, there is an over-supply of EM doctors and more and more PA/NP's are staffing ED's in rural areas and eating up those jobs, pressure from admin to see more...

Or check pulse for 6 seconds and multiply by 10 to get in the ballpark.

Ignoring a diagnosis of Marfan syndrome will lead to an earlier ending, (from ruptured aorta). https://pubmed.ncbi.nlm.nih.gov/7810492/ There have been a lot of advances in medicine and surgery and a lot can be done for these patients to allow them to live long and fulfilling lives. I was...

People with Marfan's can live long, happy, reasonably healthy lives. Average life expectancy is not that much lower than general population. Yes, you will need to take blood pressure meds, will likely need to have your entire aorta replaced with goretex sometime during the next 40 years, and...

Aortic dissection is what I would be most nervous about, with regards to heavy lifting / EMS work: https://pubmed.ncbi.nlm.nih.gov/18453784/

Life expectancy with Marfan's is ~70 years these days, though you're probably in for a lot of big cardiac/vascular surgeries to make it that far. Unfortunately, one of the things you really want to avoid with Marfan's is straining as you would do with lifting heavy weights. EMS often involves...

I think you were correct back then, but technically correct now. It depends on the context. Yes, when charting, smoking goes in the social tab. But it is often relevant enough that it should be thrown in along with other PMH in your handoff: "55m w/PMH TD2M, HTN, 50 pk/yr current smoker...

That fatality rate is creeping up though, at 1.8% across the country now. NYC was holding at 0.5% for quite a while but now they're up to 1.6%. I remember reading somewhere that in China it was taking around 14 days on average from symptom onset to death, in those who will die. I'm worried...

I can say that my SHTF closet is going to be filled out quite a bit more in the future. I feel like this pandemic has made me acutely aware of how close we are to anarchy at any given moment. People have been literally fighting over toilet paper. My local grocery store is completely unable to...

Thanks for writing this all out, this side of the argument feels a lot more reasonable to me now. My hospital is getting hit pretty hard, and the panic in the press makes it easy to forget that the sky is not falling everywhere.

What should the country do, if not lock down? Do we shrug and say "oh well, guess a bunch of people will just have to die" as the virus burns itself out? How are hospitals supposed to handle the surge of patients? I think I asked the same questions a while ago, and you said the virus wasn't...

Excellent, this hits it right on the nose.

I wonder if you guys believe this is real yet? My small, rural hospital is absolutely getting smashed, and half of our nurse+physician staff is out on quarantine for possible exposures. We have only had a couple confirmed positive patients so far and it's already a mess. There aren't enough...

You work in a hospital right? Is your facility not being affected by this? How do you think the US government should respond?

When in doubt about whether you should take a transfer that seems over your head, IMO you should call medical control. Push the liability onto someone higher up the food chain. Let the MD decide whether the transfer is appropriate or not.

Make flash cards of info you want to remember from class, and review them every day.

As a partner of mine used to say... Some people are just meant to dig ditches...

I always recommend people find a tutor. It's always worth it to sit down with someone 1-on-1 who can evaluate your thought process and see where your holes are. Ideally it would be better to find someone in real life - if you're working as an EMT-B right now, maybe you could find a medic that...

2 hours is plenty of time to call medical control and see if they have any comments/questions/concerns.