1. Forgive me, I'm just a dumb ER doc: why isn't a CT angio of abdomen good enough for a bleed? It's what I order on my hot lower GI bleeds to look for IR targets

  2. "Toxicity rate" is not a formal or actual term that I've ever heard lf. Are you just asking how toxic it is, in general?

  3. I know you don't want to lose her, but an important thing a lot of medical people have a consensus around (from being familiar with this process) is that people often don't pass all at once, but in fact in little stages, pieces at a time. I don't mean to diminish the impact of that final step, but when my grandparents passed, it helped me to know that what I feared most had already happened, incrementally, while I was with them.

  4. What's wrooonng, Naaathan? I thought you was keeping it Gaaaangstaaaa

  5. Diabetes is a magnesium wasting disease

  6. All patients who are hospitalized and have diabetes should be checked for magnesium levels. The worse the A1c, the more they need to be checked.

  7. Very cool, thanks for filling me in. I'm in the habit of giving empiric magnesium regardless of levels based on long QTc or ETOH use history; if someone is DKA/HHS and I'm giving liters upon liters of fluid, maybe I'll start throwing some magnesium in there too.

  8. God damn it, I want to downvote these every time, then I remember I subscribed to this subreddit

  9. Rigorous quantification of fundamentally qualitative data is a statistical shell game. Nobody cares if you can decrease a HAM-D. All the scales' uses as proxies for real outcomes are a house of cards because the best you can do is correlate scales with other scales. The actual pathology is frustratingly, ineffably profound human stuff that doesn't even fit well into words, let alone numbers.

  10. I think about this a lot every time I do required modules and I get asked "rank from 1-5 how much this module improved your [mandatory wellness]", then asks the same question 5 different ways. It's a lot easier to make pretty graphs out of that arbitrary number generator than to actually read all the nasty things I have to say about some chipper CMO in a module video telling me about meditation as a fix to our crumbling healthcare system bumming me out

  11. Better pray you don’t get more than 3 infarcting grandmothers. As for troponin in submassive PEs, I’ve yet to be convinced that troponin add much to the treatment plan. But I’m sure the on-call fellow will be happy to entertain your petition for additional labs.

  12. While I think you're probably right about the PEs, it is part of the diagnostic criteria, you'll have to ask whoever invented them (was it American Chest or Amer Thoracic or someone like that?)

  13. There's a syndrome called cocaine washout syndrome, where you just run out of neurotransmitters. Worth reading in to.

  14. At least this one didn't involve pregnancy. Lord knows how they avoided the temptation.

  15. You're playing with the blood, as they say. You are pushing in the right direction. Keep fighting.

  16. His response you quoted above has zero actual apology, even for how it made anyone feel, never mind whether or not he did anything wrong.

  17. Have you seen this subreddit? And not just this subreddit. Whenever sunny is mentioned it just becomes a tennis game of just lines being copied and pasted over and over.

  18. Blessings upon you. I'll never forget the nurses who taught me how to get a line in just about anyone.

  19. Or have their venous stasis or HF controlled during the day.

  20. Have you tried making a sign for deliverymen explaining this? You could also try talking to the delivery companies. Both of these are annoying but both probably worth doing.

  21. Fascinating - any chance you know why rivarox is daily then? Since it would make more sense for it to be BID if it's got a shorter halflife than eliquis?

  22. Nobody gets a fair trial in our justice system. Imagine being judged by a jury of your peers here on Reddit. The odds are overwhelmingly stacked on the side of the State. They extort a plea bargain about 98% of the time.

  23. And it will be documented as a rash from penicillins for the next 80 years

  24. I'm sure you have had the same conversation that I have numerous times. 'Why can I not see all of the patient's body, they fit through your machine!' Usually I send a note to the rad when this happens saying 'Maximum SFOV used during study. Best imaging possible obtained.' Rads understand immediately what that means but most doctors don't. But generally the rads add in a comment about the patient hitting the technical limitations of hospital equipment.

  25. Another example would be if a provider orders a CT thoracic spine and a chest CT together. A t-spine will scan in a ScanFOV (also sometimes called CFOV or calibrated FOV) of like 40cm but it is displayed in a smaller DisplayFOV of around 15cm. Anything in the SFOV is recoverable using raw data, so we could build the chest out of it. We do this a lot in trauma if they want a C/A/P and a T/L spine. Just build out the spines from the raw data in a smaller FOV so they are larger and more detailed for looking at the bones.

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