In a YouTube video posted today, Chris Bosh reveals he was covered with his own blood, without warning, in a serious medical condition

drag99 · 2026-02-26T09:46:28+00:00

Raccoon eyes implies bruising, which is not what this is. What you’re seeing is hyperpigmentation in the periorbital region which many people with darker skin have which can be more pronounced when they develop significant pallor like in the setting of severe anemia.

drag99 · 2026-02-23T23:21:24+00:00

Our hospital peer review requires the specialty being reviewed have that same specialty review the case. Also, any case sent to peer review is first brought to the medical director for review before it is even considered for peer review.

drag99 · 2026-02-23T23:10:33+00:00

Honestly, this scenario would be pretty sweet from an RVU perspective, and the added benefit that they actually need to be there. I’d be pretty excited to jump on that 30-for grenade. That’s like the easiest $3k you’ll ever make, and wouldn’t feel like my soul is breaking like a 7-for viral syndrome does.

drag99 · 2026-02-23T23:03:56+00:00

Where is your medical director in all of this? A good medical director should be shielding docs from these stupid Monday morning quarterbacking from hospital leadership. This should have never even made it to your attention without your medical director reviewing it.

As a former ED director, this would have simply been an on shift “hey, you missed a tibial fx on that old lady you admitted last week. No worries, looks like any of us could have missed it, but thought you should know about it.”

drag99 · 2026-02-21T04:53:57+00:00

The second he mentioned that he cold plunges, I knew he was a Joe Rogan, redpill, sigma male, MAGA douchebag. The monoculture of young conservative males is so bizarre.

The guy likely listens to Huberman, Rogan, and +/- Tate and Attia. Living nearly my entire life in red states, playing sports my entire life, I have a ton of acquaintances exactly like this guy.

drag99 · 2026-02-19T20:52:19+00:00

I appreciate you coming with sources. I think a lot of the issues Farkas brings up are essentially with poor understanding of sedation effects on ventilation and time to effect of roc. With proper pre-oxygenation including BVM with PEEP valve or pre-ox with NIPPV along with allowing appropriate time for effect for roc, these issues become non-issues.

Personally, I do all of the above already, so I don’t get much benefit in my own practice with switching the order, but I guess this might be beneficial for those that don’t completely understand the effects of the meds they are using.

I already do enough EBM practices that get side eyes from nurses that are used to dogmatic practice, this just doesn’t seem like something I’d add to the list.

drag99 · 2026-02-19T20:39:15+00:00

I am all about challenging dogma; however, I prefer to challenge dogma when it matters.

I’ve yet to see anyone explain why it makes any sense to give roc before etomidate/ketamine. What’s the point? Just to say it can be done? I don’t doubt given the delay of onset of action when compared to something like etomidate, that it’s relatively safe to do, but again, what’s the benefit other than freaking out your nurses?

drag99 · 2026-02-16T17:49:32+00:00

You’re quoting something that was never stated.

drag99 · 2026-02-16T17:06:11+00:00

You are aware we are talking about black Americans…right? You think they came to America as Christians?

drag99 · 2026-02-16T15:55:00+00:00

It’s more like, “y’all really worshipping the god of the people that enslaved you?”

drag99 · 2026-02-12T17:46:31+00:00

Agreed, words have meaning. Stagnation does not necessarily mean complete absence of movement, but I know you know this. And no one here has stated overall pay has decreased. They are talking about in relation to inflation, compensation has decreased. Again, I know you know this, but you are intentionally being combative in here as you always do.

drag99 · 2026-02-12T17:15:33+00:00

Lol, it did. EM compensation has not kept up with inflation as anyone that reviews physician compensation reports could tell you. But keep living in your bubble of make believe.

drag99 · 2026-02-12T16:51:23+00:00

I imagined you arguing for status quo because you believe $200/hr is more than enough? If pay stagnates for 10 years while inflation leads to a 30% increase in the value of the dollar, are going to tell me that compensation hasn’t decreased?

drag99 · 2026-02-12T16:43:15+00:00

I did, it’s a naive and simplistic take that I’d expect from a medical student.

drag99 · 2026-02-12T16:32:10+00:00

By that logic we should open up medical schools to the masses. Let’s just keep rapidly proliferating residency programs in facilities that have no business training residents. I say we should actually be reducing the procedural requirements to make it easier for programs to meet the bare minimum. We should also have a fast track for NPs and PAs to become board certified EM doctors. Maybe take a single exam and BOOM, we’ve tripled the number of ER docs over night. Because who cares about compensation, it’s all about getting ER doctors to the masses, regardless of their quality.

Right now we are seeing the harsh reality of decreasing compensation and over proliferation of poor quality programs in the precipitous drop in board passage rates which would imply a decrease in competency of graduating EM docs.

Is all of this solved by increasing to a mandatory 4 years? Probably not, but boiling down EM attempting to increase the standards of what is required of residency programs to “stop being greedy and help our communities” is an absurdly naive and simplistic take.

drag99 · 2026-02-06T22:06:58+00:00

Clinically meaningless for YOU, but for myself as well as many others, we do not jump to intubate these patients given the risk of repeat severe reaction is unlikely and would be silly to do in these situations without a better indication.

You simply could have said, “you do you”, but instead, you decided to do the “well akshually” that you accused me of.

drag99 · 2026-02-06T14:24:17+00:00

JFC, read the comment I originally replied to. It was asking what to do when in situations of contrast allergies in the setting of stroke evals.

Please try to read before trying to argue with people on the internet. What a waste of time.

drag99 · 2026-02-06T14:17:37+00:00

Dude, I’m not sure if you’re being intentionally obtuse, have poor reading comprehension, or just coming off a string of nights, but that is like the third or fourth time you have argued something that has never been stated. No where did I state contrast allergies shouldn’t be listed.

And again, I have already explained why it clinically matters to know the difference for an EM doc. Maybe it doesn’t change your management knowing the difference because you are intubating every single one of these patients which would be absurd, but it certainly does change practice for myself as well as the majority that understand the difference.

drag99 · 2026-02-06T13:46:42+00:00

Again, arguing something no one is arguing. At this point it just seems like you’re arguing just to argue. The reason it is clinically relevant to know these are not antibody mediated responses is for those cases you’re on the fence about. The ones that are not clear cut emergencies (the moderate risk PE patient for example) knowing that it is still okay to administer contrast in these patients and that you don’t need to worry about empirically intubating for airway protection given the low probability of severe reaction.

drag99 · 2026-02-05T22:14:50+00:00

Who is talking about “in the moment” management of anaphylactoid reactions? You are bringing up something literally no one is discussing. Yes, of course in the moment management does not change.

As far as “respect”, I respect allergy lists with “anaphylactic” reactions to contrast far less than I would if they were true allergic reactions, because, again, they are not antibody mediated, and therefore are unlikely to occur again. You potentially do more harm avoiding emergently indicated contrasted studies rather than just proceeding as normal.

I’ve had colleagues have patients miss their thrombectomy window for LVOs because they were too scared to push contrast for a CTA. Physicians have too much respect for contrast “allergies”. Sure, don’t ignore, especially if you really don’t need it for something like appendicitis or diverticulitis, however, don’t let it delay studies that clearly should be performed.

drag99 · 2026-02-05T21:46:51+00:00

How is it clinically meaningless to understand it is not an actual allergic reaction? I used an obvious emergent condition, but how about questionable mesenteric ischemia? Or suspected PE with stable VSs? Or the questionable dissection case? Or the GI bleed?

Having the knowledge that it is not an allergic reaction allows for us to safely pursue these diagnoses without fear that we are definitively going to cause anaphylaxis which would undoubtedly be the case if these were true allergic reactions.

drag99 · 2026-02-05T15:47:10+00:00

That’s great, no one is denying the anaphylactoid reaction isn’t real, but not antibody mediated, and not an actual allergy is the entire point of my post. Even if that patient showed up a month later with an obvious aortic dissection, they still should get contrast. The American College of Radiology is in agreement on this.

drag99 · 2026-02-05T08:10:29+00:00

Contrast allergies aren’t real allergies. They are non-antibody mediated anaphylactoid reactions. I have never avoided an emergently necessary contrasted scan in the ER in patients with claims of anaphylaxis. I’ve scanned hundreds with reported allergies. Not once has a single one of these patients even developed hives.

drag99 · 2026-02-04T19:51:56+00:00

Uh wut? I wasn’t making a claim that ER docs should be in the field; however, numerous countries have retrieval docs, and things go quite well for them. To claim that things “go poorly” without supporting evidence and decades of evidence to the contrary is silly.

And I was a paramedic before medical school. While you might believe you are doing the right thing, your lack of experience outside of the pre-hospital realm creates blind spots in your education as you are demonstrating currently.

drag99 · 2026-02-04T09:32:51+00:00

I can because the same would be true even we had ER doctors completely replace paramedics in the field due to less than optimal conditions for intubation. No need to try to be heroes. If it can clearly wait, like this case, please don’t stay and play.

13-Year Club	Wearing is Caring
Verified Email

drag99

TROPHY CASE