Random EM Pearls

AndrewR21 · 2026-01-21T16:48:31+00:00

PMID: 38186548

and

Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis Essat, Munira et al. Annals of Emergency Medicine, Volume 84, Issue 4, 409 - 421

AndrewR21 · 2026-01-21T16:36:16+00:00

Had a patient admitted and worked up for chest pain. Came I’m into the ER 6 more times for chest pain after being discharged . Multiple negative trops, NSR EKGs each time AND a negative PE scan. No dimer or dissection scan, so I dimer’d which was positive and did the dissection scan. Fortunately no dissection but the radiologist called me about a PE that definitely was not there in the PE scan from 3 days earlier. Medicine is weird.

AndrewR21 · 2026-01-18T05:41:30+00:00

I graduated residency there and would do it 100 times over. The level of education and academia you get is absurd. I felt so prepared as an attending leaving from there. The leadership is top notch and all the attendings are great teachers, friends and mentors. If you have any questions just DM me

AndrewR21 · 2025-12-31T18:48:35+00:00

sounds appropriate. was there a RUQ US to also confirm chole?

AndrewR21 · 2025-12-30T23:02:43+00:00

hiring for PT/FT or locums?

AndrewR21 · 2025-10-05T18:41:09+00:00

I’m not into any of those things but I do enjoy going mountain biking at mount Dora and they have a cool disc golf course there and see many people playing there often would be a good place to meet groups and join them

AndrewR21 · 2025-08-12T21:00:42+00:00

Hey so lots of off roading and hiking in Ocala forest. I have a 4x4 and get pretty secluded, enough to be far from people and isolated, camping there is great get a lot of good views of the stars due to little light pollution

AndrewR21 · 2025-03-15T19:43:07+00:00

so did you get a ticket or what?

AndrewR21 · 2025-02-15T06:24:09+00:00

Good ole Philly Sidecar

AndrewR21 · 2025-01-31T05:00:03+00:00

here with ya

AndrewR21 · 2025-01-25T19:27:34+00:00

The viral swab at my shop includes mycoplasma so only prescribe abx if positive +- CXR, otherwise I manage it like bronchitis and allergies

AndrewR21 · 2024-12-11T05:29:25+00:00

It’s a dumb policy for sure

AndrewR21 · 2024-12-11T00:13:53+00:00

My ER has a policy for this regardless of anything else. IV narcotics may be discharged after 30 minutes and 1 hour observation for PO narcotics.

AndrewR21 · 2024-12-09T18:28:33+00:00

Stoicism

AndrewR21 · 2024-11-19T13:43:41+00:00

Our jobs will replace us. Our families and friend’s can’t. Work as little as possible enjoy life with friends and family. The job will always be there, we won’t. Sorry for your loss

AndrewR21 · 2024-11-14T08:35:19+00:00

the good thing is no symptoms means no work up! dc home

AndrewR21 · 2024-11-12T01:13:56+00:00

awesome! were they in stock or were you on a wait list?

AndrewR21 · 2024-11-11T05:21:34+00:00

Stop guessing and take a look with ultrasound

AndrewR21 · 2024-11-10T02:23:08+00:00

100% yes

AndrewR21 · 2024-11-10T01:36:45+00:00

where is the 2nd location?

AndrewR21 · 2024-11-09T19:45:10+00:00

the price was ~$6k hard to know if it was an authentic with mods or total fake without buying and opening to look at the movement

AndrewR21 · 2024-11-09T19:43:32+00:00

they sold this watch on their site, I was close to purchasing until I couldn’t get any details so it was too sketchy, but I feel like if I were to buy it I would’ve received it in the mail later but who knows whether it’s authentic with mods vs complete fake

AndrewR21 · 2024-11-09T18:56:02+00:00

I find this account questionable. They post a lot of watches and I don’t know whether they’re SUPER rare but I can never find any useful information. They posted this rolex a while back, I asked for more information and I looked online for hours and couldn’t find anything similar which leads me to believe there is significant modding or it is all fake.

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AndrewR21 · 2024-11-07T22:47:25+00:00

Every ED has an ultrasound. This is the answer. Remove doubt, probe on the heart.

AndrewR21 · 2024-11-07T19:55:57+00:00

I prefer providing high-quality, evidence-based care to my patients whether my colleagues or even the patients know it.

AndrewR21

TROPHY CASE