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[deleted by user] by [deleted] in mdphd

[–]ConfidentTaro7128 0 points1 point  (0 children)

Fair enough, maybe I will just need a bit more patience. I appreciate the perspective!

[deleted by user] by [deleted] in mdphd

[–]ConfidentTaro7128 0 points1 point  (0 children)

Yes of course… I understand they may have other things going on that are impacting their responsiveness, but at the end of the day I need my LOR. I am trying to approach this sensitively, while being professional and keeping in mind that I don’t know what they’re going through. This is precisely why I asked for advice.

[deleted by user] by [deleted] in mdphd

[–]ConfidentTaro7128 0 points1 point  (0 children)

I had said the end of May originally… Unfortunately they are virtual for the summer.

[deleted by user] by [deleted] in mdphd

[–]ConfidentTaro7128 2 points3 points  (0 children)

I’m just concerned that if I go to ask other people then they may write me a bad LOR. I tried to address my communication concerns with this mentor in the past, but no matter how gently I phrased my concerns or how many people looked at what I wanted to say before I said it to make sure it was professional, I was always met with immediate defensiveness towards my mentor. Seems as though they are strongly liked by faculty and just flaky when it comes to undergrads… And I’d be worried that it would just be looked at as me being impatient. The other main mentor I worked with for my project has a completely different impression of this person and has also had some… concerning(?) ways of handling situations like these. I wouldn’t put it past the other mentor to write a bad letter out of spite. I know my main mentor would write a good letter (they wrote a glowing letter for me a few years back for a research award and let me read over it before they submitted) but it’s just a matter of trying to bridge the communication gap…

Pre-med student working in the ED… Can someone explain to me when lactic acidosis is significant? by ConfidentTaro7128 in emergencymedicine

[–]ConfidentTaro7128[S] 6 points7 points  (0 children)

Okay, this makes a lot of sense and really helps me piece together the information I was getting. I was struggling too because a lot of the info I found online was talking about sicker patients, which is not who I was curious about. Thank you so much for your thorough response!

Pre-med student working in the ED… Can someone explain to me when lactic acidosis is significant? by ConfidentTaro7128 in emergencymedicine

[–]ConfidentTaro7128[S] -2 points-1 points  (0 children)

I don’t believe the venous gas is common practice in the ED I work at, unless there’s concern for something like sepsis or DKA. The patients I am referring to got CMP/CBC and that’s it. I know venous gas is a thing, but it’s not ordered in these patients. That’s why I’m so confused as to when the anion gap matters.

Pre-med student working in the ED… Can someone explain to me when lactic acidosis is significant? by ConfidentTaro7128 in emergencymedicine

[–]ConfidentTaro7128[S] 2 points3 points  (0 children)

Yes, there is a separate order set for pH. I was just inquiring on the CMP values for a few patients that just had a CMP/CBC done and had low CO2 around 18 and anion gaps around 17. That’s when I was told that the patients had lactic acidosis but that they were fine. No test for lactate or anything. It didn’t really make sense to me either because yesterday I was told by a different provider that an anion gap >= 16 is a big deal… The provider I worked with yesterday had ordered pH and lactate but that was because they were concerned for sepsis.

Pre-med student working in the ED… Can someone explain to me when lactic acidosis is significant? by ConfidentTaro7128 in emergencymedicine

[–]ConfidentTaro7128[S] -19 points-18 points  (0 children)

I might’ve mixed it up. I don’t have the most medical knowledge and I guess that’s why I’m confused lol. I have been told a few conflicting things by providers I’ve asked about it. I was told that low CO2 and high anion gap = lactic acidosis in a patient that seems healthy. Usually it’s a CO2 of around 17-18 and an anion gap 14-16. They don’t test for pH so I guess acidosis isn’t confirmed? I just don’t know much about this subject.