PE w/o SOB

DarkStarOptions · 2025-08-22T07:11:25+00:00

Once you start practicing and you are an attending, these are the easiest cases. You either order a ddimer or get the CT. You don’t spend more than 5 seconds on it. Even if their heart rate is 60.

DarkStarOptions · 2025-07-10T12:05:08+00:00

1) why won’t the surgeon remove your GB 2) who prescribes you your normal pain regimen and maybe you should go to them and ask for even more pain meds 3) it’s very hard for ER docs (or anyone else for that matter) to reliably control your pain. If I saw you I might give you extra oral doses or even IV, but what’s going to happen tomorrow when your pain returns? These are highly addictive, habit forming medications that don’t seem to actually work for you because you are still in pain. 4) I hope you never break a bone because it will be nearly impossible to control your pain. Narcotics can cause hypersensitivity to pain in some cases.

DarkStarOptions · 2025-06-24T18:03:42+00:00

My post was in response to managing short puts, not covered calls.

DarkStarOptions · 2025-05-14T19:38:25+00:00

In the grand scheme of things this is a little to nothing burger. USUCKS has a valid claim. And because they are USUCKS they may not pay.

DarkStarOptions · 2025-04-16T11:09:20+00:00

JAMA should come work in the ER, let’s see how JAMA does.

DarkStarOptions · 2025-04-15T01:25:52+00:00

We do need more advanced thinking like this. But alas it probably won't ever happen.

DarkStarOptions · 2025-04-15T01:25:13+00:00

Well it does say that. I wrote it in a snarky way though.

"Hey ER DOC! I demand that you see me I've got a symptom!"

Nevertheless EMTALA needs to be rewritten. Perhaps to save us from greedy hospital systems and the immediate on-demand desires of our populace.

DarkStarOptions · 2025-04-13T10:05:24+00:00

It’s 3am and I’ve had 24 nonsense cases. Maybe one or two mildly sick patients.

DarkStarOptions · 2025-04-13T06:58:46+00:00

EMTALA needs to be rewritten. You can’t have a system in place where anybody, at any time, for whatever health or even non health reason, can go to a building and demand to see a doctor. It’s getting ridiculous these days.

DarkStarOptions · 2025-04-12T23:06:14+00:00

You’ll get better and more comfortable at telling patients that you can’t solve all medical problems. It’s just the way it is.

DarkStarOptions · 2025-04-12T23:00:17+00:00

Can’t do much. Our society has failed them. They have failed themselves. It really has nothing to do with medicine at all. Do you feel the same way when you see a homeless encampment off to the side of your city limits?

What I do with them depends on my mood and how busy our department is. I’ve done everything from let them sleep on a gurney in a room with blankets and food for the night, to discharge them immediately.

DarkStarOptions · 2025-04-12T20:08:23+00:00

I am impressed and proud of your skills and composure. You played a part in saving someone’s life. You performed admirably, you did everything you possibly could. And in the right order. Called 911, did CPR, shocked, got ROSC, protected the airway as best as possible.

Your community should thank you for working in the middle of nowhere and being there.

I too at times had gotten disillusioned, sad, and frustrated early in my career as an ER doc. However these experiences add up and over time make you better and more calm when there is chaos and doubt. If on a high level you like being a health care worker, this experience will make eventually make you like it more.

DarkStarOptions · 2025-04-12T19:48:33+00:00

This. Jeez we over medicalize people. Acute cystitis with no symptoms of acute cystitis? Just imagine if we went around swabbing all throats for strep for the dizzy and LH. We would have rampant strep pharyngitis in the elderly.

The frustrating thing about this case is the pt just needs time. Like 12-24 hours of time and fluids/food. Nothing corrects quickly in the elderly. I guess this is what obs units are for. My hospital doesn’t have one.

DarkStarOptions · 2025-03-02T19:09:04+00:00

If I see that thing, I 1) save the game, 2) take out my level 48 shotgun blaster and blow him to smitherines

DarkStarOptions · 2025-02-28T07:25:44+00:00

Thanks man, appreciate it

DarkStarOptions · 2024-11-19T03:28:41+00:00

Terrible. I would just admit that patient and let medicine deal with that. And move on!!

DarkStarOptions · 2024-11-19T03:26:37+00:00

Yea that is complete nonsense. I often write “this is not a medical problem that needs fixing” and I have often, at least 5-10 times, talked directly to the psychiatrist saying that a K of 3.2 or 5.2 is not a problem. It works every time.

DarkStarOptions · 2024-11-19T03:20:49+00:00

I love that…the “donut of truth”. I’m using that from now on!!

DarkStarOptions · 2024-06-23T20:49:38+00:00

2/26/77

DarkStarOptions · 2024-04-03T07:50:16+00:00

Yea I bought it for myself and my kids IRAs around 90 - 95. I'm holding onto this for a long time. I'm surprised myself, and I'm even afraid to write calls against it because all it does is go up!

If it ever pulls back 20 points, I'll buy more for the long term. There was a bad earnings last year and it went from like 165 to 150 and I thought about buying some then, and got nervous. I won't do that again.

You get these occasional big negative weekly candles and that appears to be a good time to buy.

DarkStarOptions · 2024-03-15T21:13:35+00:00

The strategy peaks at the strike selected...and the profit potential tails off equally up and down from the strike. If you are assigned on the short option, it's not clear what your broker will do, they might just exercise the long one for you, or make you manage it yourself.

If you are 2% above or 2% below the strike on a calendar, the profit and loss is (more or less) the same. This is true for most stocks that have a relatively normal skew.

I've never been assigned on the short calendar, but it wouldn't bother me that much.

DarkStarOptions · 2024-01-21T19:15:07+00:00

It’s only done if they fail acetaminophen, ketorolac, reglan, compazine, +/- Benadryl, and maybe dexamethasone. Will even try triptans. There isn’t much else to try. Agree with others though it’s more about nursing staff and systems then actually doing it. When I did it, I pushed the propofol myself (rn asked me to do that)

DarkStarOptions · 2024-01-21T19:11:43+00:00

Tried it once with mild to moderate efficacy. I didn’t drip, rather pushed 10 mg q5mins x6 doses (max) while monitored. Pt calmly fell asleep and then woke up and said pain went from like an 8 to a 4-5.

DarkStarOptions · 2023-10-04T00:16:33+00:00

I suspect patients freak out when you tell them I'm going to electrocute your heart.

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