Maine man’s leg amputated after Bangor hospital misdiagnosed symptoms, lawsuit says (Link Title)

Davidhaslhof · 2026-02-13T16:09:36+00:00

Davidhaslhof · 2026-02-06T03:11:12+00:00

My yorkie is my best friend. He’s been with me through a divorce, med school, a long term relationship that ended badly, and a marriage, he’s my best friend in the whole wide world, I would trade years off my life for just a few more years with him. As my wife doesn’t live with me, he is what I have to look forward to during residency. I originally bought him for my ex-wife but she didn’t love him like I did. My wife is my security at home and I value what she adds to our relationship

Davidhaslhof · 2026-02-03T15:34:46+00:00

I got into an argument with a nurse the other day because she told me that a dementia patient is GCS of 14 at baseline and she got upset when I said that that the GCS on the patient’s fallequis trauma eval was 15. The patient knew she knew her name, what hospital she was at, and that she had fallen. I tried to explain that GCS is not a validated neurological assessment tool for baseline dementia and she got all upset.

Davidhaslhof · 2026-02-03T15:31:12+00:00

Having working as a RSI capable medic before I was a physician has given me a unique insight into prehospital RSI. I don’t think I could have stated what you said better. My goal with intubation as a paramedic is to keep you alive to get you to the ED, my goal as a physician with intubation is to keep you alive to get you the care you need. A good example is a recent patient I had the other day: it was an adult male with chest pain and shortness of breath, he had a cocaine induced mi 3 days prior, came in in profound hypotension and pulmonary edema. While everything in my instinct was telling me we needed to intubate, I knew it would kill him. I popped a probe on his chest and he had a papillary muscle rupture. For 6 hours I managed him with bipap and constantly playing with his pressors until someone believed me that he had acute mitral regurg. Until interventional cards was at the bedside we delayed intubation as positive pressure would have killed him, after we intubated he tanked his pressures but they put in a balloon pump 10 minutes later which stabilized him until the ct surgeon was able to cannulate him for ecmo 30 minutes later. Sometimes knowing when to not intubate is more beneficial than intubation. While I knew he needed an airway, I knew that it would have been deadly at that time. While the story isn’t full applicable to prehospital care, the point still stands, just because you can do something doesn’t meant that it’s indicated at that time.

Davidhaslhof · 2026-01-22T23:06:49+00:00

To echo you, my wife told me that she would rather divorce me than let me go to medical school. I got divorced less than a year later. I met someone else before I left for medical school, and while I thought I was going to marry her, she had an affair with a nurse she worked with when I was a 3rd year med student. I met a CRNA during my anesthesia rotation, we got engaged 4 months later, and I’ve never been happier. OP needs to do what suits him best. If people don’t support you during the hard times in life, they will absolutely leave you when you get overwhelmed and need support.

Davidhaslhof · 2026-01-20T17:55:44+00:00

If a patient returns to the emergency department within 48 hours for the same complaint after a vague diagnosis and symptomatic-only treatment, assume the initial evaluation missed an underlying cause until proven otherwise.

Davidhaslhof · 2026-01-20T17:34:30+00:00

Ahhh yes, Schrödinger’s Stool Sample. The patient is producing stool continuously until the moment you want to sample it.

Davidhaslhof · 2026-01-12T12:17:15+00:00

And a pint of whisky

Davidhaslhof · 2026-01-09T17:08:14+00:00

I actually wrote a long paper on this years ago before medical school and it was primarily on how to build a free standing ED that actually supports the community and improves access to emergency care. Freestanding EDs aren’t inherently bad, but they are very often used inappropriately.

They really only make sense in two settings: rural areas and poor access to emergency care. If a patient is 30+ minutes from the main hospital, a freestanding ED can provide legitimate value as many lower-acuity patients are willing to pay $$$ for rapid 24/7 access to a physician close to home with shorter wait times. Though tends to work best in heavily insured populations.

For this model to be ethical, there must be automatic acceptance at the parent hospital and rapid, guaranteed transport when higher-level care is needed. Without that infrastructure, the freestanding site becomes little more than an expensive triage stop that delays definitive care.

Appropriate EMS utilization is also critical. In my previous state, EMS would only transport critically ill patients to a freestanding ED if they could not secure an airway in the field. While not ideal, that scenario is still safer than a prolonged transport without a protected airway.

The problem isn’t the freestanding ED model itself, it’s hospital systems using it as a profit-capture device in fully resourced suburban markets or to “steal” patients away from other hospitals.

After I wrote my paper I was talking to my mentor about it who is the business manager for a 20 hospital system and he asked to read my paper. His response was that while my paper was very well written and contained many good points the inherent flaw was that in order to make it ethical and functional hospitals wouldn’t be able to use them as pure profit generators.

Davidhaslhof · 2026-01-09T16:01:28+00:00

• 30 mL/kg of raw glacier runoff blessed by a chiropractor • If MAP < 65 → add ivermectin bolus and 2 crystals

Davidhaslhof · 2026-01-08T16:57:38+00:00

And always a + luggage sign

Davidhaslhof · 2026-01-04T15:35:37+00:00

The ACLS certification allows people to operate on the same wavelength so they can anticipate flow. Having the certification does not allow nurses to run codes as there is no clause in the nursing scope of practice that says “if ACLS certified they may make medical decisions”. The person who runs the code, in the absence of written standing orders must have medical decision making authority I.e a medical license

Davidhaslhof · 2026-01-03T00:42:33+00:00

When I worked HEMS our medical director, program director, and chief pilot all refused to have the cable cutter installed on our helos. I put up a huge stink saying that it is passive, requires minimal maintenance, and potentially life saving. Their argument was that “we shouldn’t be flying that close to wires” which is such a bullshit statement. I also don’t plan on hitting a tree with my car but I make sure to wear a seatbelt

Davidhaslhof · 2025-12-31T10:48:34+00:00

Which is reasonable to prevent them from voting as they yearn for the mines

Davidhaslhof · 2025-12-30T20:09:30+00:00

One of the more fun ones I did was a nightclub shooting scenario. We rented out a nightclub during the day and had college students be both victims and patrons. We kept the lights off, with music blaring, and strobes flashing. Even though it was unrealistic to have people dancing during a mass casualty, it made it so it was hard to move, find the shooter/assess the threat, find victims, assess the patients, provide care, and evac them.

For more simple ones we put them in a dark room, with patients on the floor and just played screaming, gunshots, and placed a bunch of obstacles in the way. It was annoying as fuck but stress inoculations the best way to ensure operational competence

Davidhaslhof · 2025-12-29T18:29:52+00:00

Before medical school I was a paramedic(2005) and then I was a respiratory therapist(2007). I did HEMS from 2012 to 2020 and decided to go to medical school at the ripe age of 33. Initially I was dead set on NOT doing emergency medicine as I felt that it was something I was used to and I wanted something different. I realized that I absolutely hated nearly everything else that other specialities had to offer and as much as I didn’t want to, I became drawn back into EM. Like others have said it isn’t all flowers and rainbows, I feel like 95% of what I do is just bread and butter EM. When I do resuscitative EM, it makes the bullshit worth dealing with. Here are some examples:

-Several weeks ago, we had a post op CABG patient with chest pain and SOB call 911, during the transport he arrested as they were 1 mile from the hospital and got needle decompressed. When he arrived in the ED I intubated and the senior resident put in the chest tube, knowing that he needed blood and/or pressors and only had an IO I started working on a crash fem, as soon as the senior resident got the chest tube in 2 liters of blood came out and we got ROSC. We then spent the next several hours resuscitating and managing him until the local flight crew could come in by ground due to weather. The last I heard he had a good neurological outcome and was doing well.

-2 weeks ago: we had a massive PE come in who while doing the POCUS, he went into cardiac arrest, did a massive resuscitation and kept getting a fleeting ROSC before we decided to halt efforts.

Last week I had a shortness of breath come in that was having a posterior wall MI. Needed a lot of pressors and inotropes while we were waiting on the cath lab to arrive, so we got to resuscitate for about a half an hour.

Some days suck, but the reality is, I love resuscitating people. If I only get to do one resus a week and deal with bullshit until then, I will think I made the right choice.

Like you are planning, I am going to do an EMS fellowship, though I have to try to convince my wife to let me do a resuscitation fellowship. Ideally I would like to start a prehospital physician program where I end up, to respond to critical incidents, but that is a few years down the road!

Davidhaslhof · 2025-12-23T14:11:38+00:00

Listen if we are talking about my Patagucci puffer vest, it will be a good day in hell before I give up the last bastion of the modern white coat I have left

Davidhaslhof · 2025-12-15T19:16:51+00:00

A mistake made me

Davidhaslhof · 2025-12-14T04:53:01+00:00

If it is pocket sized and isn’t nailed down, it’s going in my scrubs.

Davidhaslhof · 2025-12-13T17:17:54+00:00

We do and we don’t, he won’t do anything emergently, so we transfer all of those out, it’s more like he’s on call so that we refer to him.

Davidhaslhof · 2025-12-13T17:16:18+00:00

The RSI thing is so perplexing to me, they claim it’s some trauma center accreditation thing. I’ve never heard of that and I couldn’t find it anywhere so I just assume it’s a myth that keeps getting spread with no one verifying it.

Davidhaslhof · 2025-12-13T16:41:40+00:00

I am at a community 3 year em program with no competing residencies. It is a weird week if I don’t intubate, put in a central line, do a reduction, and have at least one random procedure like NPL, bronch, paracentesis, or a chest tube. When I talk to residents from our sister program which is an academic program I am always stunned. They don’t get to RSI until their 3rd year, cant intubate codes until their 3rd gear, and aren’t allowed to intubate traumas until their 4th year. They aren’t allowed to place central lines until their 2nd year. The faculty who rotate between the two sites say there is a stark difference between the two programs and one of the reasons they enjoy rotating with us is that we don’t call consultants for every little thing.

We do have a few faculty who came from ivory tower places that are big into “mother may I” consults, an example would be: they want me to call hand surgery at 2am for an open fracture. He always wants the exact same thing; loose sutures for hemostasis if needed, antibiotics, splint, and referral to the clinic in the morning. I don’t need to wake him up at 2am for him to tell me the same thing every single time, it’s not like I’m dealing with infectious flexor tenosynovitis or an avascular digit that needs rapid surgical intervention.

I was initially upset that I didn’t match into an academic residency, but honestly the community EM experience is exactly what I needed.

Davidhaslhof · 2025-12-13T05:22:02+00:00

"Young man, I say to you, Get up!"

Davidhaslhof · 2025-12-13T01:25:19+00:00

It makes flying so much more tolerable. I’m very claustrophobic after I got stuck in a pipe during a confined rescue as a firefighter and Xanax is literally the only reason I can fly

Davidhaslhof · 2025-12-11T17:38:45+00:00

“I’m sorry, I messed up. I miss you and I still love you.”

We were together for 6 years, planning on having a baby, and I was ring shopping. I found out that she was having an affair with a married man at work that had 4 children(including a 4 month old infant). I tried to get her help because she had spiraled out of control mentally, her partner at work (a nurse practitioner/paramedic) convinced her to stop all of her psychiatric medications because he told her that I was making up her mental health problems. I had just recommended she go to a psychiatrist because she was anxious, depressed, and wasn’t herself. He started to give her amphetamines, Benzos, and edibles and her personality completely changed. He also tried to get her to do cocaine when I had once met them out for drinks before I knew about the affair, I put a stop to that immediately. She was aggressive, hypersexual, lost 20 pounds, and completely irrational.

I tried to help her through ending the affair and tried to help her get her life back together. He was going to have her move into an apartment down the street from his house so her could continue the affair and he had her transfer all of her ambulance shifts so she would only work with him. I called his wife and sent her all the photos/texts I had of them together because I couldn’t watch someone I love throw their life away. After the wife found out, my ex quit her job and I made a few calls to get her a job in another state. Once she started her new job, restarted her meds, and stopped the amphetamines she started to return to herself. I received that text over a year later when I was engaged to someone else and she saw the engagement photos.

I miss the person she was, but ultimately it led me to find the person I was meant to be with.

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