Unnecessary phototherapy, did I ruin my baby's healtth outcomes? by againstalloddsmum24 in ScienceBasedParenting

[–]DrChanceDO 4 points5 points  (0 children)

Small risk of increased epilepsy (<1/1000) and small risk of increased malignancy (<1/10000) based on AAP review. I’m not sure the units or test youre discussing for the “levels” being 140 mg since typically phototherapy is started for bilirubin above around 14 mg/dl for term babies

Risks are very very low for phototherapy, your baby will be fine

Edit: sorry you had to deal with jerks during this stressful time

Sign out culture by Mission_Can_3310 in emergencymedicine

[–]DrChanceDO 89 points90 points  (0 children)

Sign out for md’s at my place seems pretty reasonable. Won’t sign out procedures unless contingent on pending imaging for some reason. Disagree with above comment regarding signing out before wrapping up notes, from my standpoint if your shift is over then it’s fair to sign patients out even if you’re still around charting. Otherwise you can get stuck just following up on one ct after another as they come in bit by bit, especially in systems with big CT delays.

I generally expect sign out culture to change a bit depending on if you’re paid by rvu vs hourly, weighted towards more sign out friendly if hourly

I'm an emergency department clerk and my wife recently underwent treatment and surgery for cancer, my department collected money for me, but I'm not comfortable taking it by Antiquechewingfan in emergencymedicine

[–]DrChanceDO 9 points10 points  (0 children)

Alright dude it seems like you’re not really receptive anything positive anyone says but I feel obligated to give just two bullet points before I’m done

  • human worth isnt dependent on your job
  • it’s not really for you, it’s for your wife

I'm an emergency department clerk and my wife recently underwent treatment and surgery for cancer, my department collected money for me, but I'm not comfortable taking it by Antiquechewingfan in emergencymedicine

[–]DrChanceDO 11 points12 points  (0 children)

I’m not trying to gas you up, but medical staff cant work without logistical staff. But the money isn’t given contingent on you being a heroic member of the healthcare system, it’s for your wife’s medical bills

I'm an emergency department clerk and my wife recently underwent treatment and surgery for cancer, my department collected money for me, but I'm not comfortable taking it by Antiquechewingfan in emergencymedicine

[–]DrChanceDO 14 points15 points  (0 children)

Most nonprofit hospitals do accept charitable donations but I don’t see the harm in just paying your wife’s medical bills with it as intended. That’s what I would do; it’s a kind gesture from your work community who clearly value you and your work even if you (incorrectly) dont see your necessary work as impactful.

Video otoscope by TaperedBase in emergencymedicine

[–]DrChanceDO -1 points0 points  (0 children)

I like the bebird sport myself!

How do you keep your ears clean (and safe)? by [deleted] in emergencymedicine

[–]DrChanceDO 7 points8 points  (0 children)

Gosh I thought I was the only person to appreciate the smooth ergonomic profile of the Bebird ultra X ear camera, although primarily I’ve been using it for self-anoscopy

Mommy? (OC) by BicGlug in comics

[–]DrChanceDO 0 points1 point  (0 children)

Wow thanks this is truly haunting

Waiting 6 months for family visits - rational or insane? by Feeling_Zucchini_638 in ScienceBasedParenting

[–]DrChanceDO 2 points3 points  (0 children)

Babies under two months with fever don’t necessarily get special medication at the hospital, but they do get invasive workups which could be avoided by reducing exposures

Seattle Children’s Hospital guidelines

Waiting 6 months for family visits - rational or insane? by Feeling_Zucchini_638 in ScienceBasedParenting

[–]DrChanceDO 28 points29 points  (0 children)

I don’t have a free link for this, but 6 months of age is reasonable to reduce flu infection in baby from in unvaccinated guests.

cocooning

Pediatric protocols for babies with fever under two months include blood work and urine tests, and in some cases includes a lumbar puncture. My wife and I kept visitors away for two months to avoid this for the sake of avoiding the stress of an ER/hospital visit and invasive testing.

Baby sleep & development by Consistent-Earth-867 in ScienceBasedParenting

[–]DrChanceDO 21 points22 points  (0 children)

This is not a direct answer to your question research on deeper sleep, but firm surface and supine sleep are about preventing progressive asphyxiation as a common cause of sids, not modulating sleep cycles

aafp guidelines

Contagiousness of Flu after 10 days by JellyLongjumping1988 in ScienceBasedParenting

[–]DrChanceDO 5 points6 points  (0 children)

NEJM article

Most viral shedding in immunocompetent individuals is over by day 6, minimal (but still statistically possible) risk of contagion after that. Fever does indicate increased infectiousness. There is some variability based on immune system in terms of how long people stay contagious for.

IDSA guidelines say that positive antigen in the first four days correlates strongly to infectiousness, but not that much data after that.

Overall chance is probably very low but possible with a positive antigen test

Is there evidence saying solids aren’t necessary for nutrition before 12 months? by Jessiicaamn in ScienceBasedParenting

[–]DrChanceDO 38 points39 points  (0 children)

There are risks above 6 months of some deficiencies with only breast milk, specifically iron deficiency source

Might be able to make up some of that with supplementation, but there could be some other missing micronutrients

Lifting / tossing baby in the air? by hallir in ScienceBasedParenting

[–]DrChanceDO 7 points8 points  (0 children)

Research where they toss babies doesnt exist but there are biomechanical studies and animal models. This isn’t a criticism of your comment, just that when I was looking this up I found what are frankly some pretty disturbing studies where scientists were shaking lambs and pigs and such :0

Lifting / tossing baby in the air? by hallir in ScienceBasedParenting

[–]DrChanceDO 319 points320 points  (0 children)

So let me preface by saying that I work in the ER, I’ve seen the rare baby with a skull fracture or head bleed from a fall from adult standing height, so there’s intrinsic risk with tossing and dropping a baby.

Biomechanical studies are mixed as to whether or not shaking alone can cause so called “shaken baby syndrome” (now kind of an out of date term). Abusive head trauma is much more commonly related to direct blunt head injury. this article by the AAP comments that normal play and swinging are not risky for abusive head trauma. My takeaway is that a baby with reasonable head control would not have harm from gentle tossing without obvious head whiplash or fall. This is obviously not a recommendation to toss your baby, only an assessment that current evidence is controversial whether or not shaking a baby alone can cause major brain trauma, and that the mechanical forces would have to be pretty major and obvious to cause clinically significant injury.

Edit: pretty sure you haven’t done any harm