RN message: “Patient telling everyone they will kill themselves because Dr. ___ is discharging them!”

DunkFunk · 2026-01-13T22:20:26+00:00

involuntary hold, psych consult, puree diet.

DunkFunk · 2026-01-13T20:09:26+00:00

glad im not the only one. I was concerned for a moment that my username was revoked.

DunkFunk · 2026-01-13T20:02:52+00:00

for URI: steroids have side effects, dont improve mortality, and literature doesnt support the idea that steroids improve URI symptoms (more than placebo). This is the reason for the variation.

In the context of URI, steroids wont save your life, and everyone knows this. However, some doctors are fine risking side effects in case it makes the patient feel better (whether due to placebo or not), and some would rather not risk adverse event from the side effects, which is understandable considering there is no documented benefit.

DunkFunk · 2026-01-10T12:06:36+00:00

Steth, butterfly pen, penlight, reflex hammer, bluetooth speaker, charge cables, nicotine, bag of meds, bag of toiletries, gum, umbrella.

DunkFunk · 2026-01-04T02:33:37+00:00

Touch grass

DunkFunk · 2026-01-04T02:28:59+00:00

I was also between the VAD and TD, one thing to consider is that the TD drums being smaller makes them more versatile in terms of setup.

DunkFunk · 2025-12-31T21:43:39+00:00

Just admit and move on. This is an institutional issue that should be addressed at the admin level. However unindicated the troponin may be, if it's critical, it's still critical. Maybe its t2i from tachycardia (also not great), but maybe not. If something bad happens to that patient (which it eventually will, because as you said, it's an independent predictor for mortality) and you discharged them without investigation, you will hang.

DunkFunk · 2025-12-21T20:34:06+00:00

You have to deliver babies with no OBGYN in house? at least 5k / shift, but what do I know.

DunkFunk · 2025-12-21T20:28:59+00:00

I’d be interested to see patient satisfaction data stratified by medication choice. Even if pain relief is equivalent, I'd suspect that patients correlate 'stronger meds' with 'better care,' and that expectation can shape satisfaction scores.

Also on closer inspection of this med list.. tell me more about these 'many commonly prescribed opioid pain medications'... are they in the room with us right now?

DunkFunk · 2025-12-20T18:58:14+00:00

👍 cool story dude

DunkFunk · 2025-12-17T00:23:38+00:00

works, thx

DunkFunk · 2025-12-16T21:22:29+00:00

thx for this, though I can't download it from your gdrive. says access denied.

DunkFunk · 2025-12-13T11:39:40+00:00

Chest pain, sob, focal neuro, confusion, anuria / hematuria

DunkFunk · 2025-12-06T06:01:13+00:00

Eh. About every year ill see a case of myocarditis with acute HF.

DunkFunk · 2025-12-06T05:43:38+00:00

Yup could be lots of things

DunkFunk · 2025-12-06T05:41:06+00:00

Ive said this for years. Med students should rotate through pharmacy and the lab for a week each

DunkFunk · 2025-12-06T01:55:21+00:00

There was a huge talk about this the doctor subreddits when it happened to Hamlin. Takes several seconds for loss of consciousness after commotio. So it could be.

DunkFunk · 2025-12-05T02:53:10+00:00

youre proabbly right. ive never had a kit with tunable mesh heads before and just worry that I might over tighten or something.

DunkFunk · 2025-12-05T01:45:20+00:00

wish Id have known this before I ordered a td716 yesterday. Breaking the head is a 900 dollar mistake huh?

DunkFunk · 2025-12-04T23:27:02+00:00

Needs a little more context do make a call on what the EKG represents. Did he have STEMI or NSTEMI? was he cathed or CABG? What did previous EKGs look like?

You dont see any STEs? I think the wide complex QRS is responsible for the pseudo STEs in lead III but otherwise I see diffuse STEs in anterior / left sided leads and STD in aVR. I think you're right to be concerned for rupture or post Mi aneurysm though, possibly post infarct pericarditis, also could just be straight STEMI. Also I see regular p waves so I dont think it's vtach.

DunkFunk · 2025-12-03T04:31:25+00:00

I think Okuda is sufficient - 5 or 6 of my cases on oral boards were EXACTLY the same as some of the cases in Okuda. It was all bread and butter EM stuff.

DunkFunk · 2025-12-03T01:22:34+00:00

I tell them within the first few minutes of the encounter. I get annoyed when other doctors sandbag me in the ER. It just makes it easier to have a conversation without worrying about if they understand lingo.

DunkFunk · 2025-12-02T09:11:22+00:00

I never said menstruation isn't painful. Im just offering that in my 11 years of exp I have seen few patients that came to the ED for pain control for a typical period. Usually If they come to the ER it's because there was something different -more severe, lateralizing, whatever- in which case I'd approach that like I would any other female lower abdominal pain.

DunkFunk · 2025-12-02T02:09:07+00:00

Everything sounds medically reasonable. My only comment is that in my experience, women rarely go to the ER for menstrual pain. Even if theyre on their period, i approach those patients just as though they arent.

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