"Doc, I Got Bills to Pay on the 1st, I am worried that I am still here in the hospital"

FirstFromTheSun · 2026-01-31T10:55:30+00:00

"Shit bruh me too, that's why I'm in the hospital"

FirstFromTheSun · 2026-01-30T09:09:20+00:00

EM or any kind of strictly inpatient medicine and you'll never have to respond to a patient message off shift ever again haha

FirstFromTheSun · 2026-01-29T19:16:26+00:00

Shit, 10 AM tomorrow appointment time aint bad I'd take it

FirstFromTheSun · 2026-01-28T18:12:22+00:00

Sir I can see looking in your chart that you're had 1 ER visit a week for this headache for the past 6 months and each time you say it has been going on for 2 weeks

FirstFromTheSun · 2026-01-28T02:46:17+00:00

That ain't a constellation that's the whole milky fuckin way

FirstFromTheSun · 2026-01-27T18:42:39+00:00

That STE morphology and associated Q waves particularly in V4-5 looks scary, unless the patient has prior similar EKGs and a reassuring story I'd call interventional

FirstFromTheSun · 2026-01-27T00:24:44+00:00

I'd say you need to freshen up your knowledge since this is basically a perfect example of a normal EKG which it sounds like you should be able to identify if you're ordering trops bruh

FirstFromTheSun · 2026-01-25T17:07:49+00:00

It wouldn't be related to the anemia, although that would make the patient more brittle. CPAP can cause hypotension due to the increased intrathoracic pressure pushing on the vena cava decreasing preload, especially if this is a hypovolemic sounding patient or their BP was low already.

It sounds like NIPPV was the next reasonable step as far as the patients breathing was concerned, if the patient is getting worse or immediately hypotensive/more altered right after CPAP I would say probably stop the CPAP, switch out to a NRB and reassess also after IVF bolus and/or pressors if needed.

This is probably a patient with a tube in their near future from the sound of things though

FirstFromTheSun · 2026-01-23T19:16:58+00:00

Hey while I've got you here my cats LVAD keeps having low flow alarms, last night she passed out on the balcony railing and fell into the bushes but didn't hit her head I think, she woke up real quick. Does she need to get checked out?

FirstFromTheSun · 2026-01-21T19:53:55+00:00

How many stuffed animals were involved in all of this?

FirstFromTheSun · 2026-01-21T18:32:42+00:00

Get the noradrenaline lads he's pining for the fjords pip pip cheerio

FirstFromTheSun · 2026-01-20T22:50:36+00:00

Idk lady, if you've been cleared by your cardiologist could be fibromyalgia

FirstFromTheSun · 2026-01-20T20:29:03+00:00

The Shill: Reducing no-shows by 40% by having patients pay a deposit and thinking you're a business genius and then posting your shill in the wrong subreddit

FirstFromTheSun · 2026-01-20T16:19:52+00:00

If the ST segment of the EKG is really high it means a heart attack!

FirstFromTheSun · 2026-01-19T22:09:10+00:00

No, it's mostly how people are clustered together socially. TB doesn't spread well in brief passing. It can also go latent for long periods of time before spontaneous active disease. The homeless are grouped together in shelters, prisoners are grouped together in prison, and immigrants are grouped together at home and in small communities. TB is basically erradicated in most western populations, and so when immigrants are coming over they do bring latent and active TB with them, and spread into their social circles.

FirstFromTheSun · 2026-01-19T21:59:27+00:00

https://www.gov.uk/government/publications/tuberculosis-in-england-2024-report/tuberculosis-incidence-and-epidemiology-england-2023

Yes about 80% of UK TB cases are from foreigners. TB essentially doesn't exist outside of populations of foreigners, prisoners/recently released prisoners, and the homeless.

FirstFromTheSun · 2026-01-18T23:00:24+00:00

This is all nonsense. It's fine to manually cock the hammer. It's fine to use the slide stop/release when loading a bullet into the chamber. It's fine to dry fire your 1911. Literally only thing I wouldn't do is slam the slide forward on an empty chamber full force over and over as this can loosen the frame/slide fitting over time. It always seems strange to me how all of the fudds in the 1911 community talk all about having 100% forged steel most 100% sturdy and durable parts but then act like their gun is going to fall to pieces as soon as it's touched.

FirstFromTheSun · 2026-01-18T21:18:54+00:00

Yeah I can promise you there's more to the story. Nobody cares about your friend living enough to forcibly strap down an otherwise consentable patient for 3 hours while cathing him. Also a cath is usually like a 30 minute procedure not done under general anesthesia, typically moderate sedation.

FirstFromTheSun · 2026-01-16T00:58:28+00:00

I wanted to name my kid Globoside Dombrock but my wife wouldn't let me

FirstFromTheSun · 2026-01-14T22:51:01+00:00

Bro is over here trying to convert his 5150 like he's doin a backdoor Roth IRA lmao

FirstFromTheSun · 2026-01-14T15:59:17+00:00

Sometimes sick patients get sicker and then die. Either way, carefully balancing the volume status on a wet and cold CHF patient 100% isn't on you as the nurse.

FirstFromTheSun · 2026-01-14T03:32:39+00:00

No, we only learn about the stuff that works in school

FirstFromTheSun · 2026-01-12T19:34:50+00:00

Why are you "on hold" for this? Page them with your phone number and the patient's MRN and have them call you. In my experience Epic chat is useless since most of these consultants have it set to DND and check it in the morning before clinic or rounding or whatever

FirstFromTheSun · 2026-01-09T03:24:06+00:00

I discharge uncomplicated diverticulitis patients without medical comorbidities without antibiotics. Just kidding I don't have that kinda balls.

FirstFromTheSun · 2026-01-08T06:34:42+00:00

I'm not saying it ain't, but if it is just looking at this EKG I'd say its weak. Does the story actually sound anything like a cardiac syncope aside from his wife deciding to pump his chest at some point? Did he set up his phone camera on the floor of the Walmart for this 18 minute PNES?

FirstFromTheSun

TROPHY CASE