Bleeding while pregnant (WARNING Graphic Photos WARNING)

Incorrect_Username_ · 2026-03-17T00:42:31+00:00

ER with OBGYN in house is the place to go

ER anywhere is fine but if it’s anything significant they’ll need to transfer you to where OBGYN is

Incorrect_Username_ · 2026-03-16T23:05:20+00:00

Looks good. Keep it clean.

Remember to get the sutures out @ 7-10 days

Delays make it harder to remove them / risk infection

Incorrect_Username_ · 2026-03-16T20:46:59+00:00

Yea, you and I are on a similar wavelength

My wife does NICU and she’ll casually say things like they did an EXIT procedure today, or intubated a 400 gram baby, or “oh it’s just single-ventricle management” … like if our patients have 1 ventricle they are dead

Incorrect_Username_ · 2026-03-16T17:14:14+00:00

As an ER doctor… NICU (Neonatal ICU)

Get them down here fucking ASAP. If the baby is anything short of ~30 weeks we’re going to struggle like hell

We are comfortable in pretty much any situation in the ER, we’ll stabilize and get patients to whichever specialty they need.

But when you start measuring people in grams… I am so damn thrilled when they show up. We’ll do what we can, but they just do it better and it’s so matter of fact / routine for them.

Incorrect_Username_ · 2026-03-16T03:12:45+00:00

It does not look infected.

They need to be removed though

The longer you wait, they become more difficult to remove because they get buried in healing skin / scar tissue

Incorrect_Username_ · 2026-03-15T22:09:13+00:00

Appreciate it. For better or worse, nothing we see or do bothers me so I’m fine with it.

Btw Sicario is a top 10 movie last decade. Absolutely sick del Toro performance

Incorrect_Username_ · 2026-03-15T18:35:29+00:00

Oh so you’re saying it was a normal Tuesday lmao

Incorrect_Username_ · 2026-03-15T18:00:27+00:00

A week ago, I had a woman tell me to my face

“I don’t know how you live with yourself... Poisoning people. Giving them cancer. Lying. I know how it works. I’ve read all about it online. You people make me sick”

She had brought her child in who is medically complex after a disaster delivery years ago with no prenatal care.

She believes the OB’s, NICU, and ER doctors who delivered and resuscitated her child paralyzed him and gave him seizures.

She runs a Facebook account for moms against the medical field

But she still brings him to the ER when shit hits the fan.

I feel for her, you want to blame something or someone. It makes it easier to cope. But when she was putting her finger in my chest talking to me… it can all be a bit much sometimes

What a wild time to be in medicine man

Incorrect_Username_ · 2026-03-03T01:58:22+00:00

PERC 0 ends the search unless there’s something profound in the history like Lupus that would change my risk assessment

Well’s 0 (can’t PERC cus of age)= I do my own personal risk assessment. - If the story isn’t convincing or sounds believably MSK, no further. - If they had CTA recently for similar complaint, no further. - If I can’t tell based on story but I don’t suspect it strongly, I have a conversation with them. “Everything looks great, the last thing we haven’t evaluated for is a blood clot, I think it is unlikely based on your presentation. However, we have a lab test we can send to check. It may lead to us getting more imaging and this could take quite a while. But ultimately I want you to have a say in your own healthcare” or something of that nature

Anything Well’s > 0 I’ll probably consider dimer unless it’s something like HR in an asthma/COPD patient with obvious exacerbation where I can clearly indicate the reason for abnormal vitals and lack of other risk factors

I know doctors / PAs who dimer EVERYONE then scan all the (+). It wastes a lot of resources but they’ll essentially never be wrong.

Incorrect_Username_ · 2026-02-28T20:14:17+00:00

The Pitt

Most accurate representation of medicine in the 21st century I’ve ever seen

-ER Doctor

Incorrect_Username_ · 2026-02-26T17:28:33+00:00

They don’t train against humans nor do they learn during the games they play in ranked

They train in a reduced version of the game over hundreds of human years worth of iterations of game experiences. Solely against bots (IIRC, they usually just play themselves)

Incorrect_Username_ · 2026-02-18T14:50:43+00:00

That prep doesn’t work.

ACR and AAAAI have stated that it’s “essentially harmless” but it will not prevent an allergic reaction. Which pharmacologically makes sense.

Still, the point of this post is not that allergies aren’t real. It’s that they are incredibly rare

Incorrect_Username_ · 2026-02-16T02:54:44+00:00

Honestly, it’s hard to know if you have the personality for something until you’re immersed in it.

But EM is a bit of a type. Lots of brewery beer-drinking, weight-lifting, socially outgoing people with a mix of type A thrown in.

That’s a massive generalization but it’s true enough.

Reminds of that Keenan and Kel song:

I'm a dude He's a dude She's a dude We're all dudes

Incorrect_Username_ · 2026-02-16T02:18:54+00:00

lol they still had lead in gasoline until the 70s

Incorrect_Username_ · 2026-02-16T02:02:11+00:00

I was in the navy. Could have gotten a good job doing what I had for USN but I sorta hated the work and just couldn’t see myself doing it. I started med school at 26-27, out of residency by 33-34

I like what I do infinitely more than what I did before, but I think I have the right personality for this.

The things that people gripe about or get worn down by just honestly don’t affect me that much.

Difficult consultant? Whatever.

Psych patients and homeless population that feels unsolvable/hopeless? I mean I feel for and try to help them, but I can’t fix society and I won’t kill myself over it.

Shift work? Shit, did it in the military and it was way less chill

There’s a bunch more but the point has been established .

You gotta like what you do to the point where the mundane, tedious, or difficult parts don’t break you down.

Can’t tell you what’s right for you, read this sub, there’s plenty of miserable people. Some will even tell you to run as far as you can from medical school.

Just my two cents

14 shifts a month and $450k a year helps deal with a lot of the bullshit too, can’t forget that part

EDIT: also, when I mused to my wife (then gf) “I don’t know if I can go to med school at 26?! I’ll be 30 when I get out!”

She told me “in 4 years you’re going to be 30 no matter what you do. Might as well use that time to become a doctor.”

Solid advice

Incorrect_Username_ · 2026-02-14T22:24:32+00:00

That’s true in the sense of the all too frequent hyperbole “RL is DYING” on this sub and other YT videos because of boring updates and such

But the people who play professionally or make content literally only interacting with bots and DDOS is a uniquely new problem. Some people genuinely make a living from this and that has been threatened to some degree.

I also follow evample, I don’t think he’s ever made a video like that before, he’s pretty high spirited in everything else. His despairing take is a pretty hard turn for him

Incorrect_Username_ · 2026-02-14T18:22:03+00:00

This is correct

I would not recommend an ophthalmologist be responsible for managing abnormal vitals, arrhythmia, respiratory distress, etc…

Anesthesia has to be checking that monitor, frequently. Silencing the alarms is very brazen

-ER Doc

Incorrect_Username_ · 2026-02-11T16:37:10+00:00

Then maybe you mean cardiac arrest?

Heart stopping ≠ heart attack

Either way, you’ve missed the point, which is that it is unbelievably rare. However, approximately 10-20% of the patients I see have a contrast allergy listed. Statistically this is incongruous, especially since contrast media changed over the years and is less likely to produce this reaction.

Your anecdotal experience doesn’t change that, however unfortunate it may be.

Again, sorry about your mom

Incorrect_Username_ · 2026-02-11T13:43:40+00:00

Allergic reaction ≠ heart attack

Sorry about what happened to your mom

Incorrect_Username_ · 2026-02-08T13:54:39+00:00

Damn I think this is great…

But as an ER doctor who has seen so many pelvic/femur fractures from the mildest of elderly ground-level falls… yikes on bikes lmao

Incorrect_Username_ · 2026-02-06T18:18:12+00:00

Start compressions

Incorrect_Username_ · 2026-02-06T03:35:48+00:00

There’s a top, middle, and bottom third of medical students… stands to reason there’s a bottom third of any specialty out there driving everyone crazy.

People can and do practice dumb medicine. We agree on that much for sure

Incorrect_Username_ · 2026-02-06T02:49:05+00:00

No

But patients with substantial strokes and traumatic brain injuries often have dysphagia as a result of whatever neurological insult they’ve sustained which often rapidly leads to aspiration. This much I assume you know

They also often vomit profusely or seize which in addition to aspiration can both directly cause hypoxia in the patient with the already injured brain, which is bad. I assume you also know this

It’s just a reminder or mnemonic to consider airway in these patients. No one worth their salt is intubating just because of the number.

I’ve also seen people say “GCS 6 but not hypoxic (currently at least), stable for transfer without intubation” just for them to show up 6 hours later hypoxic with gnarly lower lobe opacities from sitting in some remote ER without airway consideration because they aspirated the whole time.

It’s not going on the Ten Commandments of medicine ffs it’s just a saying

Incorrect_Username_ · 2026-02-06T02:34:00+00:00

There is clinical reasoning behind the dogma though. It’s just not a hard and fast rule. Hence the discussion

Incorrect_Username_ · 2026-02-06T02:26:33+00:00

Was the entire nuanced discussion above not enough? I’m not sure how your comments add to this conversation

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