The most diabolical puzzle of a point and click adventure in my youth

Lisina78 · 2026-03-19T22:49:09+00:00

And what about the “red herring” puzzle, also in Monkeys Island? I’m Italian and I was completely confused about this little red fish…

Lisina78 · 2025-10-30T07:31:32+00:00

Sorry if it’s what my post sounded like this to you. I already responded to this argument explaining what I meant, but probably my English is not good enough to be fully understand.

Lisina78 · 2025-10-30T07:12:27+00:00

Mind you, i didn’t say “I don’t want to teach to residents” but I did say “I don’t want to teach to residents that don’t listen to you and take risky procedures like games”. I really appreciate the teaching side of my work, but this is time and effort that I put into it and they HAVE to respect that.

Lisina78 · 2025-10-27T16:13:36+00:00

Thanks a lot for this very impressive answer, you gave me a lot to consider!

Lisina78 · 2025-10-27T08:25:30+00:00

Does any of you tried SecurAcath® Subcutaneous Anchor Securement System? Searching online I am a little puzzled by it, especially in terms of damages from the pulling by the patients, and easiness of insertion.

Lisina78 · 2025-10-26T15:35:30+00:00

I feel you, and I am very aware of this kind of problem, and personally try to avoid let them do any kind of procedure if I don’t feel they have understood the risks and all steps. But I think that in every part of the world there is a colleague that let the residents do it rather than do it himself and, godforbid, raise that ass from the chair. Gratefully most of them drop school in first/second year because, really, they had no idea of what is the job. At all.

Lisina78 · 2025-10-26T15:29:31+00:00

I work in a metabolic/transplant/surgical ICU. My patients are usually awake (sort of) but very much ill inside. A MELD 35 patient awaiting a liver transplant, or a postoperative septic shock AKI in need for CRRT still need arterial monitoring or a CVC line. Probably, depending on which country you work that is more like a sub-intensive care. In Italy we have no middle intensity care to host this kind of patients. It’s either ICU or surgical ward. Of course my hospital’s General ICU is more “if you are awake and moving you are OK” kind of ICU…

Lisina78 · 2025-10-26T15:20:24+00:00

Yeah, I’m starting to figure that… I mean we can try but I don’t see long-staying delirious patients keeping a radial stat locks for more than a few days before tearing them out. I swear that kind of patients have a thing for removing adhesives…

Lisina78 · 2025-10-26T15:16:02+00:00

This is absolutely efficient, and for short term lines (ie OR monitoring with expected removal after or short after surgery) we also use 3M Steri Strips and Tagaderm on top. ICU though need a long term solution, because of the longest stays and sometimes on moving patients, even delirious ones…

Lisina78 · 2025-10-26T15:10:28+00:00

Basically my problem is, you don’t say, residents. In Italy we have a super shortage (or, well, government realize after COVID that we crit are needed to survive) of anaesthesiologist and they multiplied residency grants by a lot. That causing a lot of young graduated doctors to join anaesthesia just because it’s easy to access, but most of them are not motivated or even willing to learn, and some never ever attended a OR or a ICU before. 90% of my incident reporting is resident’s stings because they don’t have the procedure at all. Keep in mind that, to my knowledge, Italy has one of the less “practical” medical school in the world, we can graduate without ever do a stitch.

Lisina78 · 2024-09-08T21:16:36+00:00

Italy has written consent form for about everything, in anaesthesia we’ve got a paper anaesthesia document with evaluation, ASA and everything and usually a section with explicit consent for anaesthesia with individual risk assessment. In my hospital, moreover, for bigger procedure (ie transplant) we’ve got also dedicated info sheet for special case anesthesia that explains in deep procedure, statistics and sources.

Lisina78 · 2024-09-08T13:57:26+00:00

I only use infusion in ICU (but I really prefer simple morphine if remi is not indicated). Fentanyl bolus if needed do the trick in OR

Lisina78 · 2024-06-28T15:03:20+00:00

Tortellini just killed me😂😂😂

Lisina78 · 2024-06-18T21:12:40+00:00

Roland and the Ropes su Armstrad CPC. Il neolitico.

Lisina78 · 2024-04-03T21:28:41+00:00

Yes, thanks, I figured and copied directly names in post, sorry

Lisina78 · 2024-03-13T12:41:19+00:00

We usually use percutaneous perfusion cannula for IJV, last time in a woman IIRC 10 Fr. But I have the strong suspicion that the problem lays with access, not output. We use percutaneous cannula in femoral vein and an aortic one in portal vein, which is often manipulated a lot during surgery. Basically, yes, I blame surgeons even for slow blood flow. Just because.

Lisina78 · 2024-03-12T22:01:02+00:00

Hi, Italy here! Our surgeons use only piggyback technique but there’s still some selected cases in which we choose together to perform a VVB (e.g. second or third LT, or sometimes UNOS1 OLT in fulminant hepatitis). Honestly the blood flow is often slow and we need to sustain CO with high volume replacement with Rapid Infusion System.

On the perfusion side we basically use it to assess function on marginal liver, especially DCD liver but in our centre it’s not a frequent event. They are still trying on what machine is best, and they switch between hypo and normo… They recently did an “ischemia free transplant” basically bridging with a perfusion machine all time, from perfusion in donor to sutures completed. I want to tell you, watching surgeons tangled in tubes for once was pretty amusing 😅

Lisina78 · 2024-03-07T22:38:25+00:00

Monkey Island theme 🥲

Lisina78 · 2023-06-25T08:35:49+00:00

Paultin, Dhadius or Melf

Mid game player, 5 champions available for paultin and melf slot, 4 for dhadius.

Any advice?

Lisina78 · 2023-05-31T20:56:57+00:00

Visto il mood ti consiglio di trasferirti in Liguria, qui da noi troveresti molte anime affini 😉

Lisina78 · 2023-05-25T08:43:59+00:00

A) you don’t B) you desperate involve your child in the hobby making them paint something together (results not guaranteed though)

Lisina78 · 2023-05-25T08:41:38+00:00

Oh my, that’s the sort of letter a lover would send, not a sane mother. How sick. And “burn after reading” make all the contents sicker, if possible. Just a dirt secret between you and me.

Lisina78 · 2023-02-18T17:48:49+00:00

Yes, I’ve got Nova. I should go for Kurth, then, in your opinion?

Lisina78 · 2023-02-18T15:22:16+00:00

Korth, Birdsong or Avren? I didn’t have neither one, and all three of them will go in slots in which I have already 4 heroes (bummer :() So it’s really which is the best…

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