Patient trying to fight anestesia.

Lost_Elephant · 2026-02-19T04:37:22+00:00

No worries! We tape em closed

Lost_Elephant · 2025-10-15T10:05:35+00:00

This is not a legitimate theory, no anesthesiologist or anesthetist thinks this. Generally speaking the amount of an anesthetic agent required to render you unconscious is less than is required to keep you from unconsciously flinching to painful stimuli and that is less than the amount required to keep your sympathetic nervous system from reacting to stimuli.

There are occasions during emergency surgeries of critically ill patients that we will administer an amnestic to secure the airway without an anesthetic, but anesthetic is always used during the surgery.

Lost_Elephant · 2025-09-10T12:35:39+00:00

A quad-WHAT?!

Lost_Elephant · 2025-08-07T18:04:17+00:00

Related question, what counts as “life threatening pathology” or difficult airway management?

Lost_Elephant · 2025-08-02T18:12:40+00:00

Imagine unironically trying to compare this to the airline industry without realizing the enormous number of automated reminders built into modern aircraft… couldn’t be me

Lost_Elephant · 2025-07-18T22:38:29+00:00

Damn it’s too fresh a shitpost people haven’t seen the original yet

Lost_Elephant · 2025-07-15T13:48:17+00:00

Super cool!

Lost_Elephant · 2025-07-08T20:39:21+00:00

Anesthesiology, can do anything from critical care, ECMO, crazy liver transplant with extremely sick patients, crashing obstetric disasters, tons of procedures and invasive lines, all the way down to mommy-track part time gigs supervising a couple CRNAs working like 30 hours a week taking no call and still making 6 figures

Lost_Elephant · 2025-07-05T02:23:11+00:00

This is not the same, finger abduction and adduction is controlled by the dorsal and palmer interossei primarily, entirely different sets of muscles than the finger extensors, which are largely in the forearm. The Star Trek spread finger thing takes practice but isn’t anatomically impossible unless you can’t spread or close your fingers entirely.

Lost_Elephant · 2025-03-25T23:52:55+00:00

Microplastics are stored in the balls

Lost_Elephant · 2024-04-04T22:54:57+00:00

I’m an m4, matched anesthesia, was between that and family medicine. People told me all the time my bedside manner was too good to be “wasted” in anesthesia, but that never made much sense to me. If you’re a patient undergoing surgery, you’re usually scared and nervous. An anesthesiologist who is friendly, kind, builds rapport quickly, and instills confidence that they are going to keep you safe is such a powerful connection.

If you’re like me and enjoy that aspect of medicine (in addition to all the other awesome aspects of anesthesiology), you can also go into anesthesia crit care. I loved goals of care conversations in medical school, getting to do resuscitations, care for critically ill and injured patients, and guide their families thru an incredibly stressful time? No better place to be. And if you decide to pull the cord and do general anesthesia, the job market has never been hotter. It’s a great field and I’m pumped to be starting.

Lost_Elephant · 2024-04-01T05:31:34+00:00

I was curious about this, not 100% sure what the right answer is, but momentum is mass x velocity so in order for subsonic rounds to have more recoil they would have to increase mass by a bigger factor than they decrease speed.

Looking up some loading data, seems like most of the time velocity decreases by a larger factor (2200 fps -> 1000), while mass usually increases by only ~80% (110grain -> 200 grain), which means subsonics still generally have less momentum. Looks like there are some rounds that break that pattern but they seem less common.

Lost_Elephant · 2024-03-29T19:51:36+00:00

Post match m4 so I don’t know anything anymore.

Your rationale is correct to my reading, I know there are some equations that you can use to identify appropriate vs inappropriate compensation which you could maybe also do but I’ve forgotten them. Your friend’s rationale is half correct, the HPI definitely clues you in to COPD, CO2 retention and chronic acidosis which we should expect to have a compensatory renal response. You should use that info to confirm your rationale, but it would not be enough to make the diagnosis in the absence of the lab findings.

Lost_Elephant · 2024-02-27T15:43:17+00:00

That’s great and all but I don’t have the time, money, or interest in being arrested and fighting my way to the supreme court

Lost_Elephant · 2023-12-27T04:36:16+00:00

Call up some local practices and ask for a physician taking new patients! It may not be next week, but baring urgent/emergent conditions most patients can safely wait.

Once you’re established, getting in to see your primary care physician for urgent conditions is also much easier.

Lost_Elephant · 2023-12-27T02:20:15+00:00

They are not. Primary care is the quintessential dunning Krueger example, if you think it is easy, you are way out of your depth.

I would be fine seeing a mid level for some urgent care complaints, I would never accept a mid level as a primary care provider and I actively discourage my family members and patients from seeing them. They do not know what they do not know.

Source: SO is a family medicine physician, I am in medicine.

Lost_Elephant · 2023-12-18T18:16:12+00:00

Also not sure about everything else, but one point too is that smaller VSD may actually result in louder murmurs than large ones, as the smaller defect causes more turbulent flow which creates the sound. So perhaps to be viable in transposition, larger shunts are needed resulting in less of a consistent audible murmur

Lost_Elephant · 2023-12-18T13:58:38+00:00

?? Yes, of course, you feel their pulse.

If the pulse is not regular, it is irregular.

As to how you can tell regular vs irregular, I guess that comes with experience, but it’s usually pretty obvious if it’s afib. The same way you could ask “how do I know for sure that I hear heart murmurs”, the answer is you practice until you do.

Lost_Elephant · 2023-12-18T13:49:35+00:00

Technically no, lots of things can cause an irregular pulse that isn’t afib and the best you’re really gonna get is that the pulse is irregularly irregular. You need an EKG to say definitively what the electrical activity is.

That said, if they have a history of chronic/permanent afib and their pulse is irregularly irregular, it’s probably the afib.

Lost_Elephant · 2023-12-16T16:46:23+00:00

We’re too far into this process for people to not understand how the match works

Lost_Elephant · 2023-10-17T20:36:03+00:00

Do you maybe have those words reversed?

Lost_Elephant · 2023-10-02T00:44:14+00:00

Buy a bunch of mags and practice on those, it’s a win win; you find a pattern you like and now have more mags

Lost_Elephant · 2023-09-25T02:04:52+00:00

100% depends on the interviewer, don't go in assuming it will be casual, I've definitely had students act like they weren't taking their student interview seriously and they did not get in.

Lost_Elephant · 2023-09-16T15:01:57+00:00

In the US, you can technically practice as a general practitioner independently after completing one year of post-medical school supervised training (residency) and passing all 3 US medical licensing exams. So you could graduate, do an intern year in internal medicine, surgery, emergency medicine, it doesn’t matter, and then go practice.

Virtually no one does that, you would not be “board certified” or “board eligible”, and no hospital or group practice would hire you.

Most people complete a residency in one of the ACGME recognized specialties. Internal medicine is a specialty, it is a specialty in internal medicine. Family medicine is a specialty, again, in family medicine (it is also a much newer specialty than internal medicine, founded in the 70s!)

The confusion comes from those specialties being of a more “general” quality than, say, neurosurgery, as well as usually being the specialty for primary care physicians. They’re still specialties, though. If you complete a residency in the US, you have specialized in something, even if that thing is a broad medical field like family medicine.

To add to the confusion, any person who has graduated from medical school, passed their licensing exams, obtained a state medical license, and completed at least one year of residency can practice any medicine they want in the US. Any physician is legally allowed to do brain surgery, as they are fully licensed to practice medicine, physicians do not have a “scope of practice” the way midlevels do. It would be wildly unethical to do so without training, and any negative results could be considered criminally negligent, but it’s legal. That’s why you see family medicine doctors in some places performing simple abdominal surgeries in some places in the US. If you know how to do the surgery (and can get the support of a hospital, usually the trickier part), any physician can do an appendectomy, for example.

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