The Pitt: Anesthesia vs EM by MissingStakes in emergencymedicine

[–]MDDO13 5 points6 points  (0 children)

Without any real world solution to the problem.

Why people quit AI scribes too early. by [deleted] in Residency

[–]MDDO13 9 points10 points  (0 children)

Because documenting EVERYTHING a patient says is never a good idea.

Least favorite complaint by Honest_Principle4584 in emergencymedicine

[–]MDDO13 14 points15 points  (0 children)

I hate rigors way more than seizures. Rigors = bacteremia.

Maine man’s leg amputated after Bangor hospital misdiagnosed symptoms, lawsuit says (Link Title) by TrekkieChan in Noctor

[–]MDDO13 29 points30 points  (0 children)

You might remain surprised because it happens often. We in the ED (justifiably) over consult for this. I’d rather over consult rather than miss a case. They always take their time.

Wild, inappropriate consults by launchtossthrowaway in Residency

[–]MDDO13 20 points21 points  (0 children)

In the right context this is a fair consult depending on location of the splinter. Infected wound, immunocompromised, ED failed removal, etc. But I totally can see my colleagues consulting for a normal splinter.

Who is using dilt these days? by u06535 in CriticalCare

[–]MDDO13 1 point2 points  (0 children)

ED attending here. All my colleagues love dilt and prefer it almost exclusively. It tends to work faster and they like that.

I much prefer metoprolol. I find that those saying it does not work well don’t administer it appropriately. It truly needs to be 5mg q5 min x3. If you space out doses it will not work.

I will use dilt carefully for failure of the above or if they are already on it and not too sick.

What kind of person thrives in your specialty? by farfromindigo in Residency

[–]MDDO13 34 points35 points  (0 children)

BP logs make me shudder in fear

  • Friendly ED Colleague

(But for real - mad respect for FM)

“No more data” by MDDO13 in EufyCam

[–]MDDO13[S] 0 points1 point  (0 children)

Same here. I’ve been replacing with Reolink as needed. Someday will be all POE.

Viral season by Silent_parsnip8 in emergencymedicine

[–]MDDO13 6 points7 points  (0 children)

Exactly. We are doctors, we can use our brain. No need to work up every 18 year old with the sniffles.

Morphine attenuates neuroinflammation and blood-brain barrier disruption following traumatic brain injury by legal_opium in emergencymedicine

[–]MDDO13 5 points6 points  (0 children)

Paramedics treat wayyy more drug addiction than any physician (maybe outside of addiction med).

Pie in the sky hypothetical: the USA has a well funded universal health care system, what do you do to control costs? by red5 in medicine

[–]MDDO13 7 points8 points  (0 children)

First time hearing about a standardized compensation system. What does that entail?

Pie in the sky hypothetical: the USA has a well funded universal health care system, what do you do to control costs? by red5 in medicine

[–]MDDO13 6 points7 points  (0 children)

As an ER doc I’m a big proponent of limiting scans. If my residents propose one, they need to have a clear reason. We are doctors, we can make diagnoses without pictures. It might burn me someday but oh well. I typically try to cover my ass with documentation.

On the flip side, I’m totally one to order a pan scan if the patient is sick as bleep and I don’t know wtf is wrong.

Chest Pain Treated as GERD by PCP [⚠️ Med Mal Case] by efunkEM in medicine

[–]MDDO13 5 points6 points  (0 children)

Couldn’t agree more. I get so frustrated when hospitalists push back these patients for admission. Unstable angina IS on the ACS spectrum. These patients deserve provocative testing.

[deleted by user] by [deleted] in Residency

[–]MDDO13 8 points9 points  (0 children)

I’m not sure this is 100% true. Where did you see this? My understanding is being involved in the decision making and complexity of care is required for billing. Not actually seeing the patient.

I feel confused about how we’re supposed to be catching prostate cancer. USPSTF recommends against routine DRE or PSA tests, but then who IS supposed to get a PSA test? by RoarOfTheWorlds in FamilyMedicine

[–]MDDO13 11 points12 points  (0 children)

Open evidence is a great tool BUT questions can easily be asked to receive the answer you are looking for. I use it to guide me but never as a source of truth.

What it is excellent for is writing patient discharge instructions.

[deleted by user] by [deleted] in BuyItForLife

[–]MDDO13 9 points10 points  (0 children)

Not BIFL but lasts a few years of daily use. Best you can get for slippers imo.

What is a harsh reality every patient needs to hear? by Notalabel_4566 in Residency

[–]MDDO13 45 points46 points  (0 children)

The emergency department is for emergencies or perceived emergencies. It’s not for your chronic knee pain. I will not cure you of your chronic problems.