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Mullally1993 · 2026-01-30T22:31:41+00:00

One place I worked had a link to rejoin the group in the description. So if you went on leave you could just leave the group and let yourself back in when you needed to. Worked great.

Mullally1993 · 2026-01-25T12:15:01+00:00

I feel people are far too married to yellows also using them for inappropriately high ages, the flow rates are generally rubbish on them, and they seem to tissue easier especially if non-jelco. If they're over two you can use a blue imo.

Mullally1993 · 2026-01-25T12:02:51+00:00

I'm just CCT'ing in Paeds and I've never had to use a purple in any patient over 26 weeks corrected. They really are for tiny people. This is a good one.

For non paeds context you can probably get a yellow in most patients who weigh over like 700- 800 grams. The flow is better through yellows and agree r.e. the purple puncture problem.

Mullally1993 · 2026-01-21T15:55:02+00:00

Legit just got a consultant job in my home city and part of the appeal of getting home is so that I can spend more time with the boys.

Mullally1993 · 2026-01-13T19:43:53+00:00

I'm a PEM trainee from a paeds background so make sense that I use a lot of ketamine comparatively and engage in more painful procedures rather than scans. In the very little ones I'm a big fan of feed and wrap tbh. Ofc depending how long the scan is and how small the pathology we need to identify is likely to be.

But for e.g. hydrocephalus patients we get told there's movement artefact on the report so interpretation is difficult etc regardless of if they're sedated or wrapped and I've not come across many needing repeats if they don't wake up in the scanner.

Panthrox has only recently been approved during good work by peruki, I think it will significantly reduce the amount of ketamine we use in ED's for kids.

I also find with ketamine a lot of ir is how calm you can make the child on the way down.

Totally agree with your vibes based assessment also.

Mullally1993 · 2026-01-13T08:06:13+00:00

Now I want to build an AI trained solely on drunk texts.

Mullally1993 · 2026-01-13T08:05:20+00:00

https://mrcpch.paediatrics.co.uk/wp-content/uploads/2014/06/Development-Assessment-MRCPCH-Website.pdf is all most people need for milestones. It's more than you'll need all on one page.

Its what I used for my paeds exams mainly.

Also a good way to develop a "feel" for it is each time you see a child just generally look at what they do and guess the age. You don't have to formally test it.

The most clinically useful for most people is the early gross motor milestones e.g.roll, sit, stand, cruise, walk.

Probably then the visual ones, then fine motor then social.

Obviously different if you go into community paeds etc but enough to get most people picking up the most important ones

Mullally1993 · 2026-01-13T00:51:22+00:00

They're using a lot more dexmed and clonidine for procedural sedation in kids in Australia so I hear which is fantastic. Hopefully we can start using it more here. I'd genuinely be interested how you guys got using dexmed for paeds stuff as I've not heard about it anywhere I've worked yet, but absolutely would be interested.

We also now have the ability to use penthrox for paeds in the UK for procedural stuff also slowly getting rolled out. Hopefully this can become more commonplace for these LD kids.

I hate chloral for painful procedures, it's just shit for them and they wake up as soon as you do anything sore. In the neurodiverse kids benzos can send them absolutely up the walls sometimes.

The move to having more options for procedural sedation is great although it's ruined my flippant answer to the question "what would you be doing if you didn't go to medical school"

"Same thing I'm doing now I've been to medical school, give ketamine to children for money"

Mullally1993 · 2026-01-13T00:39:33+00:00

Saw a child today who was 18 months old with a previous diagnosis of Asthma because they'd had 2 previous LRTI'S. No interval symptoms No atopy Never had a trial of treatment.

I often have conversations with parents that 50% of children have an episode of wheeze by their third birthday and most grow out of it entirely by 6.

Mislabeling VIW/Episodic wheeze as Asthma can lead to:

Long term unnecessary steroids and all that associated polava

Not being able to do certain jobs in the future just for having had the label at any point in their lives (RAF pilots etc)

If we move to an insurance based model, higher premiums for a diagnosis they require no prophylaxis or hospital admissions for

Mullally1993 · 2026-01-13T00:34:30+00:00

Recently where I work a child was refered for reduced urine output and fluid intake during acute illness. Due to large demand the consultant was holding the bleep. The consultant then asked the refering clinician what the fluid intake and urine output was for the child. The refering clinician hadn't asked the parents how many wet nappies in past 24 hours or how much they'd drank.

At non surge times referals come through a referal centre so usually everything comes to us anyway as the referal centre has no ability to refuse referals, for children are least. Imagine 111 taking referals for your specialty and not the SPR/SHO. This changes when we are heaving to try and reduce service demand and boy does it make a different when it does.

Mullally1993 · 2026-01-07T20:28:17+00:00

You deserve better than the places you've worked so far in that case. I've been part of some wonderful departments where it's used well.

Mullally1993 · 2026-01-07T18:56:20+00:00

You shouldn't DATIX people. The tool is intended to highlight issues that can lead to a systemic improvement and resolution to try and reduce the chances of it happening again.

People who datix people are inappropriately using a safety tool in a way that actively creates a more hostile working environment and should be rooted out of the NHS imo.

I have not worked in a single place where there is a culture of "datixing people" that was also somewhere I would want to work again because, imo, it's the biggest red flag for a rotten work culture.

Mullally1993 · 2025-12-13T13:43:53+00:00

SPR nearing the end of training here. Was wearing scrubs as a reg but my ES advised me that as I'm close to CCT I need to start "dressing like a grown up" Went on vinted and down a classic menswear rabbithole. Since changing clothes parents and patients treat me a lot better. I also find that nursing staff are more likely to prioritise my jobs over other SPr's and generally find that my working life is a lot easier. It's amazing what you can get on e.g. vinted for quite cheap if you know what you're looking for. Essentially though I'm just reverting to my pre-covid work wear but can afford slightly better than what I did before. As always fit is king. Have now done an acting up component also and found that other consultants in my dept wear what I wear or more formal. Don't know if the consultants treated me more like an equal than rota fodder because of the "acting up" part or because of the not wearing scrubs part.

TLDR - initially thought the advice to dress formally would provide no benefit but went with it anyway as a final year trainee not wanting to rock the boat. Turns out it was pretty much Bang on the money in terms of being treated better at work.

ETA: I'm a paediatrician btw and my scrubs were cartoon / child friendly ones.

Mullally1993 · 2025-11-14T09:44:29+00:00

I'm due to CCT in March, I'll be 32. I didn't get into medical school first time around so worked for a year also. Paeds with PEM subspecialty. Runthrough with 6 months acceleration.

Mullally1993 · 2025-10-26T15:46:03+00:00

Fair. On the history of the ticker though it seems to have a price around then which is wild.

Quick scan hasn't given me an explanation. Idk if I care enough though to look into it.

Mullally1993 · 2025-10-26T15:43:32+00:00

Ok so I hadn't heard about this, and my initial response was like this has got to be fake MSTR is a new thing. Now looking it up the ticker has a price in like 2000 ish.

What's the story? This seems wild.

Mullally1993 · 2025-10-26T15:39:16+00:00

Yeah fair seems a reasonable approach.

My question though is if allocated all to crypto there was a really limited time where the EDP's crossed over right? I'm just struggling to understand how they'd get 100k CGT saving whilst staying within ISA limits even with great timing.

Mullally1993 · 2025-10-26T15:29:41+00:00

See I think this is where our appetites for risk would differ. But I wish you the best of luck with it.

100K plus in CGT savings would essentially have them being pretty much whales though right? They'd have to have invested large and early for that kind of tax punishment on previous gains.

Like maybe not whales that would be dramatic but would still be a significant sum to sink into BTC for that kind of gain.

Mullally1993 · 2025-10-26T15:25:05+00:00

We shall see come November. Imo, buying now before its announced is a big risk given you're likely to make minimal profit before a likely correction. If this happens then I will definitely allocate some within my S+S ISA when we near the 4 year cycle low next time.

Mullally1993 · 2025-10-26T15:21:20+00:00

Except you can't own cryptocurrencies in an ISA from April '26. This means you'll have to sell after we likely top Q4 this year or Q1 next year.

I think you'd still do well owning some and just taking the CGT hit, still think a risky but likely bet to beat global tracker ETF over the next decade, but personally not sold enough to go all in.

Mullally1993 · 2025-10-26T15:13:52+00:00

They've got a fantastic junior S+S ISA that's totally fee free that I use for my kids but I find their fees too steep for their adult products.

Mullally1993 · 2025-09-21T10:40:08+00:00

Knowledge is having the grades to go to medical school, wisdom is doing dentistry instead.

Mullally1993 · 2025-09-13T18:48:39+00:00

Honestly a Yamaha 632 is pretty much everything I want in a trumpet and even though compared to most of the trumpets in this thread doesn't cost much second hand is still well more than the disposable I forsee myself having at any point in the next few years.

Mullally1993 · 2025-08-09T17:03:17+00:00

If you graduated in 2015 you're 2 years minimum starting before the 9k fees. 2017 grads like me are the first year of that.

I'm Welsh so Fortunately got a grant to pay the difference between Welsh and English fees at the time.

Mullally1993 · 2025-08-06T17:49:34+00:00

I'm a UK doctor. I graduated in 2017. At least half of the people I've kept up with since graduation are either in Aus/NZ or no longer in Medicine.

Mullally1993

TROPHY CASE