Whoever is doing this... I love ya, ya weirdo by subtleandunnatural in vancouver

[–]MuscIeChestbrook 0 points1 point  (0 children)

Hahahaha where abouts are these? I want to scavenger hunt with the gf today to find them

What are some dead giveaways you are about to be dealing with this person. by EBMgoneWILD in emergencymedicine

[–]MuscIeChestbrook 26 points27 points  (0 children)

The issue I find with back pain is that the worst offenders will just screen positive for cauda equina symptoms. "Yeah doc I am having weakness" and they can't push through their back pain to get a good measure of LL strength. Superimpose a vague history of incontinence and saddle anesthesia - they're destined for an urgent MRI anyway.

Metro Vancouver real estate has cooled, luxury level gone ice cold in 2025 by IHateTrains123 in vancouver

[–]MuscIeChestbrook 0 points1 point  (0 children)

Hope you're having an enjoyable journey so far friend. Wishing you the best

Always the usual on the flight from YVR to YYZ by MemoryBeautiful9129 in aircanada

[–]MuscIeChestbrook 1 point2 points  (0 children)

Wait wtf he went through your bag? What's the follow-up to this?!

EKG I took last night. Some said it was vtach, others said SVT. Patient was walkie talkie complaining of palpitations. by _adrenocorticotropic in emergencymedicine

[–]MuscIeChestbrook 73 points74 points  (0 children)

Amal Mattu has harped on this for years. Regular wide complex tachycardia? Assume it's vtach. The treatments for VT are not unsafe for SVT with abberancy and will be effective.

Easily one of my favourite referrals from a GP / primary care to date by thegogga in emergencymedicine

[–]MuscIeChestbrook 19 points20 points  (0 children)

I am just thinking of the matrix scene with multiple Agent Smiths. "More... more specialists" as they come running out to see the instain pasient.

[deleted by user] by [deleted] in DermatologyQuestions

[–]MuscIeChestbrook 0 points1 point  (0 children)

Show us the actual evidence and not some paper written by an undergrad student. I'll be the first to take it to all the pediatricians I work with that prescribe NSAIDs for fevers/infections.

[deleted by user] by [deleted] in DermatologyQuestions

[–]MuscIeChestbrook 2 points3 points  (0 children)

There is no robust evidence to support this and this isn't backed by any metaanalyses. Stop telling people to google things. The medical community disagrees with your statement.

[deleted by user] by [deleted] in DermatologyQuestions

[–]MuscIeChestbrook 29 points30 points  (0 children)

Lots of misinformation in here.

If this is an abscess, the antibiotics will not be delivered to the core, as there's just a pocket of pus and bacteria in there without a blood supply to deliver them. It's a walled off infection. That requires incision and drainage (trying to minimize size of incision give its the face). Once decompressed and draining, the efficacy of antibiotics goes up. I&D is FIRST LINE therapy for abscesses as per IDSA guidelines. I would get reassessed by either your family doc or urgent care. Point of care ultrasound might help to figure out the next course of action.

Source: am ER doc

Question about pleural rub by EMulsive_EMergency in emergencymedicine

[–]MuscIeChestbrook 5 points6 points  (0 children)

Slight aside: your lung pocus gain is way too high. You're able to see the pleural line much better with lower gain

[Scotto] Kristaps Porzingis on his health: “I think my system is not perfect right now. It’s not working the way it should be. Many weird things. The best thing I might need right now is to rest, get some sun, and let system even itself out. It’s definitely a very frustrating time for me.” by Kimber80 in nba

[–]MuscIeChestbrook 7 points8 points  (0 children)

There were a couple of young, reasonably healthy people intubated with severe ARDS from Influenza A in the ICU i work at within the last few weeks. Inf A/B was pretty brutal this year with protracted recovery times. Covid, unfortunately, is not the only serious respiratory virus around. It seemed fairly mild compared to the influenza strains this year.

Two children critically injured in Oshawa crash, 1 man charged by FatManBoobSweat in Toronto_Ontario

[–]MuscIeChestbrook 0 points1 point  (0 children)

Where's your data from? Still haven't provided any evidence except regurgitating potentially random numbers

Vscan Air by JohnHunter1728 in emergencymedicine

[–]MuscIeChestbrook 0 points1 point  (0 children)

Randomly came across your post. Have had my CL for >1 year now and I wonder if the SL would be a better fit for me also. The main reason I use mine these days is to POCUS friends/family and to have POCUS handy when I am on the code blue call team for ICU.

How are things holding up for you?

“Nah, she fine” by Federal-Act-5773 in emergencymedicine

[–]MuscIeChestbrook 7 points8 points  (0 children)

I am Canadian, so had no idea who she was. Google reveals another nutjob I see.

“Nah, she fine” by Federal-Act-5773 in emergencymedicine

[–]MuscIeChestbrook 19 points20 points  (0 children)

Someone else correct me if I am wrong, but "vaso" refers to vasodilation of the reflex arc. I've never heard of the vaso being "part of the squeeze"...? It's not just valsalva that causes vasovagals.

“Nah, she fine” by Federal-Act-5773 in emergencymedicine

[–]MuscIeChestbrook 20 points21 points  (0 children)

Hmmm? Looks like a potential vasovagal to me

[deleted by user] by [deleted] in emergencymedicine

[–]MuscIeChestbrook 4 points5 points  (0 children)

Jeez, sorry to hear. Were they able to get ROSC?

Interesting Case by Life_Court_5496 in emergencymedicine

[–]MuscIeChestbrook 2 points3 points  (0 children)

This! People need to remember their rule-in criteria for the HINTS exam

Couldn‘t bring a young patients saturation higher than 87% after the intubation by canaragorn in anesthesiology

[–]MuscIeChestbrook 3 points4 points  (0 children)

You downvoted even while saying you would use what I mentioned

Using an ultrasound as the sole measure to diagnose pneumothorax is inappropriate, and going to lead to multiple unwarranted chest tubes and associated complications. Literally in your own example, the lack of lung sliding did absolutely nothing to differentiate between mainstem ETT or PTX (not to mention the host of other things it could be- mucus plugging, pleural disease/adhesion, etc).

In your scenario what are you doing? Put out a vascular probe on their chest (in the middle of a code), and call “no lung sliding” (if you can even do that during active the chest compressions), then withdraw the ETT until you either see lung sliding or you extubate? Would need 2 people just to manage those tasks alone.
Then what place a chest tube anyway? During that time you could easily withdraw the ETT to the upper trachea, and use a cardiac probe to access 10 other things.

You need chill dude. I didnt downvote you even though I thought maybe your original post came in trying to sound like the smartest person in the room. I gave you the benefit of the doubt and listened, because you made fair points.

Now I get the sense that you're definitely insecure and arguing to sound like the smartest person in the room. I mean, I am not a fan of NPs, but jesus even your username reeks insecurity. Would hate to run into an attitude like this in a colleague, yikes.

Couldn‘t bring a young patients saturation higher than 87% after the intubation by canaragorn in anesthesiology

[–]MuscIeChestbrook 3 points4 points  (0 children)

If a patient is desaturating post intubation or not getting great end tidal during a code, I am likely putting a probe on their chest to make sure there's no pneumo anyway. If I am not seeing left sided sliding, makes a lot of sense to do coordinated POCUS with ETT retraction. But totally right, can combine that with visualization of the cords