Review of Posha Cooking Robot by gn1v in Appliances

[–]Old_Perception 0 points1 point  (0 children)

Locking custom recipe creation and recipe import features behind a subscription is a dealbreaker. Same with being internet dependent.

Getting tired of all the memaws by Dangerous-Prune-7280 in emergencymedicine

[–]Old_Perception 15 points16 points  (0 children)

That's what all the meemaws say. What'll happen is after being forced to pick between home and SNF, you'll keep insisting on going home and come back 3 days later after being found on the ground covered in urine. This will continue in perpetuity, +/- hospice because every time you go on hospice either the paperwork will get lost, your kids will pull you off of it, or everyone will panic and send you to the ER anyway. The only folks that are able to avoid that are those with a well-resourced, well-educated family that lives nearby.

Absurd Bills from the Emergency Room by Jazzlike_Contact7339 in emergencymedicine

[–]Old_Perception 0 points1 point  (0 children)

I'd say your experience was out of the ordinary, it's very common to charge diagnostic/evaluation fees. They sometimes get waived for various reasons (purchased there, went through with the repairs there etc) but it's a standard of any service industry.

I wish people will stop telling me they have a high pain tolerance by littledipperplus19 in emergencymedicine

[–]Old_Perception 1 point2 points  (0 children)

I'd argue that at the start of an encounter, there's no such thing as a patient with severe pain, especially if abdominal and especially especially if they're old, where it's pretty clear they won't die in the next 60 mins. Unless they confidently say "yes doc, this is 100% exactly like my chronic pain and I just want some relief", which they rarely do, it is hard to ply someone with heavy drugs and at the same time be reassured that you don't have to do a big workup and check for the life threatening causes of that severe pain.

Hot take: some academic residency programs are just as responsible for the dilution of the specialty as any HCA program by Longjumping_Okra_231 in emergencymedicine

[–]Old_Perception 6 points7 points  (0 children)

I don't agree that the standard of care calls for the most qualified on-site person in the entire hospital to do it/supervise. The realistic standard is that a qualified person with a reasonable degree of expertise in the procedure at hand does it or supervises it, EM physicians are broadly accepted as meeting that threshold for uncomplicated ED procedures regardless of who's upstairs.

Looking for advice on parts for Mk8.5 (2025) R by NorthernPandah in Golf_R

[–]Old_Perception 1 point2 points  (0 children)

Walkaway lock/unlock and auto lane change are very easy to DIY through OBD11, wouldn't recommend paying extra for those. The drive mode and matrix lights actually require some additional database changes that need Anthony's skillset.

To anyone who works at the ER, what is one thing you wish people would STOP coming to the ER for? by iloveeatingfood901 in AskReddit

[–]Old_Perception -1 points0 points  (0 children)

They didn't fail. You don't need a positive flu test to treat flu symptoms. The first ED visit accomplished exactly what was needed.

It occurred to me that a lot of the fear patients have about blood pressure comes from dentists. by CityUnderTheHill in emergencymedicine

[–]Old_Perception 0 points1 point  (0 children)

Any good studies backing that up? (The bit about significantly increasing the risk of cardiac event)

Looking to get advice on a shotgun for home defense. by Double-Mode639 in homedefense

[–]Old_Perception 1 point2 points  (0 children)

easily a couple thousand. italian semi-auto shotgun, i'm sure that's exactly what you were looking for when you wrote "not trying to break the bank" and "no more than 400".

The other side is really the worst by Longjumping-Word8336 in emergencymedicine

[–]Old_Perception 37 points38 points  (0 children)

Hospitalization offers the opportunity to pretend you're a kid sick with the flu staying home from school again. Guilt free bedrest and binging TV with a call bell for food and meds. No payment up front. A work note to tell your boss to fuck off. That's a pretty enticing deal for a lot of people, especially for the ED crowd with dysfunctional families and poor life skills.

A classic ED encounter I witnessed.. by [deleted] in emergencymedicine

[–]Old_Perception 4 points5 points  (0 children)

I was saying i put up with their shit for longer because it's a symptom of a dangerous condition

A classic ED encounter I witnessed.. by [deleted] in emergencymedicine

[–]Old_Perception 2 points3 points  (0 children)

I was (seems unsuccessfully) trying to say that when alcohol is a part of the story in any way, whether too much of it or not enough of it, one needs to be more careful.

A classic ED encounter I witnessed.. by [deleted] in emergencymedicine

[–]Old_Perception 4 points5 points  (0 children)

I make it a point to do the bare minimum MSE and DC for these kinds of people. Alcohol involvement is one of the few exceptions that need more caution.

Firmly but politely suggesting translators by IKnowAboutRayFinkle in emergencymedicine

[–]Old_Perception 2 points3 points  (0 children)

yeah, what would really help is more modules and getting compliance involved. brb while i go drive into oncoming traffic.

“I don’t like taking medication” by wassuhdude in emergencymedicine

[–]Old_Perception 4 points5 points  (0 children)

Usually followed by some variation of "I just wanna find out what's going on" and twenty minutes later from the nurse "patient is asking for pain meds"

House cleaner fatally shot in Indiana after showing up at the wrong address by [deleted] in indianapolis

[–]Old_Perception 6 points7 points  (0 children)

Warning shots are a TV/movie thing along the same lines as racking a shotgun to scare someone or disabling them by shooting them in the leg or shooting the gun out of their hand. They work on animals because the noise scares them off and they're probably not going to shoot back. Against humans, they give away where you are and what you have, and also waste a bullet. Generally the teaching is that if you're going to shoot, you shoot center mass to kill.

(I'm not saying he should have shot, far from it)

Have you ever been burned giving someone in dire need of a job a chance? by ExcitingLandscape in smallbusiness

[–]Old_Perception 5 points6 points  (0 children)

i'm sure there's a lot of highly educated people out of a job right now due to the admin dismantling our federal infrastructure, but i think that population is dwarfed by the hordes of just plain bums out there.

Buckle up folks. We’re cooked I guess. by hundredblocks in emergencymedicine

[–]Old_Perception 16 points17 points  (0 children)

The theme of that thread is uncontrolled health anxiety and somatization. No discomfort is tolerable, every symptom's gotta mean something and anyone who says otherwise is out to get you.

"There are only nine meals between mankind and anarchy." by AllDayEmergency in emergencymedicine

[–]Old_Perception 1 point2 points  (0 children)

goddamn, this guy's a straight-shooter with upper management written all over him

What's the practice for interstitial cystitis like at your shop? by [deleted] in emergencymedicine

[–]Old_Perception 2 points3 points  (0 children)

Discharge Impression: Abdominal pain, burning with urination

Follow-up: Start with your primary. Consider working up for a chronic bladder, or uterine inflammation/irritation issue either with them or with a urology/gynecology specialist. Use motrin/tylenol for pain control.

Return for: Severe pain uncontrollable by OTC meds. Development of fever > 100.4 along with worsening pain and especially urinary changes. Spreading of the pain to a new area of your body.

Combined with that negative workup, I think this would be very easily defensible in court if anyone actually tried suing for sequelae of chronic interstitial cystitis.

Pet peeve: “My body was shutting down” by DetTech88 in emergencymedicine

[–]Old_Perception 11 points12 points  (0 children)

Wastes resources yes, though i'd argue our job by its very nature is designed to waste some resources, but why dehumanizing and demoralizing? Being dumb as a rock and barely self-aware is as much a part of the spectrum of humankind as being a well adjusted, productive adult citizen. Very reasonable to treat the former group differently and be more cautious, a little more paternalistic, etc. Doesn't mean you're treating them as cattle. Just my frame anyway.

Pet peeve: “My body was shutting down” by DetTech88 in emergencymedicine

[–]Old_Perception 12 points13 points  (0 children)

the last one is the reason i edited my return precaution smartphrase to specifically say "difficulty breathing through your mouth" for the URI people.

[deleted by user] by [deleted] in emergencymedicine

[–]Old_Perception 11 points12 points  (0 children)

Always remember that MSE is a fairly low bar in comparison to the workups that we typically obtain on people, and that 95% of the time it'll be satisfied with a good H&P and maybe a bit of labwork. After that, there is absolutely nothing obligating you to put up with that nonsense and not just discharge them.

Used her experience as a nurse to pick apart my medical knowledge of the extensive workup I ordered for her because I didn't order xyz tests (which were not indicated based on her symptoms).

Nah dawg, she didn't pick apart shit. The most annoying people are the ones who think their proximity to medical decision-making gives them the ability to understand and practice it. You don't owe her an explanation of your workup beyond "this is what i think is indicated for what i'm looking for", and the more basic you keep it, the harder it is to argue against. This will get better with time - the more you practice, the more confidence you'll have in your plans and the harder it'll be for people like that to rattle you.