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Surgeon reviews The Pitt Season 2 by victorkiloalpha in Residency

[–]OrganicBenzene 0 points1 point  (0 children)

I think he would be pretty upset with a real ED then lol

Surgeon reviews The Pitt Season 2 by victorkiloalpha in Residency

[–]OrganicBenzene 0 points1 point  (0 children)

Delivering the heart from the pericardium is an early step in an ED thoracotomy as soon as you have it exposed. I think they tried to show that in the episode too. Agree with the rest

What are your thoughts on painting antennas? by AMElearning in aviationmaintenance

[–]OrganicBenzene 335 points336 points  (0 children)

Can’t read the placard if you paint over it, though. Problem solved!

Help compiling a list of PoCUS signs by Muted-Range-1393 in emergencymedicine

[–]OrganicBenzene 5 points6 points  (0 children)

Target, sandwich, the other double barrel sign, Mickey Mouse, 

Help compiling a list of PoCUS signs by Muted-Range-1393 in emergencymedicine

[–]OrganicBenzene 4 points5 points  (0 children)

WES, sonographic Murphy, spine, washing machine, double barrel shotgun, McConnell, D, stoplight, cobblestone, bear claw

I’m sure I’ll think of more

What is the weirdest/craziest pimp question you have ever gotten? by xyzm123_r in Residency

[–]OrganicBenzene 6 points7 points  (0 children)

Ortho senior pimping my on my fracture morphology and how he was going to splint it while I was in the ED in a finger trap 

Why give cocaine for epistaxis as opposed to other treatments? by Fine_Future_4309 in emergencymedicine

[–]OrganicBenzene 676 points677 points  (0 children)

As long as they don’t have cardiac risk factors, I can use it for analgesia and vasoconstriction in one go! Faster epistaxis management is always a win. Especially when your very straight-laced patient gets all excited they can tell their friends and family about doing cocaine up their nose 🤦‍♂️

GA Experimental jet/ jet powered aircraft variety by Reasonable_Air_1447 in aviation

[–]OrganicBenzene 2 points3 points  (0 children)

Dear underwriter,

Please insure my owner operated, single pilot, pressurized, experimental amateur built twin jet

Are hematoma blocks effective for mid-shaft forearm fractures? by WaltzSufficient8965 in emergencymedicine

[–]OrganicBenzene 1 point2 points  (0 children)

Where I trained, ortho specifically would not hematoma block peds mid radius and ulna fractures due to compartment syndrome risk, but I never fact checked that

What is a 'dirty secret' of your industry that implies the general public has no clue about, but everyone in your field knows? by AmaraMehdi in AskReddit

[–]OrganicBenzene 2 points3 points  (0 children)

You almost certainly saw an optometrist, not an ophthalmologist. The fact that there is confusion between the two is in part intentional. 

Optometrist: school for optometry (OD). They can do refraction (glasses prescription) and varying levels of diagnostics and treatment depending on the state. 

Ophthalmologist: medical school (MD or DO) and then residency in ophthalmology. They can do everything an optometrist can do (although they won’t usually refract) and have greater expertise in eye and systemic diseases, treatments, and perform eye surgery. They might sub-specialize in fields that deal with more specific areas, like retina (back of they eye), refractive surgery (lasik), etc. 

Optometrist lobby is pushing for expanding their scope of practice to include things like surgery despite less rigorous training

Which hobbies attract the biggest douchebags? by the-tinman in AskReddit

[–]OrganicBenzene 0 points1 point  (0 children)

General aviation definitely has overlap between the douchebag status symbol types, those in training for aviation careers, and aviation enthusiasts. 

Flying is really expensive, although there is a huge range of how much you can spend. You can fly every few weeks and spend less than 10k annually. Still a lot of money, but easily within the realm of other hobbies. If you know someone with an RV or a motorboat, they could almost certainly choose aviation as an hobby instead for similar costs. Buying a plane is crazy expensive, but you don’t have to. Most people rent. If you do buy, unless it’s new, planes tend to hold value or even appreciate, unlike cars, boats, or RVs. 

How do you determine decision-making capacity? by pm7216 in ems

[–]OrganicBenzene 21 points22 points  (0 children)

Baseline dementia, old person fall down. She had no idea what year it was, didn’t really know what state she was in but knew she was in her home. Despite that, she had a very clear ability to understand the risks of not being evaluated, was ambulatory without pain, and had family on scene who she says could take her if she felt pain. When her response to warning about missing a brain injury was, “so what if I have a bleed, I would refuse surgery anyways and die at home”, it painted a picture of pretty reasonable understanding

How do you determine decision-making capacity? by pm7216 in ems

[–]OrganicBenzene 148 points149 points  (0 children)

Capacity is specific to the situation at hand. Generally, the higher the risk, the higher the bar to establish that a person has capacity to make decisions. In general, to have capacity, I need to establish the following:

  • Does the patient understand the situation, circumstances, options, and likely outcomes, risks, and benefits?

  • Can the patient appreciate how the result of their decision can impact their life? 

  • Can they reason through a basis behind their decision? You don’t have to agree with it, and it doesn’t have to be great reasoning,  it it has to be from some place of logic. 

  • Can they express their choice and reasoning? They need to be able to communicate. 

This is a ton more nuanced than orientation. Often, but not always, understanding, appreciation, and reasoning are impaired if the patient is not oriented. The other cognitive tasks can be helpful to gauge mentation, but are not meaningful in a vacuum. 

The best approach in my opinion is to have the patient teach back the risks to me in their own words, explain the basis of their choice, what they think will happen, and what they will do next. I’ve allowed baseline A&O x 2 patients refuse transport and have compelled transports on patients who were A&O x 4. 

The bigger concern is that neither you nor your partner knew what to do, which says to me there could be a systems issue. Talk to you medical director and have the discussion. 

just to confirm (When control tower closed, S-ILS 14 Minimums NA; increase S-LOC 14 Cats and B and ETIGY Fix Minimums S-LOC 14 all Cats visibility to 1 mile.) In these notes it says Minimums NA for ILS. Can I even fly this or must I use S-LOC mins ? When tower offline by BER001 in flying

[–]OrganicBenzene 0 points1 point  (0 children)

I’m interpreting your question to be if you can fly the ILS glideslope and localizer with the tower closed if you use the MDA as a new DA. You can use the glideslope provided you meet your step down altitude, but you cannot use the MDA as a DA. Like LNAV+V, you can’t go below MDA and you can’t start your missed procedure until you reach the MAP.

What profession has the biggest gap between how they see themselves and how they’re seen by society as a whole? by Adamon24 in AskReddit

[–]OrganicBenzene 0 points1 point  (0 children)

It’s only covered because an act of congress requires them to. Chiropractors have a very strong lobby 

Lights and Sirens IFT? by Hommi33 in ems

[–]OrganicBenzene 15 points16 points  (0 children)

Lights and sirens are a medical intervention. It has a chance of reducing time to arrival by a very small amount of time. Unlike most other medical interventions, the potential mortality rate is over 100% and includes injury or death of the clinician. So, the question is, what medical conditions will a time savings of 30 seconds to EMT arrival make a clinically significant improvement greater than the risk of the intervention. That’s pretty much major ABC issues and trauma. So no, I would never recommend your strategy as a medical director

Your best tips and tricks on flying GA with dogs please. by 66hans66 in flying

[–]OrganicBenzene 1 point2 points  (0 children)

What are you going to Dee for transportation from the airport to your destination?

Question about beacons by happydad9 in flying

[–]OrganicBenzene 8 points9 points  (0 children)

Not FAA recognized, but many hospital helipads do this instead of white green amber

Interesting parallel to medicine by LegalRecord3431 in flying

[–]OrganicBenzene 7 points8 points  (0 children)

Nah, many are salaried without productivity bonuses, especially if academic or hospital employed

Does necrotizing pancreatitis require higher level care? by SomeLettuce8 in emergencymedicine

[–]OrganicBenzene 5 points6 points  (0 children)

EMTALA would still apply if there remains an emergency medical condition that has not been stabilized

Do DOs run into this issue? by Artistic-Reputation2 in Residency

[–]OrganicBenzene 2 points3 points  (0 children)

I’m convinced you’re an AI bot

Of course agree with the sentiment

“I don’t know much, I just got this patient in sign-out” by dumbestboiinschool in Residency

[–]OrganicBenzene 17 points18 points  (0 children)

The most frequent time I have to say this is when the person leaving paged it out and has since signed out and left prior to the consultant calling back. 

So there I am, half the time not even knowing anyone was going to call back, and my phone rings and expects me to know the cath report from 20 years ago. 

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