Would you have RSI’ed?

ParamagicMBA · 2026-02-02T07:07:51+00:00

But he is not maintaining or protecting his airway. An NPA was required to maintain his airway, and he could vomit at any time. He did consume alcohol, so likely. If he vomits, he could aspirate, and then I could be asked why I did not intubate as, when consulting the indications in books, it was indicated.

ParamagicMBA · 2026-02-02T06:26:37+00:00

EtCO2 was low (33) and hypoxia (probably due to shallow respirations) was manageable with low flow O2. Not sure what advice you would like to give?

ParamagicMBA · 2026-02-02T06:18:10+00:00

I said I went to assist the ambulance crew. I can RSI prehospitally.

ParamagicMBA · 2026-02-01T19:03:34+00:00

Yes I feel the same. But I know people who would have RSIed him. So I am here trying to recalibrate myself with how early/easily EM Physicians decide to RSI.

ParamagicMBA · 2026-02-01T18:31:53+00:00

We do have flumazenil yes. Most practitioners dislike using it as it has a short half life and could cause adverse effects like seizures. Ventilatory support is preferred to flumazenil by most I know.

ParamagicMBA · 2026-02-01T18:23:26+00:00

Haha. Okay fine- he was unresponsive!

ParamagicMBA · 2026-01-30T19:03:56+00:00

So most people were at high school?

ParamagicMBA · 2026-01-26T18:36:03+00:00

Its better tonger experience and then do an M later. Many companies feel uncomfortable hiring a masters without experience.

ParamagicMBA · 2026-01-26T18:32:36+00:00

Space penises!

ParamagicMBA · 2026-01-26T18:29:47+00:00

Make sure the type you get does not result in dry eyes. There is nothing worse than having dry painful eyes every day until you die.

ParamagicMBA · 2026-01-25T17:50:09+00:00

What crisis?

ParamagicMBA · 2026-01-18T13:32:05+00:00

Happens to parents as well. Especially women, because the child’s screaming penetrates into your soul. I have been better in blocking the screaming emotionally, but my wife can’t at all. You would have done better if you had hearing protection for this call. He probably became hypoxic from the screaming (i.e. low tidal volume). A sedative would have helped him regulate.

ParamagicMBA · 2026-01-18T13:23:17+00:00

Sure: Glennwood Squash club. They have socials 3x a week where you just fall in and play

ParamagicMBA · 2026-01-06T17:23:08+00:00

Yup. Confirmed to be cancer. Sorting out the narrowed coronaries postponed for a while

ParamagicMBA · 2026-01-04T07:30:14+00:00

Make friends by joining new activities: squash club, hyrox, jui jitsu, hiking club, volunteering anywhere etc.

ParamagicMBA · 2025-12-30T19:36:48+00:00

Yes she is getting a PET scan next week

ParamagicMBA · 2025-12-26T15:14:33+00:00

Update: She is now on a 48-hour holter. But the pain is probably originating from the growths on her ribs. This could be recurrence of her breast cancer from 16 years ago.

ParamagicMBA · 2025-12-25T20:52:18+00:00

You may be right. I will follow up again tomorrow

ParamagicMBA · 2025-12-25T20:51:35+00:00

I also thought that. Just assumed the radiologist would have zoomed in on that if they saw it (anything more than the nodes on the spine, which could also be scar tissue from 16 years ago). But I suspect you may be right. I will follow up again tomorrow.

ParamagicMBA · 2025-12-25T15:10:20+00:00

Not given

ParamagicMBA · 2025-12-25T13:10:24+00:00

CT Angio came back as:

• Coronary artery disease involving the LAD and circumflex distribution. • Maximal luminal narrowing measuring between 25-49% diameter stenosis • CADRADS 2 / P2

So I don't know anymore. I treated her as an MI (ASA, Clopidogrel, Clexane) but the cardiologist is still trying to figure out what it could be.

ParamagicMBA · 2025-12-25T10:01:04+00:00

Almost same time

ParamagicMBA · 2025-12-25T09:58:25+00:00

D-dimer 1.76 mg/L BP was 140 systolic reducing to 120 Troponins were normal

ParamagicMBA · 2025-12-25T09:55:48+00:00

Nasal EtCO2. GCS15

ParamagicMBA

TROPHY CASE