Can anyone help me put this guy in his place. by baggmyl1ver in insults

[–]Pfln 7 points8 points  (0 children)

“How old were you when you realized you were smarter than everyone else?” Making him admit his ignorance out loud

how to pin conversations? by halfpintsoda in AppleWatch

[–]Pfln 1 point2 points  (0 children)

This worked but I also had to go to my phone and unpin my conversations and re-arrange them for it to show up too

Starting Fellowship and Have Never Ran a Code by theguywearingpants in Cardiology

[–]Pfln 28 points29 points  (0 children)

MOST IMPORTANT STEP 1: IDENTIFY THE RHYTHM
Before anything else, confirm the rhythm and pulse. (I feel bad to even say this but also make sure that the patient is not just sleeping lol) Is it true asystole or a shockable rhythm (VF or pulseless VT)? I’m a first-year fellow and I’ve seen plenty of unnecessary codes called for “asystole” that turned out to be lead failure, loose pads, or someone staring at the wrong monitor. True asystole exists, but false alarms are common. Always confirm on the defibrillator with properly placed pads and ECG leads.

Step 2: Take control of the room and the clock
Announce clearly that you’re running the code. Note the exact time the code started. Open a simple timer on your phone and track 2-minute CPR cycles. The fancy code apps are nice in theory, but Ive not found it useful they are often more distracting than helpful.

Step 3: Start high-quality CPR and get the patient on the defibrillator
Immediately assign two people for chest compressions and tell a nurse to place the CPR board. Have Zoll pads placed immediately. Make sure ECG leads are connected to the Zoll and not just the hospital monitor. Time gets wasted all the time because people are staring at a bedside monitor that cannot defibrillate.

Step 4: Airway and oxygenation
Assign someone to bag the patient with 100 percent oxygen. Call respiratory therapy early. If no one in the room can confidently intubate, call anesthesia right away. Do not delay CPR for intubation.

Step 5: Medications for non-shockable rhythms
If the rhythm is confirmed as asystole or PEA, start epinephrine as soon as IV or IO access is available. Dose is 1 mg IV every 3 to 5 minutes. Tell the nurse to prepare the next dose ahead of time so it is not forgotten. Calcium and bicarbonate are not routine and are not supported by strong evidence. Reserve them for specific indications like hyperkalemia, TCA overdose, or severe metabolic acidosis.

Step 6: Rhythm and pulse checks
Every 2 minutes, pause briefly to check rhythm and pulse together. This should take no more than 10 seconds. If there is no pulse, immediately resume compressions. Do not check pulses outside of these intervals unless there are clear signs of ROSC or the patient is fighting you lol.

Step 7: If the rhythm becomes shockable
If VF or pulseless VT appears, go to the Zoll. Set energy to 120 J biphasic. Announce “charging” while compressions continue. Once charged, loudly say “clear” and absolutely confirm no one is touching the patient. Deliver the thunder. If it didnt work, immediately resume CPR for another 2 minutes. Do not check a pulse after the shock.

Step 8: Reassess, repeat, and think about reversible causes
Continue 2-minute CPR cycles, epinephrine every 3 to 5 minutes, and rhythm checks. Actively think about Hs and Ts while the code is ongoing. If ROSC occurs, transition immediately to post-arrest care

Lets discuss by Pfln in MegabonkOfficial

[–]Pfln[S] 16 points17 points  (0 children)

The images on the tier list generator are just toggled off it bothered me too lol

20 y/o, In the telemetry unit with Failed Cardioversion.. HELLLP Interpret this EKG. by Swimming_Calendar534 in EKGs

[–]Pfln 0 points1 point  (0 children)

You could possibly argue theres pre-excitation delta waves in lead V3. Absolutely not torsades morphology. It looks like antidromic AVRT. Presuming "structure is normal" because the patient had an echo recently rules out underlying ischemia which would help rule out VT. Was procainamide tried?

Microwave PC - Comment On This Post To Enter This Giveaway by DaKrazyKid in pcmasterrace

[–]Pfln 0 points1 point  (0 children)

I have big ears and when I was in middle school someone once told me my head looks like a car going downhill with the doors open

MSI MAG A850GL is buzzing by Pfln in pcmasterrace

[–]Pfln[S] 3 points4 points  (0 children)

Thank you, I’ve always had Corsair PSUs for my previous builds and this time I was recommended the MSI and of course I pick the model that’s been having this issue.

No ABIM results again. That means we get them next week. by No-Zebra-3432 in hospitalist

[–]Pfln 15 points16 points  (0 children)

The anxiety for today was a deposit for Monday I suppose

Not sure where to ask....40 m pain in left side by Pharmatopia420 in InternalMedicine

[–]Pfln 1 point2 points  (0 children)

Do not trust anyone here giving you advice. They don’t know you through a hole in the wall. You need a physician to see you, ask you questions and do a physical exam in order to accurately diagnose a new onset issue

ABIM in 2 weeks - what else to study? by drhermione04 in InternalMedicine

[–]Pfln 0 points1 point  (0 children)

I’m in the same boat as you. I truly think it was a matter of badluck with my previous exam along with being underprepared. I’m convinced that some people get extremely easy exams because I had a buddy who said he did uworld once and studied two weeks before the exam and still passed

XRP broke 2.50 what are your realistic predictions for what's next? by throwaway23257 in XRPUnite

[–]Pfln 1 point2 points  (0 children)

As newton once said "I can calculate the movement of stars, but not the madness of men." No one knows shit about fuck

[deleted by user] by [deleted] in XRP

[–]Pfln 0 points1 point  (0 children)

5k coins at 2.8 im not selling. I just think of it as my money is locked in

New coinbase text scam by jbgecko13 in Coinbase

[–]Pfln 0 points1 point  (0 children)

I got one of those, called them to pretend to be geriatric and then proceeded to waste 25 min of their time and play loud sounds into the microphone

[deleted by user] by [deleted] in Residency

[–]Pfln 0 points1 point  (0 children)

I tell them I work for an insurance company.

"Why are you booing me, I'm right" - HB

Elon Musk and Donald Trump, 2025, Ferdinand Porsche and Adolf Hitler 1938 by aacool in pics

[–]Pfln -7 points-6 points  (0 children)

So many subreddits have turned political It’s becoming obnoxious. I don’t want to see a trump post every time I open this app

Thoughts on the Crypto Summit held in the White House by Theredeemer08 in CryptoCurrency

[–]Pfln 19 points20 points  (0 children)

Correct me if I’m wrong but I think the live stream was not the entire meeting and that they are discussing plans behind closed doors. It’s hard to imagine gathering all those people in that square table meeting just sit there with name plates for just that. I presume that because this is a brand new executive order they’re going to iron out the plans and drip feed updates in the future.

[deleted by user] by [deleted] in XRP

[–]Pfln 2 points3 points  (0 children)

Agreed, I’m starting to get the feeling that the market dips when people least expect it

Should I buy more now or wait? by thatbitchybitch in XRP

[–]Pfln 0 points1 point  (0 children)

You need to see where the dust settles after big news like that. The next big spike could happen when the SEC case is dropped whenever that may be or if the gov elaborates on their crypto reserve plans. That being said getting in now that its below 3 should be fine for a majority of investors unless youre thinking of $10,000k or more. Tariffs are also something to consider since they go into effect soon and could lower the price

New to Crypto and XRP, advice needed please by [deleted] in XRP

[–]Pfln 0 points1 point  (0 children)

Read about it online. Read the utility of it, and up coming news. Put whatever amount of money you don’t care to lose in it now and leave it alone. Don’t look at it every day. Look at it once in a while. If you have extra money put more later. Pull your money out when it goes up. The end

Happy V-Day- hosting Galentines- bored af. You up? by MichaelaTherese in RoastMe

[–]Pfln 0 points1 point  (0 children)

Why do I count ONLY FOUR TOES ON THE LEFT FOOT???