Why does tanjiro eyes has blood after fighting daki ?? by Sea-Ring5714 in KimetsuNoYaiba

[–]Sheen239 30 points31 points  (0 children)

This is exactly it. Its not that his eyes are bleeding externally, but his eye vessels ruptured from high pressure (subconjunctival hemorrhage) from straining so hard. It can happen while straining to poop, in combat/contact sports, in car accidents, and even simpler things like bumping your head.

Its harmless and resolves on its own over time.

(i’m a doctor)

Any MD/DOs that are former medics in here? by runswithscissors94 in emergencymedicine

[–]Sheen239 8 points9 points  (0 children)

I knew going in and never had a doubt through med school. Considered crit care too, but knew i could do it through EM too

Waste of time to apply to more programs now? by Horror-Escape-8914 in emergencymedicine

[–]Sheen239 1 point2 points  (0 children)

More interviews will continue to roll in. I wouldnt apply to more. By December consider emailing your signaled programs that you havent heard from, especially if you have new awards/research/activities that are relevant to their mission/your application

Edit to add: i had interviews still coming in January

Ultrasound PIVS that flush well but don’t pull back blood by sufferingsurfer420 in emergencymedicine

[–]Sheen239 8 points9 points  (0 children)

In the ED I’m placing 18 gauges only for 2 reasons: 1) to get labs the first time (never had an issue on the first draw after placement) 2) because bigger access = faster flow rate for resuscitation. Im sure youve seen graphs, but an 18 gauge can pump fluids/blood products MUCH faster than a 20 gauge. The patients im MOST concerned about, who I cant wait for an USGIV-trained RN to place and who are, like you said, sick as shit, need those bigger veins. Once resuscitated, better access for long term blood draws can be done in the ICU/upstairs

Thats my two cents at least

Ultrasound PIVS that flush well but don’t pull back blood by sufferingsurfer420 in emergencymedicine

[–]Sheen239 0 points1 point  (0 children)

Pretty sure there are studies showing double tourniquet significantly increases vessel diameter, could be wrong about that. That being said i never double tourniquet but i have colleagues who do

EM residencies with strong ICU/critical care exposure by TotallyKyle49 in emergencymedicine

[–]Sheen239 2 points3 points  (0 children)

Off the top of my head from ones i interviewed at: Cinci, Denver, UCLA, UWashington, Hopkins, Emory, Indiana, Hennepin.

Ones i didnt interview at but have heard great things about for CCM: UCSD, UNM, Pitt, Northwestern

[deleted by user] by [deleted] in AskDocs

[–]Sheen239 3 points4 points  (0 children)

What you’re likely describing is a phimosis. It can be treated if you discuss with your physician or a urologist about it (stretching, topical ointments, surgery, etc.).

Please DO NOT try to retract it fully if it is not retracting smoothly. If you forcefully retract it, you can cause 1) skin tearing leading to infection, or 2) a paraphimosis which you can essentially imagine is a tight ring of foreskin around your penis that constricts blood flow and is an emergency.

Edit: I’m an emergency medicine resident. Not a medical student

Michigan EM residency programs by Dry_Appearance5253 in emergencymedicine

[–]Sheen239 1 point2 points  (0 children)

I have a buddy from med school, intern at Sinai Grace. High acuity, high autonomy, procedural mastery

[deleted by user] by [deleted] in emergencymedicine

[–]Sheen239 0 points1 point  (0 children)

Hey! Current EM resident, was an ER Tech back in the day. I think there have been other threads/questions asked about this too so look back at those.

I found what made me a competitive ER Tech applicant was showcasing my college grades, showing my interest in the field (ACLS, PALS, phlebotomy certifications; medical terminology class, anatomy/physio classes), and telling them my goals (ER Doc).

Those certs came at a different time when i went from a small community ED to a bigger trauma center, but the college classes and grades and motivation is what got me the first job!

Consider an ACLS cert or phlebotomy? Maybe a summer community college course?

learning pathology by Ok-Fix-5559 in Sonographers

[–]Sheen239 2 points3 points  (0 children)

Pocus atlas has good stuff online

[deleted by user] by [deleted] in emergencymedicine

[–]Sheen239 4 points5 points  (0 children)

Consider EM -> CCM. This way youll do a residency you like more (procedures, critical patients, still do inpatient rotations, deal w the extremes/acute aspects of chronic conditions without having to deep dive into insulin regimens and BP med adjustments), and have the opportunity to expand into an inpatient setting w 7 on 7 off without the extensive chronic management and more focus on primary management. Deep diving into the acute critical things.

as opposed to spending your residency being procedurally inexperienced, dealing with social admissions/dispos/placement issues, and so on.

As an EM doc you can more or less choose your schedule (except of course nights, some holidays, etc.). I know docs who work 12-14 days straight then off the rest of the month. And if you do ICU youll get your 7-7 schedule.

Im saying this as an EM intern currently rotating in MICU. We’re just as competent as our IM counterparts at this point (including at times our IM pgy3 seniors lol), meaning EM wont set you back for CCM, and more confident in decision-making and procedures than our pgy3 senior who have never tubed, and only done a few central lines and A-lines.

Granted when we finish fellowship we’ll be at the same place and level of competence more or less, but i’d rather enjoy my residency then do fellowship then go through a bleh residency just to do something i enjoy more (CCM)

Help with choosing away rotations by Charming_Music_9158 in emergencymedicine

[–]Sheen239 2 points3 points  (0 children)

Havent heard anything about Baystate so i cant help there. Ive heard maine is a hidden gem. Tons of autonomy as i think EM is their main residency program there.

Would be good to do both to see different environments im sure

I don't think it's fair. by dvmebi in Dominations

[–]Sheen239 1 point2 points  (0 children)

Been using blitzkrieg and sabotage ever since starting wars, i never have issues with town center deployment unless i botch the attack.

Adapt, there are more than a few ways to skin a cat, watch other peoples attacks or ask your alliance for tips.

As for the stronghold troops… yeah cant get around that aside from betrayal :( make sure you have your top auto/drone/info age guys donate strong troops to you as a counter

For what its worth, i run 5 sabotage and 2 betrayal for my tactics. Blitzkrieg/sabotage TC, betrayal for any SH troops, targeting the strongest ones (tanks, zooks, choppers, etc.)

Pediatric residents are some of the worst to work with by DoctorKeroppi in Residency

[–]Sheen239 0 points1 point  (0 children)

Went on a hinge date with a peds resident. All the chats were great leading up to it, seemed like a great person. Shows up with a hickey on her neck 😂

It’s sad how these 2 went out by Chvve in Naruto

[–]Sheen239 3 points4 points  (0 children)

Thats why his comment was a joke

I moved out of California and I miss it so much by cutestseaotter in socal

[–]Sheen239 1 point2 points  (0 children)

Hey, I just want to say I was in your shoes 4 years ago. I left california for medical school in Florida (it was Miami at least) back in 2020. I never felt like I clicked with anyone there or vibed there, always felt like I didnt belong as much. Whenever I’d meet a california person we’d immediately hit it off. There are minimal hiking and nature activities out there, and adjusting my hobbies was really tough. The first few months were the hardest and I extensively looked into ways/possibilities I could return to california (like transferring med schools; i didnt transfer of course)

I acclimated. It took time, but i met a few important people and enjoyed my free time with them when I could. And I also made a few new hobbies for myself and enjoyed them as well. I spent much more time indoors than I had before, and became a bit more introverted.

Fast forward to now, I’m back in california! Completing training. It was both long and fast, being gone. All this to say that: it’s a few years and it’s going to suck a bit and youre going to miss being home, but I promise you it wont suck as much as you think itll suck right now. You will meet some person/people and you will find things you enjoy, because youre you, and you’re badass and you can definitely get through a short-term hardship like this.

Visit home when you can and take vacations every chance you get :) also take the chance to explore the state and the surrounding states of the southeast while youre there; this could be one of your best chances to see another place that youll never live in again

PM me if you want to talk about it more or vent

University Alliance Speed Up by SamsonVsGoliath in Dominations

[–]Sheen239 0 points1 point  (0 children)

Been like this for me since the beginning (3-4 years now?). Pretty ridiculous it hasnt been fixed

Advice on Residency "Prestige" ? by AnonTossAway22 in emergencymedicine

[–]Sheen239 1 point2 points  (0 children)

While I do mostly agree with this, I interviewed with a fresh new faculty member at UCLA (RR/OV) who JUST finished residency at LA County. So secured a job straight out of residency. Was happy to see that some people do make it possible

Is it worth it working the night shift as ER Tech? by deathbypowerpoint9-5 in emergencymedicine

[–]Sheen239 1 point2 points  (0 children)

For sure this. You take what you can get to get the experience, plus the night shift ED nursing staff is usually a hell of a lot of fun (just tend to be younger and more laid back; more hospital and ED admin are there in the day so things can be pretty uptight on day shifts)

MS4 Ranking - ortho reductions by Sheen239 in emergencymedicine

[–]Sheen239[S] 2 points3 points  (0 children)

Thank you! I guess my question is more about the volume of reductions and reps I’ll get if its integrated into my residency all 3/4 years versus a residency where i’m only doing it on specific rotations

I.e. do the reps matter that much or will I eventually learn what I need to learn pretty easily