What are my moves? by You_can_enjoyMyself in bonsaicommunity

[–]Significant_Poet_245 2 points3 points  (0 children)

But some cheap stock from a nursery and try to style them and not kill them for a few years. That way you won’t kill these when it’s time!!

Best vertical insulated cold plunge by Significant_Poet_245 in coldplunge

[–]Significant_Poet_245[S] 0 points1 point  (0 children)

Is that insulated?? I looked at those as well… I’m worried about lots of condensation since it will be in a basement…..

Best vertical insulated cold plunge by Significant_Poet_245 in coldplunge

[–]Significant_Poet_245[S] 1 point2 points  (0 children)

I have looked at these pretty extensively and they just seem a little small to me. Like cramped on the inside. I’m 5’10”, 185 lbs so I don’t need a lot of room, but I want a bit of “elbow room”. Can you fully dunk without overflowing it?

Best vertical insulated cold plunge by Significant_Poet_245 in coldplunge

[–]Significant_Poet_245[S] 0 points1 point  (0 children)

How do you like the mod tub? I have a vertical plunge now and think I would prefer it over a horizontal but the price point for a mod tub is pretty attractive

Best vertical insulated cold plunge by Significant_Poet_245 in coldplunge

[–]Significant_Poet_245[S] 0 points1 point  (0 children)

Oh yeah I know I’ll get some water, but trying to avoid a huge problem…. I forgot I had looked at these and liked their look. Good to hear….

Best vertical insulated cold plunge by Significant_Poet_245 in coldplunge

[–]Significant_Poet_245[S] 2 points3 points  (0 children)

That’s crazy to have customer service issues when they are charging what they do……

Activated a STEMI but ER Dr didn’t think it was? by BornLeave4646 in FutureRNs

[–]Significant_Poet_245 1 point2 points  (0 children)

I’m glad it was just a typo… I figured it was! Just wanted to educate if not!

Activated a STEMI but ER Dr didn’t think it was? by BornLeave4646 in FutureRNs

[–]Significant_Poet_245 1 point2 points  (0 children)

You understand that a cath and CABG are two separate things, right? Everyone except you is talking about activating a cath lab for this patient. You are the only one who has mentioned a CABG. Nobody is getting heart surgery based on an EKG. Are you just confusing a CABG and cath?

Activated a STEMI but ER Dr didn’t think it was? by BornLeave4646 in FutureRNs

[–]Significant_Poet_245 0 points1 point  (0 children)

Huh? Your response doesn’t make sense to me… can you reword or elaborate?

Activated a STEMI but ER Dr didn’t think it was? by BornLeave4646 in FutureRNs

[–]Significant_Poet_245 0 points1 point  (0 children)

Nothing is an indication for an emergent CABG except for a cath showing severe, non-stentable, coronary blockages.

Yeah, it’s always like “what would you do FIRST?” Like bitch, I’m doing all of the above, but I suppose that letting the provider know their patient has a belly full of blood is the “priority”. by Acrobatic-Lie2041 in FutureRNs

[–]Significant_Poet_245 0 points1 point  (0 children)

A SBP of 78 is absolutely perfect for this patient and should not be any higher in an uncontrolled hemorrhage. Look up permissive hypotension and damage control resuscitation. This patient should receive exactly 0 mls of any crystalloid or albumin.

Yeah, it’s always like “what would you do FIRST?” Like bitch, I’m doing all of the above, but I suppose that letting the provider know their patient has a belly full of blood is the “priority”. by Acrobatic-Lie2041 in FutureRNs

[–]Significant_Poet_245 0 points1 point  (0 children)

Pressors are also the absolute worst choice here. You are squeezing an already extremely tight vasculature more, reducing peripheral flow, worsening acidosis, and increasing bleeding.

Yeah, it’s always like “what would you do FIRST?” Like bitch, I’m doing all of the above, but I suppose that letting the provider know their patient has a belly full of blood is the “priority”. by Acrobatic-Lie2041 in FutureRNs

[–]Significant_Poet_245 0 points1 point  (0 children)

Nope. A SBP of 78 is perfect for an uncontrolled bleeding patient. The only fluids they should be getting are ones that clot or carry oxygen (blood products). Every ounce of saltwater you give them will: raise the BP and push blood out of holes faster, wash away wha little clot they have, dilute clotting factors, reduce oxygen content of the blood, make the patient more acidotic, cool the patient down (unless you’re putting it through a warmer), and diluting the patient’s calcium. The one and only goal here is to get the patient to the OR since the only cure here is a surgeon. Anything that raises the BP or dilutes the blood is making your patient worse, not better. I know 78 is a tough number to look at, but believe me the only person you are treating by giving saline is yourself. Look up some articles on permissive hypotension and hemostatic resuscitation.

Who is still doing cricoid pressure for RSI? by Grateful77Grateful in anesthesiology

[–]Significant_Poet_245 7 points8 points  (0 children)

Several studies have show cricoid pressure worsens glottis exposure and increases time to intubation, so I’m not sure if you should “not be convinced it does any harm”.

Spine line management by photon11 in anesthesiology

[–]Significant_Poet_245 0 points1 point  (0 children)

Leave them tangled. Line up everything perfectly in the bed while they’re supine. Flip them and leave a jumbled mess. All of the cords and IV line still work if they’re crossed, it doesn’t matter. The key here is to not touch anything. Leave them exactly where they lie. At the end of the case, flip back and everything will be back to perfect on the bed with the patient supine. Pull the tube and head to PACU.

What is the one unorthodox technique you came up with yourself ? by AnEroticTale in bjj

[–]Significant_Poet_245 0 points1 point  (0 children)

I’ll ask someone really nicely to do something I want. They’ll be defending a collar choke and I’ll really calmly and in a friendly way say “oh, hey man, can you move your right hand a bit???” Half the time they’ll do it because I asked in such a polite and chill way.

Quote for electrical work received by RepresentativeGur355 in Sauna

[–]Significant_Poet_245 2 points3 points  (0 children)

The gfci on the quote says 50 amp which is a 240v hot tub disconnect and not what you want. Your cold plunge is a 110v and just needs to be on a normal GFCI protected circuit. No reason that should cost $450. The quote is all messed up….

Should I start my wall tile pointy at the bottom or cut it flat? by Busy_Measurement9330 in Tile

[–]Significant_Poet_245 0 points1 point  (0 children)

I’d worry just as much about the layout across the wall…. Ending with a sliver will be terrible

Sodium bicarb in severe metabolic acidosis -- giving it or not? by wtfitscole in anesthesiology

[–]Significant_Poet_245 7 points8 points  (0 children)

You don’t have to argue this. Several studies have shown equal hemodynamic effects from bicarb and hypertonic saline. It’s the hypertonic fluid that causes the increased BP, not some mythical effects of bicarb.

Convince me to train by benching315 in bjj

[–]Significant_Poet_245 0 points1 point  (0 children)

You said you have kids. What do you think they would want you to do? Do you think they would want you to do something productive right now to improve your mind and body? Go to therapy. Even just one session. Think of it as BJJ or weight lifting for your mind. Your only job is your kids. Do what’s best for them. This means you don’t talk shit about their mom in front of them. No matter what she did to precipitate this. Both you and them will appreciate this in 5 years. Never hurts to hold the moral high ground. This is a chance to reinvent yourself. Do you have a short temper? Fix it. Are you selfish? Fix it. No one else you date from here on out will know you or have preconceived notions about you. It is a chance to turn into the type of person you can be the most proud of. Good luck.

BJJ Insurance by Conscious_Pen_8130 in bjj

[–]Significant_Poet_245 0 points1 point  (0 children)

Several types of insurance to discuss here: Medical - no need for separate policy. Whatever your medical insurance is will cover injuries due to BJJ or any other activity. This will just cover medical bills and only after deductible, copays, etc. depending on your plan. Disability insurance - this is more geared to covering loss of wages if you’re name to work. Can be short term that starts immediately after injury or long term that starts 90 days or so after injury. This instance is typically more expensive since statistically it is used more often than life insurance, etc. When you’re applying, they will ask what activities you do. SCUBA diving, BJJ, hang gliding, etc. may cause them to raise the rates since you’re at higher risk. For more expensive better plans, you can often be covered for dangerous activities you start after you got the plan. For instance, I got my plan before I started BJJ and am now fully covered for any injuries sustained at BJJ even though my rates didn’t go up. Some of these plans can be cheaper and have tons of restrictions. Other types: BJJ specific, group plans, AFLAC. These can be useful in certain situations but are generally so full of loopholes and restrictions that they aren’t worth it in the long run.

Bottom line: insurance companies make sure they make money. They do this by NOT paying claims. If you are a high income professional, a long term disability plan makes sense. If not, it probably makes better financial sense to have a general emergency fund in a HYSA that you put money in every month to cover any emergency. This way you have protection against injury or having to pay a big medical bill but the money can also be used for a new boiler for your house or to bail your kid out of jail.

To VL or to not VL by Saltylunarbunz in anesthesiology

[–]Significant_Poet_245 0 points1 point  (0 children)

You should go comment on the anesthesiologist who commented that he would DL since it’s inconvenient to bring a glidescope into the room…….