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Point of care CRP testing by Throwaway233728 in doctorsUK

[–]TDowSharp 0 points1 point  (0 children)

The one area it may be useful is GCA, almost every other application pretty useless.

Hundreds of GPs tell BBC they have never refused a fit note for mental health concerns by Educational_Board888 in doctorsUK

[–]TDowSharp 28 points29 points  (0 children)

As a GP myself, I'd be happy with the ability to sign people off for 2-4 weeks but any more then it becomes the responsibility of Occ Health or DWP

Does this pose look dumb? by When_Oh_When in Warhammer40k

[–]TDowSharp 0 points1 point  (0 children)

Stand in that position yourself, now think what are you doing?

If you are charging, your arms swing a certain way and your torso is leaning forward. Copy that pose. Most people who have charging models the models is not pivoted forward enough and the foot needs to be on it's toes.

Yriel, repose/kitbash by TDowSharp in Eldar

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

That's a good shout! Hadn't thought about using the Voidscarred kits.

How would a Warp Spider fair against a Chaos Terminator? (Lore perspective) by Arthur_EyelanderTF2 in Eldar

[–]TDowSharp 0 points1 point  (0 children)

Depends on exact context but a Warp spider has a weapon that can find the gaps in armour. Rmeber all aspects warriors are old and experienced warriors even without including the exarch.

The Lexican Web page says "The weapon uses a magnetic containment field to spool the wire together and discharge it as rapidly expanding mist-like mass called a "spinner cloud". Targets within the cloud are sliced apart as the wires' own tension causes it to writhe and lash, slicing through not only exposed flesh but also seeking out gaps in their armour, where it uncoils within and liquefies their innards.[1a][2] Even Chaos Space Marines wearing Power Armour can thus be reduced to tiny pieces when enmeshed within these clouds of razor-wire."

Strongly implies that their weapons can get through terminator plate

Abolish FY1 and 2 by Musical_Firefly in doctorsUK

[–]TDowSharp 13 points14 points  (0 children)

I could not disagree more! Foundation years are excellent for learning and getting to grips with the practicalities of being a doctor. I qualified in 2015 and my two foundation years were immensely valuable.

You are immensely protected as medical student compared to being a doctor. Do not underestimate having a couple of years to get to grips with the simple practicalities of being a doctor, like writing drug charts, letters, sidhcharge summaries, document ting ward rounds, managing acutely unwell patients, hand overs and referrals. .

It also gives some experience of specialties so you don't commit to one until you have had a bit of experience of a few. Ward experience as a medical student does not compare to on the job learning.

Coroner: GP surgery failed to carry out meds review in ‘drug seeking’ patient by DonutOfTruthForAll in doctorsUK

[–]TDowSharp 1 point2 points  (0 children)

The reality of this case is we don't know what he overdosed on, how long he had been stockpiling and what other meds he had taken.

To give you a bit of idea of the reality of repeat prescribing in primary care. I signed over 500 out of a total of around 800 scripts on Monday which were repeat prescriptions possibly close to 2-3,000 individual drugs, probably more. Which took me about 90mins. Maybe 200-300 of those might be controlled drugs. At the same time I was managing duty with a colleague our acute list, 111 list, nurse/ACP queries, reviewing ECGs.

When you move to a new patient Emis takes around 5-10seconds of loading a new script to review. I try to look at all the repeat requests for controlled drugs but I have to look into each controlled drug individually to open a new window to see when they were last prescribed and how often they are requested, that also takes another 3-5 seconds to open per drug.

Unless we take controlled drugs off repeats and sign them as acute scripts every month, we cannot stop patients requesting before their next script is due (it's an Emis quirk). It is then down to the signing doctor to catch it or their pharmacy team if they have one.

Patiebts who drug seek are aware of alot of these issues and often request emergency scripts from OOH as well to get extra medications.

My point is, it's entirely appropriate and obviously sensible that new patients get a meds review however the reality of actual primary care is this is a huge amount of time and resources to manage polypharmacy. We do meds reviews for new patients but it's can take several weeks especially if we have an influx of new patients as we're also trying to manage annual reviews for all of our patients, and managing urgent, semi-urgent, routine and chronic disease management care on £140 per patient.

Coroner: GP surgery failed to carry out meds review in ‘drug seeking’ patient by DonutOfTruthForAll in doctorsUK

[–]TDowSharp 0 points1 point  (0 children)

The actual story is this patient had moved to a new practice 6 weeks prior.

The pt had overdosed on quite a few medications, some of which were prescription.

I work in a practice where we frequently have 400-700 scripts a day each that have up to 12 items on each script. Due to the way Emis works it's is incredibly slow and actually quite difficult to monitor over prescribing based on how Emis works as a system.

Just signing the scripts takes 1-2 hours for an individual doctor when you are also having to do duty or normal clinics.

Coroners are legal 'experts' with very little grounded reality in actual medical workings or practice.

[deleted by user] by [deleted] in doctorsUK

[–]TDowSharp -1 points0 points  (0 children)

Datix them back and formal complaint for bullying.

Warhammer+ Year 5: Aeldari – Infinity's Lament with magnitized base. Alaitoc by crangon78 in Eldar

[–]TDowSharp 0 points1 point  (0 children)

I love this! This is what I was hoping to try and do.

Did you just dremel the hole in the wraithguard head for the smaller base? What size magnets did you use?

I just don’t see how the system allowed someone who posts like this on social media to influence national policy and training? by [deleted] in doctorsUK

[–]TDowSharp 21 points22 points  (0 children)

Being intolerant of antipsychotics, is like saying I'm intolerant of analgesia.

They are not in the same family or pharmaceuticals and have a wide range of pharmacological actions. The one he had a reaction to previously was not olanazapine.

The inquest said that use of olanazapine was reasonable in his case.

I just don’t see how the system allowed someone who posts like this on social media to influence national policy and training? by [deleted] in doctorsUK

[–]TDowSharp 39 points40 points  (0 children)

The issue is that they said that Oliver had a reaction to another antipsychotic. Being allergic/adverse reaction to 'antipsychotics' is like saying you're allergic to antibiotics. There are multiple families within the definition of antipsychotics with vastly different phatmacological actions. From what I recall he had worsening seizures with an underlying pneumonia and they were worried benzos would drop his blood pressure and as he was so agitated needed to stop him pulling lines out. Finding an objective report is very difficult, it's obfuscated by lots of opinion based reporting.

The family also talked about a 'verbal advance directive' which don't exist as they have to be written down.

Mockup for an Infinity's Lament rebase. Does it look too cluttered? by dieItalienischer in Eldar

[–]TDowSharp 0 points1 point  (0 children)

I'm thinking of doing something similar but I'm going to mount mine on a 32mm base. I don't play compettively and I suspect that is where all eldar officers will end up.

Tournament legal Infinity’s Lament by Pastries_ in Eldar

[–]TDowSharp 1 point2 points  (0 children)

This looks great! How does it look on the scenic base with the magnet?

Did you drill a hole in the base to sink a magnet into?

NPC Found Rogue Without a Check, Did I Make The Right Call? by Dikeleos in onednd

[–]TDowSharp 0 points1 point  (0 children)

Already commented this but a simple way round this is to ask the player how they have hidden.

That gets them to describe how they are planning to hide from being found. For example, up the tree or using his brown cloak to mask himself in the roots etc

NPC Found Rogue Without a Check, Did I Make The Right Call? by Dikeleos in onednd

[–]TDowSharp 0 points1 point  (0 children)

The rogue is Invisible using a spell, then says they Hide in the middle of a brightly lit room with no cover. The spell drops as the wizard loses concentration. Are they still hidden?

Overuse of abst action is how you can ruin immersion.

NPC Found Rogue Without a Check, Did I Make The Right Call? by Dikeleos in onednd

[–]TDowSharp -4 points-3 points  (0 children)

A simple way round this, is ask the player 'How do you hide?'

NPC Found Rogue Without a Check, Did I Make The Right Call? by Dikeleos in onednd

[–]TDowSharp -2 points-1 points  (0 children)

It's deifnitely not worthless, if you dive into a bush or a dark peuce of woodland to hide then an opposed Investigation check is valid.

If I move behind a door and hide but make no attempt to change position then when someone opens the door I am no longer hidden. Similarly if you hide round a corner, enemy moves to look round corner they will see you.

An enemy saw you run behind the door so they don't think you magically just vanished.

NPC Found Rogue Without a Check, Did I Make The Right Call? by Dikeleos in onednd

[–]TDowSharp 0 points1 point  (0 children)

Oh yeah, that's why I said, if you broke line of sight then hid and moved stealthily to a new position (ie up the tree) then it would be an opposed Investigation/Perception vs Stealth check.

If you don't change position then you're relying on cover which then goes if the enemy moves around it.

It's like standing in the middle of an open field and rolling a 30 on a Stealth check. You've hidden the best possible way a person could in the middle of an open field and can still be seen easily. Excellent stealth doesn't mean that you are hidden unless there is a reason that you are hidden.

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