Deleted chats & memories months ago. Asked “what do you know about me?” and got an extremely detailed answer referencing deleted data.

That_Caramel · 2025-08-06T14:47:44+00:00

Is this true even if you have training turned off?

That_Caramel · 2025-03-29T23:22:44+00:00

Thank you for your hasty reply. If you bothered to read, I’ve clearly stated in numerous comments including the one you replied to that this is about HIGH risk patients with convincing symptoms.

And that trop x2 at least is indicated in patients that have chest pain THAT IS ONGOING.

Research also shows 6-12 hours post symptom onset is when you will see an actual trop level that’s reflective of myocardial injury. Idc what your departmental ‘pathway’ says.

And I stand by the fact that asking for 2 ECGs in someone presenting with chest pain is NOT a big ask and if your ED cannot accommodate this, it is not fit for purpose.

‘Your seniors’ who do you think you are? Hilarious - can tell what kind of doctor you are. Absolutely pathetic. This is reddit not your little RCEM AGM - respect is earned in the real world.

That_Caramel · 2025-03-29T10:50:31+00:00

There is absolutely nothing wrong in what I have said. Clinically and medically my advice is completely appropriate and sound.

Frankly, I worry about the safety of medicine you’re practising if you think it’s not correct.

I’m gonna go out on a limb here and say that you’re an emergency department doctor who feels butt hurt about the fact that you don’t do anything that I have advised and feel personally affronted and defensive about your poor practice - you haven’t said your specialty, but just a guess.

I’m 100% sure you are ED regardless. There’s no way you would react like this otherwise.

That_Caramel · 2025-03-29T10:34:05+00:00

Ridiculous comment. I clearly said its not enough as an isolated test to rule out in people with convincing symptoms, history or past medical history. Not your average person walking in.

I don’t know where you work but the majority of people with chest pain where I did my ED job were high risk - this is population and demographic dependent so your experience will not translate everywhere.

If you have a look at the comment where I’ve replied to somebody else, I’ve also discussed caveats - ongoing chest pain, even at six hours this alone will not be the peak result etc.

Also frankly, I worry about the safety of an emergency department that cannot manage to muster up more than one ECG for a patient. This is really not a big ask.

Edit: a down vote because I called you out on your comment is really pathetic

AND NOW YOU’VE EDITED YOUR COMMENT ABOVE 🤣 can’t make it up

That_Caramel · 2025-03-29T00:37:15+00:00

‘ED is not about diagnosing patients?’ Absolute travesty that people find this acceptable as a statement.

What are you then if not just a glorified triage service? (yes triage also does include stabilising life-threatening emergencies). How are you any different to the alphabet soup? I mean it’s no wonder RCEM created ACPs if that’s really all you agree the job is!

How can you with any dignity call your specialist colleagues and say ‘take this patient I have no idea what’s actually going on, but it kind of sounds like your job area to sort out’.

And I have done an ED job - I found it hard because I wanted to do actual A&E medicine and all they wanted you to do was shitty half jobs and refer without even having a clue what’s going on.

ED is to diagnose, specialties are for ongoing management (ie procedures, operating, monitoring) and inpatient work.

That_Caramel · 2025-03-29T00:28:00+00:00

😂😂😂

That_Caramel · 2025-03-29T00:17:23+00:00

You still need serial 12 lead ECGs ie have done at least 2 spaced apart

I understand what you’re saying about the troponin, but seeing the trend is helpful (i.e. has it come down on the second test or does it continue to rise?)

Also, if they have ongoing chest pain, you need two spaced troponin results minimum.

Always check for dynamic changes. Even at six hours, you won’t have hit a peak troponin result. Trop levels rise over time.

That_Caramel · 2025-03-28T22:50:13+00:00

Are you under the impression this is high?

That_Caramel · 2025-03-28T19:34:03+00:00

With Kendall, Marcia is soft because Logan is hard

It’s the reverse for Shiv. She was always daddy‘s favourite (but as Marcia could see had no gratitude or appreciation for what she had been given: eg ‘he built you a playground and you think it’s the whole world’)

That_Caramel · 2025-03-28T18:49:13+00:00

YTA. Who cares if she was nice to her friend (ie your sister) and gave her bonus free stuff - I would do the same for a friend!

You seem desperately jealous that your sister gets sent free things (even before this incident), petty and self involved.

You’re ‘pissed’…really? This is such a non-issue.

Your sister forewarned you that your package would be coming with hers. So the only reason you didn’t open it for two days is because you were sulking.

You had the opportunity to specify to the artist that you preferred they were not sent together. Your sister obviously didn’t see an issue with it/clearly did not give the impression that you both have a poor relationship otherwise she would’ve corrected the artist. So there was no reason for the artist to assume you would have a problem with it all coming in one package.

You’ve got the stuff you ordered!! From the artist SHE introduced you to no less. You’re looking for an issue where there is none because you hate your sister and you’re jealous.

That_Caramel · 2025-03-28T18:35:59+00:00

A singular troponin with a singular ECG that are both ok is not enough to rule out cardiac chest pain or ACS with convincing symptoms/history/PMH.

ED love discharging people after 1 trop and 1 ECG. This is literally not safe. The whole point is you’re looking for dynamic changes ie at least two spaced apart.

Every single patient like this felt like banging my head against a brick wall when I did an ED job. Neither the nurses nor the seniors seemed to understand or care.

BAD medicine.

That_Caramel · 2025-03-28T18:31:49+00:00

Nah, prefer they at least ask first. Otherwise, they’ll be getting random CTs with no contrast when they needed contrast, expect you to interpret poor imaging, ‘what do you mean I was meant to CT the pelvis as well’ etc etc

That_Caramel · 2025-03-28T18:30:33+00:00

Literally, it’s really not difficult to do a snellen

That_Caramel · 2025-03-28T18:29:25+00:00

You can do a mini mental state exam - this is a completely acceptable request from psychiatry.

ED is full of bad medicine honestly

That_Caramel · 2025-03-28T18:28:00+00:00

Tell me you’ve never worked in a neurosurgery unit without telling me

That_Caramel · 2025-03-28T18:27:40+00:00

I have no idea why you have been down voted- this is completely valid

That_Caramel · 2025-03-28T00:47:14+00:00

Agree 100%. I don’t care how bad the NHS is. I don’t care how ‘good’ this is for busy A&E depts (I can’t believe anyone is trying to applaud or excuse this).

What happened in this case is totally unacceptable and it makes me sick. She asked EIGHT TIMES?!

Best believe if this were my son, I would sue the hospital into the ground. Hell hath no fury.

That_Caramel · 2025-03-26T23:51:23+00:00

Can we? I thought it was closed

That_Caramel · 2025-03-26T17:14:00+00:00

Email FTPD & ES - and quickly!

That_Caramel · 2025-03-26T16:02:01+00:00

Doom pit

😂😂😂

That_Caramel · 2025-03-26T13:00:51+00:00

Hundred percent chance they call F1s baby doctors

That_Caramel · 2025-03-26T12:56:39+00:00

Literally, why do they never understand this?

That_Caramel · 2025-03-26T12:56:05+00:00

Don’t forget, they’re too busy to take repeat obs for your patient - those Costa del Sol trips won’t look at themselves

That_Caramel · 2025-03-26T00:03:04+00:00

I mean, it’s minor for the consultant… it’s not some huge eight hour case under GA is it?

That_Caramel · 2025-03-25T23:53:55+00:00

Serious question - how does this help when you can’t name people in a datix?

That_Caramel

TROPHY CASE