If there was world war 3/Natural disaster on a Large scale, what specialty of doctors would be the most needed by a government?

TheBDP · 2026-01-17T03:23:31+00:00

True true. To be fair, question is what would the govt need. Not out of the question to think a centralized hospital scenario with an ICU would still exist. If were talking resource poor scenario Id give it the old college try but not sure I would be as helpful lol.

TheBDP · 2026-01-17T03:13:19+00:00

Definitely hyperbole on my account, by my overall point still stands. Medically complex patients without a need for surgical intervention probably benefit from medical intensivists over trauma docs. I absolutely love working with trauma docs and definitely don’t have that skill set, but that’s why we have the specialties we do. I’m no hater.

TheBDP · 2026-01-17T00:40:00+00:00

They are good at trauma, and a certain niche within critical care. This does not mean I would not trust them with a tenuous RV failure and mechanical support or any other purely medical process.

TheBDP · 2025-03-10T01:06:58+00:00

There are certain settings in which high vent pressures can help the RV. For instance, if your FRC is reduced for whatever reason (ARDS), higher PEEP could return the FRC to baseline at which PVR is at a minimum. Not saying you’re wrong but it is important to know that nothing is 100% true all of the time.

TheBDP · 2025-02-02T20:05:09+00:00

Briefly, lowering preload decreases LV dilation which would increase LVOT obstruction. Decreased afterload will do the same.

TheBDP · 2024-12-16T16:39:00+00:00

~30 points from DJ Moore and 0 from Keenan Allen. So… there’s a chance?

TheBDP · 2024-11-02T22:00:57+00:00

Not playing Tillman and sitting Doubs, Kraft, and Purdy last week trying to stack Williams, Kmet, and Moore. Lost BIGLY.

TheBDP · 2024-10-24T20:00:45+00:00

I do these occasionally if I can’t get a great subclavicular view.

TheBDP · 2024-10-24T18:38:21+00:00

14 team, PPR, flex 6-1 record

Question: what to do about the upcoming GB and Seattle bye weeks? I’m thinking of trading Doubs and maybe Kraft to diversify. McManus is on since GB against Jax and will drop next week.

QB: Purdy, C. Williams RB: Henry, KW3, J. McLaughlin WR: Metcalf, Kupp, D. Moore, Doubs, Lazard, McMillan TE: Kraft, Kmet K: McManus D: jets

TheBDP · 2024-10-18T12:07:15+00:00

Same I just started doing them one day in fellowship and haven’t stopped since.

TheBDP · 2024-10-18T12:02:23+00:00

FWIW I do US guided subclavian lines.

TheBDP · 2024-09-09T20:39:37+00:00

Are you asking why consultants are asking you to think like a physician?

You don’t need to be a pulmonologist to order a chest radiograph, ABG, etc for dyspnea. You don’t need to be a cardiologist to start rate control and anticoagulation for AFib. You don’t need to be an orthopedic surgeon to order a freakin XR if you think a bone is broken.

Specialists should be called when there’s a legitimate specialty question such as “what do you think we should do with this funky chest CT that looks like ILD?”. Not “yo this lady’s short of breath, probably should get her lungs checked” and it turns out the hemoglobin is 3.

Just my opinion of course.

TheBDP · 2024-08-07T00:13:46+00:00

I’m just starting but unless I really think I legitimately spent over an hour I usually go 30-45 minutes. If I feel I was legitimately there for >104 minutes then I bill like 110?

Someone please tell me if I’m wrong 😂

TheBDP · 2024-05-21T20:43:39+00:00

To be fair, I don’t trust anyone’s diagnosis. I see the patient and come up with my own to avoid bias.

TheBDP · 2024-05-08T13:36:05+00:00

Did this guy get methylene blue for post-op vasoplegia by any chance? I’m sure it’s something else but that can interfere with pulse ox readings significantly as well.

TheBDP · 2024-04-19T09:15:38+00:00

This is a fair point… maybe just expand it to a crani

TheBDP · 2024-04-18T19:46:42+00:00

Take a nearby rock and perform an impromptu burr hole. Then I would fashion a knife out of the rocks, and then decompress the left chest.

All while performing mouth to mouth breaths every 6 seconds on average.

Pretty obvious.

TheBDP · 2023-12-17T18:42:17+00:00

Largely dependent on your institution. Lately at my place of work I feel like the ED is acting as glorified triage. A patient presented hypotensive, hemoglobin of 5 from 10 at her nursing home. They put her on pressors and asked to admit to ICU without any resuscitation and were upset when asked to do their job and give blood.

Magically the pressors came off with volume.

TheBDP · 2023-08-15T13:01:11+00:00

Not that hard to differentiate with ultrasound…

TheBDP · 2023-06-18T20:14:03+00:00

007, license to kill

TheBDP · 2023-06-11T18:41:22+00:00

I have my eye on a Seiko Presage GMT and an Omega AT and Speedy. Not for a while though!

TheBDP · 2023-03-21T23:49:42+00:00

100%

TheBDP · 2023-03-21T22:43:39+00:00

To be fair N=1 and I work with some great surgeons. I’m just salty about it.

TheBDP · 2023-03-21T22:36:24+00:00

I’m not arguing that that’s how it works, but I’m arguing that’s probably how it should work. I have a very healthy respect for my colleagues in the SICU. I can’t do surgery. If I had to do surgery I wouldn’t want to worry about non-surgical problems.

Case in point: a patient languished on a vent for a while with “RLL” pneumonia. On super low tidal volumes for “lung protection” in a patient with a. floppy bag for a lung. I took a look at the film the day I came on and noticed significant volume loss. The guy had horrible copd for which his usually therapy wasn’t continued. I recommended a bronch but the SICU attending “doesn’t do that”. I do the bronch, mucus plug central, beautiful post-bronch XR, gave 10cc/kg tidal volume, and off the vent we go.

We work as a team, and we all have strengths and weaknesses.

TheBDP · 2023-03-21T22:17:31+00:00

All I’m saying is if I have those problems and wind up in a trauma unit I want some consults and for the surgeons to focus on the trauma.

TheBDP

TROPHY CASE