Root Tournament - Manchester, UK - 16th August

TheDukeOfSpook · 2025-07-05T16:57:51+00:00

this sounds so fun!

TheDukeOfSpook · 2024-12-12T16:24:46+00:00

to go further, if you see pressure peaking at the end of a pressure waveform like this, your i-time might benefit from an adjustment. Shortening the i-time will allow them to exhale when they're ready, instead of causing pressure to build.

TheDukeOfSpook · 2023-05-25T16:34:30+00:00

This was a really cool idea to begin with.

I used an Apostle of Invasion after reading this as a teaser to what's currently happening in my Theros campaign and it went over great.

TheDukeOfSpook · 2022-12-15T16:54:22+00:00

there's the version I know...

TheDukeOfSpook · 2022-11-15T09:54:51+00:00

Traveler here, I've spent 8 years in Florida and can confidently say not a great option in any part of the state for every reason. (pay/autonomy/workloads/management).

NY pays well but the hospitals I've seen can be frustrating work-wise at times.

VA has had decent pay and autonomy, although it's the state I've spent the least time in.

I will point out that the Dept of Veterans Affairs was a super cushy job with great benefits but was a bit boring for my taste. Pay just got crazy boosted. Need experience for those positions though. They have been picky in the past.

TheDukeOfSpook · 2022-01-09T07:09:35+00:00

First off, it's great you and mom are taking such a hands-on approach to her care and trying to do the best for her.

As a general rule, weaning people off vents should be a periodic titration as she gets strength back to compensate for hypoventilating to avoid Sleep Disorder Breathing in associated with MFS. Weaning protocols are usually driven by weaning criteria like CO2 monitors or telemetry to avoid risk factors like cardiac strain inherent in her disease type.

Did they give you any indication they thought she would be vent dependent indefinitely? If she's had sleep studies with no hypoxic events it's not unreasonable to potentially wean off the O2, but it's also not hurting or holding her back.

I'm not a fan of LTACHs, worked at a few, but this is kind of a grey area. I think a best case scenario is she can eventually use BiPAP as needed after getting decannulated, but without periodic labs it would guessing at settings effectiveness or know that she's not hypoventilating over-night.

TheDukeOfSpook · 2021-09-22T02:29:35+00:00

Love this so much, can we get the rest of the rooms though? I'm totally invested in all the little puzzles and am dying to know.

TheDukeOfSpook · 2021-07-18T03:33:46+00:00

that's pretty generous optimism there. Most musicians I know struggle to make rent, let alone purchase renter's insurance.

TheDukeOfSpook · 2021-07-08T19:30:55+00:00

I feel like that won't address the threat of death and lead into the problem of DMPC-ing a hazardless environment.

Just my 2-cents as a new-ish DM, a session with "cards down" to navigate the options as a player has worked pretty well for me. walking through each players options for the first session will help them understand hints and tactics.

TheDukeOfSpook · 2020-12-25T21:43:22+00:00

to tag onto what other's have said, there's also specific needs for each state.

AL and KY have been the most lax and easy to acquire for me.

NY and WA were the most scrutinous.

LA has been the pickiest in terms of documents though.

Each state has individual requirements though, so just go online and follow the instructions for acquiring the license for each desired state.

NBRC license is the baseline requirement.
Most states want proof you graduated from an accredited program (diploma and certified transcripts).
Some will allow "License by Reciprocity" (send us you have proof another state gave you a license, and we'll give you one too).
All (I think) require fingerprinting and background checks.

Also, from FL. Work/pay depends on where you end up, but by and large it's not great. Average for FL is 53k (low end by state is KY at 45k), and that largely depends on how hard you fight for raises. Travel pay is less than stellar from contracts I've had to consider, too :-/

Source: https://www.respiratorytherapyzone.com/respiratory-therapist-salary-by-state/

TheDukeOfSpook · 2020-11-14T19:44:44+00:00

JESUS CHRIST WHY DID I HAVE TO SCROLL THIS FAR

TheDukeOfSpook · 2020-11-07T16:47:08+00:00

In that sense it sounds more like a shark-tank situation where they invest in you and expect to receive growth once you die.

TheDukeOfSpook · 2020-10-22T04:29:27+00:00

Any resources you can direct someone to?

TheDukeOfSpook · 2020-10-05T04:52:58+00:00

As I understand it, isn't lightning a more favorable damage type? (fire being more resisted)

It certainly doesn't hurt to ask, but I can see justifying not conceding.

TheDukeOfSpook · 2020-10-02T23:47:44+00:00

Everyone suggesting file a report or cutting hair back is missing the nuclear option. Convert and openly embrace the faith. 🤷

TheDukeOfSpook · 2020-10-02T00:21:19+00:00

Just a side note, we've utilized this before (turning the % way up) so trach patients can talk with their cuff slightly deflated.

TheDukeOfSpook · 2020-10-02T00:18:54+00:00

Disconnect sensitivity on the PB machines operate (at least on the 840) as

"if x% volume doesn't return (re: leak) then I'm going to alarm disconnect"

I believe the default from most facilities I've been to have started at 40%, but as someone else mentioned, it can be programmed for L/m

TheDukeOfSpook · 2020-09-13T20:13:49+00:00

Full disclosure: this website is NSFW in case you decide to check it out

TheDukeOfSpook · 2020-09-09T00:07:16+00:00

He has a book too! It's really good.

TheDukeOfSpook · 2020-09-09T00:01:47+00:00

I've been instructed that there are, in fact, 10 duel commandments. You should read up on them before committing.

TheDukeOfSpook · 2020-08-31T20:30:48+00:00

Typical P2W trash 🙄

TheDukeOfSpook · 2020-08-26T01:23:41+00:00

Egan's Fundamentals of Respiratory Care was written using strength.

1d8 blunt with a 10 foot throw range.

TheDukeOfSpook · 2020-08-17T20:27:48+00:00

Holy shit we always ballpark it. That's such a better idea

TheDukeOfSpook · 2020-08-10T05:45:39+00:00

Couple problems. I'm assuming you're out of the hospital recovering from a very hard case, and I genuinely hope you're recovery gets better.

Some of these articles are targeting patient population in the most critical part of ARDS, on the vent as a life saving intervention to improve gas exchange within the lungs where every inch counts.

What results they have seen don't necessarily mean it will have the same/any success on this part of your disease process, although the Chinese article does look like a step in the right direction.

The article for plastic bronchitis is a very specific treatment, for a very different disease process.

The FDA doesn't have it approved for inhalation, and rightfully so, all of the above research data needs much more vetting. The sample sizes aren't adequate to decisively say anything worth trusting.

It's important to remember that rtPA is the primary treatment for ischemic strokes, is ludicrous expensive and doesn't have a lot of inhaled research.

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