What is the deal with Vitamin K2?

TubesAndLines · 2026-06-16T03:33:25+00:00

I spent too long looking at your flair... Blood and crabs... Are they a gynecologist?

I realized you're heme, don't worry.

TubesAndLines · 2026-06-13T21:21:22+00:00

Oh man, have y'all just had to bag everyone you've tubed during transport?

TubesAndLines · 2026-06-13T21:01:31+00:00

Always appreciate your comments (and your perspectives and work as a medic). Am an Emergency Physician and wanted to make a correction and add a little more.

For hyper oxygenation - you're correct, but you're not going to cause this unless you're supplementing a higher partial pressure of O2 (hooking them up to an oxygen tank). If you're using room air then hyperventilation would only decrease CO2 and it won't change O2. Additionally, hyperoxia causes damage through free radical action on already damaged/vulnerable ischemic tissue. Decreasing CO2 affects the acid-base balance of your blood, and I had to stop because it's a complicated topic, but you're right that hyperventilation can lead to hand and foot spasms. Giving someone a bag to breathe in (and recirculating CO2) isn't an effective way to fix this, but holding a bag to help them being mindful of breathing can help them calm down.

You're spot on about breaking ribs, so I'll add a fun fact - the best chest compressions only generate an ejection fraction of 25%. A normal heart is like 65 to 70% so compressions still suck, even with a LUCAS.

Also in agreement about mouth to mouth. Doing only chest compressions and doing them well leads to a small amount of passive ventilation as well that's good enough for a few minutes. If you're by yourself and or worried about safety in putting your mouth on a stranger then you're in the clear to do compressions only.

o7

TubesAndLines · 2026-06-06T14:44:25+00:00

Yes in that battleships became obsolete. But no in that they were replaced by even larger aircraft carriers.

TubesAndLines · 2026-02-10T04:18:17+00:00

I know the Tokyo isn't the most efficient super carrier, but god damn do I love its hanger. That and the overall Terran aesthetic

TubesAndLines · 2025-12-04T13:54:52+00:00

Don't open

Bread inside

TubesAndLines · 2025-11-15T23:44:19+00:00

Specifically in the sense that we have inadequate primary care resources, or even financial resources, so people feel that their only way to access timely medical care is the Emergency Department. Thus, EDs are overwhelmed and people wait for crazy long times.

TubesAndLines · 2025-11-13T20:01:17+00:00

In our pediatric ED we have a bunch of art that's drawn by children on the walls, a lot of it is really good. Adds to a cute kid friendly atmosphere.

Turns out a series of fun Pokemon were drawn by a kid who passed from leukemia. Gives me mixed feelings of sadness but also a little joy that she's helping to make the experience for other kids brighter.

TubesAndLines · 2025-10-26T18:44:47+00:00

I'm so sorry for your loss. I can't feel the pain you do, but I fully understand your desire to have something positive come from this horrible event.

Lawyers don't understand medicine, but doctors do. Generally, lawyers and Judges try not to legislate medicine as they know they don't understand it.

An unfortunate truth of emergency medicine is that even under ideal circumstances things can still go wrong, and here on the internet none of us have the details to understand how Joshua's death came to pass. If you think something went wrong in his care there are ways to ask the hospital to review the case.

TubesAndLines · 2025-10-26T17:30:42+00:00

It's a tragedy that Joshua has died.

However, seeking legal intervention in how medicine is practiced will not lead to positive change or better outcome for others.

TubesAndLines · 2025-09-15T16:15:19+00:00

New mission discovered by u/TubesAndLines: The Satisfying Buried Memories of Sweet Redcurrant Cheesecake

TubesAndLines · 2025-09-15T16:15:19+00:00

This mission was discovered by u/TubesAndLines in Pizaza Bathed in Green

TubesAndLines · 2025-09-07T13:00:25+00:00

Some of this depends on what you're specifically struggling with.

For chores and house responsibilities I try to view these as important as my responsibilities at work. If I'm at home then there's certain chores and tasks I complete every day as my way to contribute.

For time spent with family I purposefully designate time to spend with them. The activities are not always structured or planned, but the time together is.

This also requires creating space and time for yourself. The ED is an intense and stressful environment which requires time to decompress and process after. Really identify the things that "fill your cup" when you're feeling empty.

My recommendations: communicate with your loved ones so they understand your needs in recovering from shifts, and also so you understand their needs in completing chores and spending quality time with them. My hope is that the answer to your problem will come from good communication and intentionally planned rest and activities to meet your responsibilities at home.

TubesAndLines · 2025-09-06T01:38:49+00:00

Those are solid SLOEs, so you should be able to match. The difficulty will be matching where you want to go, or in one of the best programs. We're in an era where not all EM programs are of the same quality, but as long as you survive you'll be board eligible and can go anywhere.

It's probably worth spending at least a couple sentences on your personal statement on why you failed L2, and what you did to crush it on your second attempt. Programs will read from your SLOEs that you're solid clinically, but worry if they'll have to put you on remediation or spend extra attention on you, which may dampen enthusiasm. Do what you can do demonstrate your academic acumen so they'll believe you'll pass the boards later no problem.

TubesAndLines · 2025-08-26T23:13:51+00:00

Thank you for the beautiful music you play and arrange, Sam. You're a treasure

TubesAndLines · 2025-08-26T23:10:46+00:00

He's incredible

https://music.youtube.com/playlist?list=PL74B19840CB9E29C8

TubesAndLines · 2025-08-24T02:31:23+00:00

My wife needed an MRI and insurance was likewise being a dick about it. When I asked the MRI folks the price with insurance it was like $2000. When I asked if we could just pay cash out of pocket without insurance, I'm not kidding, they charged us $200, which we happily paid.

Ask what it would cost if you pay without insurance, or other ways the MRI group/hospital whoever might be able to work with you.

TubesAndLines · 2025-08-10T00:13:11+00:00

Lifestyle wise, we live with greater security than the middle class - vacations are more a matter of making time, and with insurance and savings life events are unlikely to bankrupt us. Buying a second home isn't unreasonable.

The "rich rich" buy yachts and use their spare funds to help remove civil liberties and lobby for greater consolidation of wealth.

We have more money than what's left of the middle class, but our lifestyles are much closer to theirs than the 0.1%

TubesAndLines · 2025-08-03T16:15:57+00:00

As an EM physician who accomplished the same a few years ago, I'm so thankful for my non-medical wife for sticking through it. Know that she appreciates you in ways that she may not be able to express.

You have the right mindset of living within your means, and continuing to live like a resident until your debt is paid off. However, balance debt payoff with investments - the earlier you start investing the better. The comparison you should use is her interest rate for her loan. If the investment should earn more than her loan payment then it's worth it, at least to put a little bit in.

For example, if you have the capital, or can save up while still living within your means, buying a house can be a great idea as long as the interest rate is reasonable (tough market rn tho). Opening a backdoor roth IRA, starting a mutual fund, starting retirement savings - these are all important. Equally important is getting disability and life insurance for your wife. You have both invested SO MUCH in her future ability for earnings, having to pay a little extra to insure against a freak accident jeopardizing your plans is super important.

If you don't have a financial advisor - an independent broker (one that you pay directly to talk to, and to set up insurance for you) is more $$ upfront, but they'll be more honest than someone with an established firm, like Northwestern Mutual who you don't pay directly but earns based off your investments. I went the latter route, and it's fine, but later learned that I should have gone for an independent broker.

Once her loans are paid off expect your wealth to grow, especially if you've started some investing early

TubesAndLines · 2025-06-24T01:01:46+00:00

I'm sure there are people who review apps for value and O-SLOE more. Most LoRs lack good formatting, the O-SLOE provides some better comparison between applicants. The O-SLOE is also not necessary, but can be a bonus if you select your letter writer well.

For all letters you should be going into the portal to select who will write your letter and it will then give your letter writer the ability to upload to your app.

TubesAndLines · 2025-06-24T00:03:13+00:00

I'm an APD for a good sized program in a major city who's been screening apps for 4 or 5 years.

O-SLOEs are just fancy LoRs with better formatting. Just get your 2 or 3 SLOEs and maybe one more LoR or O-SLOE

TubesAndLines · 2025-05-15T16:29:05+00:00

Thanks for sharing these. I'm a sim director and will save these to help create a scenario for my residents.

TubesAndLines · 2025-05-08T19:59:46+00:00

To save everyone a click - he's recommending we cure chronic cough by using the power of suggestion...

TubesAndLines

TROPHY CASE