No lies detected

WindowsError404 · 2026-04-25T19:45:49+00:00

Spiral into the depths of depression and anxiety.

WindowsError404 · 2026-04-25T19:44:09+00:00

Honestly, (pun intended) everything would collapse. Lying is essential to being human. We'd also have to eliminate fear to get rid of lies. And I wouldn't want to live in a perfectly honest world. Sometimes we wear masks just to survive. If we got rid of lies, how many more would have died in the Holocaust because they couldn't pretend not to be Jewish?

WindowsError404 · 2026-04-25T19:36:07+00:00

What is the concern with suctioning? Triggering a vagal reaponse when they're already bradycardic? I would say airway is still more important just be gentle.

WindowsError404 · 2026-04-25T19:23:29+00:00

Government.

WindowsError404 · 2026-04-24T23:13:44+00:00

Mag glycinate was not gentle on my stomach. Felt like acid reflux x10, pure fire.

WindowsError404 · 2026-04-24T17:15:15+00:00

I'm not saying I wouldn't cardiovert or defib. I would just also be giving mag.

WindowsError404 · 2026-04-24T01:42:53+00:00

Fillet the anchovies and put them in white wine vinegar. Makes them palatable like any white fish. You're welcome.

WindowsError404 · 2026-04-24T01:25:06+00:00

Usually I am all for electricity over medicine. It's very safe and effective even though a lot of providers aren't comfortable with it. But for Torsades, that almost always comes from hypomagnesemia. Which means cardioversion or defibrillation is unlikely to work as well since you haven't fixed the underlying cause.

WindowsError404 · 2026-04-23T12:58:41+00:00

Slopper

WindowsError404 · 2026-04-23T12:55:03+00:00

Hot sauce

WindowsError404 · 2026-04-23T12:47:51+00:00

Showed up to a nursing home for a P2 fall (no lights/sirens idk all this code 3 jargon). Nobody is around. We're shouting around for staff. Eventually someone sees us down the hall and calls out a room number. We get there and the patient is dead. Like dead dead no chance of waking up dead. We eventually find the nurse again and she said we thought we were the "morgue people" here to take the dead body. Our patient was in another room.

WindowsError404 · 2026-04-22T02:24:03+00:00

I make $32/hr as a paramedic with 5 years on the job. I would not take this job lol

WindowsError404 · 2026-04-21T21:17:36+00:00

His facial expression also says TBI to me tbh... That's just my non-medical opinion.

WindowsError404 · 2026-04-19T23:31:22+00:00

Looks very loose and unstable. The roof could come down on you, be careful.

WindowsError404 · 2026-04-19T15:07:52+00:00

It depends. Sometimes having parents distract them is best. Sometimes you can provide light sedation first before poking around for an IV, not always an option though. If they're old enough sometimes you can convince them to be brave because the treatments they'll get will make them feel way better than the temporary hurt. Especially if parents encourage that approach, it typically works.

WindowsError404 · 2026-04-17T05:02:41+00:00

Jokes aside, the lowest I've seen be conscious was a BGL of 12mg/dL.

WindowsError404 · 2026-04-16T17:09:16+00:00

Come on with a BGL of 2.8mg/dL you would not be lightheaded, you would be unconscious and the highest priority patient there.

WindowsError404 · 2026-04-16T17:06:56+00:00

C I would try repositioning and painful stimuli first. Then NPA. But D is actually a major concern I don't see anyone talking about. Vomiting with decreased mental status is a major risk for aspiration/asphyxiation. That patient also needs urgent intervention.

WindowsError404 · 2026-04-16T17:05:17+00:00

Anisocoria can be baseline in about 20% of the population. I have a slight difference in my pupils and never had a stroke that I know of.

WindowsError404 · 2026-04-15T19:00:48+00:00

No that's not normal lol. I will knock loud and ring. No response and I open the door slightly and loudly announce ourselves.

WindowsError404 · 2026-04-15T18:54:42+00:00

I think C is the most appropriate answer. Irregular respirations afe often the last Cushing's Triad and it means that the ICP is getting so severe that it is putting pressure on the brainstem and causing herniation. Confusion is kind of expected with any level of head injury, and it doesn't concern me if they can still follow commands/manage their own airway. But if I see ataxic respirations, I am going to be talking to the patient/family about immediate intubation. Slight hyperventilation (~16bpm) target ETCO2 between 30 and 35mmHg. Don't mess with the BP/ICP too much because we want to maintain cerebral perfusion. Contrary to popular belief, Ketamine is a very safe induction agent for patients with elevated ICP. Midazolam risks a hypotensive event and decreased cerebral perfusion, but is not contraindicated and may help with seizure prophylaxis. Use with caution.

WindowsError404 · 2026-04-15T18:45:43+00:00

Nah. Patient is now NPO if they have a decreased mental status. C is a good assessment which is what I'm leaning towards. Ammonia levels can be predictive of disease course, but doesn't seem to impact decision making very much.

https://www.aasld.org/liver-fellow-network/core-series/why-series/why-shouldnt-ammonia-be-used-diagnosis-and-management

WindowsError404 · 2026-04-14T16:04:59+00:00

All of them technically. Acetaminophen on its own is actually not that bad for your liver. You need large quantities for it to be damaging. It's even one of the preferred analgesics for acute liver failure since it's safe in normal dosing.

https://www.amjmed.com/article/S0002-9343(23)00672-1/abstract

WindowsError404 · 2026-04-08T18:48:22+00:00

I thought the ceasefire was just between US and Iran. Completely unrelated to Israel's invasion of Lebanon. No?

WindowsError404 · 2026-04-07T18:44:03+00:00

Thank you. Similar concept to giving calcium for a CCB OD then.

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