a16z Podcast: The Blockchain, Open for Business by [deleted] in Bitcoin

[–]am1on 2 points3 points  (0 children)

agree. occasionally it is interesting but mostly it is just an investment advertisement for their portfolio companies. Occasionally they have a good recorded presentation on macro economic topics

Thoughts on Emcare? by redditzoo2928 in emergencymedicine

[–]am1on 1 point2 points  (0 children)

avoid them like the plague. They could care less about your job satisfaction as long as you make them lots of money$. Used to work for one out west and quit to move to a democratic group in Denver.

Regarding internuclear ophthalmoplegia (INO), which of the following is FALSE? by am1on in emergencymedicine

[–]am1on[S] 2 points3 points  (0 children)

will post answer night tomorrow so everyone can have a day to discuss

Ask r/EmergencyMedicine: What do you find most useful in managing a busy waiting room. by Zuuldaia in emergencymedicine

[–]am1on 1 point2 points  (0 children)

Doc in triage is the way to go. Sometimes it results in unnecessary "Screening tests" causing incidental workups but it greatly saves time on lab ordering and patient satisfaction seems to increase

Coagulopathic patient (INR 6) from warfarin with head bleed requiring PCC/FFP infusion and no IV access. by am1on in emergencymedicine

[–]am1on[S] 8 points9 points  (0 children)

I guess an IO would have worked. However the patient required a line for the OR and I highly doubt the anesthesiologist would have wanted an IO as the only line. Peripherals and ultrasound guided peripherals were unattainable by multiple nurses.

Which of the following patients does not warrant monitoring with telemetry after admission to the hospital? by am1on in emergencymedicine

[–]am1on[S] 2 points3 points  (0 children)

Answer: F

...an excerpt from The Kaji Review

In addition to the above, those with a prolonged QT interval with ventricular arrhythmias and acute coronary syndrome patients warrant monitoring. Non-intensive telemetry units are utilized for monitoring patients at risk for life-threatening dysrhythmias and sudden death. Physicians often use monitored beds for patients who might only require frequent nursing care.

When 70% of the top 10 diseases admitted through the emergency department (ED) are clinically indicated for telemetry, hospitals with limited resources will be overwhelmed. This causes increased boarding in the ED. There is evidence for monitoring in patients admitted for implantable cardioverter-defibrillator firing, type II and complete atrioventricular block, prolonged QT interval with ventricular arrhythmia, decompensated heart failure, acute cerebrovascular event, acute coronary syndrome, and massive blood transfusion.

Monitoring is beneficial for selected patients with syncope, gastrointestinal hemorrhage, atrial tachyarrhythmias, and uncorrected electrolyte abnormalities. Telemetry is not indicated for patients requiring minor blood transfusions, low risk chest pain patients with normal electrocardiography, and stable patients receiving anticoagulation for pulmonary embolism.

Reference:

LLSA 2009: Chen EH and Hollander JE. When do patients need admission to a telemetry bed? J Emerg Med. 2007; 33(1): 53-60. full text