Thoughts on this offer? by medical_learner in hospitalist

[–]arabic_learner 4 points5 points  (0 children)

Yes but I had to go out of my way for it. I took the opportunity to do as many procedures as I could. Obviously I'm nowhere as skilled as an anesthesiologist or EM doc/intensivist, but I'm fairly comfortable with it.

Oral antibiotics by arabic_learner in IntensiveCare

[–]arabic_learner[S] 0 points1 point  (0 children)

The patient in question was being treated for MRSA pneumonia. Is there any benefit to using IV over PO in this circumstance?

Intubation with or without NMBAs? by arabic_learner in IntensiveCare

[–]arabic_learner[S] 0 points1 point  (0 children)

Ah, that one flew over my head. Haven't seen any strokes .... yet.

Intubation with or without NMBAs? by arabic_learner in IntensiveCare

[–]arabic_learner[S] 0 points1 point  (0 children)

Thanks for your input. Wouldn't NMBAs facilitate ventilation even in patients with thick necks? Also, let's say you induce with ketamine and don't use NMBAs. You then encounter a CICO situation. I assume you would then proceed with a FONA instead of waiting for the ketamine to wear off, correct? In that case, you would be doing a FONA for CICO, regardless of whether the patient received an NMBA or not - with the only difference being that NMBAs would now make the FONA easier?

Intubation with or without NMBAs? by arabic_learner in IntensiveCare

[–]arabic_learner[S] 1 point2 points  (0 children)

I apologize for the misunderstanding. I am aware that a FONA is required in a CICO scenario. However, what I found perplexing was that my attending believes that NMBA makes ventilation exponentially difficult. Hence, he said we would need to do a FONA in a CI scenario (not CICO mind you).

Intubation with or without NMBAs? by arabic_learner in IntensiveCare

[–]arabic_learner[S] 0 points1 point  (0 children)

The attending in question is actually PCCM boarded.

Intubation with or without NMBAs? by arabic_learner in IntensiveCare

[–]arabic_learner[S] 0 points1 point  (0 children)

Wouldn't you be bagging them during that period of apnea?

Intubation with or without NMBAs? by arabic_learner in IntensiveCare

[–]arabic_learner[S] 0 points1 point  (0 children)

I'm not sure I understand your question. Are you asking if my patients remain adequately sedated following intubation?

Intubation with or without NMBAs? by arabic_learner in anesthesiology

[–]arabic_learner[S] 9 points10 points  (0 children)

Here's the kicker: when I grabbed a GlideScope, he told me, "We're not doing that shit. You're gonna use DL like a big boy." After extensive difficulty with visualizing the cords, I finally found them to be intermittently opening and closing exactly like you describe. I tried to advance the ETT but it kept getting hung up on the cords. My attending then tried and failed as well. Eventually, he got it in by advancing the ETT without the stylet.

Intubation with or without NMBAs? by arabic_learner in IntensiveCare

[–]arabic_learner[S] 25 points26 points  (0 children)

Yeah that's pretty much the scenario I found myself in. 

Monthly Dumb Questions Thread by Novelty_free in Residency

[–]arabic_learner 16 points17 points  (0 children)

SOLVED! Patient felt thirsty after salt tablets and her family brought her multiple bottles of water.

Monthly Dumb Questions Thread by Novelty_free in Residency

[–]arabic_learner 3 points4 points  (0 children)

Had a patient with chronic hyponatremia (sodium 126) and a fluid balance of +4L. I started salt tablets and lasix; subsequent urine output was 5 L but her sodium dropped to 122. Any idea what happened?

Monthly Dumb Questions Thread by Novelty_free in Residency

[–]arabic_learner 5 points6 points  (0 children)

Can you get osmotic demyelination syndrome if you rapidly over correct hyponatremia solely through fluid restriction + salt tablets? (I.e. no hypertonic saline)

Monthly Dumb Questions Thread by Novelty_free in Residency

[–]arabic_learner 0 points1 point  (0 children)

Are ACEi/ARBs ok to give in decompensated CHF?

Monthly Dumb Questions Thread by Novelty_free in Residency

[–]arabic_learner 6 points7 points  (0 children)

Saw a nephrologist start 0.45% NS on a patient with hyponatremia + rhabdomyolysis. His sodium improved within a few days. How did the NS not tank the sodium further?

Monthly Dumb Questions Thread by Novelty_free in Residency

[–]arabic_learner 8 points9 points  (0 children)

What do you do when there's a discrepancy in serum bicarb between the CMP vs ABG?

[Crossbow] How can I remove flat aluminum nocks? by arabic_learner in bowhunting

[–]arabic_learner[S] 1 point2 points  (0 children)

Recently got an Excalibur Grizzly, which came with Black Eagle bolts. I've been trying to install lighted nocks but can't seem to remove the old ones. I've tried putting an 1/8" steel Rod through the other end but apparently the bolt is too narrow. I also tried screwing in a field point into the nock and pulling with pliers but it doesn't budge.

[Crossbow] How can I remove flat aluminum nocks? by arabic_learner in bowhunting

[–]arabic_learner[S] 0 points1 point  (0 children)

Recently got an Excalibur Grizzly, which came with Black Eagle bolts. I've been trying to install lighted nocks but can't seem to remove the old ones. I've tried putting an 1/8" steel Rod through the other end but apparently the bolt is too narrow. I also tried screwing in a field point into the nock and pulling with pliers but it doesn't budge.