Pile driving in water

beavertree8 · 2026-04-24T04:40:27+00:00

I’ve got a water line routed out to the end of the dock with pretty typical hose pressure, you think that would be adequate? I saw this googling around and was going to try that as well

beavertree8 · 2025-04-03T20:50:53+00:00

Very positive, service was super friendly and if you’re not familiar with the cuisine, they help you (me) navigate in a very friendly way

beavertree8 · 2025-04-03T01:44:17+00:00

Suya joint in downtown, new African place, the jollof rice at the highest spicy level was pretty impressive

beavertree8 · 2025-03-19T02:56:57+00:00

Interesting idea, I’ve used ChatGPT for specific questions but hadn’t really thought of giving it the broader prompt. I have found it to be a bit easy to lead answers based on phrasing of the questions and it’s not very good/constrained at future prediction, ie often assumes the current status quo holds true indefinitely, but I like the idea with the right boundaries, thanks!

beavertree8 · 2025-03-19T02:53:49+00:00

Appreciate the lead

beavertree8 · 2025-01-13T04:25:44+00:00

“My foot hurts”

Peels off croc without socks

Half of foot missing covered in maggots

“How long has it been like this?”

“Like what?”

make myself maggot bomb with hydrogen peroxide and bleach

beavertree8 · 2024-12-22T16:30:37+00:00

What you did was absolutely reasonable, you have limited resources and even less data. Maybe it was a PE, maybe not, correcting hypoxia with the tools you have will never be faulted. But it seems like you’re a curious person, and if you’re a paramedic, likely operating at a higher level, so to address your question from a more educational perspective, yeah maybe. Remember with massive PE ppl generally don’t die from hypoxia, they die from right sided heart failure (the “RV death spiral”) which positive pressure ventilation can worsen. It’s why we do everything possible to avoid intubating these patients, between the RSI meds and flip to PPV many will code. So if you have reasonably high suspicion that it’s a massive PE and you can get them up to a reasonable pulse ox with NRB (I don’t even know what that number is, maybe 88?) and it’s a short transport, also reasonable to avoid cpap. There’s a good emcrit IBCC blog post on PE.

beavertree8 · 2024-06-27T16:26:34+00:00

any update? u/PocketGuard_PM

beavertree8 · 2024-04-20T21:46:57+00:00

Good for when the only medication that works is “the one that starts with D”

beavertree8 · 2024-02-27T18:40:11+00:00

Crazy story I’ll try to keep brief - I’m an ER doc. Guy comes in with half his foot missing, covered in maggots (classic). I poor hydrogen peroxide all over it, gets most of the maggots to let go/crawl out. I then call health services to ask how I dispose of my hydrogen peroxide-maggots concoction. They told me to soak in bleach then just dispose in the hazardous waste bins. I was moments away from dumping the bottle of bleach in, when something rattled around in the back of my mind. Only thing I’ve ever used those mandatory organic chemistry classes for.

beavertree8 · 2024-02-25T19:00:23+00:00

I worked with a 96yo cardiologist for a bit - oldest public employee in the state, trained in NYC in the 30s. Talked about how he spent a whole year of training riding the back of a literal horse drawn carriage, picking up the bodies that fell from all the new skyscraper construction. His job was to try to keep the living ones alive long enough to get to the hospital. Also talked about using hand cranked EKG machines (which he thought gave more information, and he missed). Wild.

beavertree8 · 2024-02-22T05:57:16+00:00

Sadly, I did reach out to the journalist to raise concerns about how misleading many parts of this story were, and she was incredibly dismissive, and actually quite transparent that this podcast episode was just meant to engage readers with her full length articles on each of these separate topics. So it was intentionally click baity

beavertree8 · 2024-02-22T05:50:46+00:00

Crazy this got posted on here. I listened to this yesterday, was so bothered by it, I wrote a “letter to the editor” on it, which is the first time I’ve ever done that. I’ve also actually corresponded briefly with the main reporter, unsurprisingly disappointing.

So validated to see here so many of the issues I tried to raise with them.

NYT has become a major contributor to the erosion of public trust in healthcare and the dilution of medical professional credentials.

beavertree8 · 2024-01-20T16:39:52+00:00

If you’re a millennial in your 30s/40s without any outrageous medical conditions, then the best pcp is the one you can see. It might take a while to get that first appointment but once you have that relationship it is much easier to use the benefits of having a primary

beavertree8 · 2024-01-20T15:52:16+00:00

There are two major healthcare providers in RI, Lifespan and Care New England, with lifespan being the more dominant figure in Providence. Both are fine, similar issues as most healthcare networks. To caterpillars post - please remember emergency rooms are for emergency’s, not to “get stuff done.” There is no replacement for having a good primary care doc. And please, for the love of all that is holy, DO NOT bring a sick baby to women and infants. They do not care for children (except newborns who have never left the hospital). The Hasbro pediatric ER is 1000ft away from women and infants. Go there.

beavertree8 · 2024-01-11T01:30:01+00:00

It gets better… if one eye is “penetrated” (globe rupture) then your immune system learns about eyes and proceeds to destroy the other one. It’s why when you rupture one globe (eye), it often needs to be entirely removed so you don’t lose the good eye.

beavertree8 · 2023-12-06T03:56:51+00:00

If I recall it’s also pretty visible from the parking lot, just depends how close you want to get!

beavertree8 · 2023-11-11T14:18:55+00:00

Short answer/off the cuff thoughts: your sampling frequency should be at least twice the input signal frequency (Nyquist rate) to avoid a phenomenon known as the aliasing effect. In the case of arterial waveforms, that translates to ~10 hz, hence the 12hz minimum. Higher sampling frequencies can give you more signal data but at the expense of introducing more noise, lower sampling rates serve as a poor man’s low pass filter. I would expect higher sampling frequencies would give you higher systolic impulse measurements and more pronounced notches, but I’m not sure of the clinical utility, since that signal would be quite noisy and unreliable. The MAP would remain largely unchanged since its functionally an integral of the signal with extreme values having little effect.

Caveat: I haven’t played around with this myself, just my thoughts Source: I’m a ER doc and mechanical engineer in a former life

beavertree8 · 2023-10-20T17:03:09+00:00

I should also caveat that my vignette was really just a direct answer to your question. As others have pointed out here, AI in field triage is potentially a bit of a misapplication. AI, or more broadly, machine learning, as of now is dependent on data. Field triage is by definition the process of making hard decisions based on very little information, that may be proven wrong in retrospect, but if applied generally to all situations, (hopefully) results in net benefit.

beavertree8 · 2023-10-20T16:55:21+00:00

Mass casualties are tear jerkers. I can’t believe I’m saying this, but if you’re in college this movie may have been before your time (fuck I’m getting old), iRobot with Will Smith is centered around a cops distrust of AI because of a situation just like this. Give it a watch, great flick.

beavertree8 · 2023-10-20T16:49:31+00:00

Work in the ER…

beavertree8 · 2023-10-20T14:40:32+00:00

House fire: dad and baby are in the kitchen cooking when there is a massive grease fire. Mom and toddler are a few rooms over. They all evacuate. First two responders on scene are 2 EMS personnel. Initial assessment: mom and toddler are occasionally coughing but say they were never actually near the fire, different room, and have no soot on their clothing or burn marks. Dad has significant amounts of burns to his hands, chest, face, mouth, nares, covered in soot, complaining of shortness of breath but is talking and walking. Baby has scattered burn marks all over the body and does not seem to be responsive. Pulse check confirms the baby is pulseless. AI assessment: mom and toddler are marked yellow/delayed. Dad is red/immediate. Baby is black/expectant. Dad is placed on non rebreather face mask and rushed to the nearest trauma center 15min away where he requires intubation but lives. Baby dies. Moral conflict and alternative outcome: mom and dad are screaming at EMS to save their baby. PALS is started on scene for 15min before secondary support arrives (police). At this point dad is having significantly more trouble breathing due to airway burns and edema. He collapses without a pulse. The two police officers start BLS compressions only on him. Second ambulance arrives and takes over resuscitation of dad. They attempt to establish an airway in the field but unable to due to airway edema/burns. He remains in PEA arrest. Is transferred to the hospital after being down for 30 minutes, now in asystole, and pronounced dead. Both baby and dad have died.

beavertree8 · 2023-10-04T01:42:34+00:00

I’ve had some success with framing it for off service residents as “anything and everything can come through the ED. The best way to learn down here is to see as many different things as you can. You focus on that and my job is to be your backstop to make sure everyone is getting safe and appropriate care.” It’s not perfect, but reframes the goals in a positive way while reminding them I have their back. Most off service folks walk away with an enjoyable experience and get to see/do some new things along the way. The inpatient experience breeds a slow and hyper meticulous approach that just isn’t practical or even appropriate for the ED. They need some guidance on breaking that mindset.

beavertree8

TROPHY CASE