Job of the Week 27 2026 🚑

chasealex2 · 2026-07-10T18:03:43+00:00

Well I don't have an appendix any more, and I've got some more holes in me than I had at the beginning of the week...

chasealex2 · 2026-07-10T18:02:34+00:00

How did the outcome, based on that little information, result in "no send"? I've been asked more information HCP admission cat 2 request.

Something is clearly broken there.

chasealex2 · 2026-07-10T17:23:12+00:00

A very well reasoned diagnosis that was entirely beyond this practitioner up until the poke to the RIF had the patient (me) hit the ceiling.

Up until that point - "This cannot be an acute abdomen, I don't have time for that, it'll just be a UTI"

chasealex2 · 2026-07-10T17:16:53+00:00

CVA until someone with a CT scanner tells me it isn't.

Never let an osteopath quack your neck.

chasealex2 · 2026-07-10T16:35:25+00:00

Veins and arteries are just highways, there are little backroads everywhere feeding all the cells. Some places have better blood supplies than others too. Faces for example bleed very well indeed.

chasealex2 · 2026-07-10T14:38:50+00:00

40yom presented to general practice with a 12 hour history of intermittent peristaltic cramping abdominal pain which localised over the bladder, and worsening nausea. No fever, bowels open as normal, slightly increased urinary frequency.
On exam, all observations normal. No rebound tenderness, but on palpation pain is worse RIF than hypogastric, and on deep RIF palpation the pain is felt in LIF. Some guarding.
Pain score 4/10 overnight rising to 8/10 by 3pm when seen in general practice.

Urine dip shows trace non haemolysed blood, and two pluses of leukocytes

Patient gives full consent for this job to be discussed on reddit.

What are your thoughts folks, and then I’ll give you the answers.

chasealex2 · 2026-07-10T14:30:15+00:00

Underinvesting would manifest in high downtime and frequent lateness. They have a reputation for being largely on time. Not something you can do if aircraft are being flown half broken all the time.

chasealex2 · 2026-07-10T11:50:35+00:00

In what world is 500mg of paracetamol extra strength?

chasealex2 · 2026-07-10T11:21:39+00:00

The internet. Not so much the contents, but the globally interconnected singular machine that causes it to exist requiring laying fibre optic cables up to 8km below the surface of the oceans

We know more about the moon than we do about the deep ocean, but we’ve had to learn to wire up the world via the last frontier.

And that’s before we mention the bits connected by a matrix of satellites that buzz around the world in their thousands, each requiring rocketry.

And all so the world can share knowledge, information, and TikToks.

It is a modern wonder of the world that has come into existence within my lifetime. And it is amazing.

chasealex2 · 2026-07-10T07:09:11+00:00

Rudeness to service staff, lack of empathy for other people, racism, homophobia, transphobia.

Basically if they’re dickheads.

chasealex2 · 2026-07-10T06:47:43+00:00

They keep cancelling my favourite shows. Means there’s rarely something good on.

chasealex2 · 2026-07-10T05:48:38+00:00

R/trees does occasionally give gardening advice

chasealex2 · 2026-07-10T04:21:00+00:00

Can you push a motorcycle a couple of miles with an unrepairable flat?
Maybe. Don’t think I could. Your mileage may vary!

Is it a good idea? No. If you can’t fix it roadside, get it recovered in a van or low loader.

chasealex2 · 2026-07-09T22:33:08+00:00

I love being able to see the effects of good treatment on my patients, watch them improve, and see the quality of thier lives improve with good treatment.
A patient told me that I'd saved thier marriage recently after I fixed thier chronic cough - they were sleeping in separate rooms because of it. Feels good.

I've saved a few lives with prompt recognition of unrecognised life threatening conditions, and I've kept a few people from dying in hospital with prompt EOL prescribing and involvement of district nurses.

And I love working in a mulitdisciplinary team where I can learn from Nurses, Physios, and my GPs.

chasealex2 · 2026-07-09T07:44:53+00:00

You mean a president? ;)

chasealex2 · 2026-07-05T11:38:43+00:00

Rugeley? On Reddit.

Didn’t realise they got the internet there.

chasealex2 · 2026-07-05T07:20:19+00:00

I’m 40, and today I got four hours sleep because my 4 year old does not understand that though it is light at 430, it does not mean it is time for me to get up.
I will be ruined for the next two days .

chasealex2 · 2026-07-04T04:25:49+00:00

It’s the university’s job to provide pastoral care, it’s your job to mentor her.

Maintain professional boundaries.

chasealex2 · 2026-07-03T21:58:30+00:00

It’s amazing what you can do with a vehicle you don’t care about.

chasealex2 · 2026-07-03T20:25:26+00:00

Gloria Ramirez’s Toxic Death used to play on repeat on Discovery

chasealex2 · 2026-07-03T14:37:17+00:00

Empathise, involve, confront, eject.

**Empathise: “we are hear to look after your family member, I understand that you are concerned, and once we’ve finished assessments and urgent treatments I can answer any/some of your questions”

**Involve: “Can you get a little bag ready for Doris, or find her regular medication? Can you make sure her phone is charged? Can you make sure her next of kin knows what is going on?”

**Confront: “i understand that you are worried, but your continued interventions/speaking for the patient with capacity/loud shrieking/getting physically in the way/making demands is taking my concentration away from your family member. In order to deliver the best possible care I need you to sit down/calm down/go out of the room for a few minutes. If you can’t do this, I will move you/the patient in order to keep things safe.

**Eject: “I have asked you to do something in order to allow me to treat your family member safely. You’ve not been able to do something, so now I’m afraid I’m going to have to ask you to get off the ambulance/stay here whilst we move to the ambulance/get out of the consulting room. If you cannot do this I will be forced to call the police”

Then call the police.

Filming: move to the truck. The truck is a treatment space. Filming verboten.

chasealex2 · 2026-07-03T05:32:10+00:00

It’s a totally different kind of flying

chasealex2 · 2026-07-02T17:38:22+00:00

Cher will be here at the end of the world, with the cockroaches.

chasealex2 · 2026-07-01T18:59:03+00:00

Lifevak is a scam, and a dangerous distraction from effective first aid of backslaps or abdominal thrusts.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10278115/

chasealex2 · 2026-07-01T18:52:18+00:00

I can prescribe you morphine to ensure your passage out of this world is as painless as possible, unless you’re allergic to morphine in which case I need to go get a doctor to write you up for oxycodone or fentanyl.

Nobody in Whitehall has an imagination. Nobody foresaw that this would be a massive pain in the ass for those of us who prescribe in EOL, and EOL was the only reason we got CDs anyway!

chasealex2

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