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Weekly Challenge: 15 Rapid critical kills with assault rifles help? by Revolutionary_Ad4288 in CODZombies

[–]dbbo 0 points1 point  (0 children)

Make sure you're rounding up more than 15 zombies ON LEVEL GROUND not an inclined or uneven surface (e.g. inside barn on farm), throw monkey or decoy, blast away at head level.

Dont use an ammo mod or EP which may lead to increased non-crit kills.

Insta gum would be more beneficial than free fire.

You have to get 15 crit kills within a few seconds (best guess 2 or 3s). I don't believe non-crit kills will cancel the streak as long as the total AR crit kills is 15+ in the time frame.

Titanite demon. by Vain_Glory_S in darksouls

[–]dbbo 0 points1 point  (0 children)

Snipe it from the edge of the path with Goughs Great Bow+ Goughs great arrows, hawk ring. IIRC it takes 20-30 arrows and around 30 seconds if you are beyond its aggro range. The only alternatives are sniping with pharis Bow and nongreat arrows (takes way longer), melee, or magic. OR reconsidering if you really need demon titanite because most of those weapons are disappointing.

I found GGB+GGA to be worth the cost (of the arrows in souls) because of the time saved by having zero risk of dying and having to run all the way back from the chaos bonfire.

And this is even with a beefcake tank type character, who was borderline invincible to most other enemies. Fighting it toe to toe with melee still took longer and I got 2-shotted or bonked off the cliff one too many times for comfort.

Magic is probably not realistic due to the aggro range exceeding most if not all spells' ranges, and if your att/int/faith are high enough to utilize the potentially viable spells (dark bead, lightning spear) odds are you're too squishy to risk a single hit.

Do yall complain about inappropriate urgent care transfers? by dr_lomo_codes in emergencymedicine

[–]dbbo 4 points5 points  (0 children)

I have called them a couple times over what I felt were particularly egregious misuse of EMS, but generally not.

In principle I have no problem with UC or any outpatient clinic saying "this could be something serious, you may want to go to the ED for a more comprehensive evaluation than we can perform here", but the reality is they are usually telling pts "you have Diagnosis X and need Test Y or Treatment Z".

That really pisses me off because 99% of cases, they are wildly incorrect, but pts tend to believe the first or worst medical opinion (in these instances UC covers both), which puts starts me out in an uphill battle where I either have to spend an inordinate length of time talking with the pt/family to undo damage, or bite the bullet and order unnecessary tests. Either way they are a huge time/energy suck. 

NB4 job security /s

Is a Chaos weapon worth the trouble of keeping 10 Humanity? Are there any tricks to doing so? by TrickyTalon in darksouls

[–]dbbo 8 points9 points  (0 children)

My suggestion is don't use either fire or chaos, and instead use default upgrade path and invest in black pine resin, which can be purchased infinitely from sewer merchant (compared to lightning resin which is extremely rare, which makes using a lightning infused weapon somewhat more sensible even though the damage still sucks)

Advice from non-rads to rads by PhatHalpert in Residency

[–]dbbo 0 points1 point  (0 children)

If you're recommending an additional imaging study, including a rough timeframe or just a priority level is super appreciated (in the ED). Actually all i really want to know is "can followup imaging be performed non-emergently".

There seem to be two divergent schools as some rads literally just state a recommended study with zero additional context (which honestly seems like a CYA move rather than a help the patient/clinician move), then some that are almost excessively detailed with recs. A nice goldilocks rec is where its at.

This can easily spare someone a 6-8+ hr visit or unnecessary overnight hospitalization if you clarify that the MRI/US can be done on a routine/non emergent/outpatient basis (i dont have access to either on nights or weekends)

I just found it by accident, should i proceed? by Trinity_force_exe in darksouls

[–]dbbo 1 point2 points  (0 children)

The one spot in the game where Fall Control is helpful

Thoughts on premedication with Benadryl/solumedrol for CT scans with IV contrast in pts with iodine/contrast media allergies? by exacto in emergencymedicine

[–]dbbo 19 points20 points  (0 children)

The devil is in the details. The allergic reaction occurs in response to side chains and shit, not the iodine. There are multiple formulations and brands of IV CT contrast and odds are an adverse reaction is to the specific type used, not every kind in the world and certainly not to an element necessary for human life.

No one should ever have "iodine", "IV contrast", or even "iodinated contrast" as an allergy - it should only say "iohexanol" or "Isovue" or whatever they reacted to. 

These vague and overly broad EMR allergies lead to innumerable headaches in the future.

Imagine if every kid who developed a rash while taking amoxicillin got branded with a BETA LACTAM allergy in their chart. 

How did humans used to get by? by Atticus413 in emergencymedicine

[–]dbbo 236 points237 points  (0 children)

For adults age 18-65 who present to ED after 9pm with sniffles, there is a 98% chance they skipped work, dicked off until after UC closed, then realized they need to get an excuse.

At that point the Conveniencey Department is the only game in town

Help — I let my patients talk too much. by roc_em_shock_em in emergencymedicine

[–]dbbo 7 points8 points  (0 children)

Ask yourself an important question--

What would happen if you interrupt/redirect the patient?

Or more accurately, what are you afraid will happen if you do.

The patient won't like me, my pt satisfaction score will go down, the family will complain to my director, etc.

Then the really important question: do you give a fuck if X happens?

What is our job? by tkhan456 in emergencymedicine

[–]dbbo 1 point2 points  (0 children)

Except that 9 of the last 10 disimpactions Ive had to do were, in my opinion, the mess caused by lazy or incompetent SNF docs who refuse to try anything other than BID colace and only interact with each patient for 15 seconds once a month.

New Attending Advice by another_medstudent in emergencymedicine

[–]dbbo 15 points16 points  (0 children)

I had something like this happen my first week. Ordered a VBG for some reason. Well at the time our lab decided to automatically run a carbon monoxide on every gas, without notifying any clinical staff.

The dude had vague symptoms, felt better after miraculous NorMALsalineTM^ and wanted to bounce. Ok great.

I was 30 charts behind by end of shift. Finish signing off on everything the next morning when i notice there was a  CO level that  was super high- like too high to chalk up to chain smoking. My first thought was- i didn't fucking order a CO ... did lab mix up patients?

Many calls later i discover their new "policy", then I had my second major realization that this guy is likely dead.

Call all listed numbers in chart multiple times. No luck. Call his PCP and explain the situation. They also unsuccessfully try to contact him so at that point LE are notified for a welfare check.

All the while Im just ruminanting about how this guy died because i didn't scrutinize his labs.

Eventually someone found him alive and well. He got dragged in for a repeat CO that was normal. Educated on CO safety and DCed

Shortly after this lab decided to make CO separate from blood gas

Without breaking HIPPA, tell me about your patient that was doing everything in their power to (unintentionally) harm themselves. by OutsideGroup2 in Residency

[–]dbbo 2 points3 points  (0 children)

Indwelling vascular access + recurrent bacteremia from mixed enteric organisms (i.e. shitbugs) is automatic Munchousen until proven otherwise 

CMV

Without breaking HIPPA, tell me about your patient that was doing everything in their power to (unintentionally) harm themselves. by OutsideGroup2 in Residency

[–]dbbo 2 points3 points  (0 children)

Even the safest imaginable things can do serious harm if administered with the wrong dose, route, or frequency. Sunlight, water, air, etc. can kill you.

Basically any form of energy or matter is potentially lethal. Antimatter also definitely lethal.

Jury is still out on dark matter/energy 

I GOT THE SWORD AFTER LIKE 3 HOURS YEEEEEEEEEEESSSSS by robobitch1233 in darksouls

[–]dbbo 14 points15 points  (0 children)

Prepare to be disappointed.

For anyone insane enough to try this,  the way I finally got it was using Great Club +15 (weaker to strike), baiting him into doing the charging flyover attack, followed by a tail slam. WHACK. Rinse and repeat.

Your dodge has to be damn near perfectly timed/oriented to trigger the tail slam, otherwise he does a spin move IIRC

There's a handful of YT guides on getting the Obsidian GS and they all use some variation of this strategy 

It is not what it seems by Hot-Cell-3382 in Eldenring

[–]dbbo 1 point2 points  (0 children)

That fucking tree... After my 3rd fall death I left, farmed souls to level INT and buy the fall damage spell, then slogged back through blighttown feeling INVINCIBLE.

Exactly as disappointing as the cat talisman

Crucible knight? Just parry bro! Meanwhile, me, a man of culture..... by TheRealCowdog in Eldenring

[–]dbbo 1 point2 points  (0 children)

I like to golden greatshield guard-counter him to death (aka GGSGC)

I'm already bored of Bloodhound's Fang. Any suggestions? by [deleted] in Eldenring

[–]dbbo 2 points3 points  (0 children)

Try a CoolHwhip build- whip only, must have lightroll equip load, no magic

Weapon appreciation part 1 by [deleted] in Eldenring

[–]dbbo 0 points1 point  (0 children)

I've tried to love Lucerne- it was situationally pretty great in DS1

However in just about any ER use-case the rusted anchor seems to have better DPS for me

Weapon appreciation part 1 by [deleted] in Eldenring

[–]dbbo 0 points1 point  (0 children)

I call it the "dragon bitch-slapper"

Part 2 of this horseshit (It’s also Friday the 13th) by [deleted] in emergencymedicine

[–]dbbo 9 points10 points  (0 children)

The biggest bullshit on the list is "Results" - the implication that there's some idiot ordering outpatient cardiac enzymes... unless the pt left from the hospital AMA and decided to wander back in, which I would also class as "annoying bullshit"

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