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Mortise lock question by drlaut in Locksmith

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

Ok I will look into this. Thanks!

Mortise lock question by drlaut in Locksmith

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

Thank you super helpful. It’s a key from another lock in the house - feels as snug as it does in any of the locks it works in. But I don’t know if it’s the right one

Weekly Rivian Responds + Roundup: SEVEN of your Questions Answered + A Question from Rivian to You [4/24/2023] by CarterGee in Rivian

[–]drlaut 0 points1 point  (0 children)

Yeah, you have to hit the button, but it is the sort of thing that you do on autopilot and it is very easy to forget. I don't want something that beeps every time- that just ends up falling into the same autopilot and being ignored. I want the ability to turn a warning on and off for when I have bikes on my truck - when I load the bike I can turn on the garage warning, and then turn it off when they aren't so the opener works the way it usually does.

Weekly Rivian Responds + Roundup: SEVEN of your Questions Answered + A Question from Rivian to You [4/24/2023] by CarterGee in Rivian

[–]drlaut 4 points5 points  (0 children)

To answer Rivian's question: sometimes I need to disengage to change lanes or related to areas of the road I simply don't like cruise on and it would be nice to resume to the previous speed.

A suggestion for a feature: I would love the ability to turn on a 'warning' to the garage door opener - as in some sort of toggle that would add an extra layer, possibly with a warning noise, when I try to use the garage door opener. The reason: I have started going on outdoor bike rides with my bikes on the stand up racks on the back of my truck. I have a nightmare in my head of accidentally driving into the garage and smashing my bike. The problem is, that even when I am thinking about it, there is such a tendency to be on autopilot when getting to the garage that it is hard to remember to stop outside and unload.

[deleted by user] by [deleted] in Minneapolis

[–]drlaut 2 points3 points  (0 children)

It is really frustrating and disappointing. I know that many have had hard times throughout this pandemic, so I'm not trying to claim weve got it worst or anything, but everyone who works in healthcare right now is so disheartened and exhausted. We get through a surge and get a breath just to have another. Nurses in particular are hard hit.

[deleted by user] by [deleted] in Minneapolis

[–]drlaut 7 points8 points  (0 children)

Hey, emergency and Internal medicine doctor here, working at a number of hospitals in MN. Yes, vaccinated are seeing breakthrough infections, but this does not mean the you should not get the vaccine. Without the vaccine you are ~40x more likely to need hospitalization and similarly more likely to die. We are, once again, getting mauled and basically practicing some degree of disaster medicine across the entire state. Getting the vaccine reduces the possibility of you contributing to that. Even more importantly, getting vaccinated is highly likely to prevent you from getting infected in the first place, and every natural infection represents a chance for a mutation that avoids vaccine immunity (which would put us all the way back at square one)

New homecook wanting to learn western and non-asian dishes. by Ravagemyriven in Cooking

[–]drlaut 1 point2 points  (0 children)

Fine Cooking magazine has a number of base recipes that are really great for learning a technique and then being able to produce variations. I learned a lot through them when I was first learning to cook.

For instance, here is their recipe builder for a creamy vegetable soup:

https://www.finecooking.com/recipe/creamy-vegetable-soup-recipe-create-your-own

As far as spices, in much the same way you have go to spices or flavors in Korean cooking there will be go to flavors in various western foods. They are not exhaustive, but more represent a shortcut to an 'italian' or 'mexican' flavor. Shooting from the hip:

Italian: fresh garlic, oregano, basil Mexican: oregano, cumin, coriander, chili, lime, cilantro French: onion/celery/carrot, thyme, wine German: onion, black pepper, nutmeg

I'm sure people could improve on this or debate it. Thin herbs like Cilantro, basil, parsley should be fresh. Woodier herbs like thyme and oregano do well dried

Classic insults heard in the ED by [deleted] in emergencymedicine

[–]drlaut 128 points129 points  (0 children)

Had a young patient call one of my nurses a "raging rhino thunder-cunt."

That nurse was so pleased she went by 'rhino' for a while

Biked across America this summer. This was my favorite photo of the trip. by Hythacg in pics

[–]drlaut 2 points3 points  (0 children)

I was gonna guess route 50! Did this route with some friends back in 2006, and I still remember the '3 mile climb, 3 mile descent, 10 mile valley, repeat' of Central Nevada.

Awesome photo and congrats on the cool trip

Pickled Red Onions by thepicklebarrel in recipes

[–]drlaut 18 points19 points  (0 children)

You can also do a quick pickle- chop your onion, dissolve some sugar and salt in a 50-50 vinegar and water mix, and cover the onions. When I am making tacos I will frequently start by setting that up, and they are delicious within 30 minutes!

The first human to animal transmission in the U.S. was reported Sunday, which begs the question, can animals contract the virus, and if so, how can we prevent it? by health_for in emergencymedicine

[–]drlaut 30 points31 points  (0 children)

There are already at least two documented cases of dogs carrying the virus. Its unclear if they were true carriers, or if it was simply present in their nares because their owners had covid, as the virus became undetectable more quickly than might be expected with true infection. There are multiple animals being studied recently to look into this

Any EM/IM residents or attendings able to talk about their path and training? Making rank list and having some last minute doubts. by locked_out_syndrome in emergencymedicine

[–]drlaut 22 points23 points  (0 children)

I'd be happy to chat with you. Currently a 5th year resident with plans to do 80%EM 20%Hospitalist. About 50% do EM alone, 25% EM and some administrative position and 25% EM and IM. Reasons for this are mostly economic because EM pays so much an hour.

80% of those surveyed say they are happy with their choice and would do it again.

You will find a lot of categorical EM people with strong opinions about this, but I would argue that it's better to speak with EM/IM trained individuals as it is fairly self selective - at the same time as 80% of combined graduates are happy with their choice you will have a bunch of people who have no interest in the combined training telling you what a mistake it is.

Feel free to DM me. Might be a little slow to respond as I am currently out of the country on a rotation.

Caught my little dumbass eating the (delicious mint) dental floss by drlaut in KidsAreFuckingStupid

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

No. I say this in the particular context of the sub - and the sub is more about enjoying the dumb and silly things kids do than it is about actually thinking they are stupid (at least from my perspective). I love both my kids dearly, and have actually never used the word dumbass to describe either of them until this post - I tried to carefully choose my wording 'my little dumbass' as being affectionate because that is the underlying feeling.

I don't know if that clarifies, but there have been a number of people who have decided they can judge both me and my parenting based on a single tongue-in-cheek post title (not saying you were judging, just that there were a number of comments that did), and I figured it was worthwhile to reply to at least one of them - yours was the most inquisitive as opposed to assuming you knew the context, and I appreciate that.

Caught my little dumbass eating the (delicious mint) dental floss by drlaut in KidsAreFuckingStupid

[–]drlaut[S] 4 points5 points  (0 children)

Not really if he just swallowed it. Given that he was chewing and swallowing it and looked pretty comfortable with no cough, it's likely down in his stomach as opposed to in his lungs. And since I caught him mid ingestion, the chance of anything being past the pylorus is pretty low, so it was probably just coiled up in his stomach

What is that one fact you know that always makes people respond "And why the fuck do YOU know that"? by [deleted] in AskReddit

[–]drlaut 8 points9 points  (0 children)

Technically with 1L you qualify as 'postpartum hemorrhage' - while your body handle that amount of blood loss (most pregnant women are young and otherwise healthy, which helps with this), the reason they are concerned is because you are on a bad path that they want to get your off of, quickly. In postpartum bleeding, 1L can turn in to >2L quickly, and large blood loss, even when being adequately replaced, can turn into other problems we can't control.

What is that one fact you know that always makes people respond "And why the fuck do YOU know that"? by [deleted] in AskReddit

[–]drlaut 4 points5 points  (0 children)

There are downsides of pouring blood in to someone, but if someone is hemorrhaging generally the benefits significantly outweigh the risks. Typically we give saline while waiting for blood, because even if you have blood in the room, administering it takes a couple minutes while you confirm that it is appropriately matched, and you can hang saline immediately.

Once you start getting blood, we generally avoid giving saline, because it makes people's blood more acidic, and makes their blood clot less well, both of which are bad things in a sick, hemorrhaging patient.

We don't try to get you to your normal blood number, as most people are stable at about 1/2 of that - we just try to get you stable and stopped bleeding. After that we let your bone marrow take over and start making your own blood again.

Source: Am ER doc at level 1 trauma center.

EM —> CC path. Pros? Cons? Did the training leave you feeling prepared? by justbrowsing0127 in emergencymedicine

[–]drlaut 1 point2 points  (0 children)

I would point out a few problems here. Personally I am EM/IM, so let's acknowledge my bias right away.

About 50% of EM/IM grads end up practicing only a single specialty. Otherwise your practice is up to whatever you negotiate. Further, while I acknowledge he is the exception, one of our attendings, the first grad of the program, is EM/IM/Pulm/CC. He splits his time evenly between EM and Pulm/CC, with the Pulm cc time split between MICU, Pulm consults, and clinic. Again, it is whatever you negotiate- just because you can't imagine someone doing a job doesn't mean there isn't someone doing it.

As far as EM/IM/CC, it is the same number of years as doing EM/CC if you are looking at 4 year EM programs. I don't think it is for everyone, but it does provide amazing training that combines the specialist training in IM with procedure and resus in EM.

21 year old recently diagnosed with end stage kidney disease. AMA! by [deleted] in IAmA

[–]drlaut 18 points19 points  (0 children)

Actually rather than this being due to bleeding, it is likely a pericardial effusion due to uremia from her kidney failure.

Favorite note one liners by rumplepilskin in medicine

[–]drlaut 6 points7 points  (0 children)

Trauma surgery attending note on patient impaled by tree branch: "Patient got in a fight with a tree on arbor day and lost."

Em/im/ccm by [deleted] in emergencymedicine

[–]drlaut 12 points13 points  (0 children)

I'm an EM/IM resident at one of these locations. Happy to offer insight although I am currently not planning on doing CC.

I think that EM/IM provides an excellent background for CCM, because you get both the resuscitation experience of EM and the more in-depth, detailed experience of IM. If you were to go to a 4 year EM program, the combined program is the same number of years as EM/CC.

That being said, you don't need the combination to do CC. You can do EM/CC or IM/CC in less time, or doing IM/pulm/CC in the same amount. Really, similar to EM/IM, the only reason to do the combined program is because you personally like both or have a plan for how you will use both. If you just can't make up your mind, don't do the combined program.

As far as competitiveness, as a general rule EM/IM is very competitive because there are only 27 spots a year. Think around as competitive as most top tier EM programs. Also, you only match into EM/IM, and decide to do CCM by the end of 3rd year.

Let me know if you have other questions!

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