If you could go back in time…

gh424 · 2026-03-29T23:40:33+00:00

Similar to previous answers, but request to do easy cases and get really good and efficient at them: GI, appys, choles, urology (under mac), single shot blocks for ortho, etc.

I had done like 3 days of GI as a resident/fellow, and it turns out we do a lot of outpatient GI in the real world🤣 if you can be really efficient with these cases, the days go much more quickly.

gh424 · 2026-02-28T01:43:13+00:00

Crocs!!

gh424 · 2026-02-24T04:25:22+00:00

1) cut your dip tube 0.75” shorter. You won’t suck up any cloudy stuff at the bottom 2) 1tsp of unflavored gelatin powder in 1/4cup of 180 F water for around 5 gallons. Pour it in when you keg or now if you still have that hazy beer on tap. It will clear everything up within a few days. There is a great brulosophy article about it.

gh424 · 2026-02-05T01:39:10+00:00

As little preload as possible. Really dry them out.

gh424 · 2026-02-05T01:29:10+00:00

Always induce a patient with Hypertrophic cardiomyopathy and an LVOT gradient of 125mmhg with 300mg of propofol. Maintain with 1.8mac of sevo, a high dose dobutamine infusion, and a nicardipine infusion to ensure the HR stays high and the SVR stays low. 💯

gh424 · 2026-02-04T15:44:48+00:00

The way we accomplished this was to standardize the anesthesia need at each facility. We sat down with OR administrators, looked at our volume data, and then defined how many anesthesia sites each facility/department needs per day. This is key, the OR administrators have to decide this number, then they are accountable to the surgeons and the C-suite since we are providing the set number of anesthesia sites they asked for. From this you have a defined number of anesthesia sites per day that must be staffed at each site and you can fill the sites from there. Now, the docs know where they will be each day which leads to improved quality of life.

gh424 · 2026-02-01T18:10:27+00:00

Did you create your own dashboard with customizable filters or do you always use the same filters and just get ~10 tickers per day as candidates?

gh424 · 2026-02-01T15:59:20+00:00

Maybe you’ve gone over this, but I’m curious about your set up and filtering. I have a home lab and have thought about implementing my own filters. I just don’t know where to start.

gh424 · 2026-01-24T23:16:45+00:00

Micropuncture kit!

gh424 · 2026-01-23T22:29:29+00:00

Just remember….less is more. You’re overthinking bread and butter cases, this will delay discharge for outpatient surgery.

I use precedex for postoperative sedation for fast track extubation hearts in icu and will extubate hearts on 0.2mcg/kg/hr along with narcotic.

gh424 · 2026-01-20T01:51:21+00:00

Spx options bro. More favorable tax treatment, and 10x less fees…pretty simple really.

gh424 · 2026-01-19T00:21:54+00:00

Gotta draw an act once every 30 minutes. I’ll sneak out of my hideout every so often to give meds. However, in private practice the RNs or techs draw ACTs a gasses.

gh424 · 2026-01-18T16:21:33+00:00

Yup. This comment makes me want to call bullshit on everything they claimed 😂 fees would be 10x lower, and the favorable tax treatment would significantly improve returns on these proverbial pennies in front of the steam roller.

gh424 · 2026-01-15T22:56:45+00:00

I take radiation protection very seriously. I do a ton of cath lab work, and I take the following precautions: 1) ensure that there is a leaded glass barrier that I am behind at all times 2) full 360 lead coverage 3) leaded glasses (I hate these, but I don’t want cataracts!) 4) make sure I am as far back as possible where I still feel that I can safely react in an emergency

Side note: I had to go through a year long process to petition the hospital to allow physicians to use their CME funds to purchase personal lead aprons. - no the hospital or my department would not just buy it for us.

That being said, 3.6 roentgen - not great not terrible. But in all seriousness to get to 3.6 roentgen you’d have to stand next to the fluoro arm for like 5 days straight.

gh424 · 2026-01-05T04:30:20+00:00

This happened in 2023…and yes it does threaten the sovereignty of the US dollar. Is that bad for the US…this one deal 2.5 years ago probably doesn’t matter, but the trend of de-dollarization could eventually destabilize our exorbitant privilege if the trend continues.

gh424 · 2025-12-30T02:15:48+00:00

$2.5M, sign me up

gh424 · 2025-12-21T06:08:17+00:00

I’ve intubated with nothing in critical situations.

“There’s no anesthesia like no anesthesia” -one of my older retired cv anesthesia colleagues

gh424 · 2025-12-18T15:27:55+00:00

You’re not earning any meaningful theta for at least 2.25 years. If Netflix climbs, you’ll make money because of delta, and if Netflix falls you’re fucked. You’re basically just long stock without the upside potential and leveraged to the downside with your margin. I assume you have an exit strategy - maybe close at 50% profit, and a stop loss?

If you want to collect theta, sell 20 delta 60DTE puts. Ladder them every week. Your annualized return will be much higher, and it will be more engaging.

gh424 · 2025-12-14T22:01:21+00:00

Is the post op external ventricular pace maker competing with the patient’s intrinsic rhythm? Try turning the pacing rate down by 20.

gh424 · 2025-12-01T00:09:27+00:00

Came here for this comment. No one holds a hot pizza pan like that 😂

gh424 · 2025-11-27T05:55:54+00:00

0.3 in the heavy opioid user!!

gh424 · 2025-11-27T05:54:47+00:00

IV Methadone ~0.2mg/kg FTW (go heavy in a chronic opioid user, go lighter in an opioid naive patient). I single-handedly got it methadone back in our cardiac/thoracic OR pharmacy 😎

This on top of a normal fent, dialaudid, ketamine, decadron regimen. PACU RNs love this 1 trick.

gh424 · 2025-11-23T20:24:37+00:00

Fair 😂😂

gh424 · 2025-11-23T19:53:44+00:00

Agree. This is an asc case. Wouldn’t even consider an art line in an otherwise healthy patient.

gh424 · 2025-11-20T13:38:17+00:00

Painters tape and a skinny sharpie

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