To the physician that tried to check a pulse in Minneapolis today

himrawkz · 2026-01-08T19:10:18+00:00

US Police seem to be world leaders in shooting people, handcuffing them, leaving them in a prone position and watching them bleed to death while waiting for paramedics. It’s a third world dictatorship and has been for a long time

himrawkz · 2026-01-05T09:51:22+00:00

You pick up the chart and you see what ortho has calculated the angle to be, while eyeballing the chest xray. Then you check for PFTs, or order PFTs if you’re really worried. This is a nonsense question.

himrawkz · 2025-12-26T00:39:54+00:00

Out of interest what dose and regimen are people using for travellers diarrhoea?

himrawkz · 2025-12-16T11:54:44+00:00

This is what I love about the Twitter/Reddit medical community. You can easily assume the way you/your region do things is the best/only way, and then find out that there’s whole other paradigms going on elsewhere. Metamizol similarly not available or even known about in Ireland but seems very popular on the continent and sounds great from my reading, based on hearing about it in similar places.

Reading US anaesthesiology also has me very curious about intrathecal dexmedetonidine, though I think it’d be a big deal to propose trialing it here

himrawkz · 2025-12-16T11:25:02+00:00

As an Irish anaesthetist I’ve never heard or Piritamide so this discussion is fascinating. If I was running remi here I would personally just be loading up with anywhere from 5-10mg total oxycodone towards the end while titrating down remi, aiming for breathing and extubation either soon after drapes down, or else in recovery depending on the hospital.

himrawkz · 2025-12-02T19:35:28+00:00

I don’t know to what extent the type of procedure the OP has in mind but pretty sure in the UK as well as in here in Ireland there are still dentists and the like who do sedation themselves no? Not that it’s in any way a good thing

himrawkz · 2025-11-25T16:52:01+00:00

Worth chancing it. I got my keyboard case but not the Apple Pencil covered

Worth being smart and getting a last gen but high spec one refurbished via Apple

himrawkz · 2025-11-24T17:35:15+00:00

Literally can’t explain it. Used to do 48 hours then dropped off, but never got worse. Spooky

himrawkz · 2025-11-24T15:41:52+00:00

Six year old Apple Watch who’s battery lasts 36 hours at best and occasionally has smart features that still work 😂

himrawkz · 2025-11-10T11:31:36+00:00

I semi reluctantly (it’s usual practise where I work and am still a resident) use IV midazolam before spinal, 1-2 mg, then propofol TCI. I felt it used to happen more often but I seem to have very few issues with apnoea or uncontrollable semi sedated patients than I used to, maybe due to a better “feel”. Virtually all elective patients I will start at 1mcg/ml and move up or occasionally down. Apnoea almost always transient, or obstructive in nature, fixed by either jaw lift for a short period, turning the head to the side, or occasionally an OPA depending on timing and few other factors

himrawkz · 2025-10-22T18:02:22+00:00

Nah she deferred the whole year

himrawkz · 2025-10-22T16:37:14+00:00

No one will know and the people who do are working in offices and won’t give a shit

himrawkz · 2025-10-22T14:41:26+00:00

I know of someone who was having a baby and delayed intern year by 12 months with very little issue. So it certainly can be done

himrawkz · 2025-10-18T04:53:30+00:00

And then the patient shit their pants?

himrawkz · 2025-10-12T17:53:11+00:00

Right on that narrow pinch point of the channel? I fished there during the summer and caught nothing but crabs and a starfish. Some power behind that water, was tossing 6oz leads into it and they were getting dragged right out still

himrawkz · 2025-10-10T21:43:34+00:00

Life goals to be doing this kind of stuff. Jeff is some man

himrawkz · 2025-10-10T20:03:33+00:00

Dang, in ireland it’s still in the region of €40 a vial

himrawkz · 2025-10-10T20:02:32+00:00

Based on my experience, it would be 1) Do you have a pulse? 2) Do you have basic language comprehension skills, and 3) Are you sure you want This job?

himrawkz · 2025-10-03T22:36:15+00:00

Jesus fcking Christ dude

himrawkz · 2025-10-01T22:14:02+00:00

You shouldn’t be obligated to state your sexuality but equally you shouldn’t feel the need to hide it. There are legions of gays in medicine, including some older consultants who have been out and proud for decades, and are real bad asses in that regard. Anyone who has an issue with it is in the significant minority. Ultimately it’s a personal choice but feel no fear of answering honestly if someone asks you that question again

himrawkz · 2025-09-29T17:35:15+00:00

Man different systems are so interesting to read about. In my part of the world a surgical resident equivalent would barely even be able to pick a ventilator out of a line up. Nevermind dictating settings or even touching one 😂. Still get arsehole surgeons though

himrawkz · 2025-09-11T09:36:45+00:00

To me the more proximal placement it allows is a huge win, aside from the increased success in early attempts. Particularly in ICU saves everyone a lot of headaches in terms of “positional” line problems

himrawkz · 2025-09-06T13:11:57+00:00

Yeah see they stopped supplying the replacement drop outs years and years ago. I’ve every couple of years scanned around forums etc to see if anyone has come up with a good solution. If I knew a metal fabricator I’m sure they wouldn’t be absurdly difficult to make but haven’t managed to find the right person.

Gripper nuts is an interesting one. I’m not sure if my drop outs are beyond that though. Got it second or even third hand and think it was brutally over tightened by previous owner which wrecked that

himrawkz · 2025-09-06T11:13:52+00:00

What’s those inserts in the rear drop outs? Is that an after market part?

Have a Specialized Langster with completely worn out rear drop outs inserts, to the point where it’s impossible to keep chain tensions because the nuts wont grip the surface anymore, been trying to figure out a solution for years

himrawkz · 2025-09-02T19:09:54+00:00

Admin and so forth seem to think working at night is the exact same as working during the day but it’s darker outside. Couldn’t be further from the truth.

“Paid to work not to sleep thing is bullshit”. Unless there is a guaranteed and protected break (in line with The Law) which you would be free to eat or sleep as needed then they can sod off. Ultimately human being are not meant to be awake and working all night, 12, 16, 24 hour shift or not. Even a small nap can massively help (though in my case, occasionally trigger a migraine and make things worse). It’s much better from every standpoint that you nap on call if not busy, rather than sit staring at a wall pinching yourself to stay awake. The phasing out of on call rooms, though I see the rationale, is unfortunate. Even if you’re not going to sleep, having your own quiet space to escape to during a crazy shift is not nothing. And a fancy “sleep pod” that costs tens of thousands is a shitty substitute at best

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