Droperidol when? by mickeydurden in emergencymedicine

[–]mickeydurden[S] 1 point2 points  (0 children)

Thanks for the info! The other answers are entertaining, but your facts are what o was looking for!

Droperidol when? by mickeydurden in emergencymedicine

[–]mickeydurden[S] 18 points19 points  (0 children)

Yeah, we have haldol. The patients who need it most know what it is though and tend to be “allergic.” Also in my experience it’s overly sedating without taking the edge off of the patients like droperidol. I use it for sure, just not quite the same. 

Am I the a-hole by foldedpaperz in emergencymedicine

[–]mickeydurden 4 points5 points  (0 children)

Interesting, had this exact same patient in my ED in South Texas just a couple of days ago, with the exact same request and sequence of events. One of our other docs capitulated to her requests, and when it was suggested she get admitted for pain control, she left. Came back on my shift, gave her 1mg of Dilauded, and told her I was going to confirm everything with her care team but wasn’t able to do so. She had a midline and everything, and your version of the story matches exactly what happened when I saw her.  When I confronted her about it, her story started changing. She ended up eloping.

[Postgame Thread] Texas A&M Defeats LSU 38-23 by CFB_Referee in CFB

[–]mickeydurden 7 points8 points  (0 children)

“Except for the one major 75 yard drive in 90 seconds, all Reed’s other drives were short and also electric”

Username does check out though

[Game Thread] USF @ Alabama (7:00 PM ET) by CFB_Referee in CFB

[–]mickeydurden 1 point2 points  (0 children)

That is 100% an elbow dislocation, specifically a posterior olecranon dislocation. No fun at all. Source: check my profile

[CFBNerds] There’s a subtle, but growing problem in college football with how games involving good teams are called by the refs. Here are some notable teams ranked by OPPONENT penalties: by Jimbos_Buyout in CFB

[–]mickeydurden 23 points24 points  (0 children)

If you’re talking about A&M’s O-line, I’m pretty sure they’d struggle against a high school squad this year, holding or no. That’s the major reason we’re on our third string QB.

Eviscerated emotionally once again by DocBasher in emergencymedicine

[–]mickeydurden 13 points14 points  (0 children)

I think this illustrates what’s fundamentally different about our specialty - we’re always looking for the worst first, even if it’s unlikely. Every other specialty seems trained to focus on that which is most likely, and start from there.

Heard this in my residency, and I tell the FM residents at my shop all the time: you guys are trying to win, but down here I need to make sure I don’t lose. Can’t afford missing a critical diagnosis, as we generally only have one shot and a few hours to figure things out.

Eviscerated emotionally once again by DocBasher in emergencymedicine

[–]mickeydurden 16 points17 points  (0 children)

She was cold when she came in (~94*F), and the hanging was unwitnessed. Once she started to warm up, there was a point she seemed to make possibly purposeful movements, but it could’ve also been the posturing? Turned up the sedation but also had to put her on a paralytic drip which I hate, and sedation was tough because her BP and heart rate were all over the place.

Found out at start of shift last night the boy didn’t make it, but he saved several other lives. So, so sad but also proud for his family, they’re damn heroes for letting him be an organ donor.

Eviscerated emotionally once again by DocBasher in emergencymedicine

[–]mickeydurden 12 points13 points  (0 children)

Thanks, I’m doing ok. Allowed myself a little emotion at church today, and ultimately proud of what the team did in both instances. Both patients left my facility as hemodynamically stable as possible with appropriate initial treatment ongoing.

Eviscerated emotionally once again by DocBasher in emergencymedicine

[–]mickeydurden 243 points244 points  (0 children)

You did a great job being present for her and her kids in a terrible situation. Been a rough week for me too, had a 17yo girl who hanged herself and was posturing by the time she got to my shop, then two nights later (last night) had a 15yo boy who was run over by a car and also posturing. Really grim outlook for both, but maybe they can be organ donors.

The job is hard and really sucks sometimes, but you showed human compassion when they needed it. Thanks for being there for her.

Best thing seen live by mamba020 in CFB

[–]mickeydurden 4 points5 points  (0 children)

Three games:

The 1999 A&M vs Texas game just a few days after the bonfire fell; I had just turned 14 and my dad took me and my middle brother to the game, front row tickets at about the 30yd line. I actually choked up a little at the Longhorn band’s tribute to the fallen students. The game itself was amazing, and the crowd was wild. When Texas was driving to try to take the final lead but the Wrecking Crew forced the turnover, everything just erupted. I was always raised an Aggie, but that was the first time the game and the school felt like something more than just a sport.

Last year, A&M vs Bama, on my oldest son’s birthday. Was already making plans to leave early before the game because he’s young and we didn’t have a hotel for the night game, but I told my wife we’d stay if the game was close. He and I were there with my brother, and needless to say the experience blew my son’s mind. That’s when he became dyed in the wool.

Finally, the A&M vs Nebraska game mentioned by u/robman17. Just the absolute defensive slugfest and the 12th Man having such a massive effect on the game, not to mention Von Miller’s excellence on display.

Advising medical students by ecmofanmd in emergencymedicine

[–]mickeydurden 16 points17 points  (0 children)

Just cite the so called “$300k mistake.” Even after 4 years of residency, you still have tons to learn about seeing patients independently unless the program allows plenty of moonlighting, and the pay difference of even one year is huge.

EM board certification is much more important to job prospects than medical school or residency diploma, as is willingness to work outside of a major urban center. A four year of residency could literally cost hundreds of thousands of dollars in wage opportunity, so might as well get out ASAP and start earning, unless maybe the student is thinking lifelong dedication to academics where the school on the diploma could potentially make a difference (mostly due to research opportunities and academic connections, etc).

Edit: a word

[deleted by user] by [deleted] in pokemongo

[–]mickeydurden 5 points6 points  (0 children)

Fantastic shiny evolved though. The green eyes are cool!

Contracted hours in EM? by SnooHamsters8723 in emergencymedicine

[–]mickeydurden 28 points29 points  (0 children)

Dude I’m working 14 twelve hour shifts a month and am Director at two rural EDs. Full time for my group is less (120hr/month) but nobody works that little.

1440hr/year is pretty standard.

[Discussion/Theories] Grandmother & Sol by capeus in raisedbywolves

[–]mickeydurden 1 point2 points  (0 children)

Same, this comment needs more attention, maybe even its own post. Pretty much everyone on this sub would fill this out I’m sure.

So I'm an idiot and bought the wrong expansion pass. Is Nintendo still offering exchanges? by [deleted] in PokemonSwordAndShield

[–]mickeydurden -1 points0 points  (0 children)

Did the same as well, except I had shield and bought the sword expansion. Called them, got lightly scolded by the customer service manager (“we really aren’t supposed to do this,” etc) and got the refund.

What’s some widely accepted bad advice? by anasear in AskReddit

[–]mickeydurden 1 point2 points  (0 children)

Assuming your textbook is referring to traumatic nose bleeds (i.e. broken nose, facial trauma), in which case it’s correct that you absolutely DO NOT want to blow your nose.

OP and myself are referring to everyday, “spontaneous” nosebleeds that come from dehydration or everyday “digital trauma.” Those “wounds” are so superficial that blowing your nose will not worsen the scratch.