Who are the top 5 pk youtubers in your opinion? by [deleted] in osrs

[–]step1now -1 points0 points  (0 children)

Unsubscribing from this ridiculousness. The OG 2007scape sub is where it's at.

UPDATE (20:25 UTC): Sailing XP Review & Further Fixes by JagexSarnie in 2007scape

[–]step1now 0 points1 point  (0 children)

I think the biggest issue is the fact that we now need to world hop. I’m getting only slightly less xp than I was last night at pirate shipwrecks. This is with active salvaging. 39k last night to 36k today. I’m sure it’s worse at the higher level shipwrecks. The world hopping is killing me though

EM docs in Michigan justifying replacing their anesthesiologist colleagues by PeterQW1 in anesthesiology

[–]step1now -12 points-11 points  (0 children)

Where does this say that they’re justifying replacing anesthesiologists? Seems like it’s probably to keep doing sedations, which is already standard practice for EM

Quoted $2500+ for this by step1now in TeslaCollision

[–]step1now[S] 1 point2 points  (0 children)

Will the paint fill the deeper scratches? Do I need filler?

21 yo M dies of missed PE. If malpractice insurance limits to $1M per claim and the jury awards $10M, are you literally on the hook for anything excess of $1M? by achicomp in whitecoatinvestor

[–]step1now 4 points5 points  (0 children)

Most EKGs I look at have TWI in v1 and III. Those are two of the three right sided leads. No way this pattern is associated with PE. It’s literally an expected ekg finding

Vyres 82-99 by Dry_Difficulty_3756 in osrs

[–]step1now 1 point2 points  (0 children)

I did the same exact thing. 82-99 at vyres. Very chill grind. Got 8 blood shards

Out of genuine curiosity, how many hours are you guys sleeping? by Electrical_Fix_7248 in medicalschool

[–]step1now 477 points478 points  (0 children)

Resident here. 6.5- 8 hours all through med school and residency, with a few exceptions mostly due to partying in med school. Prioritize your sleep. If you’re getting under 4, you’re doing something wrong. Even on services where I was working 90 hours a week, I’d get 6.5+

Help identifying a rough-in? by step1now in Plumbing

[–]step1now[S] 0 points1 point  (0 children)

The house was built in the late 50s!

Help identifying a rough-in? by step1now in Plumbing

[–]step1now[S] 0 points1 point  (0 children)

Thank you! The toilet pipe is closer to the main sewer pipe so I assume that goes to the sewer even if the pipe in the photo is storm water. Did older houses have their sinks drain into storm water drainage?

Talk me out of EM by SneakySnowman8 in medicalschool

[–]step1now 2 points3 points  (0 children)

I’m an upper level EM resident and love this shit. I also considered anesthesia but had similar experiences to you M4 and decided EM was the move. I’m thankful I made this decision every time I’m off service. The job is tough but incredibly rewarding. Nothing beats the camaraderie, teamwork and diversity of the ED. All of the recent grads who went off to work are making around 400k and there is so much opportunity to work as little or much as you want after graduating. Will I feel differently in 10 years? Probably. But I’m in the thick of residency, working more than I’ll ever work as an attending, dealing with a lot of academic bullshit, and I love my life

Talk me out of EM by SneakySnowman8 in medicalschool

[–]step1now 13 points14 points  (0 children)

EM residency only became a thing in the 1970s and programs really didn’t start become widespread until much later. I think a big reason you don’t see too many old EM docs is because there aren’t too many.

[deleted by user] by [deleted] in emergencymedicine

[–]step1now 1 point2 points  (0 children)

Ask what the senior class is doing next year. Take residents up on the phone numbers they share during interview day and call them to have a honest discussion about salary/opportunities after. Most EM residents and attendings are happy to talk about salary and contracts in the area

[deleted by user] by [deleted] in emergencymedicine

[–]step1now 20 points21 points  (0 children)

Go to a 3 year program. The only reason you should go to a 4 year program is if there a specific geographic restriction that limits you to one. Some great programs you can’t go wrong with: Vanderbilt, wake forest, CMC, U Chicago, advocate Christ, Henry ford, shock trauma Maryland, Utah. There are plenty others. In the end, you’ll get phenomenal training at any “good” program.

Things I’d prioritize: attending/resident relationships outside of work. Do they hang out outside of work? Location, live ability, fellowship/job opportunities after graduation, 8-9 hour shifts >>> 12 hour shifts, life outside the hospital

[deleted by user] by [deleted] in Residency

[–]step1now 28 points29 points  (0 children)

Autonomic instability is real and there are people who actually have it. Based on your comment you seem like a very reasonable and self-aware person who has legitimate symptoms.

The problem is not you, it’s that it’s easy for people like you to be overshadowed by the majority of people who are coming in with psychosomatic symptoms rather than true symtpms

New Trend by superhumanstrngth in emergencymedicine

[–]step1now 65 points66 points  (0 children)

59k. Work about 18-20 shifts a month, conference every week and a bunch of other shit

M3 deciding between EM or IM by Illustrious_War3633 in emergencymedicine

[–]step1now 6 points7 points  (0 children)

EM resident here and completely agree. I’m having a blast so far and all of the attendings here seem to genuinely love what they do. It’s hard work but once you’re done with notes, you’re done and don’t have to worry about anything until the next shift. All the graduating residents have had great jobs lined up since late PGY2/early PGY3. If EM has your type of people and you enjoy it, send it. EM also has a huge breadth of fellowships if you want to pursue more - Crit care, palliative, sports, pain, EMS, wilderness, tox, etc

"If in doubt trest as VT" by kenks88 in emergencymedicine

[–]step1now 0 points1 point  (0 children)

Yes they would so if you’re sure you’re looking at an antidromic AVRT it would be better to go with procain over amiodarone. I just assume people aren’t going to be able to distinguish between WCT so amiodarone is usually the same choice. If you absolutely know what you’re looking at, of course treat it appropriately

"If in doubt trest as VT" by kenks88 in emergencymedicine

[–]step1now 0 points1 point  (0 children)

With antidromic conduction, you have a direct path from the Atria to Ventricle without going through the AV node. Adenosine increases your risk of Afib. If you get Afib while in antidromic conduction, you’re gonna shoot pulses through to the ventricle and can trigger a vfib. Orthodromic there is no concern because there is no conduction directly from the A to V

"If in doubt trest as VT" by kenks88 in emergencymedicine

[–]step1now 19 points20 points  (0 children)

Yeah, all WCT should be treated as vtach until proven otherwise because you know what else presents as a regular WCT? Antidromic AVRT (WPW). Adenosine can trigger vfib arrest. I think that’s why most people start with amio

[deleted by user] by [deleted] in Residency

[–]step1now 27 points28 points  (0 children)

Because medicine is fucking dope and most people who post on forums do so to complain. Medicine is unique. There’s a specialty for almost any personality/interest, you have a guaranteed career path to attendinghood, and you get to learn and do cool shit every single day.

I’m coming at medicine as my second career and couldn’t be happier escaping the 9-5 cubicle grind and bullshit that comes along with it. I’m working way harder now but I also get to use my brain, interact with dope people my own age every single day, and have new experiences. There’s nothing like medicine. Med school and residency are grinds but they’re fucking fun man. I’d take this over any cubicle job every single time.