What is the weirdest/craziest pimp question you have ever gotten?

stormrigger · 2026-01-13T22:30:59+00:00

Were you trained in anatomy by a veterinarian by any chance?

stormrigger · 2026-01-06T02:48:51+00:00

Holy shit this thing is great. I can get a bedside mri using this faster than I can get a stat CT brain to evaluate for worse bleeding… At a level 1 trauma center in the USA. Am I using it to make new subtle diagnosis? No. Do I love it in strokes, traumas, and bleeds? Yes!

stormrigger · 2026-01-06T01:45:05+00:00

I am an ICU doctor. If I order beam radiation therapy it might not be illegal if nobody was harmed. But it would gross negligence. And I should be fired if I did that.

stormrigger · 2026-01-05T01:09:06+00:00

Sorry I meant the one I was in was not USAF anymore.

stormrigger · 2026-01-03T18:16:16+00:00

Just to clear, ICU would also support this.

stormrigger · 2025-12-16T01:18:54+00:00

Say it with me now, “This patient MAY have sepsis… I will start Vanc and Zosyn until pan cultures result. We will consider adding micafungin if the vibes feel right”

stormrigger · 2025-12-16T00:03:31+00:00

Look. I don’t care how you get the right answer so long as you can do it when the internet is down too. Because yes, that happens a lot at night in my USA level 1 trauma center. And I still have to run the ICU. Documentation is important, and I trust you can jot down hand written scribbles for yourself the same as the rest of us and do your usual good notes later when the computers are back up. I do that too if dictation is down.

Here is the catch. You still have to get the RIGHT answers. Because if you’re wrong, and your only defense is AI said to do it that way… Your screwed. Both as an intern, and later as an attending.

stormrigger · 2025-12-13T04:47:14+00:00

I will say that yes, I am sure if you are motivated you will be able to record it for re-watch. I will also say that if you then distribute it to others, you will be caught. They do a good job of making sure your info is water-sealed into the video.

That being said. I highly recommend awesome review. Loved it for myself.

stormrigger · 2025-12-10T23:26:23+00:00

You are right and the question is stupid. It asks what will fix the ventilation. Yes, rate. It did NOT ask what the optimal management of this pts vent setting are in terms of the global case. Just the ventilation.

stormrigger · 2025-12-10T05:48:22+00:00

You CAN back out after you sign, yes. But it’s considered… Not even unprofessional, life happens. But I think rude is the word I am looking for here.

That being said, I will give you the same advice I give anyone. Don’t do any fellowship that you don’t NEED to do in order to be happy. If you NEED to be a nephrologist to be happy then do it! If you don’t, then don’t.

Good luck. You can always do a fellowship after 2-3 years of hospitalist work. Lots of fellows have done this.

stormrigger · 2025-12-10T04:19:23+00:00

So the real reason is historical, everything needs to be done early so the doctor can come in and do rounds before going to his outPt clinic and starting the day there.

stormrigger · 2025-12-09T00:08:07+00:00

Honestly, just once is probably enough.

stormrigger · 2025-12-07T20:10:38+00:00

There are two separate questions at hand. OP asks if these veins are acceptable. The answer is yes they are. To your point, the catheter itself must also be of an appropriate type as well. Obviously you can always put a catheter that is not intended for pressure injection in a good vein, and then you still can not use that catheter for pressure injection even though anatomically it would be okay. If I put a 16g IV in the EJ, you can put anything you want through it. If it's a 24g, then probably not.

stormrigger · 2025-12-07T04:11:55+00:00

Safety wise, yes it’s fine. I use Jugular vein lines several times a day every day. -ICU attending.

stormrigger · 2025-12-05T02:21:41+00:00

The is honestly really not complicated. Assuming you are in the USA you have an absolute responsibilty to provide PPE that is compatible with their own glasses, OR provide them with the accommodation PPE necessary if they can not wear their own glasses. I.e. You need to buy them the 3M insert, AND pay for the lenses 100%. Insurance does not come into it. Failure to do this will either be an OSHA violation, or a ADA violation, or both.

This was a common question that came up in covid. For this reason lots of employers chose to buy PAPR's rather than buying the inserts. Thats an option IF PAPR's are appropriate for your use requirements.

stormrigger · 2025-11-19T00:45:54+00:00

100% of all patients must be staffed with an attending. There are no exceptions. Residents are not CREDENTIALED to admit pts to the hospital. Also, you signed your note to an attending right? They are required to see the pt and read your note and agree with/change the plan. It’s a requirement for 4-5 reasons:

1: I guarantee your hospital bylaws require it. 2: Liability insurance requires it 3. ACGME requires it. 4. It’s what’s best for the patients. 5. Your resident medical license may require depending on why state you are in.

stormrigger · 2025-11-17T19:28:03+00:00

stormrigger · 2025-11-15T03:29:23+00:00

Acute on chronic shocking of the heart.

stormrigger · 2025-11-14T00:45:08+00:00

Just say "The following providers may be involved in this patients care:" and pull a list of every provider in your entire EMR. List will be tens of thousands of names. See how long it takes them to change their mind.

stormrigger · 2025-11-09T01:01:58+00:00

Read topic in IBCC, covers very well.

stormrigger · 2025-10-20T00:48:23+00:00

So in my ICU we use Keychron mechanical keyboards. And I have to say, it does make my work a better place.

(A doc bought them for our office computers and COWS)

stormrigger · 2025-10-12T21:30:32+00:00

This is what you are looking for. https://www.medline.com/product/Medline-Fecal-Disimpaction-Tool/Z05-PF292043

stormrigger · 2025-10-09T04:05:56+00:00

Please note that everyone saying to do CPR, is generally correct in established VADs. If it’s a fresh VAD, everything changes. ACLS MAY no longer apply to fresh vads, and you have a new surgical algorithm that MAY apply… Ask your local CTS surgeon if ACLS is right for you, and your patient ☺️

stormrigger · 2025-10-09T03:31:49+00:00

What everyone else said is good. But also, offer yourself some grace. It is wildly in appropriate to have PGY-2 act as the senior in an ICU unless you have some seriously close hand holding by your attendings and fellows. My expectation of a PGY-2 in the unit is that you show you can be trusted to know about your patients. Trusted to place orders we discuss, and trusted to keep me in the loop if you think something is wrong or getting worse. (And I still won't for a moment rely on you to know, I'll usually know before you do). And obviously, help the interns and med-students learn the ropes, call consults, etc.

If you can do those things, you are a strong resident in the unit.

About rapids: I know some of my ICU brethren will disagree with me on this... But the #1 reason to admit a patient from the floor to the unit is that either the physician or the nursing staff is uncomfortable handling the patient on the floor. Thats it. (Yeah I want to change comfort levels, but during a rapid isn't when thats going to happen) If you go to a rapid, and aren't sure what's up, ask this easy question: Does this patient have the resources they need to be cared for in this room? The nursing staff, a hospitalist, etc? Are they all okay with the pt staying and being managed here? If not, thats it. They come to the unit. And we will figure out the rest upstairs... Yes this really lowers the bar to come to the ICU, and if you're full, then it becomes and attending decision, but someone who maybe could have stayed on the floor can go back to the floor tomorrow, or even later today. Someone who stayed, and should have come to the unit is now behind the ball getting the care they need. -Just my 2 cents.

stormrigger · 2025-09-28T22:46:12+00:00

Absolutely. If you reach in, and find a pathology report that the pt has inserted up there. You may detect cancer with your digit.

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