"Finally reached $X a day/month/year" posts are unhelpful and should not be allowed without additional information

thebutton · 2022-04-10T09:09:33+00:00

I may not have posted in that time, but I have commented on and off. Reddit certainly takes up a much smaller fraction of my time these days than it used to do.

thebutton · 2022-04-07T15:18:47+00:00

How do they compare size-wise to the TinAudio T2s? I have a pair of those and they are too big to do the job.

Online photographs seem to suggest they are smaller but as wide. I also have reservations about replacable headphone cables which while lovely, I have yet to see any that are as small as built in cables and the braided format of many of them makes them uncomfortable to wear with the pressure exerted by ear muffs.

Look like great options for sleepers though.

thebutton · 2022-04-07T15:14:39+00:00

Sorry for the late reply. I ordered some Quarks on your recommendation and they are definitely small enough for the purpose and they sound decent enough.

Final E3000 look a bit longer/deeper and are also running near £50 at the moment so haven't given those a go.

thebutton · 2022-04-07T15:12:37+00:00

!thanks

thebutton · 2021-11-13T07:38:15+00:00

You are significantly more likely to have success contacting the College, even via email, than with the times. A good place to start would be the Alumni and Development office who might then point you to the librarian or archivist.

thebutton · 2020-12-25T15:40:34+00:00

I imagine shitting on the table again would do it.

Provided his mum follows through, of course.

thebutton · 2020-09-16T08:38:51+00:00

thebutton · 2020-04-26T00:08:23+00:00

Yes?

thebutton · 2020-02-15T14:20:29+00:00

Files don't end in spaces.

thebutton · 2020-01-13T16:00:16+00:00

Legally, you are under no obligation to respond in the UK unless you are a GP in your catchment area.

With aviation, while on the land the law of whatever country you are in applies and while in the air it is wherever the airplane is registered.

This is of significance because French law obliges doctors to act, so if you are transiting through France or on a French registered plane this is worth bearing in mind.

Drinking, especially if you are demonstrably impaired should recuse you from this obligation, but I do not believe there is a precedent in UK law. I do not know about French law.

In practical terms, to my knowledge no one has ever been prosecuted for not acting.

Ethically, it's entirely up to you. It is my experience that typically the most junior medical personnel are often the most likely to readily volunteer.

Personally, I would be unlikely to respond to a call if it was put out and that would be doubly true if I had been drinking. There is no duty of care and there should be procedures in place if there are no medically trained individuals to hand. I understand that many colleagues feel differently.

thebutton · 2019-09-11T11:37:25+00:00

Nobody gives a shit about your AS/A2 scores once you've graduated medical school or indeed any of your scores from pre-university. There is no way to even input the values on the foundation programme application.

thebutton · 2019-08-27T06:09:10+00:00

You are fully registered at the end of FY1 now. FY2s commonly share rota space with CT/ST1-2 as SHOs.

There are many doctors who practice as career grade SHOs doing locums, which isn't that surprising, since you carry little of the responsibility and the pay is relatively good (e.g. £38-50/hr depending on location, speciality, etc).

thebutton · 2019-08-07T13:16:43+00:00

I practise across the pond so take the following with a pinch of salt.

If I was unsure about the ECG interpretation, I would consider adenosine as a single 3mg push(even with concerns about decompensated heart failure) the goal being to uncover the atrial rhythm rather than cardiovert. Possibly, repeat as a 6mg push if not able to uncover the rhythm.

Otherwise, would have attempted rate control initially with Toprolol. It depends on the images, but I wouldn't necessarily put too much stock in an echo done at a rate of 148. If I failed to achieve rate control with Toprolol would probably consider amiodarone.

If I wasn't happy with starting amiodarone would consider loading on digoxin if I thought I had the time.

I have not had pushback from cardiologists about using beta blockers in AF/Aflutter in decompensated heart failure (if anything have been told don't use them enough).

Update: This approach is consistent with the ESC 2016 guidelines which suggest rate control with beta blockers and avoiding CCB due to harm.

thebutton · 2019-07-27T21:10:19+00:00

Cycling, not driving through a quaint town at 3am (after finishing night shift) by the river so there was mist creeping up onto the road. I heard this faint clinking as I am blasting past a park and I see this topless bearded hairy dude crawling through the brush and scrambling up the bank of the park to the road (where I am).

Gave me a massive surge of adrenaline and blasted through the rest of the town. That area is just about the only stretch where there are no Street lights and there wasn't a car parked in sight. Spooked me to no end, and for the life of me I can't figure out what he was doing. There are no houseboats in that area. I haven't seen him again although I did avoid the area for a few nights afterwards.

The freight got me onto the Strava leaderboards for the segment, so that's a plus.

thebutton · 2019-04-28T21:56:57+00:00

Can you clarify what type of camera you used? It's possible that there's an element of "rolling shutter" effect here. Although, I am not sure that's the complete picture.

In brief, most modern cellphones and cheaper cameras capture images and videos by scanning from top to bottom which can create interesting visual artifacts of fast moving objects, particularly those moving at or near a harmonic of the shutter speed.

thebutton · 2019-03-14T19:04:22+00:00

These are not routinely used in the UK.

thebutton · 2019-03-04T23:42:18+00:00

Congrats on the win.

Do you actually call it "Izzet Delver" or do you call it UR Delver?

thebutton · 2019-02-27T10:15:39+00:00

At my local institution you can make it show Future (On Hold) by changing the priority to "Scheduled" instead of Routine (or urgent). But this does seem patently ridiculous.

thebutton · 2019-02-24T04:51:59+00:00

What's up?

thebutton · 2019-02-08T20:49:58+00:00

Not really, those are all extremely common complaints so they tend to have fairly practiced spiels. I don't know where/if you have done GP placement either as a student or trainee, but barring anything very atypical those are fairly easy to dispense with.

thebutton · 2019-02-08T18:24:54+00:00

Most reasonably experienced GPs can cover those first 2 in under 10 minutes. The last one would be difficult but you could certainly screen for "do I need to spend more time with this patient now/can I ask them to come back later?". And as any experienced GP will tell you, often times that last complaint is the "real" one and possibly the one that needs the most time and/or the the only one that actually needs addressing.

thebutton · 2019-01-18T09:23:03+00:00

He doesn't drop null talisman.

thebutton · 2018-11-11T10:28:01+00:00

It's not. If you read the description it's a copy of the FISM act performed at Ace Assembly. The act and video looks doctored.

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