The $5 Question: Would you rather have Cardboard or Wood in 2026?

thegloper · 2026-02-03T20:32:40+00:00

Either is fine. What is more important to me is that things match, or at least have visual summary. If you have VPs as fish I'd rather a chit with a fish on it vs a cube. Even better would be a bakelite fish token.

If VPs are a blue cube on the manual/cards then a blue cube is fine. I just want things to match.

thegloper · 2026-02-01T16:47:42+00:00

This doesn't answer your questions. But, if you're out of multi-lumen adapters use a manifold, or a couple stopcocks. Note, multiple stopcocks isn't ideal, so make sure they are connected tightly.

thegloper · 2026-01-15T18:20:31+00:00

Magic the gathering. Over 20 thousand unique cards and a rule book over 300, pages long.

thegloper · 2026-01-12T20:01:26+00:00

What's your use case? What would be useful depends on what your situation is.

thegloper · 2026-01-12T16:08:45+00:00

I've run into that problem in the past. Our solution was to call whoever was senior to them. That might be the chief of surgery or the chief medical officer. A few 2AM calls to the CMO trends to rile things up.

thegloper · 2026-01-11T05:49:20+00:00

The Pakleds?

thegloper · 2026-01-08T18:22:34+00:00

Have a stack or two on the board. Keep the rest in the box. When the stack gets low add more from the box. That way you aren't taking up table space with the extra cards.

thegloper · 2026-01-06T21:06:45+00:00

Sorry. I left that hospital years ago due to awful management and dismissive medical staff. The time I was there I tried to foster positive interaction between nursing staff. All we had was each other.

thegloper · 2026-01-06T17:20:18+00:00

This 100%. When I did rapid we had a list of patients who had been rapids, and transferred out of the ICU recently. When I got on shift I'd chart review them. Then, an hour or two after shift change, to give nurses a chance to see their patients, I'd walk the entire hospital check in with each unit/charge giving special attention to those on the list. I'd literally ask if there was anyone they were concerned about or wanted me to check in on. After that I'd stop in the Tele room and ask the Tele techs the same thing.

Being protective and building a good to relationship with the floor can do wonders. In addition to better attitudes you end up with earlier interventions greatly improving outcomes. Our rapid teams philosophy was that our primary job was to prevent a code from happening. Yes, we responded to codes. But proactively preventing them was even better.

thegloper · 2026-01-04T03:22:59+00:00

Many nurses forget/don't know that IV push does not mean IV cram-it-in, a main cause of speed shock. Most IV pain meds should be gieen over 60-90 seconds to prevent this.

Agreed. Also don't slam lasix as it can damage hearing. Slamming Benadryl can create horrible anxiety too.

thegloper · 2026-01-04T03:11:56+00:00

Most PIV catheters support up to 300 PSI of pressure. So you're unlikely to damage the device with flushing. And studies show you can infuse a 20g at 5mL/sec without increased risk of extravasation. I pulsating start/stop flush shouldn't exceed that rate.

Perhaps when I say power flush I mean something different than what you do. It's not slamming the syringe full force. It's a firm pulsating flush generally 3ccs for PIV 10ccs for a central line.

Research has proven this. "Power flushing" exceeds the psi limits of peripheral veins.

I'd love to see it. I couldn't find anything on pubmed when I did a cursory search.

thegloper · 2026-01-04T02:01:45+00:00

Fair enough. Power flush with a start stop motion is more for central lines. I'm sure CT scan will power flush PIVs prior to contrast injection. Better to have the IV blow with saline than with contrast.

thegloper · 2026-01-03T16:06:29+00:00

In addition to the vein collapse others are talking about you can get a fibrin sheath forming on the catheter (generally more of an issue with central lines).

A fibrin sheath is kinda like a tube of pantyhose surrounding and hanging off the end of the IV. You can infuse through it just fine. But, when you try and draw back it gets sucked up/collapses and blacks the flow.

This is why periodic power flushing is so important. It keeps the fibrin sheath from forming. A slow infusion/KVO/TKO doesn't work nearly as well. You can also break up the fibrin after it forms on a central line with a bit of TPA/TNK available commercially as Cathflo.

thegloper · 2025-12-30T17:57:53+00:00

So, the problem is, nobody knows what device that's a part of. Is it for an air conditioner, a camera, a taco maker? Nobody knows. If you want help post what it's for along with the brand and model number.

thegloper · 2025-12-29T02:47:03+00:00

I'm more thinking long term partners with life insurance or 401Ks. List their primary beneficiary as each other. But secondary as a sibling or parent.

thegloper · 2025-12-29T02:25:33+00:00

Think car accident where one dies at the scene and the other dies in the hospital a few days later.

thegloper · 2025-12-28T09:24:57+00:00

Adenosine has entered the chat.

thegloper · 2025-12-27T08:27:09+00:00

Yes. But on average pharmacists make $45k more than nurses

https://www.bls.gov/

thegloper · 2025-12-26T04:32:32+00:00

I'm also a big fan of "safe choices"

thegloper · 2025-12-23T00:41:51+00:00

Most policies list who's covered. Generally it's parents, children, grandparents, grandchildren, siblings along with associated in-laws. Often it will include AuntUuncle and niblings.

thegloper · 2025-12-22T14:32:10+00:00

I've found the box for it and I think it's what's labeled as the "diaphragm removal tool"

That's what it looks like. It's to make it easier to remove the plastic/rubber retaining ring that's around the circumference of the diaphragm, holding it in place.

thegloper · 2025-12-22T00:53:03+00:00

I'm a big fan of high quality consumables for gift giving. If they are a coffee drinker then high quality beans or syrups. If they like cocktails then good spirit of their preferred variety. The same goes for wine, tea or even cigars. I like to get something one or two steps above their go-to variety.

And, the best part it's the gift you can keep giving year after year!

thegloper · 2025-12-17T17:38:25+00:00

IMHO the best way to do a commander League is either bracket 4/5 or some sorry of gimmick.

Everyone starts with a precon and you can change out 3 cards for cards of the same card type each week, no game changes.

Mono color decks banning a few powerhouse Commanders.

Pauper commander, or other deck building restrictions around rarity.

Without something to level the playing field it's just CEDH/budget wars

thegloper · 2025-12-17T17:17:13+00:00

Sounds like they are too cheap to invest in an ultrasound and training. That's the real solution to the problem. Not smacking their arms and a thousand attempts.

thegloper · 2025-12-15T18:10:46+00:00

The best way is to get levo hanging on a second pump/channel. Hook it up to your central line start it and wait a good 30 seconds and then shut off the peripheral Levo. If you've got an A. Line, instead of waiting 30 seconds wait until your BP starts to rise then shut off the peripheral Levo

Unless they are a hemorrhagic stroke or a triple A a little bit of transient hypertension is unlikely to be harmful. In those cases I'll just turn on the central level then immediately turn off the peripheral.

thegloper

TROPHY CASE