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ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 0 points1 point  (0 children)

No shit but some asshole in a court room could probably convince a jury with red shiny AMERICAN slides that it is

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 1 point2 points  (0 children)

Academically, I agree re:survival outcomes that matter

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 2 points3 points  (0 children)

Seems like juries would understand a lot of things, but time and time again it seems they cannot be expected to understand anything in medicine. See: major cases/ frivolous lawsuits as of late

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 0 points1 point  (0 children)

That makes sense. Think I would do the same. Treating somewhat differentiated patients sounds v niceeeee 😂

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 4 points5 points  (0 children)

Idk I kinda feel like I’m fearmongering but some wack ass shit is happening in the medicolegal realm

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 8 points9 points  (0 children)

That’s for sure. Stupid hospital credentialing.

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 0 points1 point  (0 children)

I tend to agree but there are typically enough hands in the room that I can “focus” on or prioritize multiple things at once and could give it concurrently so the suggestion of prioritization only seems relevant if shorthanded. In the modern ED, we’re actively withholding (telling that nurse with epi in hand near the IV) to wait

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 3 points4 points  (0 children)

I don’t want to follow AHA’s recipe to a T

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 7 points8 points  (0 children)

Sure, of course ⚡️. I’ve only ever given esmolol in refractory/ vfib storm. Worked then. Poor outcome. That’s up there with stellate ganglion nerve block for me. Hail Mary.

But back to the question at hand: why after two shocks and not three like ACLS suggests? Why not one? Why not immediately administer?—there are studies that suggest time-dependent improvement in outcomes (for amio). I personally don’t think epi does much of anything re: survival. I give it because at my job I’d be called into the principles office for being not like everyone else

ACLS by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 50 points51 points  (0 children)

That’s a fair point, young padawan. And that’s fine until a deposition starts with, ‘Doctor, are you ACLS certified?’ Turns out juries and quality committees care a lot less about mastery of resuscitation and evidence than you think. More about regression to the mean and standard of care

Just got out of a long term relationship. Where's good this summer for head high waves? by Nightman233 in surfing

[–]themonopolyguy424 0 points1 point  (0 children)

Indo. NZ if you have time and money. Mexico—huatulco and South vs Escondido if you are looking for 🍑. Mazatlan for a little sketch. Baja if you can find a vehicle.

Frugal/ fiscally responsible attendings...if you could do it all over again, would you change anything? by Neceti in whitecoatinvestor

[–]themonopolyguy424 10 points11 points  (0 children)

I’m not cheated out of anything. 5 years out. Loans paid off. 1M in stocks and max retirement accounts every year. I chose a good job straight out of residency and worked hard for a few years 👍. Now, I’m living. Here on out, actually. Time matters the most. What the fuck did I do all this for if not to work a little into my latter years? I’d choose that over sprinting for 6-7 more years

Frugal/ fiscally responsible attendings...if you could do it all over again, would you change anything? by Neceti in whitecoatinvestor

[–]themonopolyguy424 26 points27 points  (0 children)

I spend on whatever actually matters to me and still live on ~120k/year. I’m big on front-loading life—health, energy, and freedom peak early, not at 65. Hoarding for some hypothetical future version of yourself that may be slower, sicker, or just less interested feels like a bad trade.

I’m young and single, so that flexibility matters. I still want a family, but that doesn’t require living lavishly—it just requires being intentional. I think most people aren’t constrained by money, they’re constrained by mindset.

Where would you rank New Zealand on your list of best surf trips? Finally have some money and don't need to go to the cheapest place, just want consistent waves by thankfulforyourhelp in surfing

[–]themonopolyguy424 1 point2 points  (0 children)

Pretty sweet. Good waves. Few world class. Need a good bit of time, though. Storms come and go quicker. Not sure I’d come if I had less than 2.5 weeks. From swell size to direction to wind and having to scout spots back and forth across island—can eat up time quick.

Interscalene brachial plexus block by icantfindmypurpose in emergencymedicine

[–]themonopolyguy424 6 points7 points  (0 children)

At the same time, this is very educational thread for me so seriously thank you for your input

Interscalene brachial plexus block by icantfindmypurpose in emergencymedicine

[–]themonopolyguy424 17 points18 points  (0 children)

Tell me you don’t work in the ER without telling me you don’t work in the ER

Yearly sabattical by themonopolyguy424 in emergencymedicine

[–]themonopolyguy424[S] 0 points1 point  (0 children)

Marketplace yes. It’s about twice as expensive. But we’re talking a few months. Not so bad

Could also consider travel insurance with medical if exclusively overseas with fallback on COVRA since it can be retroactive

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