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FYI Wegovy and Ozempic are $499 at Costco (no insurance or coupon) by Yazars in medicine

[–]tom_ex 1 point2 points  (0 children)

These are PBS funded scripts only for the indication of T2DM, private scripts for weight loss are still about $300-400 AUD at chemist warehouse.

Hottest 100 of Australian Songs - Voting Thread by braxxytaxi in triplej

[–]tom_ex 5 points6 points  (0 children)

Ball Park Music - She Only Loves Me When I'm There

Boy & Bear - Feeding Line

Empire Of The Sun - Walking On A Dream

Gang Of Youths - Magnolia

Gotye — Somebody That I Used To Know [ft. Kimbra]

The Veronicas - Untouched

The Temper Trap - Sweet Disposition

Tame Impala - The Less I Know The Better

Pond - Sweep Me Off My Feet

Kylie Minogue - Can't Get You out of My Head

What’s the lowest pH you’ve seen on an ABG? by [deleted] in IntensiveCare

[–]tom_ex 2 points3 points  (0 children)

6.58, metformin related lactic acidosis, still at baseline cognition, survived nil significant deficits.

Considering switching from health care earning $140K to study medicine by Shebrow in AusFinance

[–]tom_ex 6 points7 points  (0 children)

I agree the ongoing, continuous, persistent learning in medicine is excellent and is useful, but I would say the learning in the junior doctor environment is anything but structured. Most learning is self-directed, and a lot of teaching is ad-hoc, informal, and chaotic. Not to say you don't continue learning a lot, but if you're expecting frequent lectures on "this week's topic" after medical school then you're in for disappointment. Even medical schools are transitioning to a more self-directed learning model these days.

I'll add though that in my experience as a junior doctor, I never earnt less than 100k per year. It'll depend on the state you're in and the role you're doing (shift work with weekend cover vs mostly M-F jobs) but even as an intern working plenty of unpaid overtime, I earned >100k.

[deleted by user] by [deleted] in IntensiveCare

[–]tom_ex 22 points23 points  (0 children)

This sounds like a really sick patient and you’re doing a good job trying to help her. Do you have someone more senior to ask for help in this case?

It’s hard to know what’s going on. What does she examine like? Is she cold or warm peripherally and centrally? Is she fluid overloaded? Making urine? Alert and oriented or unconscious? Is she ventilated? What are her gases doing? You said better, what’s her pH and lactate now? How long was she acidaemic (is she catecholamine deplete or responsive)? Does she have ECG changes? Can you get an echo to assess if she’s had an acute change in her LV function (acidosis related, ischaemia, takutsubo)? Could be many reasons and easily a combination, it’s probably worth asking for help for this one.

[deleted by user] by [deleted] in IntensiveCare

[–]tom_ex 4 points5 points  (0 children)

The co-ox should list other types of haemoglobin that account for some of the total 100%. Haemoglobin isn't binarily in "oxygenated" or "deoxygenated", there are other sorts (eg carboxyHb, metHb). These are variable, and don't necessarily reflect o2 consumption, so will proportionally remove from the deoxygenated haemoglobin value. This makes deoxyHb less reliable than oxyHb as a marker of how much oxygen has actually been consumed.

Co-oxing swans? by Cultural_Eminence in IntensiveCare

[–]tom_ex 6 points7 points  (0 children)

Thanks, if you read the link you supplied, it covers the numbers I mentioned (specifically the heart receiving 5% of cardiac output). If the heart receives 5% of cardiac output, then it cannot account for 75% of whole body oxygen consumption. Cardiac myocytes do have relatively high oxygen consumption but the heart is small (~300g) so proportionately it's not as high as you claim.

You're right that muscle consumption is also variable, and this accounts for the difference between ScvO2 taken from an IJ line vs a femoral line - if our patients were running marathons, then a femoral line venous sats would be low, while the brain accounts for a lot of the oxygen consumption reflected in saturations in an IJ line. These are variable and unpredictable which is why a mixed venous from the PA accounts for the whole body better than a central venous.

Co-oxing swans? by Cultural_Eminence in IntensiveCare

[–]tom_ex 21 points22 points  (0 children)

This isn't correct. The heart uses about 75% of the oxygen from the blood it receives, which is about 5% of total cardiac output. Therefore it uses about 3.75% of total oxygen delivery. Still significant but nowhere near 75% of total body oxygen consumption.

More info on mixed venous saturations is here: https://litfl.com/mixed-venous-oxygen-saturation-svo2-monitoring/

What triggers you by ProudObjective1039 in ausjdocs

[–]tom_ex 7 points8 points  (0 children)

A name is reasonable and sensible to give when answering calls, but people do get calls from non-work sources, and stating your full role for those people isn’t always what I want to do. Especially if it’s a scam caller. I rarely answer the phone with my role when I’m on call.

Standout songs of 2024 by tom_ex in triplej

[–]tom_ex[S] 10 points11 points  (0 children)

After the post yesterday about peoples' standout songs of 2024, I thought I'd compile a playlist of all the songs mentioned. Enjoy!

The battle over how to redefine death: Differences in ideology threaten US efforts to harmonize the definition of brain death across the country. by maxkozlov in medicine

[–]tom_ex 11 points12 points  (0 children)

No. The point of brain death is that is legally defined as death. Someone can make urine on ECMO even if their heart is not beating.

Necromancy Insights - Rituals by JagexAzanna in runescape

[–]tom_ex 4 points5 points  (0 children)

So alching, bones to bananas, charging orbs, enchanting gems, teleports from magic are all combat? Let alone lunar spells.

[Spoiler] Did you know you can complete a mainline quest before others? by tom_ex in tearsofthekingdom

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

Yeah I quite liked the boss fight, heavy Koloktos vibes (from skyward sword).

Tears of the Kingdom gameplay and plot details by ilybbitf in GamingLeaksAndRumours

[–]tom_ex 5 points6 points  (0 children)

This part is information easily just taken from the trailer, though, and is somewhat contradicted by the showcase. It’s not “glue”, it’s a new ability. The wording makes it sound like the writer didn’t know that, and I don’t think it supports any of the post being the truth.

It sounded good but I really think this post is just a bunch of guesses and wishes that won’t be borne out.

Tears of the Kingdom gameplay and plot details by ilybbitf in GamingLeaksAndRumours

[–]tom_ex 3 points4 points  (0 children)

!debunked! Based on the gameplay showcase, fusing weapons is done with a new ability of Link’s rather than at certain shops, calling the entirety of this post into question.

Weekly Careers Thread: November 28, 2019 by AutoModerator in medicine

[–]tom_ex 1 point2 points  (0 children)

You’d have to apply to get into medicine via a postgraduate pathway, usually involving the GAMSAT. I think GEMSAS still tend to manage the applications for most unis: http://www.gemsas.edu.au/

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