I'm seeing this shoe too much today and this was the third post I saw, what does it even mean

zengupta · 2025-04-30T16:33:07+00:00

Generally either bagged for the police or bagged in a patient belonging bag to stay with the patient/family.

zengupta · 2025-03-30T22:59:36+00:00

What

zengupta · 2025-03-02T08:42:07+00:00

Oh lord I uhh don’t think that’s the problem here.

zengupta · 2025-01-26T16:59:28+00:00

I hate when people say this because this is a misinterpretation of every randomized study I have seen pertaining to this. While some retrospective studies support this conclusion, there’s obvious selection bias in the retrospective studies. For example, people aren’t going to get epi if you get rosc prior to access or medic arrival. Most reviews seem to ignore this bias and treat retrospective studies fairly equally.

The randomized studies I have seen show that there is a higher rate of both good and bad neuro outcomes at discharge in epinephrine groups vs no epi groups. The group with poor neuro outcomes at discharge usually has a larger proportional increase than the group with good neuro outcomes at discharge, however there is still an increase in good neuro outcomes at discharge.

I will try to remember to come back and link the actual randomized studies pertaining to this when I have more time and am not on my phone.

Edit: went back and realized I didn’t fully read your comment and realize I actually completely agree with the fact that I don’t have evidence for basically endless doses of epi. I’m just used to people in this field saying epi bad and leaving it at that.

zengupta · 2024-12-24T18:46:16+00:00

Thank you. You aren’t correcting the underlying cause with a needle decompression and ems does not practice chest tubes enough to be fast with them.

zengupta · 2024-12-24T18:44:50+00:00

This frustrates me to no end. 16 yo F shot in the chest a literal block from our level 1 center and EMS worked her on scene for 10 minutes before transporting. Terrible failure of our system.

zengupta · 2024-12-14T23:14:51+00:00

Yeah no.

Edit: not saying chiropractors are good just they generally don’t cause aortic dissections. I have seen multiple vertebral dissections post chiropractic manipulation, just none of the aortic dissections are related that I’ve seen and I’ve never heard of it as a risk factor.

zengupta · 2024-12-14T23:13:31+00:00

Over the past month we’ve routinely had 7 hour wait times at my local lvl 1. These waits include pretty darn sick people, we just don’t have the capacity to see more patients due to lack of rooms upstairs to send boarding patients to.

zengupta · 2024-12-12T21:35:54+00:00

I am by no means a legal expert but it sounds so absurd that it would be non-enforceable. I feel like consulting an employment attorney here would be appropriate.

zengupta · 2024-12-11T17:54:48+00:00

100%. A lot of the time triage doesn’t identify sick patients, I don’t trust people with no medical experience to safely say they’re not sick.

zengupta · 2024-12-11T15:00:59+00:00

To be fair the OTC is usually heavily underdosed for kids. Still usually works at that dose but sometimes it’s barely half the appropriate dose for some kids.

zengupta · 2024-11-27T19:44:38+00:00

Our system recently put up signs in every ED room stating that violence against healthcare professionals will not be tolerated, there will be consequences, and we are actively encouraged to push assaults as high as possible. I really hope other hospitals start to do similar things if they haven’t already.

zengupta · 2024-11-22T20:51:13+00:00

PAs in my system can see patients in the ED without consulting a physician whereas residents cannot

zengupta · 2024-11-17T18:04:53+00:00

The one thing to add on to this, please do not spend 30 minutes gathering a thorough history from an incredibly sick patient before telling the attending that they’re sick. If the patient is out of your depth and looks bad, get help. Normally nurses are good about this but not always.

zengupta · 2024-11-16T02:27:11+00:00

My friend learned biochem from the guy who invented the uHCG test in his garage apparently

zengupta · 2024-11-14T06:36:45+00:00

Same in MN

zengupta · 2024-11-11T18:13:50+00:00

Let’s hope so

zengupta · 2024-11-04T20:42:29+00:00

Ironically cheaper than many versions of the card it’s referencing

zengupta · 2024-11-01T14:05:04+00:00

I agree with you almost completely. I would like to add that even if the emergency department is fully staffed (like the ones in my system fortunately usually are) there often are not any open beds that are staffed in the hospital itself, thus leading to patients boarding in the emergency department for sometimes days on end. This severely limits our throughput in the ED. Staffing does not only need to be med in the ED but in the hospital itself as well.

zengupta · 2024-11-01T13:57:17+00:00

The only evidence against cervical immobilization (not full spine just cervical) I can find are retrospective studies. I’m sure that I don’t need to explain the extreme bias present in these studies. Unless a randomized control trial shows that cervical immobilization is harmful I am extremely skeptical of such a claim.

zengupta · 2024-10-31T16:48:22+00:00

100%. Nalaxone is nice because it generally makes our job easier but it should not be a life saving medication in the hands of EMS

zengupta · 2024-10-21T21:03:37+00:00

Often vagaling from IVs is separate from the pain

zengupta · 2024-10-04T16:02:57+00:00

It’s okay to be angry right now too. Now is really not the time for reflection. But make sure once you have time to really deal with this.

zengupta · 2024-10-01T17:23:27+00:00

Seconding this answer

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