Winter 2021 LC Thread—I Want Sous Vide

Pauwl · May 13, 2021, 1:49am

I recall the chia pet. Were you allowed to eat what grew on it? They didn’t market it that way.

Trolly · May 13, 2021, 1:52am

Who’s going to stop you?

Mr_Unstoppable · May 13, 2021, 1:56am

wait there is an app that can turn you into a young hot chick…

…

ok might as well try this out…

LOL heyyyyyy guysssss

MrWookie · May 13, 2021, 2:01am

Lol, geez, if only pokerjo had this back in the day.

For anyone not in the know, pokerjo posted on 22 under the adopted persona of some model, got found out for using public pics, left 22 in shame, and then came back years later and came out as transgender, documenting her transition in strikingly frank, open, and really interesting fashion.

mosdef · May 13, 2021, 2:05am

OH HERE WE GO AGAIN WITH THE NANNY STATE TRYING TO TELL US HOW TO LIVE OUR LIVES ME AND MY SIBLINGS ATE CHIA PETS ALL THE TIME WHEN WE WERE KIDS AND THE TWO OF US THAT ARE STILL ALIVE TURNED OUT FINE CHESSMATE LIBTARD

DrChesspain · May 13, 2021, 2:16am

A vegan replacement for a backdoor gerbil.

Devil · May 13, 2021, 2:25am

This may have been the source of my chia hesitancy. I hated that jingle.

NhlNut · May 13, 2021, 2:44am

Inside?

SensiblePerson · May 13, 2021, 4:45am

I’ve been noticing that too, in a bunch of Seattle Times articles. Some new AP style change?

Rexx · May 13, 2021, 6:00am

Did you feel any better when you were a health nut?

Pauwl · May 13, 2021, 6:25am

Not that I can recall. It was 4 years ago or so. I remember I got blood work done and the doctor said I was pristine. It was a good period that changed my overall diet and outlook on food in general to this day.

bobman0330 · May 13, 2021, 12:22pm

Really good:

mosdef · May 13, 2021, 1:25pm

Agree this is a good article. I think it lends too much weight to the change in the “moral authority” of the US arising from the Iraq War and not enough to social media. The undermining of faith in democracy within the US population IMO has way more to do with the weaponization of social media by fascists to spread propaganda. Existing institutions were totally unprepared for an all out misinformation attack from within the US.

TJ_Eckleburg12 · May 13, 2021, 2:55pm

CaffeineNeeded:

Had a case that hit hard.

Older woman, but still functional and living on her own, came in without a pulse by private vehicle driven by her husband. She had a pulse as she came into triage, but didn’t when she got there. Story was that she had some chest pain and wasn’t feeling well.

These are some of the hardest situations. When codes come in by ambulance, you get a heads up, time to lay out your equipment, assign roles, etc. When it comes in like this, it’s a fucking hot mess in the beginning while you try to do 10 things at once. I’m the closest doctor to the front so I hear about it first and run in from another patient room.

We call for help but it’s going to take some time for the calvary to arrive. Priority in this situation is:

Chest compressions

Connecting pads for possible shocks

Running the code

Airway support

IV access

Fancy stuff

A tech starts compressions, a nurse starts connecting pads, a nurse starts bagging. My job is to run the code.

My job at this point is to direct people to a job as they come in. Calvary arrives and we start getting things done.

Pads on → Pulse check → Ventricular fibrillation on the monitor → Clear/Shock → Compressions

Anesthesia tubes, get an end tidal carbon dioxide → lets me monitor lots of fancy stuff including if we’re doing good compressions, pulses are back, etc

IV placed, IO (think an IV that goes into the bone placed), → epinephrine/amiodarone/magnesium/bicarb/calcium

We get her back a few times, but we get her back for more than a moment or two after ~15 minutes and 5 shocks.

Sounds good right? Well, not really. The monitor shows her heart is beating in a way that isn’t sustainable. Her heart is dying but it’s not quite dead yet. It’s time for fancy drips, but we don’t have good enough access. Slap a fancy central line into the femoral vein in 2 minutes with no regards to sterility, only point is to do it as quickly as possible. Fancy drips started… and she loses pulses again.

The brutal cycle starts: compressions, shock, pulses for a few moments, crash.

I do this for 45 minutes. That’s too long. I only do this because we keep getting her back for brief moments. I’m updating the husband just outside the door. We stop getting pulses back. I’m about to call it. I talk to the husband about what she’d want, and he agrees it’s time.

We stop compressions, and I’m about to call it… AND HOLY SHIT IS SHE MOVING HER ARMS?

I’m baffled. I check everything twice. I bring the husband in and he holds her arm and says that he loves her. She grips his hand for a moment or two… and her heart stops again. She goes limp. Continue on for another 10 minutes with shocks but she’s not coming back even briefly anymore. We call the code.

Seems like she just wanted to say good-bye. They’d been married for basically their whole lives. I felt awful the entire resuscitation as it felt like I was torturing her on her way out. Hopefully I got her what she needed.

Code situations like this really terrify me because I’m afraid my inexperience would lead to a negative outcome. I have some trainings and mock codes coming up, but I’d be a fish out of water if this came into my emergency department the next time I’m there.

It sounds like you and your team did more than everything that could be reasonably expected in any code. I guess someday it’s just someone’s day, and that feels so unsatisfying working in health care, at any level.

microbet · May 13, 2021, 3:27pm

Not bad. Sending a few hundred million vaccines to poor countries would have gone a long way in that stepping up that he mentions.

jmakin · May 13, 2021, 4:55pm

They didn’t even try that hard on my dad. I stood there watching his dying heart on the monitor while two nurses bagged and yucked it up about something else. They were actually giggling about something while this was happening.

I don’t lightly wish death on people but in that moment I wanted them to die. I know the job desensitizes you, but jfc. My friends are mostly nurses. I get that it’s a defense mechanism for horrible shit you see all the time. But man that image is just burned in my mind forever, down to what they look like. I’d easily recognize them again.

Anyway the doctor just told me they could keep going but it had been 30 mins and explained his heart was quivering but it wouldn’t come back and it seemed like he wanted my permission or something so I just said ok