Trauma Goon
@Rockurownium
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Following
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Statuses
814
Helicopter jockey who's past his prime. I teach medicine to the underpaid but idealistic. Generally done with your shit.
Joined May 2009
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Pinned Tweet
EMS is the E4 Mafia of medicine.
I said what I said.
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@autixcx
I have no idea how this ended up in my feed, but it definitely sounds like you're angry because you can't get laid.
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@Andr3jH
The terrifying thing is that I can actually picture people saying this unironically.
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@Oilfield_Rando
It was a goofy white kid who designed it, and he actually gave a pretty reasonable description of the intent and inspiration.
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@notcapnamerica
This makes absolutely no sense.
"Williams was working at a construction site in the Tampa, Florida, area in August when he sustained the head injury. He was taken to a hospital, admitted to the ICU and induced into a coma after a laceration on his head became infected. He was
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@QuasiInstitute
@Luciferous_22
@theridgefield
@Cernovich
Psychosis is a feature of schizophrenia, but is not determinative of schizophrenia... E.g. all schizophrenia includes psychosis, but not all psychosis is due to schizophrenia.
Given the myriad of stimuli that can cause psychosis (everything from antidepressants, to
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@kthorjensen
Can it just happen already? This thread is clear evidence that we no longer serve a useful purpose.
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Let's talk about blunt head trauma.
What we see here is called a "fencing response", which is a tonic posturing seen with some frequency after moderate-to-severe TBI, where one arm involuntarily extends, while the other flexes, in response to trauma to the lateral vestibular
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@Cernovich
Lol. 25 year Paramedic here. The only calls I run where Marijuana was the major precipitating factor are more comical than anything else.
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I'm not ashamed to say it; I've been upping my protein intake recently, and as a lot of folks know, sometimes you get a little... Backed up. For me, it had been a couple of days.
One of the nurses gave me something called "Dr. Tobias Colon Cleanse". It was an innocent-appearing
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It's cold and gray outside.
You can still get your reps in. Go do it.
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@The_MOReilly
@nellen55
Being so worried about what other people drive that you have to talk about it on Twitter sounds like a whole lotta cope to me.
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@arrtnem
@paularambles
This. This is why it doesn't seem like a big deal to us. I mean Paris to Prague is obviously a bit much, but still.
I've had jobs where my daily commute was longer than it takes to drive from Prague to Dresden. 🤷♂️
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Dear ED staff:
Don't do this. Having beds in the hall outside your resuscitation bay pre-staged with body bags instead of sheets doesn't exactly say "you're going to receive the best care possible" to your patients and visitors.
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It's absurd that in the US, an epinephrine MDI is available over the counter, but Albuterol is not.
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Alright you
#EMS
degenerates. I keep meaning to use this account for more than shitposting in replies and being antagonistic. You wanted it, you got it: let's talk about pressors in hemorrhagic shock.
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@armyemdoc
I love that there are only two types of responses to this:
Answer A, the anesthesia/critical care/European bourgeoisie: "Utter bollocks! What is this nonsense?! This is the stupidest thing I've ever seen! You should use [insert invasive device or more complex technique here]
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@armyemdoc
@GreensladeGL
It's not common, and I've only seen it a couple of times in the last 25 years (maybe because I've always been in the titrate-to-adequate-respiratory-effort camp), but noncardiogenic pulmonary edema is a thing after big doses of Narcan.
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@armyemdoc
Or you can be a true champion of the people, and embrace the "peripheral IJ". When you absolutely, positively need real large-bore access in a hurry... It's a nice trick to pull out of your back pocket.
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@armyemdoc
Bro, you're really reaching here.
You're going to do what you're going to do, because you can. My observation and advice would to try to set aside the defensiveness for a moment, and critically evaluate why you choose the approach that you do; is it because it's the best
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@armyemdoc
If a patient is/was in respiratory arrest/hypoventilating and they get/got better after receiving naloxone, you have confirmed that opioid ingestion was the cause of their respiratory depression.
And just because the FDA says I can give 50 mcg/min of norepinephrine doesn't mean
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RIP to the insurance adjuster who assumed my angry, unhinged ass was bluffing when I said I would file suit if they tried to stiff me on a rental car after one of their customers rear-ended me.
His boss got served with the Motion for Judgment yesterday, and today he got served
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@quietstation27
@matheusedusch
@autixcx
No, not at all.
What I understand is that the people who are most interested in regulating what consenting adults do in their bedrooms are generally either:
a) repressing something because, at some point, they were taught that they should be ashamed of their own sexuality, or;
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@Luciferous_22
@QuasiInstitute
@theridgefield
@Cernovich
Well, I did read it the paper that was posted, and read beyond the abstract.
I have some methodological concerns that I feel may make the conclusions drawn... Well, dubious at best.
My first concern is that the "marijuana potency" that they're using as an independent variable
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@Luciferous_22
@MatthewTevault
@QuasiInstitute
@theridgefield
@Cernovich
Well, he said schizophrenia. If you can't differentiate, then perhaps it would be best to not comment on it. 🤷♂️
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Almost 4 years, and I'd managed to dodge it this whole time. Boosters as soon as they come out etc.
Taking a shit and realizing you can't smell it is a hell of a way to find out you have COVID. 😆
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@Snakeeater36
@thewardoll
This. Everyone has their strengths and weaknesses; For example, I'm 6'6" and built like a 5 ton. 90% of y'all are gonna lap me on a run, but I can drag everybody off the X at the same time. 😆
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@Exiled_Patriot
@Champagne8Perry
@M938151l
@Ragland1836
So I looked it up. According to the news story, it sounds like it was a rifle. ()
That being said, the probability of 22LR having enough terminal energy at 880 yards (
@Champagne8Perry
's claim), or even at 500 yards (the distance cited by the article) to
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@Stargazer196498
@ConInsurgent
@mtntallpaul
I've spent two and a half decades working in trauma, and have seen at least hundreds, more likely over a thousand GSWs over the years.
If you've done the same, then you know that orthopedic injuries secondary to penetrating trauma are dependent on everything from terminal
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@Luciferous_22
@MatthewTevault
@QuasiInstitute
@theridgefield
@Cernovich
It's not about trade-offs, but about relative risk when compared to other stimuli.
I think it's also a bit disingenuous to say that it "triggers" or "causes" schizophrenia in people under 30... Because, independent of substance use, schizophrenia generally manifests before age
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@IAmericanMama
Patty today: "Happy Thursday! It's an awesome day!"
Patty on Friday, after getting someone with the wrong friends fired over dumb shit:
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Throwback to that time when Maimonides lost all their chill.
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@quietstation27
@matheusedusch
@autixcx
Says the "regulate porn" profile.
Is it really that hard to get laid these days?
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@GiaMMacool
@Cernovich
Lolz. Do you know how many physician friends of mine love to pop an edible after work?
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@Konkrauss
@ChrisandOla
@CreepyOrg
They might be wearing soft armor, it's hard to tell. But that's not the main point. The main point is that from a tactical perspective, civilian police are not equipped or trained to deal with actors who are organized, equipped, and even minimally trained.
Why do I think this
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@Sonjalovesbikes
Maybe it'd be less of an issue if payers treated the mouth bones like the rest of the bones, and people didn't have to pay cash?
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@matheusedusch
@autixcx
Meh. I'm part of a lot of problems, and am the whole-ass problem on many other occasions.
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@Spark898
*laughs in Alaskan*
Yeah, no. With good tires, my F150 wouldn't even be in 4x4 for that.
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@Shadzey1
@TobMelone
@uwu_hyna
@drsuffy
@visegrad24
Seriously, no one thought to throw this in the mix? I'm disappointed.
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@paramedeq
Here's the thing: before you decide it's the job, make sure it's not just where you're working.
I love flying. But I have worked in places that suck so much joy out of it, that it doesn't seem like it's worth it anymore... Once you stop though, you look back and are like "fuck,
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@Illisconsin
@Cernovich
None of my BH homies refer to themselves as "mental therapists", so I'm dubious of your claim... But I'll play along.
"Therapist at a BH facility sees patients with acute psychosis"... This is news?
How many of those patients have an underlying pathology, versus how many are
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@AuroraO83
@yourmiyahfav
@wokbonds
@DrRupaMarya
@JVPBayArea
@AlanVRK
Howdy. Medical flight crew here.
For the record, no, we can't land on top of gridlock traffic.
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@Branmiz25
To be fair, it's a carrier with a 10x12 SAPI plate. He's wearing too high; it's designed to protect the important bits in the middle, so the top of the plate should come just under the sternal notch.
But yes, he sucks, and I think he looks more like Ralph Wiggum 😆
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@nola_nobody
I was just thinking to myself "I really should get a new sling". Perfect timing. 👌
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@realnikohouse
Don't bitch out now,
@realnikohouse
. Say it with your chest. Who do you think the good guys were?
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Not being able to taste is one of the strangest sensations. I eat something, and my brain knows what it's *supposed* to taste like, but doesn't receive the anticipated input. Nobody designed an error handler for this, so my insular cortex just divides by zero and everything
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I don't know who needs to hear this, but if you're constantly in conflict with everyone around you, there's a good chance that it's not a them issue.
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@FistusGoodus
@SoftwareGuy3
@Lead_Flinger
@CapnGadsden
Counterpoint: if there is a threat significant enough that you can't remove your eyes from it in order to safely holster if needed, you should still have eyes to gun, on target.
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@toxicologist12
My go to for the last several years has been "vital signs are within acceptable limits for this patient".
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Wandered into a Wegmans for the first time, since I needed a couple of things and was going to drive right past it.
I am definitely not cool enough for a grocery store that has a special section for indoor-grown lettuce.
I mean, what?
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Alright, so hear me out. The Hilux post had me looking on Facebook, and...
I need someone to let me hold 30 large for this '92 Hilux diesel, right-hand drive thing of beauty. I will mount an RPK in the back just on principal.
We can share custody. This needs to happen.
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@dr_jon_l
On the flip side of this, the disaster management training in me can't help but look back at the supply chain disruptions that we saw from what was, for all intents and purposes, a relatively tame pandemic (compared to what could have been had it been an agent of greater
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Because people who have been held hostage by your murderous terrorist friends for over a month probably don't have "talking to the media" as the first thing on their priority list, you fucking kumquat.
lsrael does not want the hostages to speak to the public. WHY?
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Two questions:
a) Did you go work out today?
b) Have you washed your ass?
If the answer to either question is no, go do it. Preferably in that order.
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@uberarchangel
You've gotta know how to fight to consciously do that sort of thing. This was just a loud-mouthed kid, who is now probably going to have a hard time doing math.
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@Kiel_Samsing
This somehow made it to my feed, and I'm glad.
It's about time we're starting to see this. Firefighting and EMS are two distinct professions that require different skill sets. If the fire service doesn't want to divest itself of EMS, at the very least it can start allowing
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@Lead_Flinger
Awww, it's cute that they think Social Security will be around to draw from in 20 or 30 years.
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Favorite movie you like because of your father?
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@schizogpt4
@Clarksterh
@JohnArnoldFndtn
What real school are you getting a BS/BA from for less than $10k?
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@armyemdoc
@EricJaegerTNG
@JakePot82518129
@richardarmour99
You never answered my original question: what clinically relevant reason do we have, given two approaches with similar outcomes data, to choose the approach with the potential for worse withdrawal/reversal symptoms and that's more uncomfortable for the patient?
You seem to enjoy
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@armyemdoc
@richardarmour99
Immediate reversal with big doses might be quick and convenient, but it really isn't good medicine.
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@RealGatorHours
@armyemdoc
It absolutely does. It's great for large volume transfusion, and you can very easily put a wire down and convert it to a dirty CVC once things aren't quite so tenuous.
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@GLOCKKING11
is a scammer. They claim to be a gun store out of Luisana. I called the store, and they confirmed. Watch your 6.
Reweet this as they have 10k + followers and people need to know!
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@Exiled_Patriot
@garner_forest
@Champagne8Perry
@M938151l
@Ragland1836
I would maintain that it is highly improbable.
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