btach

Saw something like this in one ER I worked at years ago. Guy in his 50's was brought in for seizures. Don't remember exactly where he came from, but it was some place where tapeworms from pigs was not unheard of. CT of head showed numerous cysts in his brain. I remember seeing the spots in his head being a bit smaller than in the imagery in the article and more spread out. Anyway he was diagnosed with neurocysticercosis and admitted. No idea what happened after, often I didn't get follow-up in the ER setting. Anyway, that... was memorable. Never ate undercooked pork before that, but after... never ever will.

This happened at the hospital I currently work at a couple years ago. A patient was brought some chicken noodle soup hot in the thermos but didn't open it. A few days later I was working night shift on that floor when we all heard a sound resembling a cross between a BOOM and a BANG (something you don't expect at 2AM). There was his thermos at the bedside table with no lid, still sitting upright. Scattered around (both floor and ceiling) was some fermented soup smelling of fermenting vomitus. And a lid-sized-and-shaped hole in the ceiling.

I had a patient who checked in the ED for chest pain (felt like indigestion but he was intelligent enough to know it wasn't). Arrested just as we were getting vitals. CPR and shock -> came back awake and asked what happened. EKG after ROSC indicated STEMI. Arrested again, this time we just shocked right away before CPR and he awakened with ROSC. Eventually the cath lab was no longer occupied (this was a small hospital) and he went and got taken care of. Even if he arrested once and awakened it would have been amazing. But twice, I had never seen that in my years working in various emergency departments. That story had a happy ending (or continuation, as life moves on to new seasons), something I don't see very often. Other than that, my experience matches up mostly with yours in that for patients who arrest, happy outcomes are rare. One medic called 911 for his wife who had arrested - luckily he had witnessed it and went straight to the chest while his teammates on duty came to bring her in. I can't remember if they got ROSC or if we did, but she had a fair outcome. She had a long rehab time but was able to live a mostly normal life after that. The ones who just don't have a good ending are too many to count.

Empathy vs sympathy?

I agree - the comment tree has been baffling to me too, but rather amusing. I understand that some people disagree with your original post about using a particular book to sound people out, but I don't understand the harsh reactions to the method itself (it seems some were against the method rather than the book?). That kind of thing sounds to me like an interesting conversation starter or prompt!

Emergency Department

Unrestricted access doesn't mean unmonitored access. Narcs are counted at every single access and records of who pulled what are kept and audited.

Most ERs have a fast track area dedicated to this kind of thing.

There would definitely be an investigation, as all sentinel events are investigated. Management would do their RCA and I'm sure the issue with alarm fatigue would be ignored or underplayed (Something bad happen? make sure an alarm sounded. If staff ignored it, it must be the fault of the staff). I doubt any one person would be in trouble as it was a collective/systemic failure, but I don't know exactly what would have come of it. Likely a policy change or daily reminders for the next few weeks about not ignoring the monitors even if it has been going off nonstop for hours. Maybe extra charting or peer audits. It's a lot less expensive and effort to put pressure on staff than it is to change technology (even if it is as little as setting different, more sane, defaults). Depending on what was recorded from the monitor to the chart, if it looked like there wasn't a delay in resuscitation/cardioversion (like if the lethal rhythm wasn't recorded initially), it may have been just put down as clinical course for the patient, like you suggested. My perspective of that place is a bit jaded (and therefore biased), that place was a toxic burn-out factory. BTW, "post mortem"? Thanks, the morbid humor made me laugh!

Anecdote: At an ED I used to work at, our cardiac monitors got "upgraded" to another manufacturer. Silencing false alarms was a black hole of a game of whack-a-mole. You could never silence them all, another would just pop up to spite you. Anyway, one night, it was continuing to alarm and being ignored (with a glance occasionally to make sure). Except somebody was in v-tach and the person who noticed was a medic bringing a patient in. Thank goodness they noticed amid the noise! (We had as good of outcome as could be expected with that patient, and they went to the cath lab and lived).

Ugh, that is why I have always done my own car work. Many potential downsides, but for me the upsides have outweighed the downsides.

Related, when I had to live in a certain area that had a high bike theft rate, I got myself a pink bicycle. In the year I was there, it was never stolen. Well, except for the seat (which was black).

I appreciate the Star Trek reference (V'ger incase somebody doesn't know what I'm talking about - Star Trek, The Motion Picture). That movie awed me as a kid.

Gravity well. You would exit hyperspace before hitting the planet. Same concept as how the Interdictor class Star Destroyers prevent hyperspace/pull ships out of hyperspace.

...#sublimeshame? I don't understand what is shameful. Nor do I see anything to be proud of either. It's a fantastic tool. I used Sublime Text for quite a while at version 2 and eventually bought a license. Later upgraded to 4. Still using it almost daily. It's a staple in my workflow and I don't see that changing anytime soon. Other tools would probably be just as good, but whatever, it is valuable to me.

Thanks! That made me literally laugh out loud.

Tldr: Because there already exist many photographs of what I photograph that are of good quality, and time seems to be better spent obtaining such photographs from others' collection than photographing them directly.

This gets me thinking about the issue of doing something for the satisfaction of the creative process vs the satisfaction of the practicality of the end result.

I appreciate it exactly how it is - I find a simple blog like this much more accessible and less off-putting than anything else. That, of course, is just me. I also don't think you're wrong with what his writings could become with professional production.

I can't be the only one who looked at the top picture and thought it was Mr. Bean about to spit out toothpaste on some hapless soul as he drove by.

Are you me from a parallel universe? My wife does this, bless her heart.

"It's Boquet, dear!"

...

I sympathize. Part of me also wishes to be a fly on the wall for these interactions.

I almost spit my tea out. You made me laugh.

I've read a few fan fiction stories that I think were quite good. Protagonist wasn't superhuman, was effectively foiled as seemed appropriate, had flawed notions and perceptions, etc. That being said, I've read many more fanfics that made me cringe. I've enjoyed finding the good ones (that are good to me, anyway).

Yes. I initially ran into binfmt_misc issues, did a bit of reading on Justine's github repo for Cosmopolitan and found it can be an issue, especially if you have WINE installed. Once I disabled it

  systemctl stop systemd-binfmt" on Manjaro

  build/bootstrap/make.com -j$(nproc) o//third_party/python/python.com

I've been pretty happy with Fantasque Sans Mono.

Looking at the title and skimming the diagrams, vaguely reminds me of a souped-up TIS-100.

ED nurse here. Of course n=1: "can be added" doesn't means "will be added". Our ED regularly boards admitted patients to the point we have a single resuscitation room left for new patients checking in or coming in via EMS. Plenty of rooms and physical beds in the hopsital, and by official metrics hallway beds are counted in "beds available". We did have National Guard present for some time, but it was non-clinical warm bodies to sit with patients on suicidal precautions, stock supplies, etc. No extra clinical staff. Though they were incredibly helpful and lightened the load, they did not enable more beds to be available.

One of the reviews on the first link alluded it was $1500

That's interesting. I am only speaking from experience working in the ED as an RN and do not have any experience with studies like this that give medications that are not positively known (by myself). What you (and others say) actually does make sense. Thanks.

The nurse administering it is most certainly liable for what s/he administers. It is a very big no-no to blindly administer a medication of which you cannot reasonably verify what it is. To push a syringe or start a pump of something that "could be ketamine, or could be NS" is walking an uncomfortable line for your license to practice nursing. Right patient, right medication, right dose, right route, right time. If you as a nurse cannot attest to all of the above when you push something, it is in error to push it.