davycro

The emergency room should be good at diagnosing emergencies, but most ailments aren’t.

This wouldn't solve the problem of diagnostic standards. Let's say you are a pediatrician and want to predict which kids with bronchiolitis will develop respiratory failure and need the ICU versus the ones who can go home. How do you determine from the body cams which kids had bronchiolitis in the first place? Bronchiolitis is a clinical diagnosis with symptoms that overlap with other respiratory illnesses such as asthma, bacterial pneumonia, croup, foreign body ingestion, etc.

Same. My use case is ultrasound segmentation. These models struggle, understandably so, with medical imaging.

What about a subreddit?

This tracks with my own bias as an ER doc. I do feel that the risk of c-spine injuries from mountain biking is understated. As they said in the article, you are especially vulnerable to a hangmans fracture when thrown over the handlebars. I wonder if the ergonomics or geometry of a bicycle could be modified to better protect a rider’s neck.

You can do CPR without a computer system, but changing systems in the middle of resuscitation where a delay of seconds can mean the difference between survival and death is absolutely not ideal. CPR in the hospital is a coordinated team response and if one person can’t do their job without a computer then the whole thing breaks down.

I sent them your contact info, pretty sure they will be asleep for the next few hours

The system crashed while my coworker was running a code (aka doing CPR) in the ER last night. Healthcare IT is so bad at baseline that we are somewhat prepared for an outage while resuscitating a critical patient.

I would use this at work in the hospital, especially ultrasound guided procedures.

CPR shouldn’t work on someone dead from a traumatic injury. For example chest compressions will only hurt someone dead from having their chest crushed against a steering wheel in a car accident. What happened to you is a true miracle and far outside the norm.

I’ve always wanted to have an MRI. I want to know how it feels to have all of my protons reoriented by a giant magnet. Would I be the same person after?

I use windows when I work in the emergency department. These ads drive me bonkers when I’m trying to use the software to take care of patients.

I presume this is intended for wounds in areas with poor circulation, like a diabetic foot or a walled off abscess. The bloodstream is damn good at delivering antibiotics and immune cells to infected areas.

Received mine this week for a service address on the Navajo Nation. I imagine the wait is shorter for less populated rural areas, which should correlate with need. My old isp charged $60 a month for 1.5 Mb/s down and 750kb/s up. This should be a great improvement.

No seriously. The estimated prevalence of venous thrombosis in the United States is 1:1000. The reported numbers of VTE after the vaccine would be normal in the general population. I am an emergency physician and I diagnose and manage PE and DVT several times per week. To me this seems much ado about nothing.

Those numbers appear lower than the baseline prevalence of venous thrombosis in the general population [1]. Maybe the vaccine is protective?

https://www.cdc.gov/ncbddd/dvt/data.html

It would be better if the author had vetted this with an epidemiologist or infectious disease specialist. I am an MD and I feel that this topic is outside my expertise and that I’m not qualified to comment on it. That said the author makes it clear his views are opinion and conjecture. He poses smart thoughtful questions I hadn’t considered and will discuss with colleagues in the future.

Neat suggestion. I too am seeing shades of brown for most queries. Maybe this would help.

The test in the article screens for colon cancer, which is one of many reasons to have a colonoscopy. It sounds like the GI doctors you consulted performed colonoscopies to assess the cause of your digestive symptoms by looking at your GI tract. The test in the article could not replace that.

Implantable defibrillators are designed to be stopped by a magnet. This is a critical safety mechanism to stop a defibrillator that continues to fire inappropriate shocks. Any emergency department will have a special magnet just for this purpose. If anything it’s kinda cool that the iPhone can achieve this.

Amazing! Thank you for digging!

This is the most common question that I am asked at work.

Do you have a citation for this claim? I heard or read similar but then couldn’t find the source.

I’ve worked in four emergency departments in three states this year. All of them have been overwhelmed by patients with covid, and not patients with overdoses, suicides, or domestic violence. Granted the incidence of those non-covid pathologies are likely higher this year, but they are no-way elevated at the scale of covid-19. I haven’t seen, or heard from any colleagues, hospitals brimming with suicides and overdoses to the point where they are filling an entire icu with those patients, or having so many domestic violence cases that they have to shut down operating rooms and convert them into icu beds.

The case fatality rate is around 1.8% in the USA [1]. Current population is 330 million. So if the entire population becomes infected that’s 5.9 million dead.

The case fatality rate would likely increase as we overwhelm healthcare resources, so it could be even worse.

1% may sound trivial but it becomes meaningful at the scale of a population. The benefits of the vaccine far outweigh the risks.

I was injected yesterday along with my fellow emergency department and ICU staff. People seemed giddy with hope and relieved to become protected. If you see enough people die of covid then the risk of the vaccine seems trivial.

[1] https://coronavirus.jhu.edu/data/mortality

Make sure you are getting your vitamins. Would be embarrassing if you developed scurvy.

I commute on a specialized turbo vado sl, a similar lightweight e-bike. An electric bicycle this light will handle more like a conventional bicycle, and it’s easier to lift up steps or load onto bike racks.

This bicycle looks less cartoonish than my specialized, weighs less, and costs about the same.

My specialized has a walk mode. Not illegal in the states

Long shot but do you think this would be sufficient to r/o tumor in someone with a first time seizure? What about assessing for hydrocephalus in peds with a shunt?

Heck yes, will do!

For intracranial pressure did you look at ocular ultrasound? How did that work out? Did you have ICPs from actual bolted patients for the gold standard / ground truth? That would be incredibly useful especially in patients on a ventilator who can’t provide a neuro exam.

Pneumothorax seems tricky since really it requires a lung point for diagnosis, and those can be hard to find. Did you simply look for lung sliding? That’s all a physician really needs to make an informed diagnosis.

I love hearing about this. Thank you for the work you do

I could assemble a small dataset of less than a hundred ultrasounds to test the algorithm. A big dataset that could train an AI would require quite the effort.

Great questions, and you highlight the need for shared ultrasound data.