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76 F, sudden onset of back pain, no prior history of heart disease, what's your interpretation? by miserable_pothead in EKGs

[–]Goldie1822 24 points25 points  (0 children)

Sudden onset back pain with ischemic changes. Stop, do not pass go, do not collect $200, rule out aorta disruption.

As far as the ECG. Sinus rhythm. Conduction delay in borderline long QT and borderline bradycardia.

RSR in v1-3. We have RBBB by definition.

T wave inversion most notable in precordial leads. This is prominent and we also have ST depression. This usually means acute myocardial ischemia. So we have a subjective cardiac complaint (acute back pain in female) with objective findings (ischemic ECG) this warrants a cardiac workup.

Plan: imaging of aorta, cardiac enzymes. Rule out MSK origin of back pain of course. If money was no object I’d also get an echo and I’d repeat the 12 lead to see if there are any changes to ST segment.

I’m 17 years old and I don’t understand why you all think piano is so hard by rummikubenthusiast in classical_circlejerk

[–]Goldie1822 6 points7 points  (0 children)

Ur satire

I’m 17 years old and I don’t understand why you all think piano is so hard by rummikubenthusiast in classical_circlejerk

[–]Goldie1822 -1 points0 points  (0 children)

Except that's what you're doing. This is the opposite of humbleness.

Not everything comes easy to everyone. It's just the way humans work.

Enjoy your innate talent and whatever...this....is...do the opposite. Be humble.

Post awhile back about a residency director asking residents to write a guide for midlevels? by brsboarder2 in emergencymedicine

[–]Goldie1822 1 point2 points  (0 children)

I'll rebut once, but that's it.

First, you have no idea who I am, where I've been, what I've done, and all the other W's.

As I, you.

So, the ad hominum bitching shouldn't be something you resort to, as it weakens your position.

For the record, I am in fact not a midlevel and have probably been in medicine twice as long as you have.

I am sorry that you don't feel heard and it sounds like you work at an institution that is disconnected. The nice thing about this profession is that you can easily find employment somewhere else. As I stated before, with the proliferation of for-profit healthcare conglomerates, this practice will not only continue but increase. This involves trimming nursing staffing, trimming ancillary worker staffing, and, you guessed it, swapping out physicians for mid levels. This is already commonplace in anesthesia, almost every single ICU, and it's coming for EM and IM as well: midlevels are going to be running the show with physicians providing oversight. This is not good, and I think we are in agreement here, however, none of us have provided a solution. I think the most reasonable one would be legislating a reform of midlevel education.

AECP is a joke. I was referencing residency metrics and, well, you can search this sub for posts few months back to get up-to-speed on that.

My takeaway from your post is that you're generally miserable and lack coping mechanisms. You had an emotionally traumatic and frustrating sentinel event? And were named in a suit. I take it now that has led you on an anti-midlevel campaign for the rest of your life as an outlet for your frustration.

That is bad.

You were wronged by someone who didn't know what they didn't know and now you hate an entire group for it. I find that analogous to bigotry? Like anti-immigrant or anti-____ group sentiments. And it comes from a bad place.

Anyway, I strongly recommend therapy. It's a tough world, tough career, and tough industry. I promise you can benefit from learning about de-stressing, coping, and so on. I am a success story of therapy myself, and recommend it to damn near everyone, but you especially.

Your downvote ratio speaks volumes as to what others think of your (shitty) opinions. It's also the way you voice your opinions.

Gift for Cello Player by BruceWayneManor_ in Cello

[–]Goldie1822 2 points3 points  (0 children)

Usually the cellist has a personal preference. Don’t recommend this.

Intel Announces Layoffs After Paying $1.5 Billion In Q1 Dividends by NotALotGoingOnReally in technews

[–]Goldie1822 2 points3 points  (0 children)

All in the name of turning profits year over year

Post awhile back about a residency director asking residents to write a guide for midlevels? by brsboarder2 in emergencymedicine

[–]Goldie1822 6 points7 points  (0 children)

Show me on this doll where the PA hurt you

​

​

BTW, my brother in Christ, midlevels are not going away thanks to more and more corporate buyouts, less physicians being pumped out than extant need, and many other reasons. If you witness gross incompetence, report it to the board and the CMO. Otherwise your campaign against midlevels is akin to an old man yelling at clouds.

Can I get help with a cipher? (1 2 3 = T E L) by Goldie1822 in escaperooms

[–]Goldie1822[S] 6 points7 points  (0 children)

Good job!

A cyclist was hit by a car while crossing the street at a roundabout in The Hague, cyclist was examined in the ambulance and received some first-aid, transport to a hospital was not necessary by deminion48 in ems

[–]Goldie1822 1 point2 points  (0 children)

Been saying this when I worked on the ground too

A cyclist was hit by a car while crossing the street at a roundabout in The Hague, cyclist was examined in the ambulance and received some first-aid, transport to a hospital was not necessary by deminion48 in ems

[–]Goldie1822 -1 points0 points  (0 children)

see the asterisk

A cyclist was hit by a car while crossing the street at a roundabout in The Hague, cyclist was examined in the ambulance and received some first-aid, transport to a hospital was not necessary by deminion48 in ems

[–]Goldie1822 0 points1 point  (0 children)

We do not have CT or X-ray. This patient could’ve had internal bleeding or a head injury and still had stable vitals and be refusing transport.

Yeah, this is legal. However this will always manifest into physical signs (sometimes this manifestation is too late to intervene, sure)

​

That is why we recommend transport based on mechanism, because we do not have the tools to rule out serious internal injury. It’s not because our assessment abilities suck.

Nah simply doing a load-and-go or calling for a helicopter without doing a comprehensive assessment and simply looking at the vehicle collision, for example, is more what I'm referring to.

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Cipher! (self.riddles)

submitted by Goldie1822 to r/riddles

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Can I get help with a cipher? (1 2 3 = T E L) (i.redd.it)

submitted by Goldie1822 to r/escaperooms

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Substitution Cipher (i.redd.it)

submitted by Goldie1822 to r/mathriddles

Cipher Challenge by [deleted] in puzzles

[–]Goldie1822 0 points1 point  (0 children)

Hint: 1|2|3| = "T E L"

I've been playing just under a month. Any tips to make my bowing more consistent? by OhmssArona in violinist

[–]Goldie1822 3 points4 points  (0 children)

Okay, this is something your teacher must work with you on, and should, and probably will.

​

There are a number of incorrect things going on with ya, starting from simply the way you're holding the violin (collapsed wrist), holding the bow (weird pinky thing), posture (lunched over), etc.

I think you should recognize these above things first and correct them, then start working on long slow bowing using the entire bow but making the sound consistent.

Use the entire bow up and down and just play an open string and try to control the speed and pressure to make the sound consistent.

A cyclist was hit by a car while crossing the street at a roundabout in The Hague, cyclist was examined in the ambulance and received some first-aid, transport to a hospital was not necessary by deminion48 in ems

[–]Goldie1822 9 points10 points  (0 children)

Hot take: Mechanism of injury is an excuse for incompetent assessment abilities*

​

I'd hate to see some of you doing standby at boxing or MMA matches kidnapping every fucking athlete.

\sometimes critical thinking is required)

I've been playing just under a month. Any tips to make my bowing more consistent? by OhmssArona in violinist

[–]Goldie1822 0 points1 point  (0 children)

You should get a violin teacher

Gen Z has ‘lowest’ patriotic sentiment in US, poll shows by just-a-dreamer- in army

[–]Goldie1822 52 points53 points  (0 children)

08 crash

Oh you mean big bank bailout while nothing was done for John Q Public, that one?

I love the commissary!!! by Delicious_Rip_5948 in army

[–]Goldie1822 7 points8 points  (0 children)

ngl costco is just as good

4 people in Grafton overdose, one has face mauled by a dog by buckmelanoma77 in news

[–]Goldie1822 -7 points-6 points  (0 children)

Grammar journalist nerd here:

The headline is missing a verb! 4 people WHAT? Die? Involved in? Affected by? Enjoy?

Also one shouldn’t use the numerical “4”

The army made me homeless update by skulltab in army

[–]Goldie1822 0 points1 point  (0 children)

This is it.

Call your next higher CSM and request an urgent open door meeting.

68T? by Prestigious_Crab2311 in army

[–]Goldie1822 0 points1 point  (0 children)

I know a few.

I've deployed with a few.

Are you talking about reserve or active duty?

Is your question in reference to FORCECOM or MEDCOM like the other guy said?

It's almost exactly like a civilian vet tech, but also with Army things like map reading, marksmanship, chain of command, PT, etc.

Guitar Tuner on Tuba! by [deleted] in lingling40hrs

[–]Goldie1822 0 points1 point  (0 children)

??

Uh this is very common

Trying to save some money and buy a new set OCPs online but don’t know which is the right one? by tH3_R3DX in army

[–]Goldie1822 32 points33 points  (0 children)

Both are “legal”

I’m an officer and have to buy my own. I’ve used the very website you’re.

However they won’t have the IR tabs only the ones from AAFES or PX have those.

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