@@skyhappy other specialties absolutely love dumping agitated or delirious patients on psych when it’s completely unnecessary. The patient doesn’t have a new onset psychosis or a new onset depression - they have delirium, and whatever cause it’s secondary to is NOT psych’s problem.
You laugh, but ID knows that a tie made damp by the ICU attending's frothing saliva as they yell at everyone is a major vector for Acinetobacter and Pseudomonas transmission
You're legitimately too talented at this to continue with a career in medicine. So is the guy on the keyboard. Yalls faces and voices are fucking perfect.
The eternal struggle between BB and critical care is as old as time. That hit home. If you want 20 migs per kig of blood products, dont let your standing T&S expire, unless you want to emergency release.
I worked as an ER Tech for awhile, it was like watching an MMA fight seeing all the different attendings argue with each other during a major trauma code. No one could agree on anything, meanwhile the ER attending is just like "get them out of the ER Idk"
Man during my last rotation the vibe between surgery and ICU was so backwards hahah it felt like an alternate universe hahah surgery would be worried, would beg for an abdominal CT-scan. ICU would say no, I’m not worried about his abdomen hahahahaahhaha
Me describing (badly) a post op scar: a gapping 1x1cm at the distal part of the op scar My surgeon: apex Me : what My surgeon: at the apex of the.. The wound: a literal straight line
This happens so many times... When ur a med student and u r presenting a case some of them don't listen to whatever you were saying and in the end they are like... U didn't say that ... Next time you present make sure to add the lung sounds 🥲
Patient is oozing fluid out of his skin and has an ef of 30% but we gotta keep those maintenance fluids going. Something something, insensible loses. (I am currently applying for critical care fellowship lol)
ID saying “why don’t you put on some PPE?” to the ICU doc is very on brand. ICU docs give 0 fucks lol I watched one palpate around an open abdomen pt w/ enhanced precautions no gloves, no PPE ….also I still don’t understand how oncotic pressure works and I’m too scared to ask at this point
Literature Loving Attending is why everyone trynna to go to med school should work food service in undergrad. Abuse won’t even register on your radar anymore 😂
Problem is that the patient has leaky capillaries. Albumin will leak into the interstitium and cause more edema long-term. Patient has significant weight gain (2 lbs in 24 hrs) and blood pressure is elevated. There is no reason to give albumin. Lasix will lower intravascular volume, but that change in fluid gradient will pull fluid from the interstitial space in to the intravascular space.
@@nicholasbyram296 give albumin to stop the hypoproteinemia.. secondary to a tanked liver. Then use spironolactone and furosemide to zap the edema. Pt is probably a cirrhotic. We do that all the time for Hepatic Encephalopathy.
Oh good gosh, I hope when you come up and are the attending, you will recall all this. And while some of what was said may have been important, it was delivered with a level of brutality that was utterly unnecessary. Medicine needs to change because people ate valuable.
