Evan

@ifjerif @WRCPAST I think you're on to something!

@EvanDownUnder @WRCPAST oh wow a doctor on a turn of a literal supercar race. must have been planned.

⚠️ Accident footage ⚠️ 🇮🇹 Marco Bezzecchi A frightening accident yesterday during the Moto GP race at the Dutch Grand Prix at Assen for Marco. The fact Marco is ok after such a high speed crash is absolutely unbelievable but perhaps there needs to be extra protection against that wall. These riders really are unbelievable but what a scary crash. 🎥 Credit to the fan who captured this scary moment. 👏🏻👏🏻 #motogp #assen #Bezzecchi #italy

@rlaxton @ZappedAU 1000V would be a slight deterrent

@ZappedAU Assuming that the primary purpose is copper theft, the return vs cost of the damage is insane. A few bucks worth of copper, over $1000 worth of damage every time. Pitiful scum.

Shame that people honestly go so far out of their way to vandalise and damage things…

@Ausbones aren't you supposed to do two more AFB smears? -😋 Not a TB doc here

A sputum smear is negative for acid-fast bacilli, but clinical suspicion for pulmonary tuberculosis remains high. Which microbiological test is most likely to provide a rapid diagnosis?

@stefanolson dude V13 consistently misses my street! (blows straight past at 80kph). I wouldn't complain about which driveway 😋

FSD 14.3.3 DU is both amazing and infuriating. Took me to my destination tonight & parked perfectly. On the way home was perfect. I thought wow this will be the first intervention free return drive! BUT it just drove straight past our driveway and tried to park at the neighbours!

@LynetteF17527 @trikomes simple analgesia (Tylenol and ibuprofen ) reduces the opioid requirement.

@EvanDownUnder @trikomes If he is on oxy why the tylenol?

Visited a friend in the hospital this weekend who nearly died from an infection. Turned the corner, recovering nicely. He is on antibiotics for the infection as well as oxy for pain. I asked him and his wife what the doctors were saying. "As long as the infection doesn't show signs of flaring up, I can go home Monday. They also want to monitor my liver, which they said is inflamed." Two minutes later a nurse came in, and gave him 975 mg of Tylenol, which apparently they give him multiple times per day.

@KatsGoneRogue @trikomes simple analgesia (Tylenol and ibuprofen ) reduces the opioid requirement.

@EvanDownUnder @trikomes He was also prescribed Oxy, which would make one argue why he even needed the Tylenol onboard as well?

My equation is something like this: 1. Arrive at the lowest state of charge you're comfortable with, given the geography and charger reliability. 2. unplug once you can make it to the next charger as long as you expect the charge rate to be higher at the next charger than you're currently getting. Because the RWD teslas are pretty slow at charging I try to unplug as soon as I can after it's under 100kW. Harold will be more of a pro than me though.

@EvanDownUnder @harald_murphy @Tesla @TeslaAUNZ @TeslaCharging That makes sense - basically limit your range to 250 and gain in charge times

AUSYtour FSDStour @Tesla @TeslaAUNZ Model YL Day 8 Arrived Tailem Bend South Australia after traveling 209km from Kaniva. Efficiency 175Wh/km. Charging at the @TeslaCharging V3 Supercharger.

@zaynhasn yeah the wait list thing is probably half of it, and the committee reviewing transfusion requirements is the other. Maybe if the hospital can supply the EPO you can fix their anaemia of chronic disease 😏

Cynic in me thinks some bullshit waiting list nonsense at play, moreover more admin, as not only do we get tasked with the clinically impossible but also another referral letter once said impossible is done rather than some PIFU/open access thing.Patients naturally hate us for it

A weird thing GPs are being asked to do more frequently by surgeons is to “reverse” people’s anaemias. Not as easy as optimising BP when you have patients with normal haematinics and MCV, usually anaemia of chronic disease (CKD etc) or mildly low HB due to thalassaemic trait.

@dynoclaus @trikomes DIRE Straights!! By 'single large dose' what you actually mean is more than 10-20g. Yes I'm glad he didn't get that.

@EvanDownUnder @trikomes With the infection, antibiotic, multiple grams of Tylenol combo, that liver is in dire straights. A single large dose of Tylenol can be fatal. Sometimes that means just a couple grams

@stefanolson we'll keep training it for the anticipation that one day it'll work and we can take some ownership!

Today's FSD 14.3.3 DU kid's drop-off. Ran 2 red lights! See videos. Both on the same intersection. Tries to go through a red right arrow. Couldn't stop quickly enough so I force it to go straight. Turned round went through the lights on the other side. Once again a red arrow, in this case pointing left. Went over the intersection line and was going through the red before I stopped it. @Tesla_AI @TeslaAUNZ

@harald_murphy @Tesla @TeslaAUNZ @TeslaCharging Norwood! I often prefer the Evie charger in Paralowie just north of the city 350kW and right off the highway.

AUSYtour FSDStour @Tesla @TeslaAUNZ Model YL Day 8 Arrived Adelaide South Australia after traveling 103km from Tailem Bend. Efficiency 170Wh/km. Charging at the @TeslaCharging Norwood V4 (stall) Supercharger.

turns out there was a hand written letter from the GP that stated 'query appendicitis' and they were ' reassured it was not appendicitis'. It appears from the evidence available, the coroner deliberately misrepresented the hand written letter and is looking for a scapegoat to cover the catastrophic situation of a dying child being refused a medical doctor.

@EvanDownUnder @DrNeenaJha From what I read it says that the GP documentation was missing - so nobody decided the GP was wrong, or had idea what the GP thought. Also a consultant surgeon opined that not all clinicians would necessarily diagnose appendicitis.

Child with severe abdo pain + fever GP diagnosis ?appendicitis - for urgent A&E r/v Seen by ANP in A&E - misdiagnosed as constipation & sent home. Does NOT escalate to a doctor Child later dies from a perforated appendix 🚨 Doctor replacement with non-drs COSTS LIVES! Enough!

@m7md_shaiban Flaperon sounds like a made up word, like some mechanic mis-stated aeleron. I believe you even if you're pulling my leg.

بعد وصولي من رحلة لندن أبلغني مدير المقصورة أن فيه راكب عنده سؤال ويريد مقابلتي .. قلت حياه الله وأثناء خروجي من الطائرة وجدت الراكب ينتظرني على الجسر وبعد السلام قال لي.. "يا كابتن.. صورت هذا المقطع أثناء الرحلة ولاحظت حركة هالزعنفة طول الطريق وحبيت أعرف منك شخصيا وش وظيفتها.. صراحة محيرتني" شغل لي المقطع وكان مصور الزعنفة الصغيرة Flaperon وهي تتحرك باستمرار أثناء الطيران.. كما تشاهدونها في الفيديو المرفق. حقيقة شدني سؤاله.. وفي نفس الوقت أحزنني أنه ظل يراقب حركة هالزعنفة من لندن إلى جدة والسؤال يدندن في رأسه طوال الرحلة 🤔 عموماً...هالزعنفة اسمها Flaperon وهي جزء من نظام مخصص لقمع المطبات الهوائية أثناء التحليق.. يتوفر هذا النظام في أغلب الطائرات عريضة البدن .. ورغم أن فكرة هذا النظام موجودة في بعض الطائرات منذ سنوات إلا أن البوينغ طورتها في الـ787 بشكل ملحوظ لتصبح أكثر دقة وكفاءة في التعامل مع المطبات الهوائية.. يعتمد هذا النظام على أجهزة استشعار دقيقة موزعة في أجزاء مختلفة من الطائرة ترصد باستمرار تغيرات الرياح والاضطرابات الجوية وخلال جزاء من الثانية يرسل النظام أوامر إلى هذه الزعنفة وهي متواجدة في الجناحين لتتحرك بعكس الحركة التي يسببها المطب فتقلل من قوته وتخفف جزء كبير من الأحمال الناتجة عن المطب.. لذلك يكون الإحساس بالمطبات أخف بكثير على الركاب وأكثر راحة.. وبما أن هذا السؤال قد يخطر على بال كثير من المسافرين قلت أشارككم المقطع والإجابة.. وسلامتكم.

@realglenappleby @harald_murphy @Tesla @TeslaAUNZ @TeslaCharging shorter is faster (5-60%) as long as you don't have to travel far off the route to charge and the chargers are over 100kW. Longer is fine if there's stuff/meal to do, but slower overall once you're on a fast network

@harald_murphy @Tesla @TeslaAUNZ @TeslaCharging Is it just me or is Harald doing a lot of short runs compared to how the majority of LR users travel? I aim for 350 to 400kms between stops and not 200 to 250kms.

also note the surgeon used the word 'clinician' - not doctor. If the surgeon expects a surgeon to get the diagnosis, he would expect the same from an emergency doctor. The reason he uses 'clinician' is (in my opinion) to admit a nurse might miss the diagnosis. Secondly, if the child came directly to ED without seeing the GP you are still expected to find appendicitis. The GP referral should be irrelevant to this root cause analysis, and they are fully responsible for managing their patients completely, not diverting blame.

you will see they have omitted what was told to the mother by the GP (I.e. I'm sending your son to emergency because I think he has appendicitis) and what was told to the hospital staff by the mother (I e. the GP sent me here because he thinks it's appendicitis). Then blamed the lack of documentation so they didn't have to blame the system. Either way, in this particular case, the doctor picked it up and the nurse didn't. So saying that 'doctors miss things' is not pertinent to this scenario when the diagnosis had already been obvious to a clinician.

@joshibza yes, sadly the coroner is too scared to tell the truth and address the clear systemic failure

Let us be absolutely clear: the issue here is not the absence of a referral note. While a handwritten letter is a useful tool, fixating on it completely misses the point of clinical accountability. If that patient had lost the referral, would we truly send a distressed child back to the GP to get another copy? Of course not. The moment a patient arrives in the Emergency Department, they are our responsibility regardless of what is written on a piece of paper. The referral is an aide, not a crutch, and it certainly does not replace independent clinical assessment. The real failure occurred when a nurse, operating beyond their competence, failed to clerk the patient, failed to examine them, and dismissed a child in severe painful distress as simply constipated. That is the fundamental error we must address. The question that should have been asked in that moment is painfully obvious: why would a General Practitioner refer a routine case of constipation to an Emergency Department if it could be managed safely in the community? The answer is that they wouldn't. The GP recognised an emergency; the nurse, unfortunately, did not. Let us not make excuses for poor clinical judgment or for placing unqualified individuals in positions of critical responsibility. In Australia, Canada, and the United States, such unsafe practices would not be tolerated. Cheap labour comes with costly consequences misdiagnosis, delayed treatment, and avoidable harm. We cannot use gaps in the rota to justify gaps in competence. Medicine demands that we all work strictly within our scope of training. Do not use qualifications you do not possess to make decisions you are not equipped to make. A referral note may guide you, but it does not replace your own history-taking, physical examination, and sound clinical reasoning. That is the standard we must uphold not just for the sake of process, but for the safety of every patient who walks through our doors. That is non-negotiable.

@drsthanus what about getting their neck blood pressure, Doc ?

The diagnosis that should make you question a non-invasive blood pressure reading of profound hypotension while a radial pulse remains palpable is pseudohypotension secondary to a vascular anomaly or obstruction, most notably subclavian artery stenosis or aortic dissection affecting the subclavian artery branch. ●To determine the patient's true systemic perfusion status, perform the following diagnostic steps: 1. Measure Bilaterally: Immediately cycle the blood pressure cuff on the opposite arm. A discrepancy of (>20mm Hg}between arms strongly confirms a localized vascular issue rather than true shock. 2. Assess Lower Extremities: Take a blood pressure reading on the patient's thigh or calf to confirm central perfusion if both upper extremities are suspected of vascular anomalies. 3. Check Central Pulses: Correlate your findings by palpating central locations, specifically the carotid or femoral arteries, to gauge overall circulatory status.