JamesMD

@rbarbosa91 Something worth noting with these devices is that a lot of them are not rated for pressure injectors with CT scanners.

There is a specialized catheter that is designed to be fed in through the introducer sheath and it comes with a fastening device so that it can just be twisted on and clipped there. It is more secure in the sheath than a regular CVC. (I didn't open the package to show this).

The side tubing of the Cordis is much larger than the 9 Fr sheath itself and is about the same size as the IV tubing present elsewhere in the circuit. So the side tubing only adds minimally to the total resistance (ie it is not really part of the Poiseuille equation).

@MSharifpourMD I had to switch to decaf in undergrad because of palpatations per my PCP. Probably the worst month of my life, maybe check in to see if they’re okay?

Met with a friend at a coffee shop cause he is a “coffee lover” and he ordered a decaf coffee! Not sure if I want this friend anymore

@rbarbosa91 Both suck have the potential to go off the rails. If they inadvertently extubate the patient then I can help switch to using the bronch to reintubate vs make the trach faster easier, bag, call anesthesia, etc.

You are doing a percutaneous tracheostomy with a resident (R2-3) as the second person. As the attending, you would do:

@jtrebach Desperation is the key flavor additive.

why does a hospital graham cracker taste so much better than a regular graham cracker

@WendyHassonMD Every hospital. The magic unwritten policy that nobody can find. I usually try the, “oh I’m sorry I’m not familiar with that policy. Can you show me the policy for my education so I can ensure compliance in the future?”

This interaction happens weekly at every children’s hospital I’ve ever worked at. Curious if this happens in adult medicine as often as it does in peds? “We have a policy that xyz…” “If you show me the policy I’d be happy to follow it” “Well, it’s more of an unwritten policy…..” #medtwitter

@rbarbosa91 I think while some patients really benefit from rib plating (pain control, ventilator liberation, etc) this is somewhat elective in that it is not an immediately life threatening process where implied consent can be employed.

A multiply-injured patient would (really) benefit from surgical stabilization of rib fractures. The patient cannot consent for themselves, and there is no surrogate. Neither of these things is likely to change in the near future. For this non-emergent case, you would:

@drclairetaylor Not everyone has an electric kettle. My wife uses the microwave for tea. I use a stovetop because I fear microwaves.

Cool fall morning. Cozy fuzzy blanket. French press. Morning full of lectures and QI to learn and improve care for my patients.

There is an IV fluids shortage (0.9% MS & LR) due to hurricane Helene. Because of the shortage everyone should stop ordering routine maintenance fluids for the next 2-4 weeks. Because of good medical practice everyone should stop ordering routine maintenance fluids forever.

@nickmmark Oh pick me!

“Now that my talk is over, would anyone like to summarize their CV and tell a short story disguised as a question..?”

Aw man, price finally dropped. Should I get it?

Congratulations to UW resident Nina Clark who was awarded the best paper presented by a resident at the AAST @traumadoctors @UWSurgery

First month out of training: read six books (four non medicine). Caught up with family and friends I’ve missed. Plenty of time in the hammock. All is well.

Maybe getting an espresso maker was a bad idea. Or maybe it’s the ten shots I’ve had today so far.

@missmedstudent I think it’s supposed to be post match 4th year. I failed to match 4th year and so my fourth year was filled with stress, shame, and guilt after doing away, interviews, applications, debt. Just like all of life it isn’t universal.

keep hearing about how awesome 4th year is… so far my 4th year has been the most chaotic and overwhelming of all…. Am I 4th year-ing wrong or are we not being given accurate information?🥲

People trying to adjust their statistical models to get p<0.05 before that abstract deadline.

@rbarbosa91 Fred would be jazzed you referenced him.

This would presumably lead to the phenomenon pictured by Qafiti and Buicko (paywalled)🫤: Not deep enough: Modeling the effect of shallow placement of the DaVinci Xi “bariatric” long trocar on the muscular abdominal wall | Surgical Endoscopy (springer.com)

Technical question for robotic surgeons: If the black mark on the 'bariatric' trocar is at the same distance from the proximal end as it is on a 'regular' trocar, then won't this mean the black mark isn't at the fascial level (which is where we want it to be)? (1/2)

Something oddly nostalgic hearing the Wednesday afternoon tornado siren tests.

@easwanson2005 Just got in. So weird but good being back after a decade around.

@easwanson2005 Come hang out.