Glen O'Humeral

Patient: doc, I need something to help me stay awake Doctor: take two of these and call me in the morning Patient: but these...aren't these your kids? Doctor: trust me, I'm a doctor.

Since laughter is the best medicine, we really should find a way to encapsulate it and sell it as a pill. Obviously we would call it Laughophed

If an ophthalmologist is an eye dentist, does that mean the normal dentist is a tooth ophthalmologist? I need answers, @DGlaucomflecken

@Swole_Medic For single coverage community shops, it can be a lot

@HumeralO Only two ambulances inbound? Must be a slow day.

Gen Z lingo translated into Emergency Medicine: • “delulu” = this patient meets criteria for delirium • “crash out” = what happens when the CT scanner goes down • “chat, we’re cooked” = the ED’s full, the waiting room is full, and there’s 2 ambulances inbound

May the 4th (space) be with you

Deep tendon reflexes are really quite profound. There’s a reason they’re not called shallow tendon reflexes.

Dermatologists be like: “palpable pruritic purpuric patches of papules and pustules parading partially past the platysmal plane alongside prominent plaques of pedal petechiae”

Cardiologists will give you a stress test and tell you your heart is in terrible condition but won’t even say what your stress levels are. smh

There comes a time in every emergency medicine doctor’s life when they would rather run a resuscitation than do long division.

Retirement plan: an old-timey candle company called The Olfactory Ole Factory.

@shortney0006 @ronnoc_rd Exactly this

@ronnoc_rd @HumeralO I am not doing fundoscopic exams or obs on asymptomatic hypertension. We start them on antihypertensive meds (which you can also do) and tell them to follow up with their PCPs for reeval. There is no indication for further ED testing without symptoms.

Emergency doctors when primary care providers send patients with asymptomatic hypertension to the ED

@BroBobbyFan Well, it is more than one room, so it’s not really an ER. ED can have different connotations, I’ll give you that much

@HumeralO That's the same look I give ER docs when they use ED but we all know what it really means.

@ronnoc_rd Sending every asymptomatic SBP >180 to the ED seems bonkers to me. I’m not suggesting that high BP is not urgent — controlling BP is vitally important to preventing bad outcomes — but EM does not deal in preventative medicine, PCPs do. This is part of why EM burnout is so high

Symptoms don’t always manifest until too late. If I, in a community research clinic, see a patient with a BP >180 systolic local guidelines dictate that I must arrange for same day assessment. If I deviate then it’s my licence on the line. I know you guys are busy but asymptomatic doesn’t equal unimportant or suggest a lack of danger. Just because you don’t often initiate an intervention doesn’t mean the U&E, fundoscope and observation that you can provide that many can’t aren’t important.

@cardiojaydoc02 But the patient has a heart and the cardiologist should know about it

Cardiologists when a troponin is ordered for asymptomatic hypertension.

@OSHeartDoc But the patient has a heart, and the cardiologist should know about it

@HumeralO Me when an ER doctor calls me about an asymptomatic troponin elevation

@ronnoc_rd Emphasis on asymptomatic. Symptoms + severe hypertension = send to ED every time. These aren’t the cases I’m talking about. We give return precautions all the time in the emergency department, seems reasonable to tell people that if symptoms develop they should go to the ED.

@HumeralO How u supposed to check for end organ damage in an 8 minute long appointment exactly and who gets sued when it becomes symptomatic four hours later

The exorbitant price of tuition is largely a scam during the first two years of med school since it’s widely recognized and accepted that students will need multiple third party resources in order to pass their exams (which is usually paid for by the students as well)

Flight attendant over the intercom: “is there a doctor on board?” Me: *raises hand* Flight attendant: “oh…”

@FLTDOC1 Technically, a sandwich on both ends because the RSI extreme is really a paralytic sandwiched between a sedative and an ETT.

Acute tx of the agitated/potentially dangerous pt is a spectrum not a procedure - with a sandwich on one end and RSI on the other.