Causality Doctor

Interesting letter from Colm Henry @HSELive to @AssocEmergMedIE . If patient in the emergency department who could and should be seen by acute medicine responsibility lies with emergency medicine(EM). So we are now openly saying if system dysfunctional all risk remains with EM?

Agree and disagree. Much of the availability is to cover the gaps in other professionals care. Few of the patients are true emergencies though many have the potential to be. Ritual whippings of emergency physicians should be discouraged (or continued until morale improves)

We can’t schedule death but we can structure it. But not in a crowded room with no personal space, no dignity and staff with little time to allow their empathy to shine.

Be thankful you had an opportunity to help someone in a way that was previously missed. Do not let your ego drive you. Remember that doctor you helped by focussing on the patients concern might help you again some day. We are all far from perfect.

@VirtueOfNothing In fairness not controversial. It is a standard specialist approach where risk stratification of relatively benign disease is pushed more and more for emergency medicine to see and sort out. Ology guidelines. It also largely means chest pain cannot be managed in primary care

How is this controversial?

Listen to this termination of resuscitation… which is how it should happen. There are several things to note that Dr. Robby from The Pitt did here that are spot-on. 1. He, in no uncertain terms, told her parents that her cardiac arrest was non-survivable. This is not the time to list out percentages or probabilities. This is the time to provide certainty to the inevitable death. 2. He told the parents when the appropriate time was to terminate resuscitation. Notice… No one said, “hey, so, do you want us to keep going or what?”. When a statement like that or similar is used, what the family hear are, “so… do YOU want to let granny die now or what?” You, the medical professional, that understands physiology and abysmal outcome even if ROSC is achieved at this point should be the one bearing the burden of making that decision, not the family member. 3. He offered to allow the remaining family to come in before stopping all of the visible efforts of resuscitation. (see previous post on this topic) My general gist is something like this, “Johnny has had no pulse and no blood flow to the brain for 40 minutes. Even if all the things we are doing were to get his heart beating again, he has suffered permanent brain damage. He will never wake up and be the same person you’ve him as. Now is the appropriate time to stop.” More to come on potassium levels and cardiac arrest... #emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #army #armymedicine #armyemdoc #resuscitation #research #data #family #death #cpr #medx #medtwitter

Wow. This UK Comedian just demolished MAGA. Watch until the end. I promise.

@ronancollins7 For medical consultant on call 1 in 14 number of hours outside of standard working week causing difficulty would be 516 hours or average 1.5 hours per day. For average emergency department it equates to 19.71 hours per day. Not sure which should be having concerns over a Friday.

@ronancollins7 Imagine working in an emergency department where 66% of your working week is without other services available (outside 8-4) and crowding levels are such that many patients presenting in office hours are seen much much later removing all options for safe discharge.

All aspects of a health service need to be operational for 7 day working to be effective .... thejournal.ie/readme/ronan-c…

Nothing says that @sinnfeinireland have moved past their violent past more than lauding cold blooded killers. Feel free to mourn your friend but portraying a murderer as a patriot is a step too far.

Ukraine the aggressor! Much like the United States attacked Japan in 1941 in their provocative actions at Pearl Harbour by the way they let the bombs fall and destroy both men and machine. Every time I think they cannot get more stupid or inept they continue to surprise me.

The difference between an educated leader and whatever is on the right.

@cuntasaurus22 @TadhgCalbhaigh @Healyhack No sympathy for a racist

LATEST: Right. It’s been a long day. But we got there. Have spoken to pals of South Anne Street murder victim Quaham Babatunde who provided this new photo of him and confirmed that yes - he was previously in court accused of rape in Italy. Full story: #source=breaking-news" target="_blank" rel="nofollow noopener">irishmirror.ie/news/irish-new…

@TadhgCalbhaigh @Healyhack I have a liking for due process. First he was not convicted of said crime. Secondly and more importantly he is dead by another’s actions. Why do you feel the need to fight this battle. Have a little respect. I really hope you treat your colleagues in healthcare with more respect.

@JDVance @mehdirhasan Really sad that a politician cannot engage without insults. Coming across as a petulant child. I would have thought denying the press the ability to ask questions is an attempt to control the narrative and as such a threat to free speech.

@mehdirhasan Yes dummy. I think there’s a difference between not giving a reporter a seat in the WH press briefing room and jailing people for dissenting views. The latter is a threat to free speech, the former is not. Hope that helps!

Hey @JDVance, I know you’re busy lecturing the Europeans on free speech, but have you seen this?

@TadhgCalbhaigh @Healyhack A man is dead. The article does not comment on a conviction so he is an innocent man who died violently. Please take the healthcare worker comment off your bio. You likely work in a system totally dependent on foreign workers so your attitude is poor to say the least.