medgremlin
@medgremlin@midwest.social
- Comment on 2 life pro tips in one meme! 1 week ago:
Our water is polluted enough as it is. I will always advocate for yeeting the rich…into volcanoes.
- Comment on Anon is a good samaritan 2 weeks ago:
I have done CPR on people before, and it is astonishingly brutal. To do it correctly, you have to cave their sternum in to be able to apply enough pressure to the heart to actually move blood around. For “Out of Hospital Cardiac Arrest” patients that receive bystander CPR, the survival to discharge is around 10%, give or take. The most common outcome of CPR (if it is successful and you get a pulse back) is days to weeks of dying slowly and painfully in the ICU. The older someone is, or the more health problems they have, the much lower the chance of recovery is.
CPR is absolutely reasonable for a younger person that stands a good chance of walking out of the hospital at the end of it, but 90 pound 90-year-old is extremely unlikely to survive in a meaningful way. It is very reasonable to request to not be put through that massive amount of suffering for a very low chance of any meaningful benefit.
There’s also degrees of DNR. There’s separate options for CPR, intubation, supportive care, active treatment, palliative care, etc. It’s a lot more nuanced than CPR yes/no in most situations.
- Comment on Karaoke place 2 weeks ago:
I think the other part of it is that something like a full colonoscopy is a lot safer if the patient isn’t moving at all given that one of the biggest and most serious risks is poking a hole through the colon with the camera.
- Comment on Karaoke place 2 weeks ago:
That sounds more like a waking sedation. Those will get used in American medicine if it’s just a sigmoidoscopy (the last bit of the rectum and colon), but for a full colonoscopy, they really prefer to conk you out a bit more than that.
- Comment on Karaoke place 2 weeks ago:
The ones I observed with my attending physician were using twilight sedation with propofol, and I think they got small doses of fentanyl to manage discomfort/pain during and right after the procedure. The propofol lets them knock you out for a while without putting you under so much that they have to intubate. (That is anesthesia’s job though, so it might be recorded differently on your records)
- Comment on Karaoke place 2 weeks ago:
The ones I observed with my attending physician were using twilight sedation with propofol, and I think they got small doses of fentanyl to manage discomfort/pain during and right after the procedure.
- Comment on Karaoke place 2 weeks ago:
Not if they did the bowel prep well enough.
- Comment on Karaoke place 2 weeks ago:
It’s usually propofol.
- Comment on Why I Haven't Seen Any Trump Supporters In Fediverse (Lemmy and Mastodon)? 3 weeks ago:
Biden absolutely has some control over this, but Netanyahu is the bigger problem at the moment. Biden has influence over Netanyahu (with a lot of caveats and red tape due to decades of foreign policy), and Harris has influence over Biden…but that’s not the same thing as absolute control. There are also parts of this that have to get approved by congress and there’s only so much the office of the president can do unilaterally.
They can be doing more, and they should be doing more, but Harris’ role and capability is limited to that of an advisor (under strict scrutiny from everyone) right now, and that doesn’t actually give her that much power.
- Comment on Why I Haven't Seen Any Trump Supporters In Fediverse (Lemmy and Mastodon)? 3 weeks ago:
I’m not terribly old, but I’ve been around long enough to know that the lower offices are where you actually affect change in this country. The higher the office, the less they listen to their constituents.
- Comment on Why I Haven't Seen Any Trump Supporters In Fediverse (Lemmy and Mastodon)? 3 weeks ago:
There are lower ranking Democrats that are espousing the right ideas about things like the filibuster, gerrymandering, and even some that are agitating about the electoral college BS. The best strategy I see right now is to clear as many Republicans out of office as we can, and support the newer, lower-level representatives that are aiming to affect real change.
My voting strategy has always been to “vote blue, no matter who” on the top of the ticket, then do my research and be more selective about the offices lower down, especially in the primaries. Unfortunately, it doesn’t matter if more progressive candidates take hold of the House and the Senate if everything they pass just gets vetoed by the fascist in the Oval Office anyways.
- Comment on Why I Haven't Seen Any Trump Supporters In Fediverse (Lemmy and Mastodon)? 3 weeks ago:
You do realize that she’s the Vice President and doesn’t actually have any authority or power unless Biden kicks the bucket, right?
Because it really seems like you think that she has any ability to make unilateral decisions or enact her policy platform right this second, and that simply isn’t the case.
- Comment on Why I Haven't Seen Any Trump Supporters In Fediverse (Lemmy and Mastodon)? 3 weeks ago:
America is, unfortunately, a two party system. If not enough people vote for Harris, Trump wins. Period. There are no options besides Harris and Trump, and only one of them has talked about how Israel should literally nuke Gaza (I’ll let you take a guess on which one it was.)
I see your idealism, and I agree that any amount of genocide is unacceptable, but letting Trump win will just accelerate the genocide in Gaza, expand it to the West Bank (more noticeably, anyways), and likely start new genocides here in America. I’ve been writing to my representatives and sending them articles about the atrocities being committed by the IDF and imploring them to do something about it…but I’m not dumb enough to withhold my vote from the Centrists and allow the Fascists to take over.
I repeat: withholding your vote from Harris is effectively a vote for Trump because America is a two party system, and there’s only two options to pick from.
- Comment on Thanks to science, men can now locate the clitoris with micrometer accuracy. 4 weeks ago:
Context for people unfamiliar: this is a video-assisted intubation. The white bit on the screen is the larynx (vocal cords), and the fold below it is the opening of the esophagus.
- Comment on Thanks to science, men can now locate the clitoris with micrometer accuracy. 4 weeks ago:
The little white ring is a larynx. This is a video-assisted intubation.
- Comment on It is what it is 5 weeks ago:
Oof. Tell me about it. I went to a Gen pop hospital after working in a level 1 peds ER and the other ER folks gave me “the look” when I talked about some of the stuff at the peds hospital. Non-accidental trauma cases are a special kind of PTSD.
- Comment on Anon is a soyboy 5 weeks ago:
Personally, I prefer soy milk to cow or oat milk because it has a better nutritional profile. It has less sugar and fat, and more protein, as well as having fiber. (Some oat milk brands do have fiber in them, but most of the ones I’ve found are very high in fat, sugar, and calories.)
- Comment on Anon tries to be ethical 1 month ago:
Thankfully, the extent of the religion in the education is in the ethics discussions and strong recommendations to discuss spirituality and religion with your patients because faith communities are “very important”. The religion does not make it into any of the actual medicine or science.
- Comment on Anon tries to be ethical 1 month ago:
I accidentally ended up at a religious university for medical school and you better believe I’ve gotten in numerous fights with the law and ethics professor (who, to be fair, is actually a MD/JD) regarding the prescribed conservative religious approach to the ethics discussions. I absolutely did not change his mind, but I did get a bunch of my classmates to start asking questions by putting myself out there and challenging the professor on their BS.
- Comment on Anon tries to connect with a coworker 1 month ago:
I mean, I’m partial to the Tang dynasty in part due to Wu Zeitan. Her history and time as empress are absolutely fascinating and the relative prosperity of her reign is really impressive.
- Comment on Breast Cancer 1 month ago:
I think there are some techbros out there with sleazy legal counsel that promises they can drench the thing in enough terms and conditions to relieve themselves of liability, similar to the way that WebMD does. Also, with healthcare access the way it is in America, there are plenty of people who will skim right past the disclaimer telling them to go see a real healthcare provider and just trust the “AI”. Additionally, there’s enough slimy NP professional groups pushing for unsupervised practice that they could just sign on their NP licenses for prescriptions, and the malpractice laws currently in place would be difficult to enforce depending on outcomes and jurisdictions.
This doesn’t get into the sowing of discord and discontent with physicians that is happening even without these products existing in the first place. Even the claims that an AI could potentially, maybe, someday sorta-kinda replace physicians makes people distrust and dislike physicians now.
Separately, I have some gullible classmates in medical school that I worry about quite a lot, because they’ve bought into the line that chat GPT passed the boards, so they take its’ hallucinations as gospel and argue with our professor’s explanations as to why the hallucination is wrong and the correct answer on a test is correct. I was not shy about admonishing them and forcefully explaining how these “generative AIs” are little more than glorified text predictors, but the allure of easy answers without having to dig for them and understand complex underlying principles is very alluring, so I don’t know if I actually got through to him or not.
- Comment on Breast Cancer 1 month ago:
There are way too many techbros trying to push the idea of turning chat gpt into a physician replacement. After it “passed” the board exams, they immediately started hollering about how physicians are outdated and too expensive and we can just replace them with AI. What that ignores is the fact that the board exam is multiple choice and a massive portion of medical student evaluation is on the “art” side of medicine that involves taking the history and performing the physical exam that the question stem provides for the multiple choice questions.
- Comment on Breast Cancer 1 month ago:
I once had ideas about building a machine learning program to assist workflows in Emergency Departments, and its’ training data would be entirely generated by the specific ER it’s deployed in. Because of differences in populations, the data is not always readily transferable between departments.
- Comment on Breast Cancer 1 month ago:
People just need to understand that the true medical uses are as tools for physicians, not “replacements” for physicians.
- Comment on [deleted] 2 months ago:
Is there anything else in that head of yours? Do you have space in your mind alongside this vitriol for anything that makes life worth living? Family? Friends? Hobbies? What things do you find to be positive or wholesome in your perspective? I’d genuinely like to hear what your ideas and beliefs are beyond the topic of Gaza.
- Comment on If everyone is fired by AI, who's going to buy the products and services made by the companies if no one has money anymore? 2 months ago:
And as long as CPR machines are obscenely expensive and difficult to obtain and maintain for a lot of smaller hospitals and EMS systems.
- Comment on If everyone is fired by AI, who's going to buy the products and services made by the companies if no one has money anymore? 2 months ago:
Here’s the problem with that: it relies on things like the LUCAS CPR assist machine which doesn’t fit on a lot of people. I’ve done CPR on a lot of people, and only a handful of them would have even fit in a LUCAS in the first place.
- Comment on This will be YouTube in 2025 3 months ago:
The image won’t load, but based on the replies, I think it’s a weeping angel, and now I don’t want the image to load.
- Comment on Why is alcohol legal if it's much more harmful than marijuana? 5 months ago:
When I was working as an ER tech, I had a patient that was in the early stages of DTs in the lobby because he lied and told the medics in the ambulance that he was having a panic attack. We were up to 8 hour waits in the lobby and non-critical ambulances were being brought out to the lobby. He was perfectly lovely the entire time, but around the 5 hour mark when the valium was wearing off, he started sweating and shaking profusely. I had to have our registration folks distract his dad so I could ask him privately if he was withdrawing from alcohol. When he said yes to that question, that bought him a ticket to the front of the triage line and we got him into the next available room.
I will remember that incident for the rest of my career, because if I hadn’t looked at his medical record to see that he had previously had a consultation regarding alcohol cessation and known what the symptoms of withdrawal looked like, I wouldn’t have pulled him aside to get the truth of the situation and things could have gone extremely badly for him. I can’t imagine what he was feeling, devolving into DTs in front of his dad who was so judgemental that he had to lie to the medics about what he needed help for.
- Comment on Why is alcohol legal if it's much more harmful than marijuana? 5 months ago:
Withdrawal from many drugs is miserable to go through, but because of the chemical mechanism of the dependency formed in alcohol use disorder, withdrawal from alcohol can lead to death without other comorbidities or complications. Some of the symptoms of acute withdrawal include delirium tremens and seizures which, while awful, are just the harbingers of the later stages of acute alcohol withdrawal that lead to death. This is also ignoring the plethora of other health problems that can develop as a result of long term alcohol use disorder, many of which can be fatal all on their own.