Day 12 of hitting “report phishing attempt” on every email in my work account. I’m tired of the bullshit emails from IT trying to fool people. So now I just label everything as phishing including email from admin.

Some days in the ER have you asking wtf. If I had a nickel for every patient I’ve ever seen with a sodium greater than 180, I’d only have two nickels. But it’s jacked up that it happened in one shift.

Six years ago I took care of a very sick teenager in Haiti and we got him eventually to Cuba to see a pediatric cardiologist. Today I found out he is doing well and has been accepted to med school. I’m not crying, you’re crying.

The number of times that i was asked by coworkers to take a patient (especially to place a urinary catheter) because the patient was saying creepy things is surprisingly high. Even now as a provider, I do it because so many men get creepy to female healthcare providers.

A pretty good read, and tracks pretty well with what those of us working in healthcare in the area know about Phoebe and other hospitals like it here.

Same pretty much. Though I still go 10 day for bad tooth abscess. The meth mouth around here is bad.

Yeah. I would say around 20 percent of patients I see in the er admit to taking some “leftover” amox they had or a friend gave them. I’ve really embraced the recommendations for the shorter durations because if you write a 10 day course, they will stop at day 7 and hoard the rest.

I am determined to deplete the area supply of bromfed. So many kiddos with the flu in the last few days. But I’ve been pretty hardcore on the no antibiotics position with the parents.

One of the small rural hospitals has decided to stop stocking liquid amoxicillin because it is “too expensive”. This is the second dumbest thing I have heard today after a parent said they don’t vaccinate because it causes autism and they trust RFK.

This years flu vaccine is an imperfect match for the dominant variant, subclade K. The shot gives some protection, just reduced effectiveness. But you can’t convince most people of that, the vast majority of patients I have seen are saying they either didn’t get the shot or won’t get it next year. 🙄

@kamalaharris.com told us exactly what would happen.

Every year the holiday period makes me question my decision to work in rural emergency medicine. So many people flooding the ER with cold and flu or stomach issues.

The hero we need.

Yeah I am really enjoying it. Rhea Seehorn is wonderful.

4 hours into the ED shift and I’ve already seen three dental complaints, two ortho, one assault, one burn, two URI, and two abdominal pain with V/D. Definitely the day after Thanksgiving here.

Pic captioned “I’m in!” With a background of a dirt road in Kansas and the Unbound Gravel logo.

Well this is either gonna be the best idea I had or the worst idea. Training starts Monday.

My therapist has been discussing with me that I need to set new fitness goals now that elite bike racing is off the table. I miss racing cyclocross and MTB so much. So I’m trying to shift into a mentality of doing events for fun and fitness only. So I entered the lottery for Unbound to have a goal.

I feel that those of us outside the perimeter in deeper rural south GA are just generally screwed. The state has a long history of gerrymandering type shit, that’s why there’s 159 counties - to help dilute the power of Atlanta in state politics.

4-panel vertical comic. (1) 100 Years Ago [two people standing next to bicycle with small car nearby] PERSON 1: It’s too dangerous riding a bike with these cars around. I should get a car, too. (2) 50 Years Ago [two people between smaller car and bigger car] PERSON 2 with short hair: Small cars are less safe in collisions with larger vehicles, so I should get a bigger one. (3) Today [two people between big car and even bigger car] PERSON 1: Everyone has huge SUVs now. If I don’t get the biggest one, I’m putting my family at risk. (4) Soon [two people next to large armored car with spiked clubs attached] PERSON 2: If I don’t install more whirling spike clubs, I’ll be destroyed by all the other drivers who...

Car Size

xkcd.com/3167/

I’m disgusted, but not surprised, by the USA Cycling decision to change rules to prevent trans athletes from participating fully. The decision to enforce a “sex at birth” rule for categories is just bending the knee to the current administration and is opposite of the UCI position.

100 helicopter flights to date delivering aid and medical flights in Jamaica since the start of ops on Oct 30.

Here we go.

www.instagram.com/operationone...

Photo of me in front of the AMTC logo.

Made it to the Air Medical Transport Conference in Omaha. It will be interesting to see how my presentation on the rise of vaccine preventable diseases and managing these patients in transport will be received.

I’ve only seen a few complete Simpsons episodes and none of the Treehouse of Terror ones. I just never got the appeal of the show.

I’m gonna try Halloween Horror Nights for my poor mood and burnout.

Banner at the Emergency Nurse Association conference. It says “Tenacity - emergency nursing 2025” with the ENA in tenacity highlighted.

Made the trek to New Orleans to participate in the legislative general assembly of ENA. Once again advocating that membership and classes are unaffordable for nurses in developing nations.

Well it happened. Yesterday a patient insisted on being admitted for URI symptoms because he was convinced he had the covid variant that kills you he read about on Facebook. He wouldn’t listen to my explanations and left AMA to go to another hospital that “isn’t a liberal shithole.” I can’t even.

And there’s a comma in the troponin

REVIEW: An Airway Manikin You Can Actually Afford? YouTube video by Cliff Reid

Here's my full review of the cheapo Temu manikin. Spoiler: It's pretty good
youtu.be/1MwPOu0wG8M

Can confirm that the vast majority of Covid patients I am seeing in the ER complain of sore throat, either “razors” or “ground glass” as the descriptor.