This is why we talk to our patients even when sedated. Why they get their hand held, hair sorted, music on. We look after people, not numbers. This is quite a thing to watch.
Six long days of full bullshit in covid ICU and it’s time for a beer. For fuck’s sake folks, you do not want me phoning your loved ones to have the conversations I’ve been having this week. Stay home, wear your masks, get your vaccine. Stop believing eejits on Facebook. Dave x
Speaking as an intensive care consultant: PAY SOMEBODY ELSE TO FIX YOUR ROOF. Men over the age of 50 I am specifically eyeballing you here - put the ladders away and get someone who knows what they’re doing. Especially if it’s skates on a 2 story house above a patio. Believe me.
I’m a geneticist, not a microbiologist, but my working hypothesis is that this double plug socket is producing some new, as yet undiscovered, antibiotic.
@MattHutchings10
I am just a man sitting in an ICU reading through 40+ yrs of notes hoping that ONE OF YOU EEJITS WROTE DOWN WHAT THE REACTION TO PENICILLIN ACTUALLY WAS INSTEAD OF JUST WRITING: ALLERGY- PENICILLIN.
Seriously, don’t do this. I need to know if it was anaphylaxis or a rash.
I want to employ a CT1 on the basis of, “I’ve done fuck all audits and haven’t been to a conference yet, but I’m really interested in anaesthetics and quite like physiology and don’t flap when people are sick.”
Once worked with someone who clamped a urinary catheter to stop the patient losing fluid. In HDU.
Every now and then I think about that moment, and wonder what that person is doing now.
Some proper kindness shown by the ICU and ED nurses at Edinburgh Royal tonight, insisted on making sure a starving tired doc on transfer and our Paramedics got tea/coffee/cake even though it was was clearly busy as usual. Simple stuff but meant a lot. 👍🏻☺️
Right: stop writing shit like “claims to have been run into by a dog” in the notes. You’re not in Line of Duty it’s a 40 yr old woman with an ankle fracture she’s literally telling you what happened you clattering arse.
Due to lockdown in the residences the junior docs have started a guerilla garden/plot. Local garden centre have donated veggies and flowers for it and everything! 💐
This is true. Injuries I’ve seen farmers present with:
Flail chest sat in waiting area quietly.
Ran over himself with his own tractor. Drove tractor to farm.
Fell off haybale impaled onto fork tine. Walked to hospital carrying fork.
etc
We’re getting unconfirmed reports that Elon Musk is readying some submarines and digging equipment to rescue Paul “actually it’s vagina” Bullen from the deep hole he’s dug himself.
Graffiti on North Bridge in Edinburgh: “FUCK FASCITIS”. Genuinely not sure if this was a runner having a bad day or a comment on current politics. Possibly both.
You can create all the new surgeons and anaesthetists you want - but for each one of us doing an operation you need at least another 5-6 theatre nurses/ODP/HCSW, multiplied up to scale. Work on recruiting THEM. Start by paying them properly.
In the last 24hrs I have had to endure the following:
“Defiblerator.”
“Particklery expecial.”
“Hatmanns.”
and the perennial teeth-clenching classic... “expresso.”
I for one am going to welcome the sweet cleansing nuclear fire.
Idly remembering a consultant who would rescrub completely to site an epidural/spinal if the patient farted while he was trying to put it in. The record was 3 times in a row.
Meanwhile folks are out there doing LP’s with blue gloves and a KFC moist towelette.
Consultants, eh? Amazing. Years of experience, they know the hospital, might have known the patient for years... but they are NOT PSYCHIC AND CANNOT HELP YOU IF YOU DON’T TELL THEM. Even at 4AM. Phone them.
#TipsForNewDocs
Tips for new gas docs: you cannot do this job hungover. You really can’t. The level of sustained concentration plus the smell of burnt flesh/blood will put you in the locker of deep regret. Do not test this advice.
I remember a house officer who, if asked to cannulate someone tricky at the end of their shift, would put in a subcut blue and tell the nurses he’d done the cannula. Of course it wouldn’t work so they’d bleep someone to come and do it. Often wonder where he eventually was buried.
Local distillery has made hand sanitiser for our hospital. ☺️ But it smells really strongly of raw spirit/tequila and it’s giving a fair few folk hangover flashbacks. 😂😬
I’m an anaesthetist. An intensivist. Occasionally I do something clever. Mostly I just cheerlead the incredible team around me making the difference. I don’t give a shit what you call me but try starting with, ‘Dave’.
Weirded out by incredibly slow-walking doctors. What charmed life have you had in your career that you’re just sauntering along a hospital corridor instead of the usual harried hurricane?
*leans into mic*
ABSOLUTELY THE FUCK NOT. Why are people so poorly trained that they think this has to happen? We do inductions on spectacularly unstable people without this sort of bullshit in other parts of the world - why don’t you just learn how to do it?
.
@DrPetDetective
: "When your hand gets forced to intubate the grossly hemodynamically unstable hemorrhagic shock patient with poor GCS, specifically not responding to voice, consider doing a paralytic-only intubation (without induction)."
#AMPS23
#CCTMC23
@AMPAdocs
Maaaaybe, if you’re a hospital doctor of some senior standing and experience, helping the overworked juniors out on the wards by seeing/clerking patients might be of more use than doing something you’re not even registered to do.
There are some anaesthetists who can skillfully do just about any technique for any case for any patient, and there are some anaesthetists who only give one anaesthetic but they can give it to anyone for anything and make it work.
Don’t underestimate the skill of the latter.
Well this is all demonstrable idiocy, isn’t it? I would urge
@gmcuk
to not automatically respond to every tweet threatening GMC referral without taking a moment to see what’s going on first.
“Boss? Yeah. Hi. So… I was putting a central line and thought I’d have a go at landmark and… well… yes, bed 6, why? Yeah… Yes I’m pressing on it. You’re coming in? Oh good.”
This is bullshit.
1) We deal with trauma, yes. So are soldiers - why is their PTSD allowed and ours isn’t?
2) Twitter is whatever you want it to be
3) He and many others. He was not making it about him
4) He absolutely is
If you’re aiming for parody, you’re failing. Grow up.
The experienced among us will know that the words “farmer presents with mild headache” means you immediately go to find out what particularly horror has happened. Aaaand look. Told you.
Yearly reminder of a common conversation at this time of year:
BLEEP
“Hi, it’s Dr. X on for Anaesthetics?”
“I need help with a venflon but my registrar’s in theatre.”
“If your reg is in theatre operating where do you think I am as the anaesthetist?”
“…🤯”
Folks, let me share something nice as a change from all the grim. This is a story about one of my colleagues here in Dumfries. I can’t imagine how this would’ve felt.
Your first intubation attempt failed. You have to bag the patient back up before you go to plan B.
This is what your patient should look like...
It's far easier to bag when you've double-barreled their nose and placed an OPA.
#emergency
#emergencymedicine
#foam
#foamed
If you’re still writing ECHO in the notes, even as a consultant, I am silently judging you. I know this reflects badly more on me than you, but still. Judging.
Because we would choose your nicknames and absolutely rinse you. If you don’t want your callsign to be ‘heparin-fingers’ or ‘bladder-predator’ maybe just stick to introducing yourself by name and learning the names of others in your team.
If I get arrested running on an empty country road out here in the sticks with no-one around because of laws enacted due to some pissed-up cretin on a bench in Richmond sodding Park I will be LIVID.
Hearing nursing colleagues say “oooh I’m not getting the vaccine I’m gonna wait” while I’ve just told my own parents we can’t see each other on Xmas day and cases rise across the country is a complex mood, I’m not gonna lie.
High five to everyone who passed the primary this week and then couldn’t get a venflon in. The anaesthesia gods do this to everyone, it’s not just you.
AAAAAAAAAAAAAGGGHHHHH listening to the BBC talking about sepsis on the 6 o’clock news is painful. Please, PLEASE, someone make it mandatory for any report script on medical issues to be ran past an actual, currently working, doctor. Important topic mangled.