Recent content by Janders

This would be my advice though I’d use a solo401k instead of sep-ira to leave the backdoor Roth option easily open.

CPT 49083 A Abd paracentesis w/imaging

yeah the difference between a diagnostic para-- (1) place POCUS order (2) stand up, grab US, walk towards room while passing by suture cart. (3) at suture cart, grab 2 syringes, 2 needs, a bottle of lidocaine, chlorhexidine and a bandage. (4) Walk in room, slap probe on, one click save image...

Caveat— i love the type of book One second after is, but I didn’t enjoy its writing style and tone. Meh. Sticking to at least vaguely scifi isssssh: Dark Matter (as an audiobook, a thriller, not high literature, great for commuting) Station Eleven for your post apocalyptic vibes The Murderbot...

MA doesn’t allow ems diversion unless you are code black due to something like loss of water / fire in progress. So in MA during respiratory season every single tertiary hospital is on xfer divert due to “lack of capacity” but oddly their post op dat 2 complex surgical disasters keep landing...

If you’ll work for $120/hr I can hire you for weekday shifts in an ED.

A lot of this is true. I chair our community ED. I work about… 75-80% of an FTE clinical schedule. This is after cutting back recently. I work the same night % weekend % and holiday % as the rest of the group (nocturnist excepted). I do get second dibs in the schedule considering the metric...

But sometimes the community and academic groups are separate entities…

Exactly. I work in an ED that sees around 40k/yr. L&D isn’t here, Ob/gyn doesn’t do ED consults, and is a 20min ambulance ride (at best) in any direction to get to an L&D. This is after you get an accepting MD (can take 1-2hr of calls and pulling teeth) and an ambulance (lolz). So if a lady...

One of the issues with emtala is there is less of a defined rule book and more a set of prior decisions (which aren’t published in a comprehensive single source…) which we read like tea leaves. The general concept is that saying / doing things that may encourage a patient to walk out prior to...

Exactly. Its OK for seniority to come with some minor perks. But if you want to not work nights because you've been at a shop for 10 years... you should still PAY for that perk. Its a BIG perk. We do a night tax where if you work more than your share of nights you make bonus money, less than...

Historically? Way less that 15%

Made more model "tanks" (these are actually self-propelled anti-aircraft guns, but hey they have tracks and guns its a tank!) The first is a ZSU-23/4 relic at an outdoor museum in Hanoi (I posted the source photo I used for the rust/paint/etc), the other is an M42 Duster from the American side...

I do NOT usually send them to the OR. I do send them to the OR if paralysis is needed as I don’t push sux in my ED unless I am intubating. I try 95% of hip dislocations myself. Occasionally they are so moribund I’m not going to sedate them. I succeed 80-90+% of the time. This is by myself...

Also I don't do paralysis when I do sedation. I ABSOLUTELY agree it would help with a hip dislocation. This is usually why I call anesthesia and Ortho takes them to the OR... so they can do anesthesia and paralyze the patient and get the hip in. Could an EP do this safely? Sure. I do find it...