The Walls be Closing

[Kemp]

19 hours ago, Doc said:

 

You sure you want to go down that path, considering there were more deaths under Joke in the same time period, despite "listening to the science," reforming the pandemic response team and having vaccines and treatments that weren't there under Trump?

 

Did you inject bleach?

[Kemp]

Any Trump fans here who can explain why Trump has once again praised the Communist leaders of Russia, China, and North Korea in his latest interview?

The most remarkable part is that Trump fans accuse those who don't like Trump of being Communists. An amazing failure of logic and a great example of living in denial. 

That's why we wonder if it's stupidity or evil that drives all of you. I realize some of you are both.

Since none of you can answer why Trump loves Communist leaders, you'll have to change the subject and talk about Hillary or Biden or post an emoji, because what else can you do?

 

[Doc]

12 minutes ago, Kemp said:

Did you inject bleach?

 

No.  Did you?

[Kemp]

Just now, Doc said:

 

No.  Did you?

 

You shouldn't show disloyalty to the stable genius. 

[Doc]

2 minutes ago, Kemp said:

You shouldn't show disloyalty to the stable genius. 

 

Like you with Joke?  No, I don't roll that way.

[Joe Ferguson forever]

1 hour ago, BillsFanNC said:

 

Imagine walking into @redtail hawk office wearing a MAGA hat. That oath he took goes right out the window....

happened all the time.  Saw some pretty scary tattoos.  Didn't change a thing re my professionalism.  but imagine how @Doc would react to someone wearing a Che Guevara T shirt to his surgery center.  Might never wake up.

[Doc]

1 minute ago, redtail hawk said:

happened all the time.  Saw some pretty scary tattoos.  Didn't change a thing re my professionalism.  but imagine how @Doc would react to someone wearing a Che Guevara T shirt to his surgery center.  Might never wake up.

 

I see them after they've changed into their gowns.  So that saves them...

[Joe Ferguson forever]

4 minutes ago, Doc said:

 

I see them after they've changed into their gowns.  So that saves them...

that wouldn't help your lack of knowledge...what happened to the pt with 2nd degree HB?  ICU and pacemaker?  How did u respond immediately?

Edited April 12, 2023 by redtail hawk

[Doc]

22 minutes ago, redtail hawk said:

that wouldn't help your lack of knowledge...what happened to the pt with 2nd degree HB?  ICU and pacemaker?  How did u respond immediately?

 

Didn't seem to affect you... 

[Joe Ferguson forever]

15 minutes ago, Doc said:

 

Didn't seem to affect you... 

I’ll bet u frantically asked the hospital operator to find someone like me that knew how to keep the patient alive all the while $hitting your pants.  Been there done that

[Doc]

21 minutes ago, redtail hawk said:

I’ll bet u frantically asked the hospital operator to find someone like me that knew how to keep the patient alive all the while $hitting your pants.  Been there done that

 

No.  As you correctly deduced, it was intermittent and she was back in NSR and remained that way in PACU.  Had a nurse contact her PCP and sent the rhythm strip.  They said to send her home and they'd follow up.  And I made sure I documented everything, especially that last part.

Edited April 12, 2023 by Doc

[Joe Ferguson forever]

1 hour ago, Doc said:

 

No.  As you correctly deduced, it was intermittent and she was back in NSR and remained that way in PACU.  Had a nurse contact her PCP and sent the rhythm strip.  They said to send her home and they'd follow up.  And I made sure I documented everything, especially that last part.

So you didn't do a preop EKG and then didn't consult a cardiologist for 2nd degree type 2 AV block.  Good lord.  Did you at least do an actual 12 lead before sending him home?  Document all you want, he goes into complete heart block and dies, you'll be named.  Talking to his PCP doesn't absolve you of not doing the right thing.  btw, when do you find time away from the forum to actually see pts?

Edited April 12, 2023 by redtail hawk

[Doc]

1 hour ago, redtail hawk said:

So you didn't do a preop EKG and then didn't consult a cardiologist for 2nd degree type 2 AV block.  Good lord.  Did you at least do an actual 12 lead before sending him home?  Document all you want, he goes into complete heart block and dies, you'll be named.  Talking to his PCP doesn't absolve you of not doing the right thing.  btw, when do you find time away from the forum to actually see pts?

 

Again it was a 53 year old woman with no diagnosed history of heart issues, much less HB and she went back into NSR so the 12 lead in PACU captured nothing.  And again I contacted her PCP and informed the patient and her husband about the risks of just following up instead of waiting for hours in the ER and documented it all.

 

And when I'm in a room, there is plenty of time between cases to post.  When I'm supervising, even more.  Today I have the day off.

Edited April 12, 2023 by Doc

[Joe Ferguson forever]

1 hour ago, Doc said:

 

Again it was a 53 year old woman with no diagnosed history of heart issues, much less HB and she went back into NSR so the 12 lead in PACU captured nothing.  And again I contacted her PCP and informed the patient and her husband about the risks of just following up instead of waiting for hours in the ER and documented it all.

 

And when I'm in a room, there is plenty of time between cases to post.  When I'm supervising, even more.  Today I have the day off.

I really hope for the pt sake that you aren't a doctor.  you are clueless:  https://www.ncbi.nlm.nih.gov/books/NBK482359/

 

"Mobitz type II is rarely seen in patients without structural heart disease. It is often associated with myocardial ischemia and fibrosis or sclerosis of the myocardium. This rhythm often progresses to third-degree atrioventricular block.

 

Treatment for a Mobitz type II involves initiating pacing as soon as this rhythm is identified. Type II blocks imply structural damage to the AV conduction system. This rhythm often deteriorates into complete heart block. These patients require transvenous pacing until a permanent pacemaker is placed. Unlike Mobitz type I (Wenckebach), patients that are bradycardic and hypotensive with a Mobitz type II rhythm often do not respond to atropine."  

Please tell me you're lying about being a doc.  If not, call the pt and ensure her safety and ensure follow up with a cardiologist.  @Wacka is concerned with bedside manner and I'm worried about negligence and lack of concern.

Edited April 12, 2023 by redtail hawk

[BillStime]

5 hours ago, Kemp said:

Any Trump fans here who can explain why Trump has once again praised the Communist leaders of Russia, China, and North Korea in his latest interview?

The most remarkable part is that Trump fans accuse those who don't like Trump of being Communists. An amazing failure of logic and a great example of living in denial. 

That's why we wonder if it's stupidity or evil that drives all of you. I realize some of you are both.

Since none of you can answer why Trump loves Communist leaders, you'll have to change the subject and talk about Hillary or Biden or post an emoji, because what else can you do?

 

Crickets from @BillsFanNC and @LeviF? Shocker 

[All_Pro_Bills]

5 hours ago, Kemp said:

Any Trump fans here who can explain why Trump has once again praised the Communist leaders of Russia, China, and North Korea in his latest interview?

The most remarkable part is that Trump fans accuse those who don't like Trump of being Communists. An amazing failure of logic and a great example of living in denial. 

That's why we wonder if it's stupidity or evil that drives all of you. I realize some of you are both.

Since none of you can answer why Trump loves Communist leaders, you'll have to change the subject and talk about Hillary or Biden or post an emoji, because what else can you do?

 

What's the fuss? I'd expect all the fake liberals would be wetting their pants over Trump poor choice of words and dumb praise.  As those leaders run a version of the same fascist system the democrats are working so hard to establish here.  Sadly, while they bask in self-belief of superiority over the common working person the truth is they're to slow-witted to see it.

[LeviF]

17 minutes ago, BillStime said:

Crickets from @BillsFanNC and @LeviF? Shocker 

 

Sorry I don't identify as a Trump fan and have been very publicly critical here of both him and China.

[BillsFanNC]

11 minutes ago, LeviF said:

 

Sorry I don't identify as a Trump fan and have been very publicly critical here of both him and China.

 

And as the fu kc stain that @BillStime knows full well, I dont ever see his/her/their posts unless someone unfortunately quotes him/her/them. Same goes for the rest of the PPP commies.

 

[Wacka]

1 hour ago, redtail hawk said:

I really hope for the pt sake that you aren't a doctor.  you are clueless:  https://www.ncbi.nlm.nih.gov/books/NBK482359/

 

"Mobitz type II is rarely seen in patients without structural heart disease. It is often associated with myocardial ischemia and fibrosis or sclerosis of the myocardium. This rhythm often progresses to third-degree atrioventricular block.

 

Treatment for a Mobitz type II involves initiating pacing as soon as this rhythm is identified. Type II blocks imply structural damage to the AV conduction system. This rhythm often deteriorates into complete heart block. These patients require transvenous pacing until a permanent pacemaker is placed. Unlike Mobitz type I (Wenckebach), patients that are bradycardic and hypotensive with a Mobitz type II rhythm often do not respond to atropine."  

Please tell me you're lying about being a doc.  If not, call the pt and ensure her safety and ensure follow up with a cardiologist.  @Wacka is concerned with bedside manner and I'm worried about negligence and lack of concern.

English please. Part of bedside manner idscommunicating with the patient.

[Joe Ferguson forever]

20 minutes ago, Wacka said:

English please. Part of bedside manner idscommunicating with the patient.

the patient needs a temporary pacemaker now followed by a permanent pacemaker due to risk of death.  the rhythm implies blocked  arteries or "bad wires".