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Type: Posts; User: Sensei

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    Well, he may be disappointed that he doesnít have...

    Well, he may be disappointed that he doesnít have one for each hand...:)

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    Yep. All of my Wilson 9mm 1911s and EDCX9s have...

    Yep. All of my Wilson 9mm 1911s and EDCX9s have gone back at least once. This includes a Colt CCU that was sent to Wilson for an overhaul only to come back less reliable, a CQB Elite in 9mm, and a...
  3. Iíd like to thank these people for providing the...

    Iíd like to thank these people for providing the justification for my purchase of a Barrett M107A1, suppressor, and 200 rounds of API ammo. My wife now understands my thinking...

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    Iíve got some bad news and not-so-bad news. The...

    Iíve got some bad news and not-so-bad news. The bad news is that it is correct that these monoclonal antibodies and convalescent plasma will not provide a meaningful benefit to the novel strains. The...
  5. Multiple Miggs approves... 66385

    Multiple Miggs approves...

    66385
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    The transplant patient with donor-derived COVID...

    The transplant patient with donor-derived COVID died yesterday from bleeding complications associated with ECMO after more than 2 months in the ICU.

    #notcosteffective
    ...
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    My personal experience with treating more than...

    My personal experience with treating more than 100 critically ill patients with COVID (8 on VV ECMO) is that patients who get sick as piss in a couple of days often recover quickly. That happened to...
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    Our outcomes are nowhere near this good since I...

    Our outcomes are nowhere near this good since I arrived at one of the nationís largest ECLS programs in mid-pandemic:...
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    There have been anecdotal and retrospective...

    There have been anecdotal and retrospective reports of thrombosis associated with COVID-19. This includes higher rates of VTE, increased ACS/CVA risk, and frequent circuit and vascular clots in...
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    We have one SICU attending who rules the roost...

    We have one SICU attending who rules the roost and insists on loooong courses of IV methylpred - basically the ARDSnet taper over 28 days, but keeps them going until ďimproving.Ē Well, these people...
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    I suspect that itís one of those instances when a...

    I suspect that itís one of those instances when a grain of truth takes on a life of its own. For example, we ran into issues with our step-down unit not having enough HEPA filters and negative...
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    Shot in a Prius nonetheless. Perhaps it was...

    Shot in a Prius nonetheless. Perhaps it was missing the obligatory ďEqualityĒ bumper sticker?
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    My institution received their shipment 3 days ago...

    My institution received their shipment 3 days ago and a select group of hospital leaders were videoed as they got their first dose, and that was uploaded to the institutionís Facebook and Twitter...
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    A couple thoughts. While obviously industry...

    A couple thoughts. While obviously industry sponsored, this was a randomized control trial of 40,000 subjects which means it sits near the top of the evidence food chain. It was not a...
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    I know some of the physicians in FCCC. Their ring...

    I know some of the physicians in FCCC. Their ring leader, Paul Merik, is quickly becoming the Sidney Powell of critical care - someone who built up a remarkable career with minimal resources (EVMS is...
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    Iím an ICU physician at one of the busiest ECMO...

    Iím an ICU physician at one of the busiest ECMO centers in the world (one of our faculty invented the technology 40 years ago). We cannulate about 150 people per year. Iíve been in the SICU for the...
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    Unfortunately, I feel that the effectiveness of...

    Unfortunately, I feel that the effectiveness of masks for preventing community spread was oversold. Much of the mask literature is based on studies in the clinical environment with near ideal...
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    My personal experience is that the sickest...

    My personal experience is that the sickest patients with COVID are incredibly hard to sedate, and I think that some of the issue is profound air hunger. We have patients on massive doses of fentanyl,...
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    This was sent to me by a co-worker who finished...

    This was sent to me by a co-worker who finished his anesthesia residency this past Summer at Columbia in NYC. One of his residency classmates wrote it, and it got published in The Atlantic. Columbia...
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    Oh boy. So much to unpackage here. So, do you get...

    Oh boy. So much to unpackage here. So, do you get to see the donor organ before itís attached to you?

    To show my multiculturalism and dedication to racial equality, Iím fine with an African...
  21. Lots and lots in 5.56 2 in 308 1 in 300 blk (3...

    Lots and lots in 5.56
    2 in 308
    1 in 300 blk (3 if you count my MCX and rattler)
    1 in 6.8 spc
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    This is a Google maps picture of the Shell gas...

    This is a Google maps picture of the Shell gas station that is next to my old hospital. Notice that the Comprehensive Cancer Center is the closest building in the background. Like most hospitals in...
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    Weíve found that just over 60% survive to...

    Weíve found that just over 60% survive to discharge if cannulated for VV ECMO within 7 days of intubation. This is consistent with prior experience with non-COVID ARDS. Outcomes are less favorable at...
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    Transplant patients is much better - off nitric...

    Transplant patients is much better - off nitric and pressors for a while. Sill on milrinone and inotropic dose epi to offload her RV. Neurologically interactive. Vent settings reasonable and will...
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    Daddy must very proud...

    Daddy must very proud...
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