submassive PE due to liver mass leading to IVC obstruction with visible ivc clot! improved with lysis #StoweEM20 by @ThinkingCC
portal vein gas on ultrasound is more sensitive for badness (vs AXR or CT) but doesnt necessarily indicate a catastrophe! no longer “the undertakers sign” #StoweEM20 by @ThinkingCC
shock with normal LVEF on transthoracic US... TEE showed torrential MR! #StoweEM20 by @ThinkingCC
sepsis/ARDS patient treated woth crystalloid.. developed congestive nephropathy... multi-organ failure resolved with diuresis (combined diuresis loop/thiazide despite being on norepinephrine 😛) #DiuresisJedi#StoweEM20 by @ThinkingCC
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how to place a consult: you MUST understand the five stages of consultant grief.
once you can understand this painful and natural process, requesting consults will make a LOT more sense
buckle up, it can be a little rough…
🧵 1/6…
stage 1: denial
- You dont need a consult.
- You called the wrong service.
- 18 years old? consult pediatrics
- I’m not actually on call now
- Everything’s fine, just walk it off…
stage 2: anger
- you should have consulted us earlier/later
- you should have checked this test before calling us
- you’re a terrible doctor/student/human being