Pretty sure that was just nature attempting to course correct

Long story short: if history is our guide, we're pretty f*cked.

The DNC belief that institutions protect us, fight wrongs and bend towards equality are symptomatic of the Democratic Nationalism poisoning our society and fails to help anyone but those who benefit from power. Those who will lead us out prioritize people above institutions, humanity over profits.

Those fighting to keep these institutions open fail to recognize how it's their blind devotion to institutions themselves, their false belief in the institutions to correct these problems, that are fueling the greatest injury. They're complicit in the harms that will follow. History shows this.

Seems to be dose dependent if you're administering hydrochloric acid to your patients. So don't do that. pubmed.ncbi.nlm.nih.gov/16966998/

I low key love it. I order it. It's given. Intervention complete.

I still get hepatology hold outs who futz at me for having given steroids for alcoholic hepatitis...
"They don't have great follow up"
... They have even worse follow up when they're dead...

They definitely lost me at dextran/hetastarch 😂
You can model all you want, but the evidence is clear that these have no purpose. Albumin... Meh. I like it in refractory burn resuscitation which this seems to support. Certainly not a sepsis/ICU panacea.

I'm somewhat curious how this is eminence based... They have created models that seem to be decently reflective of reality. I would consider it eminence based if they just claimed "believe me, it's in the third space" and provided no real support. Seems to me they brought the receipts.

Finally some public support of push dose dilt for svt. No one appreciates the adenosine doom

A lot more methin around these days. It's been interesting watching the arc of substance use trends with the rise of the opioid epidemic to the combo stimulants/fentanyl speedballs towards the dominance of stimulants.

Some of my best worst cases in training were on patients with horrifically severe PAD and bypasses wherein we could not get accurate arterial monitoring nor any accurate NIBP. Titrate pressors to vibes (mental status, urine output).

Prepare to be met with "yeah, that was just bluster. He didn't actually mean it literally." It's all a joke to them because it doesn't affect them in any negative way (yet).

I like that term p-fracking.
It's not just hacking. It's a toxic degrading means to squeeze out what they want with no regard for the consequences