Is starting a weight loss clinic while in residency possible?
During medical school I became interested in weight loss and got heavily involved in research. I've started working through the requirements for the American Board of Obesity Medicine CME pathway and should be done in a couple weeks. Part of the requirement to state that you are ABOM certified (even though it's not a recognized ABMS specialty) is to have completed a residency program and be board certified within that specialty. I'd have the information, and feel like I know more of it...
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Source: Student Doctor Network - February 22, 2022 Category: Universities & Medical Training Authors: EMTAB Tags: Family Medicine Source Type: forums
Blood glucose level to cancel cataract surgery
Thoughts on this? What would be your BG range and cut-offs?
Recently I cancelled one whose BG was 400-500 mg/dL. Pt claimed to be compliant with all her diabetic medications. Talked to her PCP and found out she was lying and that she actually ran out of her humalog a month ago. No recent A1c.. given the hx I can assume her BG in the 400-500's range for the past month. Not the healthiest patient either, with CHF exacerbation in the last 3 months, known CAD, morbidly obese. Known history of...
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Source: Student Doctor Network - January 20, 2022 Category: Universities & Medical Training Authors: coffeebythelake Tags: Anesthesiology Source Type: forums
Neuro sending pts to ED for LP
There's a neuro group locally that has made a habit of sending patients in for non-urgent LPs (mostly massively overweight women getting pseudotumour cerebri workups).
We used to refuse however as of late, a couple of their midlevels have been writing down on the ED referrals "r/o meningitis" on patients who are afebrile, nonmeningeal and have had chronic headaches for months.
Is it worth continuing to fight these? I'm not RVU based (salaried hospital employee) so I literally gain...
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Source: Student Doctor Network - December 29, 2021 Category: Universities & Medical Training Authors: Lexdiamondz Tags: Emergency Medicine Source Type: forums
OB epidural tip
On another forum I saw a thread that mentioned unsuccessful attempts to place an epidural in OB due to being off center. When you get an extremely obese patient where you are unable to palpate or see any landmarks I always found it useful to ask the patient to point to the center of their back. They would unerringly point to the midline. Hope this helps someone at 4 a.m. (Source: Student Doctor Network)
Source: Student Doctor Network - December 24, 2021 Category: Universities & Medical Training Authors: pastafan Tags: Anesthesiology Source Type: forums
Re: Childhood obesity: are new treatment centres the solution? Of course not
(Source: BMJ Comments)
Source: BMJ Comments - December 8, 2021 Category: General Medicine Source Type: forums
Childhood obesity: are new treatment centres the solution?
(Source: BMJ Comments)
Source: BMJ Comments - November 26, 2021 Category: General Medicine Source Type: forums
Re: Closed incision negative pressure wound therapy versus standard dressings in obese women undergoing caesarean section: multicentre parallel group randomised controlled trial
(Source: BMJ Comments)
Source: BMJ Comments - October 1, 2021 Category: General Medicine Source Type: forums
New Trend I see Happening not mentioned in usual education- OSA.
Overweight, snores, problems falling asleep but not staying asleep.
When I see patients have all 3 of the above, and referred them for an OSA test so far 100% of those patients had OSA. How many have I referred for an OSA test? Literally several dozen and well over a hundred in the last few years. Despite this I see the typical patient with the above, and their PCP or other psychiatrist puts the patient on a sleep med and not address the OSA at all.
I believe this has been more a trend...
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Source: Student Doctor Network - September 30, 2021 Category: Universities & Medical Training Authors: whopper Tags: Psychiatry Source Type: forums
Norepi
So case comes up from emerg recently.
Septic on peripheral norepi.
No art line or even attempts at one.
Morbidly obese
Lactate 5
Q 1. Norepi. Through a 22g peripheral iv in a crappy forearm vein on the 'palmar' surface. One of those crappy veins under your watch clasp...
8mcg/min
Is this ok?
It was also leaking under the tegederm.
Q2. The norepi bag was spiked with a 3 port infusion set, unmarked, and all 3 ports were not plugged with dead enders or even tape.
Vanco and ppi were also...
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Source: Student Doctor Network - September 13, 2021 Category: Universities & Medical Training Authors: Newtwo Tags: Anesthesiology Source Type: forums
Covid exposure
So I was called to intubated a patient in the middle of the night, 30 something, obese, found unresponsive, ED tried unsuccessfully, I go down and do intubation while CPR is paused. Nobody in gowns, ED people have N95 with regular mask over it. I totally forgot to wear an N95, must have been in a sleep state because it completely passed my mind.
I had assumed it was an overdose or something, I ask the ED people after I leave they say no, asthma attack. I ask them to test for Covid.
what do...
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Source: Student Doctor Network - September 5, 2021 Category: Universities & Medical Training Authors: dipriMAN Tags: Anesthesiology Source Type: forums
Loss of smell due to COVID-19 presents a rare opportunity for a natural experiment to study the obesity pandemic.
(Source: BMJ Comments)
Source: BMJ Comments - August 22, 2021 Category: General Medicine Source Type: forums
What is the NNT for an EM physician to have a better outcome...
Comparing physicians and PAs as solo providers in a rural... : Journal of the American Academy of PAs
f the host institution were analyzed. Although minor variances in metrics were appreciated, transfers, 72-hour returns, and death rates were all similar among provider types. Results from this work do not demonstrate a clinically meaningful difference among ED metrics between physicians and PAs...
journals.lww.com
Just came off shift where I worked alongside an EM doc a few years out of 3 year residency. Last patient with pneumonia failing bipap wi...
Source: Student Doctor Network - July 25, 2021 Category: Universities & Medical Training Authors: Boatswain2PA Tags: Emergency Medicine Source Type: forums
What is your Ketofol regimen?
Does anyone have any good recommendations for ketofol infusion dosing for patients with spinals? There are a fair number of LE surgeries in my practice and a large number of morbidly or even super morbidly obese patients which can be difficult to sedate on propofol necessitating the frequent use of oral airways. (Source: Student Doctor Network)
Source: Student Doctor Network - July 2, 2021 Category: Universities & Medical Training Authors: Outrigger Tags: Anesthesiology Source Type: forums
Expressions that may impact on Health. People first language - putting forward the difference between being obese and living with obesity
(Source: BMJ Comments)
Source: BMJ Comments - June 15, 2021 Category: General Medicine Source Type: forums
"Awake Fiberoptic" Intubation
65 yo M in pre-op for dental extraction planned for future implants. The usual comorbidities: morbid obesity, HTN, DM, OSA not using CPAP. His airway exam shows a thick neck, small mouth opening, big teeth, and a big tongue. Neck moves okay and he can sublet his mandible anterior to his maxillae teeth. Planned asleep glide until he says, "I was at the OSH having a cysto and they told me they had to wake me up to put the breathing tube in me. Whaddaya think that means, doc?"
I was able...
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Source: Student Doctor Network - June 7, 2021 Category: Universities & Medical Training Authors: cchoukal Tags: Anesthesiology Source Type: forums
