Skip Navigation
InitialsDiceBearhttps://github.com/dicebear/dicebearhttps://creativecommons.org/publicdomain/zero/1.0/„Initials” (https://github.com/dicebear/dicebear) by „DiceBear”, licensed under „CC0 1.0” (https://creativecommons.org/publicdomain/zero/1.0/)ME
Posts
5
Comments
210
Joined
2 yr. ago
  • I think an important consideration is who gets to decide what knowledge and culture get preserved. For example, I would say that medicine, agriculture, and human language would be much more important to preserve than computer science or economics, but I'm sure someone would disagree.

    In general, I think art is very valuable and should be protected when possible (and not just European art), but if the choice is between a painting or a human life... the painting goes every time.

  • I recently saw someone on Lemmy point out that the UK has an emergency plan to move precious artwork to bunkers in the event of a nuclear attack, but no such plans exist for the people. Paintings can be replaced or remade. People cannot. The planet cannot. There are many things in this world far more valuable than art, in part because life is the source of art.

  • The problem with AI and poorly educated professionals is not the ability to diagnose and treat based on evidence-based medicine. The problem is that you have to know enough about medicine, and enough about real human people to know what kinds of questions to ask in the first place. If nothing else, there is a massive amount of information gained from a patient's body language, mannerisms, behavior, and the physical exam itself that would be extremely hard to quantify in a meaningful way for someone without the background education and experience to come to any useful conclusions.

  • I worked professionally in medicine for a few years before starting medical school, and thus far my approach has been to entirely disregard anything they said on the subject and continue as normal unless the nonsense they're spouting has the potential to cause serious harm. Our patient care professor is training us to listen attentively, then dismantle the nonsense as politely as possible while guiding the patient's viewpoint back to something approaching reality.

  • There's some things you look for that are difficult to describe to someone who hasn't seen it before. That's part of why experience is so valuable in Emergency Medicine, and it's not uncommon to put your best nurses out in triage. People will do this kinda twitchy/wilting/loss of focus/change in pallor/change in posture right before they go down. I don't have a good way to describe it, and it might be easier to draw even, because it really is a body language thing and the general appearance of the patient that can inform your decision making.

  • I have thought about trying to plan out a learning algorithm that could spit out suggestions for triage level and preliminary tests based on input data like vital signs, symptoms, and complaints... but I would never implement something like that as anything beyond a tool for the nurses at triage to use. There would have to always be an option to override the algorithm because there's some aspects of patient presentation that are not easily quantifiable. I'd never be able to explain it in a way that one could input it into a computer, but even with my limited experience, I can tell which patients are going to crump on me.

  • NPs working under a physician with actual oversight is fine. The ones I have problems with are the ones that have a physician sign the hundreds of notes a month while maybe reviewing a handful, and worse, the ones pushing for independent practice without even that sham of oversight involved.

  • At least I can rest assured of the fact that AI will be next to useless in my intended field. Emergency medicine is an environment where you get a random constellation of symptoms and complaints with very little direction on which are related to the current illness, and which ones are not currently relevant. Also, in the time it would take to get all the info into the AI for a trauma/cardiac/code situation, the patient might be dead or rapidly heading in that direction.

  • Asklemmy @lemmy.ml
    medgremlin @lemmy.sdf.org

    Is anyone else caught in a weird Venn diagram of Imposter Syndrome and furious indignation and disdain for actual imposters in your field?

    Context: I'm a second year medical student and currently residing in the deepest pit in the valley of the Dunning-Kruger graph, but am still constantly frustrated and infuriated with the push for introducing AI for quasi-self-diagnosis and loosening restrictions on inadequately educated providers like NP's from the for-profit "schools".

    So, anyone else in a similar spot where you think you're kinda dumb, but you know you're still smarter than robots and people at the peak of the Dunning-Kruger graph in your field?

  • Our server has been having some federation hiccups. I actually play with a really chill unit. Oddly enough, all the Arma units I've encountered have been pretty progressive. As a cis woman, I am almost always outnumbered by the trans gals because there's always a bunch of them around. Also, all the units I've been with have a negative amount of tolerance for bigots.

    I pretty much always play as the medic in our PvE ops, and unfortunately I'm a little incompetent when it comes to actual combat, so I haven't been horrendously useful when we play Anyistasi.

  • Day by Day Cafe in downtown St Paul is lovely. They have a nice library room to sit in during the winter and a patio with a koi pond out back for summer. They have some of the best breakfast food I've ever had and their early bird special is a really good deal (especially when I'm on nights).

  • Unless you are obfuscating something, or there were some very unusual mistakes involved, I would think that medical neglect that caused a disability in an acute timeframe would warrant a consultation with a malpractice lawyer.

  • I think you misunderstood. EMTALA defines disability in relation to an emergent condition, injury, or acute illness. The degradation of a chronic condition into a disability is not something that an ER can or should be trying to treat. Disability as a whole can include things like chronic pain in addition to other neuropathies, parasthesias, or paralysis, but the definition of "disability" in terms of emergency medical care is entirely related to the disability being caused by an emergency medical problem, not a chronic one.

  • Per the laws involved here, "permanent disability" means something like paralysis from a spinal injury, or loss of organ function due to acute critical illness like a necrotic bowel or something. Unfortunately, according to the medical and legal literature on the topic, disability from pain or chronic disease is beyond the required services of an ER. Arguments can be made for acute-on-chronic situations like splenic damage or rupture in sickle cell crisis, but those areas can get pretty fuzzy.

  • What I have been trying to say is that we didn't make any assumptions about that guy. We treated him with the same standard of care and urgency that any emergent medical condition would warrant until we had proof that he was faking it and after he grabbed a nurse's breast so violently and so hard that the entire right side of her chest was bruised for a couple of weeks. We made no assumptions and only acted on his behaviors and proven medical condition.

    The experiences you have had are horrible, but they are not universal. Unfortunately, the way the emergency medical system has been stretched to its limit lately means that the best the ER can do is to keep people from dying, and diagnose and treat the more straightforward conditions. For most of the more complicated and chronic stuff, there's very strict laws about how much medication for what duration can be prescribed by an emergency physician, and a significant amount of the time, the best we can do is make sure you're not actively dying and put in a referral to the specialists with a note that you should be bumped up the waiting list a bit depending on severity. Hell, even trying to admit people to the hospital isn't a sure bet these days because the inpatient departments are allowed to enforce their staffing-to-patient ratios, so the ER gets stuck trying to take care of inpatient and even ICU patients with ER resources for up to days at a time.

    My somewhat glib comment about people not being aware of what counts as an "emergency" is very literal when it comes to triage. We do our best to treat everything that comes through our doors, but if there's not an immediate threat to life, limb, or permanent disability, there's pretty distinct limits on what we're able to do on a short timeline and what the hospital allows us to do for free. EMTALA stands for "Emergency Medical Treatment And Labor Act" and it dictates that anyone who turns up to an ER with an emergent medical condition that poses immediate threat to life, limb, or permanent disability will be treated and stabilized to the accepted level of care regardless of ability to pay, and a mother presenting in active labor will be provided with delivery care or appropriate timely transfer to a labor and delivery department if appropriate regardless of ability to pay. There's very strict rules about the level of treatment to be provided and when or if transfer to another facility or provider is warranted and permitted, but past the stipulations of that law, it comes under the hospital administration's rules and regulations about what level of care can be provided by the emergency department.

    I've seen quite a few physicians defy the hospital rules by ordering some of the special labs and tests that the specialist would order so that the results are already available in the system for when (if) the patient gets seen by the specialist, but they can get in quite a bit of trouble for it, and if it's not documented just right the patient's insurance might not pay for it. That's one of the other delightful limitations on what the ER can do...we have to toe the line on what needs to or should be done versus what the patient's insurance will pay for, because believe it or not, we really don't want to stick you with a bill for thousands of dollars of tests that your insurance denied coverage for.

    Due to overwork, understaffing, antiquated training, and burnout, a lot of physicians' and nurses' bedside manner could use a fair bit of work, but in terms of the care provided, 99+ percent of the time, it really is the best we can do under the restraints created by laws, rules, resources, and insurance.

  • Jerboa @lemmy.ml
    medgremlin @lemmy.sdf.org

    Top-right menu buttons aren't working

    It's been a week or two now since the top-right menu buttons stopped working for me. I can use the one to select between "Local", "Subscribed", and "All", but the buttons for the sort/time and the three-dots button don't do anything anymore. Has anyone else been having this problem? (And if so, have you found a way to fix it?)

    Edit: Jerboa Version 0.0.49, Android Version 12, Surface Duo 2

    Also, after a force stop of the app and rebooting the phone, it now works on the left screen, but not the right screen. I tested to make sure it wasn't a dead spot on the touch screen, and that corner is responsive in the OS and other apps. So apparently it's just this app in the top right corner of the right screen which seems very odd.

    Another edit: the top right corner button for saving posts or comments and other interactions work fine in the top right of the right screen, it's just the menu buttons that don't work on the right screen

    196 @lemmy.blahaj.zone
    medgremlin @lemmy.sdf.org

    mental health positivity (rule)s

    Animals and Pets @beehaw.org
    medgremlin @lemmy.sdf.org

    Just a little bit of little goat parkour!