bearsnowstorm

Works really well and given the cost of space for a second desk it was a very cost effective solution - only minimally affects the utility of the wardrobe as a wardrobe. (We didn't build the laptop holder this guy describes, the laptop just gets sat on top of the clothes in the drawer below that shelf with attention to make sure we're not blocking a fan intake. We had a powerpoint and a ethernet port put into the back of the wardrobe but actually we just end up using Wi-Fi mostly.)

Comment · 3 years ago

I'm a doctor (ICU) who also does some IT stuff for work (nothing complex, mainly writing small web apps). I really enjoy writing stuff where you know the requirements, make all the decisions, write the code and maintain it. However, doing this has allowed me to get some exposure to what bigger projects with lots of moving parts, data sources, stakeholders, regulatory requirements etc look like - and it's seriously hard work. Nothing like "coding, the hobby".

I guess this commonly occurs in many fields at a certain level of seniority - the "managing a large system involving many people" aspect can dominate the domain-specific part, be it software engineering, accounting, manufacturing etc. As such I'm really glad I chose medicine rather than SWE (even though I've been writing and loving code for >35 years, and it was a real toss-up when I went to uni) because:

1. You can still stay very hands on, even as a senior clinician, especially procedurally.

2. If you so choose, there's a lot of variety in what you find yourself doing as a doctor (my mix looks like making clinical decisions / talking to patients / families / doing procedures / performing and interpreting ultrasound / going to other hospitals to retrieve super sick patients and bringing them back in ambulances / mentoring / teaching / coding / managing a clinical service / etc - but there are lots of other options too). I'm not sure if this kind of variety is as easy to arrange as a SWE? (though I suspect I'm about to be corrected, thanks in advance.) Variety is quite important if you're easily bored, which is a common problem for bright people.

3. Although AI is coming to all fields, I do think the impact will look more like "better tools", rather than "job replacement", or "vast reduction in number of people needed", for longer in medicine (at least in my area). As a breadwinner this is a not inconsequential consideration.

Hope you find the career you love, and that it leverages the work and study you've already done in some way.

Comment · 4 years ago

A 27 or 30G insulin needle with some lidocaine (still often called lignocaine here in Australia ) is a nice addition to this procedure. I rarely omit it unless the patient is unconscious. If you inject the local anaesthetic under real time ultrasound, it can also serve as a seeker so you see if you’re off target with the 30G needle and adjust based on that information, which improves your success with the larger (commonly 22G) needle used to take the gas. Not unreasonable to request local anaesthetic, really - it is known to be a painful procedure.

Comment · 4 years ago

For really small kids we tend to use a transilluminator rather than ultrasound for peripheral IVs (though it doesn’t tell you the depth like ultrasound does). For CVCs or bigger people, ultrasound is often very useful. Like all things, experience makes a big difference! In my opinion, for known tricky veins (in adults at least) it’s best to use local anaesthetic from the outset - it does make it slightly harder but if (when?) you miss it’s easier to keep the patient on side for the next attempt.

Edit: YouTube link to a transilluminator being used - beware the video does have an unhappy child in it

https://youtu.be/ixyqKa3bDMQ

Comment · 5 years ago

The documentary The Crash Reel is about a snowboarder who gets a traumatic brain injury, but the comments of one of his brothers (who has Down’s syndrome) on his life and on his family form part of it - really interesting to watch

Comment · 5 years ago

I also wonder how much it might heat up the brain? And whether that would be a problem for sustained use? (In practice this heating effect is occasionally limiting for some other forms of ultrasound (e.g. TEE) requiring you to take a break or reduce the power.)

Comment · 6 years ago

What other tools did the hospital open source this year?

Comment · 6 years ago

In my experience the commonest current mainstream use of this is for Sezary Syndrome / mycosis fungoides (cutaneous T-cell lymphoma). See for example:

https://my.clevelandclinic.org/health/articles/8493-mycosis-...

Comment · 6 years ago

As others have commented above, reducing the rate of spread (social distancing and hygiene, and convincing others to do likewise) so that this is a more smeared out event with a lower peak need for equipment and staff is the most important intervention. It's also very hard to do; not sure if there is a technological lever that will move the needle on this (advertising?)