Heard some important information on Twitter today, and thought I’d post it here for anyone who may not have heard it. This is actually a thing, devised by human rights organisation called Karma Nirvana.
Reblog to save a life?
Signal boost just in case
girls this is important as fuck
I will never not reblog this. Nothing is more important than this. Remember it always.
this goes for everyone. men and women and everyone else too.
Domestic violence is serious.
#hufflepuff4ever #hufflepuffpride
Everyone is scared of something.
Sweet baby Hufflepuff Newt <3
Colin Firth in What a Girl Wants (2003)
How could you not love Colin Firth?
It’s for science
my phone is on silent
Hedwig's Theme <3
Kathy Bates performing ‘That’s What I Like’ by Bruno Mars is the best thing you’ll see all day.
I didn't know I needed this in my life!!
Female Awesome Meme → [2/10] Females in a movie
Nymphadora Tonks, Harry Potter.
My favorite hufflepuff #hufflepuffpride #hufflepuff4ever
❤❤❤
My beloved. So beautiful!
I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career.
WHEN LOOKING AT ECGs FOR THE FIRST TIME:
1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough.
2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number.
3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on.
4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II.
5. did someone say HYPERTROPHY?
6. P-waves
7. PR interval
3rd deg block “complete block”
8. QRS complex
9. ST segment
LBBB can look like STEMI. How to tell?
Inferior STEMI. Could right ventricle be involved?
10. T waves
11. Q waves
I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart.
Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.
This is Medblr gold. Reblogging for anyone staring down the barrel at 1 July.
I learned a lot here.
It won’t be the vomit or needles or blood or urine or feces that turns your stomach. You’ll get used to that. You’ll come to accept it’s just part of the job and get to the point where you’re thinking of the 38 different things you have to do while absentmindedly cleaning up a bowel movement.
What will turn your stomach will be 40 shallow breaths a minute in a patient in respiratory distress
A freshly born infant that is limp and blue and hasn’t cried yet
Tripled troponin levels on your sweating and anxious patient as you realize they’re having a heart attack
Feeling cord during a cervical check, then trying to hide from your patient the shaking in your voice as you call for help
The pale skin of a Jehovah’s Witness with a hemoglobin of 4 as she declines a blood transfusion and says goodbye to her family because they haven’t found the source of the bleed and she’s running out of time
A blood alcohol level of .18 on a 4 year old who is barely responsive and being intubated after getting drunk on mouthwash and then hitting his head
An elderly woman in the ICU signing her DNR while her sobbing daughter begs her to reconsider, knowing if treatment is stopped then her mother will die
A child in the pediatric ICU who hasn’t had a visitor in months
Not being able to find the heartbeat on a pregnant mom who hasn’t felt the baby move in a while
In the face of everything else that comes with being a nurse, I promise you’ll get used to the poop.
Or the 9 year old coming into the ER with the diagnosis of pregnancy... and not leaving with her parents
40 Shades of Snape - part two.
11-20/40 Full length frock coat majesty.
Full length without the robe on makes my heart a flutter <3
