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Recently released.
You are now allowed to sit and watch a monitor without blinking for 4 hours.
Get a burner phone? 😉
He said she said. Lies, lies, and more lies!!!Won't help since the OR nurses were willing to testify that he was using his phone.
Or just destroy the phone and don't hand it over.
ExactlyWhat do you think this is, the New England Patriots???
What do you think this is, the New England Patriots???
Hi Tom Brady!Or just destroy the phone and don't hand it over.
Tip of the iceberg on this stuff
Anyone use a vpn?
Yes, but this wouldn't help if nurses are testifying that you were on your phone.
Also, side rant: everyone should be using a VPN service for their everyday internet activities. If you don't believe me, read Glenn Greenwald's book No Place to Hide about NSA domestic surveillance programs. In addition to the government agencies, your ISP is also recording all of your internet habits and selling that data to anyone with $$.
How do I start using a VPN?
I know virtually nothing about them, except what it stands for.
I know it slows down your internet connection by 25%. I know it costs money. I know it hides your IP address.
Honestly, I don't care if the NSA knows about my google searches and my emails. I wouldn't be embarrassed. However, I am a firm believer in my privacy as a general rule (fully supportive of Snowden and anyone who thinks he should have gone the whistleblower route needs to read more) and I would likely do a VPN just in the name of privacy.
How do I start using a VPN?
I know virtually nothing about them, except what it stands for.
I know it slows down your internet connection by 25%. I know it costs money. I know it hides your IP address.
People mainly use them to hide IP from things they are searching/doing/posting, or download illegal software, or access websites currently forbidden by their current IP.
That's a hard sell when you standing over a corpse....even if the case was bread and butter stupid simple. I heard about a case of a lap appy in a 20 something year old that died because the surgeon put a trochar in the aorta. Not anywhere near anesthesia's fault...but let some defense attorney find out I was on Twitter leading up to the disaster.....which is why I try my best to not Tweet during my cases. I'm not always successful, but this thread will make me more mindfulMaybe everyone needs to be re-educated that depending on the intensity of the case we can be on our device and still be paying attention to the case.
That's a hard sell when you standing over a corpse....even if the case was bread and butter stupid simple. I heard about a case of a lap appy in a 20 something year old that died because the surgeon put a trochar in the aorta. Not anywhere near anesthesia's fault...but let some defense attorney find out I was on Twitter leading up to the disaster.....which is why I try my best to not Tweet during my cases. I'm not always successful, but this thread will make me more mindful
does a VPN prevent the judicial system from reviewing your internet history ? I would think it's fairly easy for lawyers to figure out you have a VPN and maybe a subpoena if those private records be available ?
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Presumably the VPN companies don't even keep records in the first place.There are no VPN records theoretically. Not to mention VPN companies are offshore so a subpoena is not that easy to enforce.
There are no VPN records theoretically. Not to mention VPN companies are offshore so a subpoena is not that easy to enforce.
Unfortunately, as with most things in court, the facts matter much less than the appearances. The jurors are not Hercule Poirots; they have average IQ of 100-ish, which is a very polite way of saying they are much dumber than the doctors they pass judgment on (and probably too dumb to pass judgment at all). It's one of the reasons why most civilized countries have specialized medical malpractice systems, even judges, and definitely no juries, and don't let any Joe Sixpack count as a physician's "peer". And why smart and/or rich people become "elitist" and would rather govern without the plebes.
It's all smoke and mirrors, and about who has the better smoke, mirrors and magician, especially in malpractice courts in certain areas of the country. There is one illogical and unpredictable jury decision after another; hence people settle out of court at malpractice insurance limits, to avoid nasty surprises. Most of these jurors are not passionate about justice; most of them didn't want to be there in the first place.
In a case like this, even if the anesthesiologist has done no harm to the patient, one can expect punitive damages levied on him. Why? So that all anesthesiologists are taught a lesson, not to do anything else while taking care of a patient, even if providing excellent care. Why? Because that's what "the people" want. They don't care about guilt, they don't care about facts, they care about appearances. That's why minority physicians are still discriminated against by some patients; appearances and brainwash shampoos matter more than most sheep realize. Let's not speak about the entire atmosphere stoked against physicians, with a lot of negative public sentiment to start with. The public wants its doctors to be Mothers Theresa; this guy was not.
The main medical error in this case was that there was a TEE in the room, and yet nobody used it to see what was wrong.
Next time you miss an easy diagnosis because you don't know TEE/TTE, don't expect the jury to be sympathetic. It's 2017, and even first year EM residents know how to take a look at a heart. The same way regional is a requirement nowadays, basic ultrasound skills are a must, and that applies to most of the body.
I'm not sure we can reasonably call TEE "standard of care" yet.The main medical error in this case was that there was a TEE in the room, and yet nobody used it to see what was wrong.
Next time you miss an easy diagnosis because you don't know TEE/TTE, don't expect the jury to be sympathetic. It's 2017, and even first year EM residents know how to take a look at a heart. The same way regional is a requirement nowadays, basic ultrasound skills are a must, and that applies to most of the body.
Not TEE, TTE. Basic transthoracic cardiac echo (PLAX, 4-chamber) should be standard of care, the same way it is for a central line. At least at the level of diagnosing an effusion.I'm not sure we can reasonably call TEE "standard of care" yet.
Of course, juries can be unreasonable.
Regarding TEE: in this case, there was a TEE in the room and at least one person who knew how to use it.
Good point. I didn't think about that.They might have wheeled it out after initial exam to exclude thrombus.
I know. I've been there. But it's a fantastic tool, especially in the more ICU-ish limited versions which allow one to measure cardiac output and get just a few major views. Probably much better than all the bioimpedance/arterial waveform contour crap.Many anesthesiologists haven't touched a TEE since residency. They don't know when to use it and have no desire to learn.
I know. I've been there. But it's a fantastic tool, especially in the more ICU-ish limited versions which allow one to measure cardiac output and get just a few major views. Probably much better than all the bioimpedance/arterial waveform contour crap.
The problem is our current fellowship system acts as a silly gatekeeper in preventing people from learning and subsequently using ultrasound in its various forms. Many hospitals now require people to have a cardiac fellowship to be TEE certified, so the thought process is that since you need a fellowship, there's no point in even learning the basics. I agree with you that basic ultrasound skills should be required of all anesthesiologists, but the fellowship system puts an obstacle in place that prevents people from learning new skills beyond residency.
As a nonfellowship trained anesthesiologist, I completely disagree. We didn't even have ultrasound for lines and blocks when I was a resident. TEE was biplane, you got 0 or 90 degrees. Nothing is stopping you from acquiring new skills. Learning resources are plentiful and free for those who want to learn. You do need a fellowship to be TEE certified but anyone can become a testamur and that is good enough for most hospitals. Around here, even if you're not boarded or a testamur, nobody is going to stop you from using echo when you need it. The hospitals have no idea even what an echo board is. It's usually up to the anesthesia department to determine what certifications are needed.
I think I learned more after residency than during. A fellowship may be an efficient way to learn, but it is absolutely not the only way to continue your education.