I got tired of numbered migration files. Typical workflows mean you write the SQL to get from A to B by hand, keep those files forever, and hope nobody applied step 17 twice. I wanted the Infrastructure as Code (IaC) loop for Postgres: declare the desired schema, preview the…
I run most of my homelab tooling (Ansible, kubectl, Git) inside a Debian WSL2 instance on my Windows workstation. I wanted to SSH directly into that WSL instance from other machines on my LAN / Tailscale network without hopping through Windows first. Here's the setup that…
I spent the morning troubleshooting this and I wasn't finding much useful info through searches, so this is just a little info dump post to be helpful for others with similar problems. I briefly explain the Manjaro Linux audio stack, the relevant packages, and how to…
This post will review the presentation, workup, and treatment of euglycemic diabetic ketoacidosis (eDKA). Particular attention is spent discussing refractory acidosis, treatment failure, and insulin dosing. TL;DR eDKA is a medical emergency and the management is NOT…
Have you ever intubated a patient, initiated sedation, and then the patient started desatting? The ETCO2 is 35. You listen to lung sounds and they seem quieter on the left. The ETT is only at 23 cm and you swear that you barely went past the cords. You already ordered a stat…
The intensivist is a master of vascular access, but from time to time we still find ourselves with a challenging case. Sometimes the odds stack against our favor. Think of an elderly patient who is on dialysis, in shock, obese, and with just a small little femoral artery. When…
The hardest part about learning CRRT is deciphering the alphabet soup. It's easy to get lost in the sauce. Once you learn concretely the vocabulary and what all the tubes and pumps do on the CRRT machine then the rest kind of just falls in to place. This article is targeting…
TL;DR Phenobarbital is a good alternative or adjunct for treatment of alcohol withdrawal syndrome. It has particular benefits for patients with severe alcohol withdrawal. High risk patients are those with prior seizure, delirium tremens, ICU admission, benzodiazepine…
I would say this fully depends on the medical students and how busy my team is at the time. If things are chilling, then I rarely interrupt. I let them talk talk talk and give feedback +/- some teaching at the end. On the other hand, if my team is busy, then I give them fair…
Math can be inserted into Jupyter notebook markdown cells with LaTeX. The following works for Jupyter Notebooks in VS Code Center align with $$ math blocks $$ \Large\frac{N(t) - E(t)} {N(t)} $$ Left align with $ math blocks $ \Large\frac{N(t) - E(t)} {N(t)} $ Align on an equals…
I used to have the problem of massive Jupyter notebooks. They were slow and I couldn't find what I was looking for. I was adding markdown headers and jump links... In retrospect, I was doing too much in one notebook and was not pulling out big functions into scripts. Now I use a…
In theory, the decision to intubate is straight forward. Intubate if the patient is not oxygenating, ventilating, or protecting their airway. In practice, it can be a LOT harder to decide to pull the trigger on intubation. This is compounded when incomplete knowledge of patient…
This post outlines lab cutoffs for iron deficiency in healthy patients and those with heart failure, ongoing inflammation, or chronic kidney disease. Oral and IV treatment options are reviewed. Does your patient have iron deficiency? The most useful labs are ferritin and…
I ran into some major issues setting up the SSL certificate and HTTP to HTTPS forwarding on my Ghost blog. I'm outlining corrective steps here for other and for future reference. Basically, after setting up the SSL certificate my site had two major problems. First, it was…
TLDR This post shows an implementation for creating a smooth line over a datetime dataset with pandas and matplotlib. Introduction I recently ran into an issue where I wanted to make a smooth line over a 2 dimensional dataset. I'd been messing around with R and thought the…
I've been thinking about starting this blog for a long time now. Usually when I Google something and don't find a good answer. I'm a resident physician training in a combined emergency medicine and internal medicine program. I'll be doing a critical care fellowship. I'm going to…