POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

[Handyman]

Um.....the bear wastes trillions of dollars and thousands of lives due to some desperate machismo-driven attempt at payback?

That will show 'em!!

[state of hockey]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

Isn't Russia supposed to be the bear?

[Kepler]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

I would agree. "We're safe, because who really wants to mess with America?!"

That being said, if you do poke the bear, guess what?

You get the horns!

No, wait. Let me check my notes.

[Kepler]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

The end of another 15 Minutes of Fame.

Some peak early.

[The Rube]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

You get the horns!

No, wait. Let me check my notes.

Fighting war, blah blah, Japan decides "Hey, Pearl Harbor!" Oops.
Al Qaeda/ISIS says "Hey twin towers!" Oops.

Just saying.

[busterman62]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

With the limited knowledge of this case I would strongly disagree with this sentiment.

The language they used "multi-organ system failure, endocarditis, dilated cardiomyopathy with a low ejection fraction" is the type that sounds really scary to someone without medical training (Brent) but this line can be used on probably 20-30 patients in an average tertiary care facility at any point. Most of these people are walking out of the hospital at some point.

I believe you are a physician on the older side (correct me if I am wrong). Just wondering, but do you do a lot of inpatient ICU work or consultations? We do a much better job than 10, 20 years ago. Granted, I work in Cleveland so our ICU care and cardiology care is probably better than average. Reading between the lines, this sounds like it could be a case of acute cholecystitis which was missed, treatment was delayed, and he eventually went septic. When you catch this early, people do well. At my institution, we see plenty of cases (of all sorts) that have had delayed treatment, or wrong diagnosis, and we have to play catch up. Most of the time, we can.

Unless more information comes out, this just screams to me to be a case where warning signs were ignored. If this patient got timely treatment, I bet even the "ICU at the Mayo Clinic" could handle this one.

I was countering Kep's hyperbole with, you guessed it, more hyperbole. You caught me.....sort of.

Pt c/o abdominal pain at 1300hrs on 7/20. Seen by facility NP and sent & admitted to near by critical access hospital. Transferred to tertiary care at 1330hrs on 7/21. Arrested on 7/22 at 0400hrs. Second arrest and demise at 1500hrs. (Source)

You are correct as to me being old school and not being at a tertiary care facility. However, the development of MSOF (agree that it was most likely from sepsis) within 48hrs in a Pt with a dilated cadiomyopathy puts this guy on the wrong side of the prognosis odds regardless of local. Could he have survived with immediate transfer to tertiary care? Maybe at MC or CC but I still think the odds are in favor of the Grim Reaper. We'll never know the whole story and anything we postulate about it is flawed.

[Deutsche Gopher Fan]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

Man, this sounds like a "disgusting, rat and rodent infested mess."

When Trump finds out who runs these places, he's going to be *furious* https://t.co/oebQEXyvc3

— Kevin M. Kruse (@KevinMKruse) July 27, 2019

[LynahFan]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

I think you guys are both missing the point. I want to hear about his treatment BEFORE this dire diagnosis. Maybe he was too far gone by the time he was seen by appropriate care - how did he get that way and why?

[FadeToBlack&Gold]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

Summarizing these views, Greenberg concluded that while working-class white men look very tough for Democrats to win over next year, the party has an opportunity to consolidate its modest 2018 revival among their female counterparts. For many of the women who backed Drumpf in 2016, he wrote, the president now “is seen as ego-centric and divisive and failing to deliver for working people, particularly the women and particularly on health care.”

I'll believe it, when I see the election results.

[WisconsinWildcard]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

I think you guys are both missing the point. I want to hear about his treatment BEFORE this dire diagnosis. Maybe he was too far gone by the time he was seen by appropriate care - how did he get that way and why?

Based on this timeline: "Pt c/o abdominal pain at 1300hrs on 7/20. Seen by facility NP and sent & admitted to near by critical access hospital. Transferred to tertiary care at 1330hrs on 7/21. Arrested on 7/22 at 0400hrs. Second arrest and demise at 1500hrs. (Source)"

I would say you cannot conclude much with the above timeline (which I agree with buster on). My main issue was with the (self admitted) hyperbole.

Acute cholecystitis can occur relatively out of nowhere and it can move fast. It is quite possible that everything was done correctly with the limited information that is out. Now if we find out that his abdominal pain was ignored for a day then that is probably on ICE. Or if he showed signs of SIRS (or now as the new kids on the block say, qsofa), which are early sepsis signs, and he was not started on aggressive fluids and broad spectrum antibiotics right away, that would be a medical miss.

[aparch]

Re: POTUS 45:55: Wow, @CNN RATINGS HAVE CRASHED. LOST ALL CREDIBILITY!

Biden: So I am keeping the Nest Thermostat app installed on my phone, and not giving the password to the account to anyone. I want to change the temperature of the air conditioning on him.

Obama: