iiinova — where your digital self keeps evolving

Petulant Skeptic @petulantskeptic.bsky.social · 2h

I think NFL penalties should only affect the individual who did the penalized action. Replay the down with the ball at the same place but the lineman who false started 5 yards back. Or CB who held 15 yards back.

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Petulant Skeptic @petulantskeptic.bsky.social · 04/10/2026

Can you spot the intubation of the high risk cardiac infant, the difficult IV, the arterial line (without success), and the (third) meeting of the day?

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Petulant Skeptic @petulantskeptic.bsky.social · 03/10/2026

Two months ago I logged into Epic and tried to start a sedation and it wouldn't let me into the sedation module and my trying to do so *also crashed the ability of every one of my partners to do a sedation in Epic for an entire day*. What is going on

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Petulant Skeptic @petulantskeptic.bsky.social · 03/10/2026

I have done well over a thousand MRI sedations and never experienced anything like this. Nearly every PICU or sedation shift for the past 3-4 months has just been some weird new chaotic event or a bunch of the most tragic things. Just relentless

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Petulant Skeptic @petulantskeptic.bsky.social · 03/10/2026

I just want one normal, chaos free day Today's highlight was a 30 minute sedation for a neck MRI turning into an hour and 45 minute MRI technology failure when the machine went into an infinite loop, crashed, and needed to be restarted… twice. All while I kept the child sedated.

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

I'd bet a lot that they fucked up the IV and ended up putting all or most of both syringes into her subcutaneous tissue. Pentobarb doesn't absorb well from there (though enough to put her to sleep and obstruct her airway) and will cause diffuse tissue injury.

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

particularly when one considers the lack of clinical expertise on hand to assess whether a person is sufficiently obtunded to be aware of their chemical paralysis and/or the burning and crushing sensation of a potassium overdose

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

among the various protocols different states use nitrogen asphyxia is almost certainly the least painful and barbaric; the press coverage when it started being used was not particularly accurate with regard to the physiology of it

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

yeah, pushing a paralytic with a questionable assessment of whetehr the patient is completely obtunded is literal barbarism and torture

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

who knows what size the doses are, but I routinely use very large (but still medicolegally defensible doses) for end of life analgosedation and patients often receive quite a lot before they ultimately die

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

I know that makes it sound like I'm blaming the pharma companies (and maybe I am?). I agree with what they're trying to accomplish, but the end result is so much misery it makes me so sad. I wish we just didn't execute people.

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

the patchwork of different state lethal injection protocols (which are here: deathpenaltyinfo.org/executions/m...) is a consequence of pharmaceutical companies refusing to sell for the purpose of the drug being used in lethal injection, which makes the states come up with these barbaric recipes

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

I used up the entire hospital's supply of hydromorphone and lorazepam for a single patient once. Had to switch to fentanyl and pentobarb

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

probably upper airway obstruction from insufficient pentobarb the current Tennessee protocol is just pentobarbital alone and anyone who's done end of life palliative care knows just how shockingly much barbiturate or benzo some people can absorb before passing away

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

it might be among the most valuable field manuals to have on hand during sere, depending on the weather and the font size

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

(yes, the mansplaining tone was intentional, it's part of the bit, I don't need to hear about it)

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

He probably meant "throw me on the pyre" or "tie me to the stake" but mixed up his witch burning metaphors

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

I finished 'The Long Ships' and man, what a delightful book, wish I hadn't put off reading it for so long.

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

My two best PICU-doctor friends (neither of whom have children) are telling me this is abnormal and I should see a therapist.

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Petulant Skeptic @petulantskeptic.bsky.social · 01/10/2026

Every time I go to one of my daughter’s track meets I spend the whole thing anxious that some child is going to collapse and I’ll be the most qualified person around to resuscitate them

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

This 19 year old just did four schools that Hegseth never completed in <6 months (Ranger, Airborne, Air Assault, and Pathfinder). lol

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

Why do we need another combatant command for CENTCOM to steal stuff from?

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

I care more about who got it since I was also around for the OPM hack that gave all my info and security questions to China. I have noticed a lot more spam phone calls in the past few months tho

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

I ETS'd in June and have heard nothing. Nice (additional) farewell fuck you that they don't even bother notifying everyone who was affected

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

Didn't the DoD swear at some point that they didn't "pick" the code names of JSOC and other highly classified operations, there was some weird automated selector thing that just grabbed <adjective> <noun> from prepared lists?

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

Somewhere, in a carpeted office some Cornell functionaries met about the rape incident and had a conversation that boiled down to: "Should we do the right thing even though it will harm our reputation in the short term or do we flip a coin on becoming toxic to women for a decade?"

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

It is shocking to me that elite institutions (i.e. Cornell) don't realize that their future is female (nearly a 60-40 split at the undergrad level, only growing for the past two decades). Protecting the institution at the expense of womens' esteem (a charitable view of what they did) is suicide

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

I think the surest path to increasing voter turnout (and early voting) is to create a national opt-in system that registers receipt of your ballot and simultaneously exempts you from having to see any more campaign ads or receive any fund raising text messages.

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Petulant Skeptic @petulantskeptic.bsky.social · 30/09/2026

This is probably the last time that I get to vote insanely early compared to others (Washington [a 100% mail in ballot state] sends ballots to registered servicemembers 6ish weeks before elections to make sure they receive them in time).

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Reposted by Petulant Skeptic

The Wall Street Journal @wsj.com · 28/09/2026

The alarms keep patients from getting sleep and overwhelm nurses. Now, researchers are making alarms smarter and less annoying. on.wsj.com/4hiACDz

on.wsj.com

The Constant Beeps in Hospitals Drive Everyone Crazy. There’s a Better Way.

The alarms keep patients from getting sleep and overwhelm nurses. Now, researchers are making alarms smarter and less annoying.

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Petulant Skeptic @petulantskeptic.bsky.social · 28/09/2026

This is some incredibly biased refereeing

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Petulant Skeptic @petulantskeptic.bsky.social · 28/09/2026

I’m an inpatient creature so I have a different take and set of worries but; yes, the system is fundamentally broken and its failings fall disproportionately on those who are are disadvantaged in some way

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Petulant Skeptic @petulantskeptic.bsky.social · 28/09/2026

Cris Collinsworth be quiet for longer than 13 consecutive seconds challenge: Impossible

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Petulant Skeptic @petulantskeptic.bsky.social · 28/09/2026

Unrelated but there is an incredibly easy cohort study just begging to be done: Admission rate for DKA for kids with T1DM seen by MHS peds endos vs Tricare outside providers vs regular care.

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Petulant Skeptic @petulantskeptic.bsky.social · 28/09/2026

Incredible. Dallas could’ve just waited to touch him a second or two

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Petulant Skeptic @petulantskeptic.bsky.social · 27/09/2026

Not breaking news but Lincoln Riley confirming what a piece of shit he is: "Riley faced questions about Stephens' presence on the USC sideline [in the 2nd half] after his ejection. "Why (was he out there)?" Riley responded. "Because he's on our football team."

cbssports.com

Dante Moore injury: What we know on Oregon QB's condition after he was carted off the field Saturday night

The star QB and top NFL Draft prospect was subjected to a violent late hit in the Ducks' win over USC

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Petulant Skeptic @petulantskeptic.bsky.social · 27/09/2026

If USC had won after their shameful celebration of injuring Moore it might’ve broken the universe. Fuck USC

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Petulant Skeptic @petulantskeptic.bsky.social · 27/09/2026

Truly. Never has a team deserved to lose more than this USC squad

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Petulant Skeptic @petulantskeptic.bsky.social · 26/09/2026

I am yet again asking a reporter (@amandamull.bsky.social?) to write an explainer for the pharmaceutical ads for diseases with very few customers. Who is the target? How can they be positive ROI?

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Petulant Skeptic @petulantskeptic.bsky.social · 26/09/2026

If I haven't used my car or home insurance this year, does that mean that I'm doing fraud?

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Petulant Skeptic @petulantskeptic.bsky.social · 26/09/2026

There's a 25 year old theory about how Bush did 9/11… does Israel have that for Bibi and 7 October?

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Petulant Skeptic @petulantskeptic.bsky.social · 26/09/2026

I have some friends who worked for Aquilino. They've got some funny stories. It's hilarious he signed all his emails "-Lung"

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Petulant Skeptic @petulantskeptic.bsky.social · 25/09/2026

Put off getting my flu shot on my post call day earlier this week bc I was so tired and then the hospital flu drive was set up outside the physician lounge today (very smart) so I did it.

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Petulant Skeptic @petulantskeptic.bsky.social · 24/09/2026

Imagine every ventilator starts reading low delivered O2 over 5-10 minutes but the knobs still hiss when you turn them and the pressure monitor in the wall isn't alarming. It'd take forever to figure out because the people who can trouble shoot it would be at bedsides… it's really nightmare stuff

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