A Budding Emergencist
Friday, December 08, 2006
  Money Shots from ER Blogs II.

Round and round we go...


New (to me, at least) ER blogs! More grist for the mill! Fuel to the fire! Throw another virgin into the volcano! BOHICA!

Seriously, I love coming home and warming up to a nice long session of emergent goodness. The more, the better! Always room for one more! Avast, ye wretches and wenches!


Mr. Hassel's Long Underpants -- SHAZAM! Can't believe I dint blogroll this before. Some choice tidbits:
"Life threatening problems are easier to treat than patients who arrive with high expectations and non-life threatening problems."

Amen, brother.

"I am more than just a triage doc with ACLS/PALS certification! Not that I need to convince myself of this, but it irks me that some docs really think this of ER docs."

Yeah, we're just glorified triage nurses, or stuck in intern year the rest of our careers. What's that, you say? Difficulty breathing? No sweat. You finally got those rock-hard abs you wanted, but the peritonitis got you down? Relax. Started your patient on Celexa and now he's blowing a deer rifle? Chill. Your patient will be here in the morning. Go back to sleep.

Trauma Queen -- "I stand in the middle of the weirdest shit, big heavy scary stuff, the dead and dying, people who've "not been seen in ages" who we find festering on their mattresses, surrounded by a stained outline that saves the police some chalk, people who've slashed their wrists in the midst of a houseful of screaming relatives."
Some potent prose there, pal.

Hallway Four -- "One interesting thing that happened during the past month is that I did my first solo intubation."


"Once you’ve paralyzed someone, they are completely dependent on you to breath for them, so if, for some reason, you can’t breath for them, they will die."

Simple does not equal easy, eh?
Remember, air going in and out, blood going round and round.

"...the intubation went off without a hitch and we got her on a ventilator and her 02 sats improved and she stabilized and went to the ICU a few hours later."

Now do it 10,000 more times. Retire. Tatoo "DNR/DNI" to your chest. Await celestial discharge.

Richard Winters, M.D. -- A diamond in the rough. Great stuff from start to finish. Too many delicious pithy morsels to list, but here's a few...

"Dear Sir:

Congratulations! You got the job! That is probably what you were hoping this letter would say. But it doesn't, because you didn't.

Personnel Department

Yuk, yuk, yuk. Sob.

"I think Taser should consider making a defibrillator gun.

I'd like to be able to defibrillate someone while standing 30 feet away.

I'd see v-fib on the monitor.
I'd whip out the Taser Defibrillator Gun.
I'd shout "CLEAR!"

The patient would wake with a jolt of biphasic joules.

Of course, I might miss and hit a nurse.

That might hurt nursing recruiting.


"I see a fair amount of people who present as RTT with BBB.

Rata-Tat-Tat with a Baseball Bat.

I'll add it to the list.

KnifeMan -- "I had to move 'small bowel obstruction' out, and off to theatre, hope that 'stridor' would hold her own for a bit. That gave me the chance to see 'dislocated ankle' (with bonus 'altered conscious level') and pull the offending limb; once that was done, we whipped in 'dislocated hip' - lots of pain, very anxious - albeit with no real success.

This calm procession was interrupted by 'acute lower GI bleed (?perf)' man, and his party trick, "the vaso-vagal". Once MY pulse normalised, I was able to attend to 'young fractured wrist' , 'large scalp lac kid' and the re-do ankle manip. In the background was a poor unfortunate lady with a broken hip. To add insult to her, already substantial, injury, her heart kept trying to give out on her.

Time for a deep breath.

Bread and butter, man...bread and butter.

Trench Doc -- Intern stories:
"While the intern was performing a rectal on a teenage female, the nurse decided to help the young girl by saying, “If you don’t relax, it’s not going to feel as good.

Wink, wink. Nudge, nudge.
"Say no more!"

"While attempting to reduce a priapism (pathologically engorged penis) an intern noted, “hmm, you know this is the first time I’ve ever held a man’s erect penis in my hand… it feels weird.” The patient was unimpressed."

Like this --> :-|
Or this --> :-/

"An intern, quite full of himself, yelled at a nurse, “why hasn’t the patient gotten the tylenol I ordered”…
Nurse- “you ordered it to be given IV.”
Intern- “that’s damn right, and that was 20 minutes ago”
Nurse- “yes, and just like 20 minutes ago, tylenol still only comes in pills

HA HA! Stupid intern!
[Rushes off to change IV Tylenol orders.]

More later.
That's all folks!

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Emergency medicine, from the beginning of a new doctor's career.

Location: Big City, Metropolis, United States

Walk softly and carry a big vocabulary. Don't be inhuman. Find and greet God in every person you meet. The patient is the one with the disease. Do not get distracted. Charity begins at home. Do good and be happy. Don't just do something, stand still. Wear sunscreen. Don't get anyone pregnant, and don't go to jail, young man. Budget your luxuries first. You don't know what you don't know. People like learning, they just don't like being taught. When in doubt, go out. When life gives you lemons, make lemonade. Honey attracts more flies than vinegar.

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