Adventures of a New PA : Specialties

Mental Triage: The Art of Emergency Medicine

Timothy Loerke — Mon, 19 Mar 2012 13:03:00 GMT

Triage is the act of prioritizing patients based on their probable diagnosis and necessary treatments. It comes from the French word tier , meaning to sift or to separate. Our ED has a "triage" area where patients are seen by a nurse who collects basic...(read more)

Back Up

Timothy Loerke — Mon, 12 Mar 2012 15:00:00 GMT

As I write this, my body is suffering from a 9-hour jet lag and 4P-4A shift in the ER. On Saturday, I returned to the States after an 8-day trip to Uganda. Our purpose was to teach at a leadership conference in the northern part of the country. We flew...(read more)

Think of the Worst, Hope for the Best

Timothy Loerke — Mon, 05 Mar 2012 16:20:00 GMT

Today I want to give you an insight into the emergency medicine world. This is one of the few areas of medicine where the focus is general, but the depth is shallow. We are looking for things that will kill you now, not later down the road. For instance,...(read more)

Medical Spanish: Dangerous or Necessary?

Timothy Loerke — Mon, 20 Feb 2012 14:56:00 GMT

Him, "No English." Me, "Uhhh, well, ummm, duele (pain)?" Him, "Spanish word, Spanish word, Spanish word" and then points to his right lower quadrant as he writhes in pain. This patient began with the luxury of his PA using the translator phone, but as...(read more)

No Room for Mistakes

Timothy Loerke — Mon, 13 Feb 2012 13:28:00 GMT

The medical director said, "We don't want you to make mistakes because they're too costly," when I asked him for some tips. My first day of emergency medicine orientation was spent one-on-one with the ED director. This one stood out. He went on to explain...(read more)

Experience Enhances Preparation

Timothy Loerke — Mon, 06 Feb 2012 19:44:00 GMT

Friday was my last day as a full-time PA in orthopedics. We had two knee scopes. The day seemed typical. I arrived early so that I could read more from the Tintinalli Emergency Medicine Manual. The supervising physician noticed my studies and made some...(read more)

Surgery and Its Physical Demands

Timothy Loerke — Mon, 23 Jan 2012 14:07:00 GMT

If you are interested in surgery, there might be a few things to think about. Yes, there is nothing like the rush of gowning up, seeing/holding the inner-parts, closing up the incisions and seeing the patient off to recovery. It is very rewarding, yet...(read more)

New Beginnings for a New PA

Timothy Loerke — Tue, 03 Jan 2012 15:38:00 GMT

When considering my first job as a PA, a topic of concern was the commute. At the moment, I drive about 30 to 45 minutes each way, not to mention the time spent between the offices, hospitals and surgery centers. I initially thought this would not be...(read more)

Patient Awake! For Surgery, That Is

Timothy Loerke — Mon, 19 Dec 2011 13:58:00 GMT

Have you ever considered staying awake for your surgery? I have absolutely no desire to be awake for any moment where knives and drills are involved on my body. Back in school, I saw one surgery where the patient had to stay awake due to a heart condition....(read more)

The Productive Response to Difficult Clinical Cases

Timothy Loerke — Mon, 24 Oct 2011 13:38:00 GMT

Organic chemistry was the big bear of undergraduate studies. I remember everyone freaking out before the class even started. People had heard from upperclassmen how tough O-Chem was and that many had failed it. I was at a critical point in my education...(read more)

Outside of the 8-to-5 Hours

Timothy Loerke — Mon, 17 Oct 2011 13:15:00 GMT

The majority of PAs work 40 hours a week and do not take call (see the latest AAPA Census Report ). More than 31% take some sort of call, whether actual in-house call or simply keeping their phone or pager nearby during the weekend just in case they are...(read more)

PAs: What Do You Want From Your State?

Timothy Loerke — Mon, 26 Sep 2011 14:43:00 GMT

If you could have anything as a PA in your practicing state, what would it be? A salary of $1 million per year is not the answer I’m looking for, although a pay hike would be nice. Would it be schedule II prescriptive authority, partnership and association...(read more)

The Self-Treatment Paradox

Timothy Loerke — Mon, 12 Sep 2011 13:03:00 GMT

Sometimes, being a healthcare provider feels like you are surrounded by the ocean: water, water everywhere, but not a drop to drink. If you are sick or injured, most of the time you know the diagnosis, how to treat it, and so on. Obviously, as a medical...(read more)

Avoiding Paralysis by Analysis in the OR

Timothy Loerke — Tue, 06 Sep 2011 13:46:00 GMT

The operating room is becoming more of a familiar place. I am much more comfortable with the preparation (positioning, shaving and draping the patient), intraoperative assisting (retracting, drilling and hammering) and wrapping up the case (suturing,...(read more)

Assessment & Plan: The New PA & the Veteran MD

Timothy Loerke — Mon, 29 Aug 2011 14:04:00 GMT

Thankfully my schedule is a little more predictable nowadays. I am in surgery 5 mornings per week, with afternoon clinic 4 out of the 5 days. I assist 2 surgeons in the OR (one has 20+ years of experience and the other is 3–4 years out from fellowship)....(read more)