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The nurse asked, ''What labs do you want?'' Like clockwork I
responded, ''CBC, iSTAT, POC UA and UPT.'' I walked away thinking about what I
just ordered. Really? Are those even
necessary? Am I simply in robotic-non-thinking-mode? My suspicions were confirmed
when the supervising physician asked me, ''What are those labs going to ...
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
history and vital signs. We rely upon this information in our overall
assessment. Last ...
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 in
at 2:30 PM that day. On Sunday, my normal schedule resumed.
The shift was ...
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 fate would have it, the phone lost service in the
beginning of the evaluation. ...
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 that mistakes are avoided by asking questions whenever you're unsure
Next week I
will start my new job in the ER. Along with reading my Tintinalli Emergency
Medicine Manual, I have spent a little time at the PA
Forum. If you have
not been over there, they have a little something for everyone (pre-PA, PA-S,
emergency medicine section is packed with pearls of dos and do nots, odd ...
I have tremendous respect for my PA and NP colleagues in dermatology. With eyes as skilled as Picasso's, they have the horribly difficult job of identifying literally thousands of skin conditions, ranging from benign to deadly.
Dermatology confuses me. It must me my engineering background. I'm more comfortable with mathematical equations and ...
I'm confused. I've been using Epocrates Essentials for two years now, and I love the program. The ability to look up diseases, medications, lab tests, tables and more has made this an invaluable tool in the clinical setting.
Then, a few months ago, I downloaded Medscape from WebMD on my iPhone. One striking difference between the two programs is ...
With nine shifts down and six to go, it's hard to believe that my emergency medicine rotation is more than halfway complete. (You may remember that I was originally scheduled to work just 12 shifts this month. Through a change of events, I was fortunate enough to pick up three extra days in the ED.) This month I am given 150 hours on the job to ...
Wow! The first week in the ED was an eye-opener! I walked in on Monday and the preceptor said, ''Pick up a chart and go.'' For a moment I thought she was joking or I was in some sort of dream. I opened the chart and read the chief complaint, ''Right side pain.'' As I walked toward the patient's room, my mental rolodex of differential diagnoses was ...