r/emergencymedicine

Will not be answering questions at this time, thank you.

Hi all, found my way here as a non-healthcare lady who's recently dating an ER physician. I fully knowledge I have little to no grasp of what he experiences in his day-to-day, but I'm trying to learn.

Of course communication between us is important, and this ask is in no way a substitute for talking about this with him, but if you guys could give any advice for dating, maintaining the relationship, and/or understanding his world, what would it be?

Without giving too much away, he is not at a designated high-level trauma center most of the time, and works fairly normal hours.

ER resident here, was reading about interscalene block for shoulder dislocations and I was wondering how commonly is it practiced. Personally I have never seen it being done in my facility.

Is it worth doing considering its complications if done incorrectly?

Hey all,

I'm an EMT, and today I had a chaotic call involving what I believe to be a neuro TBI patient, and I would like some input on what I was looking at.

Got called for a stroke, patient was slumped over in her wheelchair, AOx3, GCS 15 but slow to respond, abnormal from baseline. Negative Stroke scale, no ataxia, slurred speech, equal strength and sensation bilaterally.

Pts husband says she had a fall yesterday with a head injury but didnt seek medical attention. Negative LOC and Negative anticoaglants.

On scene, our patient within seconds went apneic/agonal breathing with no gag reflex, and profoundly hypotensive (50/26). NSR on cardiac monitor but eventually went to bradycardia at a rate of like 25-30BPM. My Paramedic partner gave 100mcg Push dose epi and raised the BP to 75/40, but pt has an intermittent gag reflex, comes and goes, so we stuck to BVM ventilations.

On arrival to the ED, pt immediately Asystolic with no cardiac down trend. NSR now at 60ish to asystole in 2 seconds flat. Medic partner shared concerns that it may be late stage herniation, but they just did a thoracotomy, noticed cardiac standstill, and pronounced TOD.

Obviously extremely chaotic, and I very well could be hyperfixating on herniation when it could be anything. Just figured I'd see if anyone has input, clinical suggestions, or any other comments to wrap my mind around what happened.

Howdy, incoming PGY-1 moving to a cool new city in the NE with higher COL than I’m used to.

I’m currently able to apply to 2 types of places, but having trouble wondering if I should prioritize convenience vs. affordability.

Option 1:

Basically luxury apartment

- about $300 above my monthly budget

- Smaller apartment (~600 sqft)

- Insane amenities. I’m talking huge state of the art gym, wellness center with saunas, spas, massage tables, etc. Huge pool, hot tub, fire pits, outdoor bar spaces, the works.

- Fully enclosed attached garage parking (so nice and safe from elements + vandalism, I’m also a young woman)

Option 2:

Refurbished factory building

- Closer to budget (~$100 over, which is acceptable)

- Exposed brick and wood beams with 1000 sqft

- In my absolute favorite part of town with 100/100 walkability that’s also about 10 minutes closer to my hospital

- A little outdated, will need a deep clean

- Parking has a waitlist that hasn’t budged in 6+ months, street parking is an option :/

- No amenities other some storage and secure package area

Should I prioritize convenience? My thoughts being that I’ll be in the hospital all the time so whatever extra cash I might normally spend out and about can go towards rent. I also struggle to prioritize my fitness, so having it available might make the difference in my wellness.

Thanks in advance!

Do you find dental cases in the emergency department? How do you manage them?

Other than some nerve block, my dental expertise is limited!

Hospital installed cameras right over the doctor station... positioned so as the intent seems to be more to look at our workstations as there's already a camera at the Pyxis around the corner and there's no other benefit to the camera. Doc station is behind doors and in-between two nurses station so I'm not exactly worried about patients coming in. Is this normal anywhere else????

Hi guys so i tried NotebookLM to summarize chapter from Rosen but I could not summarize anything beyond the approaches, any idead how to make it into an audiobook or a conversation to be listened too as an audio learner?

hello friends,

I am a third year med student and I want to dual apply w EM as my backup. I dont have any EM LOR (no SLOE either). The rest of this year is core rotations and then next year my plan was to do subis in my preferred specialty (PMR). i could honestly squeeze an EM rotation before apps are submitted and get a SLOE but I would be sacrificing a sub-i. I am also fine with SOAPing EM idc about the program, three years is quick.

My eventual plan is to go into interventional pain.

I would honestly prefer doing 3 years at a shittier program for EM (via SOAP) vs 1 TY and then 3 at another program.

What do you think. any advice is appreciated. thank you

anyone know how to get the “queen of hearts” app? It sounds useful and I would like to try it out. thanks

I want to stress test the following idea. What value / problems do you foresee if a clinician were to start a practice based on diverting patients from the ED saving the payors some money and pocketing a fraction of the savings. Say one could identify a member of an ACO or even health insurance company who is just about to go rack up a $3000 ER bill for a simple cystitis, med refill, ankle sprain, otitis. Said clinician could contract with the payor to see these people either in person or vial telehealth and get paid a fraction of that cost (that'd be negotiated idk 50%) . Certainly seems like a good idea to me, what challenges do people see ? One would mitigate medmal risk by only assuming the most obviously benign cases (nothing undifferentiated like chest or abdominal pain) . Thoughts? If you think its a good idea with surmountable issues PM me and lets try to build out a pilot!

Hey guys.

So I’m a teenager and while thinking of jobs a may want I stumbled across emergency medicine doc. I have always considered a field in medicine but I’m worried I do not have what it takes, here are some of my concerns:

Unrealistic expectations: I’m worried that it is a lot more work then I think and I would not be up to it. Additionally, I’m worried that I wanna do it partly because I have seen the Pitt (great show) and am delusional about that. I’m also worried that I just want to do it because of some of the money you can make and I’m just kinda heartless.

The pain: I’m especially worried I would not be able to deal with child death and any death and honestly have no ideas how you heroes deal with it. It seems like so much sadness day after day and idk if I would be able to handle it.

Challenges: I’m worried that I’m not smart enough and just a lazy loser who would not have enough willpower. even if I tried to become a doctor and even if I did, those patients would probably be better off with a different doctor who would actually know what they are doing.

The reason I really want to be an ER doc?

I want to help. I may not make an impact in the community but if I can save at least one persons life who other wise would have died, then my life would be worth it because I would make up for the waste that I am for saving someone else. It may not change the world but it would change their world (corny and dumb I know). Please can you guys give me your honest opinions about what you think cuz currantly I think I’m just a dumb kid with delusional dreams. I also see people like you guys as true heroes and thank you for everything you do. Oh also on the off chance you think I can live up to my dreams I would enjoy any resources that could help me live up to my goal.

P.S i have already been diagnosed clinical depression