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Sunday, April 26, 2015

my job ain't no tv show


Every time I flip through the cable channels, there seems to be a new ER reality show.  So I thought I would put together a list of one's that I know of.  Here they are:

Trauma life in the er

Untold stories of the er

Bizarre er

Las Vegas er

Sidney er

NY med

Boston er

The little I have watched of these shows, naturally it's about dramatic shit. Every time you turn around someone's crashing or they're cracking a chest. So this is what public has come to believe an ER is, one exciting moment after another. In reality, working in an ER on a daily basis can be boring and routine. It has its moments, but really it's about a lot of abd pain, back pain, LOLLOL's, drunks and drug seekers.   It's a lot of starting IS an giving Zofran and Dilaudid......*yawn*.

I guess vomiting and grandma coming in covered in stool or Harold the drunk making his 3rd appearance that week doesn'the attract an audience and advertising money.

Friday, April 24, 2015

fun ideas for triage

Sitting at the triage desk watching people walk down the hall of shame toward the desk. I love the ones who either walk very hurriedly or sprint toward the desk..

Anyway, I had the idea to make life in the ER a lot easier for everyone concerned. We have this sort of vestibule type area with glass doors that can be locked. At night a security officer sits there are gives out name tags since its the only entrance to the hospital.

So I thought: Have this set up in the vestibule where there is a breathylyzer machine that everyone who wants to be seen in the ER has to blow into. Just think, you would already know the alcohol level of every patient right up front. The machine would instruct them to how to use it and then say:BLOW! BLOW! BLOW! BLOW! BLOW! It wouldn't unlock the door until they did it successfully.

Part# 2: Put a bathroom down there and have everything pee in a cup for a drug screen. You put your specimen into a little door thing in the wall, like at the doctors office. You have to wait for the results before the door will announce your name and unlock the door. This would be useful for drug seekers.

The thing is how would you prevent people who haven't been approved to now move ahead to the triage desk from running through the door when it opens? Hmmmm... We could have a place in the floor that opens and somehow propels the cheaters outside.

It was a slow evening in triage....

Tuesday, April 14, 2015

SEPSIS is the new black

All of a sudden sepsis has become the IT thing in the ER. We have had septic patients for a long time and have treated them with fluid, antibiotics, sometimes pressors, etc.  We aren't really treating them any differently now, its just that now someone with sepsis has become

       ******THE SEPTIC PATIENT!!!*****

Now..if you have a fever you are possibly septic and we treat you as such.  The whole world has become
possibly septic and all that entails: fluids, blood cultures, lactates, etc. Sniffles with fever - SEPTIC!  Sore throat with fever - SEPTIC!! Everyone is septic until proven otherwise dammit!

We are getting new machinery around this that has us tilting the patients legs up at a 45 degree angle for a few minutes to determine where they are with their fluid status involving CO, SV and all those other letter things that they understand on CCU and I never wanted to understand. Its too complicated for my feeble brain. Another machine to hook up to the patient.  Its getting to the point where we won't be able to see the patient because of all the cables going from them to the machines. 

Of course we had an inservice which went in one ear and out the other.  

It is admirable that attention is being put on sepsis and trying to decrease the mortality rate that goes with it. Why does it seem like whenever a something like this starts, they go overboard? **

**I know the picture has little to do with this content but I thought it was funny....so sue me.