Emergency rooms find on-call specialists rare

[gasnewby]

his name is LUSER, what do you expect?

---

Members don't see this ad.

 

[gasnewby]

where's castro's banana and hooker talk when we need him to hijack the thread some more?

 

[elwademd]

btw, i'm an i.m. resident, just thought the topic/article was interesting

lady comes to the er with a wound so bad she needs an urgent plastics consult... but not so emergent that she gets sent home... or was it so emergent that she needed a plastics consult, but not so urgent that she was sent home?!!? idk. i'd like to think that if the er doc was really committed to this patient, the patient would not have been sent home from the er. but since she was sent home, i'm guessing the er doc didn't really want to bother anyone else... or just wasn't truly committed to the patient... or just really didn't think that it was that bad, which it may very well have been.

sluser11, that seems to be the issue for most of us non-er folks, no committment to the patient, often times no thought one way or the other. i've received calls on patients who were already dead, patients whom the er doc was not sure whether the patient is a man or a woman, patients with big spleens, patients who came in for leg pain but a troponin is just above detectable... is every er doc that way? i hope not, but it seems to me that most of the time i'm on call, i'm bound to get some sort of admission that doesn't really make a whole lot of sense, and trying to explain it in the morning to the attending doesn't make a whole lot of sense.

for many of us non-er people, it'd be easier just to have nurses triage patients, and have the nurses call us for them, and let us decide to do from the jump. add to that, we wouldn't have to sift through what the er guy/gal is saying (yea this guy is altered) and what the er guy/gal means (his alcohol level is 400... i.e. he's drunk).

in any event, don't take the comments to heart, keep trying to do what you feel is right for the patient... just make sure that when you're headed home, you haven't just dumped a bunch of patients on different services because you've got somewhere else to be.

btw, castro viejo, my vote is for the stipper with tassles, sans bananas and three headed monkeys!

 

[gasnewby]

btw, castro viejo, my vote is for the stipper with tassles, sans bananas and three headed monkeys!

obviously you haven't seen what some strippers can do with a banana.

ever been to amsterdam?

 

[labst]

sluser11, that seems to be the issue for most of us non-er folks, no committment to the patient, often times no thought one way or the other. i've received calls on patients who were already dead, patients whom the er doc was not sure whether the patient is a man or a woman, patients with big spleens, patients who came in for leg pain but a troponin is just above detectable...

I've gotten consulted on patients who aren't registered yet (routinely), someone who they weren't sure if they had an amputation or not, a number of people that they didn't know the name or bed location, and countless people who had been sitting around for thirteen hours who suddenly needed to be seen immediately because it was shift change.

 

[gasnewby]

very funny, from the gas forum:

Had one case a while back where the general surgeon got a call during our case from another hospital where the ER doc is asking him to accept a transfer of a patient with bilateral occluded femoral arteries, severe CAD/HTN/DM, 74 y/o, uninsured, now needs aorto-bifem bypass. I'm holding the phone to his ear and listening to the ER doc's voice explain the situation and how there is no vascular surgeon available at that hospital (we both know that was a lie) and the patient needs a facility that can provide a higher level of care.

"Uh-huh . . . uh-huh . . . uh-huh. Well, I'd rather eat **** with a fork and die."

ER doc: "Excuse me?"

"****, fork, die, GOODBYE!"

 

[elwademd]

obviously you haven't seen what some strippers can do with a banana.

ever been to amsterdam?

nope. but with that in mind, maybe i need to be on my way!

 

[ESU_MD]

Great thread

ER docs are ok for something- I guess. maybe sometimes just entertainment.

anyway. to all a good nite.

merry christmas to all

 

[Winged Scapula]

I thought you didn't take any general call any more. What, are you thinking a lot of women with breast masses are going to suddenly show up at your doorstep?

.
I don't take general surgery call anymore.

But, when in practice, someone has to cover the practice and cover the EDs every night and on weekends and holidays.

No, I don't expect to be called, except perhaps by some post-op patients of my partners, but we both cannot leave town at the same time. I volunteered to stay, so hence I am on call.

However, you would be suprised at the number of consults for non-emergent things that other services somehow think we need to see in-house rather than at the office after discharge. Trauma patient with chest wall hematoma? Has some hematoma extending to the breast? Sure, that's a breast emergency. GI Bleed with nipple discharge? Yeah, there's another one. And don't tell the radiologist it was MY idea to get a mammogram and ultrasound that he won't get paid for while she's in-house. I said it could wait.

The above goes to show you that ridiculous consults, poorly worked up patients and false information (the nipple discharge was billed as a necrotic nipple with mass) come from all services, not just the ED.

 

[Winged Scapula]

Oh and BTW, since my TWO warnings above were ignored, I'm closing this thread.