Em satisfying?

[Wboyc]

What parts of a Em doctors practice are instantly gratifying other than trauma? What parts do all of you enjoy most about Em? How often do you save a life or at least make a big difference in their life, and what do you commonly save people from? And finally, what are the most uncommon procedures that an Em doc does? Anything with scopes? Sorry for the wave of questions and thanks to any and all responses!

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[RustedFox]

Trauma is the least gratifying, and most formulaic bit of EM.

 

[Daiphon]

Trauma: overrated.

Instant gratification: I love Nursemaid's elbows.

Enjoy: diverse population, not being in clinic

Make a difference: dunno. Frequent fliers would suggest never, the occasional cookie dropoff would suggest sometimes. Split the difference?

What are they saved from: natural selection, mostly.

Least common procedure: perimortem c-section.

 

[DrDrummer]

Satisfying: reassurance, compassionate management of the dying that helps them avoid a bad death, tension pneumothorax decompression, effective and safe procedural sedation and excellent repair of bad pedi forehead lacerations, and topical analgesia in corneal abrasions. There are probably a lot more, but that's a few of the things I've found very gratifying so far.

 

[WilcoWorld]

Strangely, I really love cerumen disimpactions.

Perhaps it's cuz I had it done once and I felt immensely better immediately after.

 

[winkleweizen]

Abscesses....it's like popping a giant pimple

 

[exsanguination]

I just want to reiterate that even as a resident, trauma is probably the least gratifying part of EM for me. I enjoy it, it's fun, it's totally still a rush for me, but like mentioned above, getting a family to reconsider their 98 year old grandma (who is demented, a SNF resident, takes too many medications to count, and PEG'ed because she can't swallow reliably any more) to consider comfort/DNR rather than intubation/pressors/central line/full court press is WAY MORE satisfying than any chest tube or ED thoracotomy.

 

[emergentmd]

I find the most satisfying running a code on a 80 YO bed bound double amputee dialysis nursing home pt that is full code b/c their family likes to collect their SS $$$$$$.



But a close second is a nursemaids elbow.

 

[Perrin]

Instantly gratifying, securing an airway.

Most enjoyable, having a hunch proved correct

Make a difference, arrange complicated outpatient rehab, f/u, specialist referrals for grandma when the PMD just cuts 'em loose to the wind.

Most uncommon, I second the peri-mortem c-section. Did one once and never want to again.

 

[da8s0859q]

Most uncommon, I second the peri-mortem c-section. Did one once and never want to again.

Nobody around here has actually done that. Care to share?

 

[engineeredout]

I just want to reiterate that even as a resident, trauma is probably the least gratifying part of EM for me. I enjoy it, it's fun, it's totally still a rush for me, but like mentioned above, getting a family to reconsider their 98 year old grandma (who is demented, a SNF resident, takes too many medications to count, and PEG'ed because she can't swallow reliably any more) to consider comfort/DNR rather than intubation/pressors/central line/full court press is WAY MORE satisfying than any chest tube or ED thoracotomy.

Agree with this. Never would have thought that the greatest satisfaction from this job would be allowing people to die, but it is definitely the case.

 

[Old_Mil]

How often do you save a life or at least make a big difference in their life, and what do you commonly save people from?

Maybe a handful of times a month. Most people who come to an emergency room are either not sick at all, or don't have a medical emergency.

And finally, what are the most uncommon procedures that an Em doc does?

Probably nasotracheal intubation and chest tubes, in that order.

Anything with scopes? Sorry for the wave of questions and thanks to any and all responses!

Unless you are at a shop that has a fiberoptic scope for intubation through the nose, no.

 

[gro2001]

I find the most satisfying running a code on a 80 YO bed bound double amputee dialysis nursing home pt that is full code b/c their family likes to collect their SS $$$$$$.



But a close second is a nursemaids elbow.

Sounds like the perfect ED ECMO candidate. Or REBOA. Or something else terribly expensive.