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- Jan 28, 2014
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Do you have a good story about your first EM shift as an intern? What were you thinking, what did you do, any pearls of wisdom for those of us who are starting in July?
Be open minded. Realize that you're close to the dumbest person in the room, so everyone has something to teach you. Whether or not you learn it is up to you.Do you have a good story about your first EM shift as an intern? What were you thinking, what did you do, any pearls of wisdom for those of us who are starting in July?
Be open minded. Realize that you're close to the dumbest person in the room, so everyone has something to teach you. Whether or not you learn it is up to you.
At first I read this and I was like:My first shift I learned not to give Toradol to a headache patient until you're sure it's *really* a migraine!
My first shift I learned not to give Toradol to a headache patient until you're sure it's *really* a migraine!
So I understand the theoretical risk w/r/t decreased platelet aggregation in the 2% of patients or so who turn out to have a bleed -- but my understanding was that this concern was overblown and that studies of patients who received NSAIDs before the dx was confirmed showed no difference in outcomes. Anyone have better info on this? Some quick (<10 min) pubmed searching didn't give me much except a mediocre lit review:
http://www.ncbi.nlm.nih.gov/pubmed/22950380
The issue is that there are significantly better migraine medicines that have no risk of worsening a SAH. And some of them don't even start with "d".
Back on topic, I'd love to hear more intern year stories. I'm terrified about starting intern year in a couple months!
My first shift I learned not to give Toradol to a headache patient until you're sure it's *really* a migraine!
Why would they yell at you? I assume you were a medical student, and generally nowhere can a medical student order therapy on a patient (at least where I've been).On my 2nd EM away rotation I got absolutely crushed by a PA on this point right in front of the attending. Yelled at me for a good 5 minutes about it. It was a rough overnight :\
True; but that'd be more an opportunity to educate than chew out. Chewing out would be if an intern/resident screwed up and possibly/actually harmed a patient.Maybe he included it in his A&P during a presentation.
True. Perhaps the PA was also a doucheTrue; but that'd be more an opportunity to educate than chew out. Chewing out would be if an intern/resident screwed up and possibly/actually harmed a patient.
wasn't my first shift, but my first unsupervised central line, i dropped a lung.. doing an IJ.
mistakes will be made. people will die. breathe in, breathe out, move on!
Blind?
Aim towards the feet...not the head.The patient wasn't blind before the IJ
no, ultrasound guided. but used the femoral/long needle because i didn't know any better, and was way past the vessel on short axis.
but i got my first chest tube out of it!
Yeah, I was a fourth year student (still am, but just matched at my top choice!)Why would they yell at you? I assume you were a medical student, and generally nowhere can a medical student order therapy on a patient (at least where I've been).
My first shift I learned not to give Toradol to a headache patient until you're sure it's *really* a migraine!