one for the trainees

[deleted126335]

In my experience, it's the rare militant shoulder-chippy I-can-do-anything CRNA who refuses to recognize the edges of his competence and does things he ought to refer or consult an expert on.

Unless that expert happens to be a physician anesthesiologist.

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[MaximusD]

5 pm on friday you finish your last EGD on a 33 yof with epigastric pain. Propofol wears off. She complains of pain and blurriness in her left eye. Nothing abnormal on gross exam. Everybody including yourself is anxious to go home. Plan?

Hmm..

Well, certainly the quality of the pain and the look of the eye is going to make a huge difference. Is the eye red? Is there anisocoria? Is the blurriness really blindness? Subjective visual field loss? Foreign body sensation?

If there's foreign body sensation, itchiness accompanying the blurriness, I might just give the pt some erythromycin ointment or some cortico/polysporin opth gtts and have him/her follow with ophtho as an outpatient. If the eye looks like hell, I might have a drive-by ophtho consult before d/c.

Hard to say with the prompt.