A Couple Random EM Questions I have

[TallScrubs]

Hey residents and attendings, I have a few random questions for you. Before you lambaste me, I have read through a lot of the threads in the 'EM FAQs', etc., etc.

1) I see that a lot of attendings say they are 'single coverage' in the ED. Does that mean that of their group they are the only one there, or does it mean that they are the only attending in the ED?

2) I am confused about how long patients stay in the ED before being admitted, if needed. I ask because on that god awful show, "Untold Stories of the ER", the EPs are often doing extensive work-ups and it seems like they are still the patient's physician even after being admitted and even though I know this isn't true.

I guess that is all I have for now. Thanks for your time.

TallScrubs

---

Members don't see this ad.

 

[Arcan57]

Hey residents and attendings, I have a few random questions for you. Before you lambaste me, I have read through a lot of the threads in the 'EM FAQs', etc., etc.

1) I see that a lot of attendings say they are 'single coverage' in the ED. Does that mean that of their group they are the only one there, or does it mean that they are the only attending in the ED?

2) I am confused about how long patients stay in the ED before being admitted, if needed. I ask because on that god awful show, "Untold Stories of the ER", the EPs are often doing extensive work-ups and it seems like they are still the patient's physician even after being admitted and even though I know this isn't true.

I guess that is all I have for now. Thanks for your time.

TallScrubs

1)Single coverage means you are the only physician in the ED. The hospital will contract with a single group to provide coverage for the ED, not multiple groups.

2) We've been out of unit beds for quite some time, and I think the longest ICU hold we've had in the last couple of weeks was 1d 20hrs. Who takes care of that patient after they've been admitted before they go upstairs should be the admitting physician, but in practice you're closer. So unless you redirect them, nurses will often come to you with requests for meds or new/worsening symptoms.

 

[TallScrubs]

1)Single coverage means you are the only physician in the ED. The hospital will contract with a single group to provide coverage for the ED, not multiple groups.

2) We've been out of unit beds for quite some time, and I think the longest ICU hold we've had in the last couple of weeks was 1d 20hrs. Who takes care of that patient after they've been admitted before they go upstairs should be the admitting physician, but in practice you're closer. So unless you redirect them, nurses will often come to you with requests for meds or new/worsening symptoms.

So it is possible for a large ED to only have a single EP? What happens if the doc physically can't tend to all the patients? Does that just make the wait insanely long?

 

[DrMom]

So it is possible for a large ED to only have a single EP? What happens if the doc physically can't tend to all the patients? Does that just make the wait insanely long?

It can.

I work 12 hr shifts usually with 9 of those hours as single coverage. The vast majority of the time I can get through everyone okay, but it takes me longer to disposition patients (either admit of discharge home) when all of my rooms are full (depending on which hospital I'm at, I have anywhere from 9 to 12 real rooms with hallway beds that can be added) or when I have multiple truly sick patients. Basically, the earaches, coughs, dental pains, ankle sprains just have to wait.

EDs that are busy 24/7 aren't the ones that usually schedule long periods of single coverage.

 

[TallScrubs]

Thank you Dr.Mom.

/thread