As a radiologist, how comfortable are you with emergencies

[VoiceofReason]

That is, say any common emergency were to happen when you're off the clock out in the city or town or what have you (car crash, choking, etc) --- how comfortable are you, if at all, dealing with the situation (at least until emergency services arrive)?

i hope nobody feels that i'm judging radiology in any way, i really am just curious because its one more thing to think about in my specialty considerations.

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[Man In White]

I very comfortably take out my phone and dial 911.

 

[smq123]

That is, say any common emergency were to happen when you're off the clock out in the city or town or what have you (car crash, choking, etc) --- how comfortable are you, if at all, dealing with the situation (at least until emergency services arrive)?

i hope nobody feels that i'm judging radiology in any way, i really am just curious because its one more thing to think about in my specialty considerations.

Why do you care whether or not your specialty prepares you to deal with random accidents in a plane, or an elevator, or on the side of the road?

Unless you plan on carrying around a sterile suture kit, several pairs of sterile gloves, an ETT, an IV kit, a doppler, a face mask, a stethoscope, a syringe, and a sterile scalpel around with you at all times, what are you going to do in those situations? Pretty much what you'd do if you were a random passerby who's watched a lot of Discovery Health. Medical school really teaches you how to use specific tools in emergencies, not how to fashion a syringe out of a Bic.

And that's ignoring the fact that many physicians will advise you NOT to get too involved in an emergency; since you don't have access to the tools that you'd normally use, you could do real harm to someone....and there's no Good Samaritan law that prevents someone from suing you, despite the fact that you were trying your best.

 

[VoiceofReason]

Why do you care whether or not your specialty prepares you to deal with random accidents in a plane, or an elevator, or on the side of the road?

Unless you plan on carrying around a sterile suture kit, several pairs of sterile gloves, an ETT, an IV kit, a doppler, a face mask, a stethoscope, a syringe, and a sterile scalpel around with you at all times, what are you going to do in those situations? Pretty much what you'd do if you were a random passerby who's watched a lot of Discovery Health. Medical school really teaches you how to use specific tools in emergencies, not how to fashion a syringe out of a Bic.

And that's ignoring the fact that many physicians will advise you NOT to get too involved in an emergency; since you don't have access to the tools that you'd normally use, you could do real harm to someone....and there's no Good Samaritan law that prevents someone from suing you, despite the fact that you were trying your best.

i pretty much knew i was going to get a response like this im actually surprised it wasnt the first one. I admit that i'm in the middle of second year and haven't had any actual time on the floors or on rotations but do you mean to tell me there is literally nothing an M.D. can do in virtually all situations? What do emergency services personnel do when they're off duty and are actually present at the moment of a car crash? They simply call the ambulance and then play pocket pool until the wagon arrives?

i understand the point you are trying to make, but there can't be nothing that a person can do, literally nothing that separates an emergency physician, for example, from a "civilian" in these situations.

(and no i'm not dreaming about doing an emergency cric with the dick pump in my trunk)

edit: or doing any other equally hollywood stuff

double edit: to answer you initial question, i am interested in the answer to this question because i'm not sure i'm down with not knowing at least what should be done in an emergency (in a very general sense, not necessarily the detailed management of most emergencies) even if i dont have the tools. You may ask 'Why' again -- i just don't think i'd like that feeling, not knowing.

 

[Taurus]

I second calling 911 and standing back if there are others who know more than you. I may do chest compressions if needed.

Liability is a real issue here, especially if you say to everyone "I'm a doctor". People will then naturally defer to you. Are you really trained to provide emergency care? No. So if you don't know the protocol and you say "I'm a doctor" and you screw up, guess what happens to you? It's your license and future, use your head. If you want to do all that hands-on stuff, go do internal medicine or emergency med. You'll see after your 3rd year why people start to gravitate toward radiology.

 

[Man In White]

2nd year, eh? I shall refer you to the stages.

If/when you decide on radiology you'll get over it.

 

[tkim]

What do emergency services personnel do when they're off duty and are actually present at the moment of a car crash? They simply call the ambulance and then play pocket pool until the wagon arrives?

Pretty much, unless you carry a 'jump bag' in your car. When I was medic I used to carry a jump bag full of crap in my car - BVM, bandaging stuff, etc. There were other people with even less of a life who carried O2 tanks and other assorted crap. As the years went on, I carried less and less stuff, until someone broke into my car and stole all my crap. I never replaced any of the stuff. Now I just carry a phone.

Really the best thing you can do is make sure someone called 911 so they can arrive with the drugs and equipment that they need. A lot of medicine is equipment-dependant. You and pocketknife will not save the day - ever.

 

[Amxcvbcv]

BLS/ACLS...

That's pretty much it until help arrives.

 

[synapse lapse]

Yeah dude, what do you expect to be able to do with no tools? What seperates you from John Q Public is likely only your calm head and ability to think in critical situations. You can administer first aid with whatever tools you have at your disposal, hold pressure, stabilize the person from moving, fashion a splint, etc. Anyhow I have no clue why you would consider random accidents into your choice of a specialty.

 

[Man In White]

Anyhow I have no clue why you would consider random accidents into your choice of a specialty.

It's because he's in the first stage.

 

[gluon999]

2nd year, eh? I shall refer you to the stages.

If/when you decide on radiology you'll get over it.

I love that post!

To the op, if you are really concerned about saving someones life in a rAndom emergency, I am sure internship will prepare you for that. And as far as not having the right tools outside the hospital, I would limit myself to chest compressions/holding pressure until 911 arrives. Wait till you get to the third year, you will see that CYA medicine triumphs all.

 

[smq123]

i understand the point you are trying to make, but there can't be nothing that a person can do, literally nothing that separates an emergency physician, for example, from a "civilian" in these situations.

Actually, that IS what I'm trying to say - in these types of situations, without any tools, there isn't much that would separate a physician from a civilian. The only major difference that I can think of is that maybe you wouldn't get light-headed from the sight of blood, but a civilian would. That's a stretch, though.

Furthermore, most of BLS is really just common sense. If you're smart enough to get into radiology, you'll probably be smart enough to figure out that, oh, blood is spurting out of a huge gash on his arm and that I should put pressure on it.

double edit: to answer you initial question, i am interested in the answer to this question because i'm not sure i'm down with not knowing at least what should be done in an emergency (in a very general sense, not necessarily the detailed management of most emergencies) even if i dont have the tools. You may ask 'Why' again -- i just don't think i'd like that feeling, not knowing.

Even as an intern about to enter radiology, you still need to be BLS and ACLS/PALS certified. If you're really into it, you could become ATLS certified as well. Those courses are designed to teach you what to do in an emergency PROVIDED that you have the necessary equipment.

Well, everyone will know which car is yours, now. You'll be the one with the crash cart in the backseat.

 

[VoiceofReason]

Even as an intern about to enter radiology, you still need to be BLS and ACLS/PALS certified. If you're really into it, you could become ATLS certified as well. Those courses are designed to teach you what to do in an emergency PROVIDED that you have the necessary equipment.

Well, everyone will know which car is yours, now. You'll be the one with the crash cart in the backseat.

believe it or not i didn't know this, thanks. Thanks for all the responses actually i think my question has been pretty much answered

 

[Amxcvbcv]

believe it or not i didn't know this, thanks. Thanks for all the responses actually i think my question has been pretty much answered

One of the things you will get comfortable treating is iv dye allergies, which can range from benign flushing/nausea/vomiting to all out anaphylaxis, so BLS/ACLS certification are more than just hospital CYA requirements.

 

[fun8stuff]

..and there's no Good Samaritan law that prevents someone from suing you, despite the fact that you were trying your best.

actually, there is a good samaritan law and, although it varies state to state, most extend to healthcare professionals as long as they are not receiving compensation...... in fact, some only apply to those who have received formal training.

 

[Man In White]

actually, there is a good samaritan law and, although it varies state to state, most extend to healthcare professionals as long as they are not receiving compensation...... in fact, some only apply to those who have received formal training.

Heh, I think he's aware of it. He likely meant that the law cannot stop someone from initiating a lawsuit - it'll still cost you.

 

[Wrigleyville]

Good samaritan laws are generally pretty beefy, I wouldn't worry too much about liability in providing emergency care.

In Texas, a plaintiff has to show that a defendant showed "willful and wanton" negligence, which basically amounts to having to prove that the person providing emergency care intended to injure the victim.

I know there is fear of nuisance lawsuits, but plaintiff attorneys are running a business, they aren't going to spend 1000s of dollars on a guaranteed losing case.

 

[Taurus]

Good samaritan laws are generally pretty beefy, I wouldn't worry too much about liability in providing emergency care.

In Texas, a plaintiff has to show that a defendant showed "willful and wanton" negligence, which basically amounts to having to prove that the person providing emergency care intended to injure the victim.

I know there is fear of nuisance lawsuits, but plaintiff attorneys are running a business, they aren't going to spend 1000s of dollars on a guaranteed losing case.

Losing the lawsuit is not what I would necessarily be worried about. I worry more about having to hire a lawyer and spending the time to defend myself before the case gets tossed out or be found not guilty. Just defending yourself could cost from $5k to $50k. If you try to counter-sue, how much do you plan to collect from an unemployed mother of 5 kids?

California Supreme Court allows good Samaritans to be sued for nonmedical care

Woman Sued for Rescue Effort in Car Crash

It is sad what our society has become but that's the reality. If you come to an emergency outside of a hospital, I would be very, very careful before you blurt out, "I'm a doctor!!!".

Know your limitations and liabilities.

 

[Vince]

That is, say any common emergency were to happen when you're off the clock out in the city or town or what have you (car crash, choking, etc) --- how comfortable are you, if at all, dealing with the situation (at least until emergency services arrive)?

i hope nobody feels that i'm judging radiology in any way, i really am just curious because its one more thing to think about in my specialty considerations.

This should NOT be a consideration in chosing any specialty, including radiology. Could a dermatologist, ophthomologist, or other such specialist be able to handle the same issue better? Probably not.

I am a Radiology Resident going into IR. In IR, you need to be able to handle a code, and even as a resident, there will be codes in the CT scanner/contrast reactions/etc. Just pay attention and participate in codes during your medical education/internship.

I have only had a couple instances where a doctor/medically trained person was needed in an emergency and I was a bystander walking/driving by. It's pretty rare.

The last one(a few months ago) was pretty bad....teenager hit by a car and was unresponsive lying in the road...I went ahead and stopped(didn't have to), and determined how bad he was hurt, and when EMS arrived I told them what needed to be done, and to get to the trauma center quickly....it brought back memories.

Don't sweat it though...most of the time help is just a phone call away and you can at least do some basic stuff until help arrives.

If you do an ER rotation during internship, which most internships require, see if you can ride out with the local ambulance service/fire department. Most agencies have ride along programs, and you'll probably have more fun than seeing urgent care stuff in the ED.

Vince
PGY-5 Radiology Resident
PGY-12 Paramedic

 

[Man In White]