Best Consult EVER!

[bucknut101]

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For those of us who need some amusement while studying for OKAPS
Got this stat consult a few weeks ago for "please evaluate for intraorbital or intraocular foreign body which was seen on CT"
Luckily I looked at the CT scan first 😀
Here's the CT of the foreign body:

 

[Pinkertinkle]

Looks pretty deep in there.

 

[7ontheline]

Looks pretty deep in there.

Yeah, you better call your retina attending. I'm sure he'll be happy to come in and dig that out.

 

[DOCTORSAIB]

For those of us who need some amusement while studying for OKAPS
Got this stat consult a few weeks ago for "please evaluate for intraorbital or intraocular foreign body which was seen on CT"
Luckily I looked at the CT scan first 😀
Here's the CT of the foreign body:

That's freakin ridiculous.

Who are these people who send "stat" consults like this?

 

[qwopty99]

I don't know how to read these.


Can anyone explain what I'm looking at? (don't throw stones!)


Edit: nevermind - I see the surface thingy...

 

[Jokestr]

Just curious, what was that thing?

And what kind of idiot "doctor" writes intraobital or intraocular? Can you imagine cosulting a surgery doc with peritoneal or thoracic hemorrhage? Or better yet, cardiology with chest or groin pain?

 

[MedEye]

Whoever asked for this consult didn't wait for the radiology resident to read the CT. But if he/she just spent a second realizing that there are actually 2 foreign bodies, one in each eye, they would not have called for a consult.

As for calling other doctors idiot or stupid, I guess residents in every single specialy call their colleagues in other departments this way, not realizing that this is not their field or their area of training. For example, a cardiology fellow getting upset because the surgery resident didn't know that this is pericarditis on the EKG, not an MI.
A retina fellow told me one time that he got a call from the nurse for a blood pressure of 200/100 on his patient. Guess what he ordered?
Lasix 40 mg PO x 1!
If you tell this story to a medicine resident, he'll laugh for 2 days.

In the real world after residency, all attitudes change and I've seen it. You get the stupidist consult in the world, you thank the requesting physician for his kind referral and see the patient promptly. This rarely happens in residency.

 

[bucknut101]

Just curious, what was that thing?

I'm not really sure what it was. The patient was involved in an MVA so I'm assuming it was a piece of glass. By the time I saw the patient whatever it was on his eyelid was long gone.

I'm still not sure if the consulting service misread the radiologist report or if they looked at the scan themselves and misread it. The radiologist had read it correctly.

 

[bucknut101]

Whoever asked for this consult didn't wait for the radiology resident to read the CT. But if he/she just spent a second realizing that there are actually 2 foreign bodies, one in each eye, they would not have called for a consult.

As for calling other doctors idiot or stupid, I guess residents in every single specialy call their colleagues in other departments this way, not realizing that this is not their field or their area of training. For example, a cardiology fellow getting upset because the surgery resident didn't know that this is pericarditis on the EKG, not an MI.
A retina fellow told me one time that he got a call from the nurse for a blood pressure of 200/100 on his patient. Guess what he ordered?
Lasix 40 mg PO x 1!
If you tell this story to a medicine resident, he'll laugh for 2 days.

In the real world after residency, all attitudes change and I've seen it. You get the stupidist consult in the world, you thank the requesting physician for his kind referral and see the patient promptly. This rarely happens in residency.

As an ophthalmology resident you do get your fair share of frustraing and silly consults. But I'd rather have somebody ask for our assistance if their not sure about something.
For me its even more frustrating to recieve patients with ocular problems that other physicians have attempted to take care of when the problem was clearly out of their realm of expertise.
For example if your a PCP treating a patient for chronic conjuctivitis and they have a big white opacity in the center of their cornea then we need to take a look at that! That's clearly not just "conjunctivitis: (seen this a few times in my residency)