Busiest ED's

[Idiopathic]

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In recent years, Cook County has asserted that they have the "busiest ED in the country". Is this true? What would you guys say about where is the training facility that would most likely present a resident with the most diverse cases and largest amount of trauma? Just out of curiosity.

 

[mikecwru]

Originally posted by Idiopathic
In recent years, Cook County has asserted that they have the "busiest ED in the country". Is this true? What would you guys say about where is the training facility that would most likely present a resident with the most diverse cases and largest amount of trauma? Just out of curiosity.

In feeling for busiest ED, you can't just look at the absolute # of pts/year. What you have to look at is size the facility was built for, # of staff, # of nurses, etc. ie, our program only sees 80-90k per year, but the current ED was built for 40k, so it's extremely busy. Some of this will be alleviated when our new ED opens in april.

mike

 

[EMIMG]

When you are applying to programs, or are interviewing, ask to see one of the resident's procedure logs. This should give you a good understanding as to what the residents get to see and do. I believe that the RRC has certain procedures that they want every resident to fill out which includes things like central lines, intubations, chest tubes, as well as number of medical and trauma resuscitations they run or participate in.

No residency program should hide these numbers from the candidates. I think that you may be suprised by some numbers that you will see.

 

[jazz]

as alluded to in the previous replies, it's not just the total number the er sees. it really depends on if you get to see it. for instance, if an er has only 20,000 visits a year but there is usually only one resident on at a time, then likely you will get to do the procedure, see the sick patient, etc...

i realize that the higher the number of visits, the higher the chances of you seeing diverse/sick pathology. but also, the larger pure numbers of bs/fast track stuff. just pure stats.

asking to see resident logs is an idea but a lot of programs don't strictly enforce procedure logs. it's hard to take time to keep track once you;ve gotten a lot of a certain procedure.

 

[beyond all hope]

It's also about acuity and support staff.

You can easily see 2-3 patients an hour and be pretty relaxed if they're not sick and you have lots of help. However, you can work your ass off seeing a patient every 2 hours if they are really sick and/or you have to do your own scut.

Definately check on procedure numbers. Every residency program will say their residents get 'tons' of procedures. Don't try to pester the PD to open the books, but definately grill residents on how many ETTs, how many chest tubes, how many resuscitations they perform every week/month.

 

[Sheerstress]

A litmus test seems to be that where procedures are plentiful, the residents will often say that after a certain point in their first year, they were gladly giving away central lines and intubations because there were more than enough to go around.

 

[DrQuinn]

Originally posted by Sheerstress
A litmus test seems to be that where procedures are plentiful, the residents will often say that after a certain point in their first year, they were gladly giving away central lines and intubations because there were more than enough to go around.

Agreed. This is probably a good indicator.

Q, DO

 

[deleted6669]

when I worked as an L.A. county paramedic in the early 1990's the staff at la county/usc claimed that they were the second busiest e.d. in the world, second only to a massive trauma ctr in so. africa.
I wouldn't be surprised if that were true. we used to routinely run trauma codes in their waiting room for lack of space in the trauma bays.

 

[Coleman]

completely off the topic, but . . .

idiopathic, nice reference to Mr. Eddie Izzard in your location, picture, etc. Definitely the funniest and smartest comedian I have ever heard, he tops Robin Williams and Seinfeld in my opinion.

For everyone else, he is worth checking out. A nice comedic break from reality.

 

[jashanley]

Originally posted by Coleman
Mr. Eddie Izzard in your location, picture, etc. Definitely the funniest and smartest comedian I have ever heard, he tops Robin Williams and Seinfeld in my opinion.

For everyone else, he is worth checking out. A nice comedic break from reality.

I completely agree. I haven't laughed as hard as I did when I saw one of his hour long specials. Eddie Izard is unbelievably funny.

 

[Chris_Topher]

Some actual statistics that most EDs keep is their admission rate and ICU admission rate. These are hard numbers, and can be found on the SAEM Residency Catalog. Just more numbers, use in addition to above suggestions.

Idiopathic, I also have to give you credit for the Peter Griffin quote. Hi-Larious. Family guy is under-appreciated. For a good time, it is worth a watch on the Cartoon Network 11:30 weeknights EST.

 

[SilleAngyl]

Originally posted by Chris_Topher
Family guy is under-appreciated. For a good time, it is worth a watch on the Cartoon Network 11:30 weeknights EST.

Family Guy is AWESOME. By far one of my favorite shows of all time. I am so happy they are gonna make new episodes again! YAHOO!

 

[Coleman]

Family Guy is so funny! Good catch Chris, I laughed at that quote but forgot that Peter was Family Guy!

I can't believe it is coming back, that is very exciting!