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A lot of the threads on here focus on the negative sides of EM. Can we hear some positive things? Anything that makes you happy that you chose EM over another specialty?
 
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dotcb

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Fun
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Teamwork - close interaction w/ EMS/Fire/Police, nurses and consultants
Always learning - I usually see at least one interesting thing or something I haven't exactly encountered on every shift.
Procedures
Shift work - no pager
I work 12 eight-hour shifts/mo as full time employee - lots of time off...
good pay
Taking care of sick patients.
Reassuring the worried well.
Save a life (a few times a year).
Catching a patient with subtle presentation of a severe disease.
Use nearly everything I learned during med school and beyond.
I like my bread and butter and am good at it - abd pain, chest pain, pregnancy/gyn complaints, sepsis, neuro emergencies, lacs, MSK pain, trauma, drunks, psych, etc.
Get to help patients at very vulnerable/critical moments in their lives.
Procedural sedation
Airways
 
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Birdstrike

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A lot of the threads on here focus on the negative sides of EM. Can we hear some positive things? Anything that makes you happy that you chose EM over another specialty?
EM allows one to make really good money, save the occasional life and provide a lifetime of cocktail-party stories inspired by HIPAA-anonymous people that have impossibly lost various power tools, legumes and/or livestock up their butts?

(Hey, I think I just invented a word. Every seen a live hipaanonymous?)
 

emergentmd

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A lot of the threads on here focus on the negative sides of EM. Can we hear some positive things? Anything that makes you happy that you chose EM over another specialty?
1. 3 Yr residency
2. Take 1-2 week any time you want. Before kids, we took a vacation 6 times a year
3. 350K+ income in south
4. 3 Yr residency
4. Did I say 3 yr residency making 350K/yr? Name me another specialty that makes 350K for 3 yrs?
 

TimesNewRoman

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The Stories
You actually get to help some people
Immediate gratification
Salary
Relatively low hours
Short residency
Respected by the community
Being able to answer basic medical questions by family and friends
Significant advances in EBM and tech (read:US)
Being the most calm person around a critically ill patient
Ability to moonlight in residency (for good money)
Working on a team
Specialists (outside of academia) generally do value you
Airways/Resuscitations
Always having opportunities to teach (EMS, nursing staff, etc)
You get to wear scrubs and comfy shoes to work
You don't have to round
You get to dispo patients that are a pain
Ability to work other places (EMS, hyperbarics/wound care, sporting events, things outside of medicine in your time off)
Fellowships: Critical care, pain, ultrasound, international
You get to chemically restrain some people
Knowing about everything from brain bleeds to hangnails to kids with a fever
You get to blow off esoteric stuff (most of the time)
Seeing everything from kids to grandma
Seriously, the stories are amazing


It's a pretty great field. It's just that it's also a pretty terrible field.
 

Angry Birds

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Fun
Time flies
Variety
Teamwork - close interaction w/ EMS/Fire/Police, nurses and consultants
Always learning - I usually see at least one interesting thing or something I haven't exactly encountered on every shift.
Procedures
Shift work - no pager
I work 12 eight-hour shifts/mo as full time employee - lots of time off...
good pay
Taking care of sick patients.
Reassuring the worried well.
Save a life (a few times a year).
Catching a patient with subtle presentation of a severe disease.
Use nearly everything I learned during med school and beyond.
I like my bread and butter and am good at it - abd pain, chest pain, pregnancy/gyn complaints, sepsis, neuro emergencies, lacs, MSK pain, trauma, drunks, psych, etc.
Get to help patients at very vulnerable/critical moments in their lives.
Procedural sedation
Airways
12 8-hour shifts. Is this in academics? Do you have any other responsibilities?

That sounds great.
 

emergentmd

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12 8-hour shifts. Is this in academics? Do you have any other responsibilities?

That sounds great.
The majority of my shifts in a community practice is 7-8 hrs of work. Some 12 hr shifts at the free standing we cover but the main hospital is 7-8 hrs before the new guy comes on.
 

Hercules

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12 8-hour shifts. Is this in academics? Do you have any other responsibilities?

That sounds great.
I'm in the community and full time for us is 10-13 shifts. We staff with four 8 hour shifts on the weekdays and three 10 hr shifts on the weekends. I love this blend as it makes for more weekends off for everyone and the higher quality of life on the weekdays that an 8 hr shift yields.
 

WilcoWorld

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My two year old got croup last week. My wife was terrified, but I could see that my kid just needed to be calmed down to the point that I could get her to swallow a shot of decadron (which was 60 proof, BTW).

My four year old complained of a "sharp pain in my tummy" the other day, and I avoided a trip to the hospital with watchful waiting/serial exams.

I'm about to go on vacation with my extended family. I hope we don't have to save my dad's life again, but if he arrests I'll be able to provide good BLS until the medics arrive.

But really, I do it for the chicks. And by "chicks" I mean the ability to make a good living while doing something I am proud of. Yes, there are pressures to be unethical in EM, but those pressures are omnipresent outside of monasteries (and probably within those too). However, in EM there are still enough job opportunities out there that if I don't like me current work environment I can find another one in under three phone calls.
 
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dav86

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Great Variety
Use your clinical skills everyday
See something new every shift
You are challenged every shift (at least starting out)
Procedures (not just intubations/lines, but reductions, arthrocentesis, nerve blocks, lac repairs, chest tubes, canthotomies, etc.)
No call
Great Pay for 3-4 yr residency (most areas except large cities over 200/hr, if you get the right group 300/hr)
Still opportunities at small democratic groups (though I don't know how much longer they will last)
Teamwork (work with EMS, RN, consultants, techs, residents, students)
Save lives every once and a while
Make a difference/impact a life every shift
Cool niche/fellowships (EMS, US, hyperbarics, palliative care, wilderness)
Flexibility (if you manage your finances you can cut back or do PRN work later in your career)
 

namethatsmell

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Memorable parts of my last shift: started off by intubating and dropping a subclavian in a pulseless GSW while patient got clamshelled, saw a patient with lower abd pain/positive home pregnancy test and did a transvag sono to confirm IUP with mom nearly jumping off the bed to hug me when I showed her the screen, maneuvered a difficult airway in a BMI +70 pt who failed BiPAP, diagnosed and managed a thyroid storm patient who was initially billed as tox, and got urology to actually accept a patient to their service (the biggest win and rarest zebra of them all).

That said, you'll have plenty of shifts full of patients with same-old abdominal/chest/back pain and kids with fever...and there are plenty of things only specialists can do and plently of things we don't know. There are definitely downsides to our field--but I guess that's for another thread.

In a nutshell, the spectrum of what we see and what we can do is just awesome (probably only rivaled by the few full-scope FM docs that are still out there).
 
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barnacle

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It is the most hands on job in medicine. There is no job description for what we do. You will get to be the doctor, RN, tech, respiratory therapist, secretary, IT consultant, biomedical engineer, microbiologist, phlebotomist, ultrasonographer, orderly, dietary aid, social worker, care manager, chaplain, environmental specialist, maintenance person, and hopefully the voice of reason. You will get to help the poorest of the poor and some of the most marginalized people in our society. You will get to be person that cares. You will get to feel the pulse of your community. You will get to be open during the good times and the bad. You will get to laugh, cry and sing. You will get to clock out, go home and be free.
 

The White Coat Investor

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Great lists here. First the non-clinical positives.

It's a heck of a lot of money. Someone up above was bragging about $350K. I'm trying to figure out why he is so underpaid. :)
It's a heck of a lot of time. I work 15 eights for now, but that works out to 28 hours a week. It is simple for me to take off 7-10 days (in a row) every month. It makes the rest of the month kind of suck, but I can have 12-18 weeks a year off while working full time. Not a lot of jobs where you can do that. But I pretty much take 5-6 in a row and go somewhere every month. A vacation, every month, for your entire career.
Relatively easy to change departments. The job is fairly standardized. You're the most expensive cog in the machine, but if you wish to change machines, it is fairly easy to do. No having to build up a practice, take a big paycut etc. Of course, if the supply were higher, you'd be easily replaced too.
The supply isn't higher. You're in demand. Unless you're terrible, your job security is extremely high. You will be able to be employed.
No call. I hated being on call as a student and resident. I had phantom pages for a year after residency.
3 year residency. That's so short that some docs tack on an extra year just for kicks.
Relatively easy to leave work at work compared to most specialties.
The coolest people. I went canyoneering this May with a group of 5 docs. One pediatrician (married to an EP) and four EPs. I only know one other doc that does that (an orthopedist.) In fact, as near as I can tell, essentially all the fun people in medicine are in EM, ortho, and anesthesia.

Now, the clinical.

I still love critical patients, intubating, and procedures. I thought that would eventually go away, but it hasn't.
The funny stories. I really enjoy seeing how "the other half" lives.
Everyone is a little nutty, but as near as I can tell, that's how all of medicine is. At least we can tie our nuts down, knock em out, and ship them off relatively easily.
The diagnosing. Many specialties have the diagnosis handed to them. Half of our patients don't even have a diagnosis when we're done with them, much less when we first meet them.
Practical skills and knowledge. You're the guy on the plane who can actually do something. My kids basically only go to the pediatrician for well child checks.
Not knowing what kind of a day it will be until the day is over. I'm a little ADHD, but I detest being bored at work.
Being able to boil things down to their essence and seeing the end from the beginning. I'm not going to ask you 100 questions, because only three questions matter in what I'm going to do.
Being able to work something up as far as you want before passing the patient along to someone else. Interested? Keep going. Not interested? Turf.
I love the breadth- eyes, gyn, ob, medicine, surgery, trauma, peds, chronic stuff, acute stuff, derm, ENT, radiology, anesthesia, cardiology, pulmonology, neurology etc etc.
 

pandahunter

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After a horrifically draining and depressing start to EM intern year, this is a little bit of what I needed to read.
 

KinesiologyNerd

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It's 4am, the ED is empty, and I got to suture my first lac tonight. Life is good.
 
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TimesNewRoman

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Seriously! Shouldn't that be the high end of EP salary?
Depends where you live. Ok living in a rural area? That's nothing. I get recruiters offering 500k routinely if you're willing to live somewhere that kinda sucks.
 
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Perrin

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Routine vag bleed turns into... I get to hold pressure on an intravaginal lac with arterial bleeding using ring forceps with surgiseal soaked in thrombin and the side of the speculum. OB was kinda skeptical of my description of the situation. He showed up quick, I moved the forceps over to show him the very pulsatile bleed and he said, yup, never seen that before, let's get her to the OR. From presentation to OB arriving, BP dropped from 130's to 80's and hemoglobin went from 10.5 to 8.4. Good rescucitation with fluids and PRBCs.

Just one of the 'typical complaints' that turns out to be something interesting and a little sphincter tightening. I'm getting the rep of being the OB/Gyn black cloud at this place.
 
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TimesNewRoman

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Routine vag bleed turns into... I get to hold pressure on an intravaginal lac with arterial bleeding using ring forceps with surgiseal soaked in thrombin and the side of the speculum. OB was kinda skeptical of my description of the situation. He showed up quick, I moved the forceps over to show him the very pulsatile bleed and he said, yup, never seen that before, let's get her to the OR. From presentation to OB arriving, BP dropped from 130's to 80's and hemoglobin went from 10.5 to 8.4. Good rescucitation with fluids and PRBCs.

Just one of the 'typical complaints' that turns out to be something interesting and a little sphincter tightening. I'm getting the rep of being the OB/Gyn black cloud at this place.
I tend to be a bit of a black cloud.....but that's not the kind of black cloud I'd want to be, lol.
 

dchristismi

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I think it was the "intern" part of that sentence.

Most of my intern year seemed like it was spent everywhere but the ED... yes, it's program specific, but I didn't have my first ED rotation until like November.

I had some simple stuff tonight but made a difference for a few people. Explained some stuff. Translated "medicine-speak" into "Southern."
Today was a lot of little-quick stuff... and one anaphylaxis in a 9 year old with a newly-discovered nut allergy.
Calm. Cool. Grace under fire. And funny to boot.
Have you ever hung out with EPs? I mean, I've hung with some ortho guys who got really introspective at 3 am, but it's the EM guys who are cutting up, cracking jokes, and planning their next ultramarathon/scuba adventure/road trip around some 3rd world country... Playing rock-paper-scissors for the inbound STEMI.

Black cloud here. The EMS guys know it... and I tease them that I'm saving TWO code beds at a time now.
I've also cut a cooking pot off a 2 year old's head. Where else in all of medicine do you do that? Half fly-by-the-seat-of-your-pants, "oh, I meant to do that," half "damned if I know, just hold pressure!"

It will get better, young padawan.
 
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anbuitachi

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If you go work in a hospital.. it seems like every field is hating on EM. But that's prob cause they are jealous. EM is one of the hottest residency these days. I would say the most attractive aspect is working like 16 shifts a month and getting paid a ton. Literally 2x per hour than many other docs. Plus you see everything and become well rounded, and EM is more useful in the field than most other specialties. Would you rather work 7 days a week on medicine floor dealing with social work, or be in the ED for 3-4 days a week and make more and not play the long social waiting game?
 

Birdstrike

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If you go work in a hospital.. it seems like every field is hating on EM. But that's prob cause they are jealous. EM is one of the hottest residency these days. I would say the most attractive aspect is working like 16 shifts a month and getting paid a ton. Literally 2x per hour than many other docs. Plus you see everything and become well rounded, and EM is more useful in the field than most other specialties. Would you rather work 7 days a week on medicine floor dealing with social work, or be in the ED for 3-4 days a week and make more and not play the long social waiting game?
It's not so black and white. There are advantage and disadvantages.
 

Arcan57

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If you go work in a hospital.. it seems like every field is hating on EM. But that's prob cause they are jealous. EM is one of the hottest residency these days. I would say the most attractive aspect is working like 16 shifts a month and getting paid a ton. Literally 2x per hour than many other docs. Plus you see everything and become well rounded, and EM is more useful in the field than most other specialties. Would you rather work 7 days a week on medicine floor dealing with social work, or be in the ED for 3-4 days a week and make more and not play the long social waiting game?
That's a relatively skewed view of both specialties.
 

pandahunter

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What was "horrifically draining and depressing" about it?
mostly just not having anytime off to see my family or friends outside of the hospital. It's also disheartening to really understand how little I know and how wholly incompetent I am, especially on my off service rotations. I used to feel that as a med student, but now I can't walk away from it and use my lack of an MD as an excuse. It's just really draining to have to take care of patients when you don't fully know how to, but the patients and nurses expect you to have attending level knowledge.

I think adding to the stress/depression is that it's hard to talk to my cointerns about it, since they all seem very into EM and are very motivated people especially when they're on their EM rotations, whereas I don't really have that magic feeling when I'm on my EM shifts. And of course I can't talk to faculty about it because they've endured worse in their residencies. It's a lonely feeling.
 

TimesNewRoman

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mostly just not having anytime off to see my family or friends outside of the hospital. It's also disheartening to really understand how little I know and how wholly incompetent I am, especially on my off service rotations. I used to feel that as a med student, but now I can't walk away from it and use my lack of an MD as an excuse. It's just really draining to have to take care of patients when you don't fully know how to, but the patients and nurses expect you to have attending level knowledge.

I think adding to the stress/depression is that it's hard to talk to my cointerns about it, since they all seem very into EM and are very motivated people especially when they're on their EM rotations, whereas I don't really have that magic feeling when I'm on my EM shifts. And of course I can't talk to faculty about it because they've endured worse in their residencies. It's a lonely feeling.
You absolutely can talk to your co-residents and faculty!!

I probably wouldn't talk to the other interns about it because they may have some pride and deny that they felt that way.

Ask an upper level to grab a beer and talk out it.
 

Birdstrike

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You absolutely can talk to your co-residents and faculty!!

I probably wouldn't talk to the other interns about it because they may have some pride and deny that they felt that way.

Ask an upper level to grab a beer and talk out it.
I agree. Everyone feels lost in the beginning. Some just fake the confidence a little better than others. It gets better.
 

Druggernaut

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It's just really draining to have to take care of patients when you don't fully know how to, but the patients and nurses expect you to have attending level knowledge.

I think adding to the stress/depression is that it's hard to talk to my cointerns about it, since they all seem very into EM and are very motivated people especially when they're on their EM rotations, whereas I don't really have that magic feeling when I'm on my EM shifts. And of course I can't talk to faculty about it because they've endured worse in their residencies. It's a lonely feeling.
First, put it out of your head that the nurses expect you to have attending level knowledge. They don't. I'm a daisy-fresh intern too, so maybe I'm not in a place to give advice, but between being off-service, getting to know a new EMR, and getting to know a new hospital, there's a lot of stuff I don't know, medical, procedural, and political. So far I've been getting by asking my seniors and the seasoned nurses questions, always being sure to say please and thank you, and admitting when I don't know and explaining my thought process. Everyone's been cool with that.

I haven't seen much of my co-interns the last few weeks, but whenever I swing down by the ED to do an admission or run into them in the halls, we all laugh about how overwhelmed and stupid we feel. If anyone tells you otherwise 6 weeks into residency, they're either lying or dangerous.

Or maybe I'm wrong and that's just what I tell myself to keep from collapsing in on myself like a dying star. Still works for me.
 

Birdstrike

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I haven't seen much of my co-interns the last few weeks, but whenever I swing down by the ED to do an admission or run into them in the halls, we all laugh about how overwhelmed and stupid we feel.
Lol. That's exactly what you have to do. It goes for life in general, but especially for this time. It also helps to grab a med student, and a pre-med, to tag along with you and teach them something, because why? They know much less than you. Healing powers.

It also helps to remind yourself what many of us want to deny and convince ourselves of otherwise. It really is. Just. A job.

It's a job. Put in your days hours. Go home and do something you enjoy, that's not a job, with someone you like.

Just a job.
 
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frosted_flake

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As an ER tech, I just wanted to thank the ER doctors who take time out of their busy schedule to explain procedures/other aspects of what they are doing (especially for us who are pre-med.)
Any attendings here who worked in EMS prior to working in EM? Are you happy you continued your education?
 

Tenk

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When I first started moonlighting as a third year resident, I actually got somewhat depressed and began to question why I even chose medicine. Malpractice, times, waiting, charts, the chaos.

That's when I spoke to one of the older docs I worked with who was always so bubbly and seemed to really enjoy work.

He told me: "Every time I see a patient, I just try to do what I can to help them and focus on that instead."

I started doing this. It was actually difficult. It's difficult to actively ignore a growing waiting room, charts, metrics, upset patients/staff and constantly smile and be happy and encouraging. It takes a lot of effort at first but the payoff was huge.

I grew to absolutely love my job. My positive attitude made all my staff's attitude better every time I would go to work. I found enjoyment in helping patients. Even from very basic simple things, I just try to help them. In some way shape or form, I go back to that basic principle of why I started this whole career and just help people.

So if you're burnt out with your job or medicine in general. I urge you to just try to focus on the simple act of making someone's life better when they step through your door. Don't focus on WHY they are here at 3 am but instead how YOU can help them in their hour of need. It works, just requires some effort at first to retrain your mind.
 

Angry Birds

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People in other jobs around me are always worried about getting laid off and not finding employment. One of the blessings of EM is that, due to the extreme shortage of EM-trained physicians, there is no shortage of jobs. Even in the most competitive areas of the country, you can still find EM positions with very little work. I interviewed at numerous places recently and knew I could get any of the positions I interviewed at. At many places, you will be offered a sign-on bonus. If you go through a recruiter (not that I necessarily recommend that), you feel like a top athlete looking to see which team to sign with.

You can literally call or email an ED medical director and if they have an opening (which often they do), you can often get an instant interview. How many jobs can you say that about? I say that, from this angle, we count our blessings...since I know some hard-working and bright engineers who have to fight for jobs.
 

dozitgetchahi

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mostly just not having anytime off to see my family or friends outside of the hospital. It's also disheartening to really understand how little I know and how wholly incompetent I am, especially on my off service rotations. I used to feel that as a med student, but now I can't walk away from it and use my lack of an MD as an excuse. It's just really draining to have to take care of patients when you don't fully know how to, but the patients and nurses expect you to have attending level knowledge.

I think adding to the stress/depression is that it's hard to talk to my cointerns about it, since they all seem very into EM and are very motivated people especially when they're on their EM rotations, whereas I don't really have that magic feeling when I'm on my EM shifts. And of course I can't talk to faculty about it because they've endured worse in their residencies. It's a lonely feeling.
When you're off service, think of it like this - 'I don't know as much as these people in terms of this specific topic, but I can actually learn a ****load of stuff from them if I try'. Ask a ton of questions and don't be afraid to look like an idiot. Do I know as much cards (I'm IM) as a cards fellow? No, but if I work hard and ask, ask, ask I'll get that much closer to their level. As you get farther along as a resident, you begin to see these rotations as an opportunity to pick up knowledge rather than something to be afraid of.

Subspecialty housestaff and attendings respond very well to this (usually). Engage them and ask questions about weird situations you've encountered, practice decisions, 'this is what I do - is this what you guys would do?' etc. This is how you get the most out of these rotations.
 

KarlPilkington

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Routine vag bleed turns into... I get to hold pressure on an intravaginal lac with arterial bleeding using ring forceps with surgiseal soaked in thrombin and the side of the speculum. OB was kinda skeptical of my description of the situation. He showed up quick, I moved the forceps over to show him the very pulsatile bleed and he said, yup, never seen that before, let's get her to the OR. From presentation to OB arriving, BP dropped from 130's to 80's and hemoglobin went from 10.5 to 8.4. Good rescucitation with fluids and PRBCs.

Just one of the 'typical complaints' that turns out to be something interesting and a little sphincter tightening. I'm getting the rep of being the OB/Gyn black cloud at this place.
I'm there with you,
Patient came from "bible study"
Was literally bleeding out from a huge vaginal lac/bleed.
GYN was hesitant to come down, but within a minute of seeing the pt they were moving to the OR.
 

engineeredout

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I love the feeling of walking into the room and being the calmest person there. Especially when I'm covering the floors/ICU and something serious comes up. The hospitalists are usually crapping their pants and are more than happy to let somebody else run the show. I guess it comes from knowing I can usually handle most of what comes up. If the person needs their airway managed I can manage (or at least temporize) it. If they get tubed I can manage their vent settings. I can put in the central line, put in the chest tube, drop a blakemore, run a pretty efficient code, and have no shyness about calling whatever specialist I think needs to be here now. Your average internist is not going to do any of those things.

I run towards codes and RRTs because you know what? That is my idea of fun. And excitement. Three years into residency and the excitement is still there; it's the panic that has drastically gone down since I started. Love the adrenaline, and I hope that feeling never goes away.
 

Angry Birds

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I can't find the EMS thread, so I'll post in here, since it's somewhat relevant. Basically, I was sitting on a bench and all of a sudden I hear a loud *womp* next to me. The girl next to me had a syncopal event and banged her head. She then had what I believe were myoclonic jerks. At the time, I thought she might be having a seizure, so I protected her airway, calmed everyone down, and told someone to call 911 for seizure-like activity.

Yeah, that was pretty cool being able to help and just know what I am doing. That's a positive of EM.

The police were pretty nice to me and grateful when I introduced myself. The EMS guy, on the other hand, was kind of a douche. I was just trying to explain to him what I saw, and he was totally ignoring me. He said, "We got a call for a seizure? So, it wasn't a seizure?" I tried to explain to him that the patient had myoclonic jerks, but I don't think he knew what that meant, and also he thought I was some yahoo pretending to be a doctor. Anyways, I quickly told him what I saw, and then said "well, looks like you boys have it from here, so I'll peace out." And then I peaced out.

But yeah, links back to the previous thread: it doesn't seem like EMS really wanted me there at all... even though I tried to make myself as small as possible.
 

Psai

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I can't find the EMS thread, so I'll post in here, since it's somewhat relevant. Basically, I was sitting on a bench and all of a sudden I hear a loud *womp* next to me. The girl next to me had a syncopal event and banged her head. She then had what I believe were myoclonic jerks. At the time, I thought she might be having a seizure, so I protected her airway, calmed everyone down, and told someone to call 911 for seizure-like activity.

Yeah, that was pretty cool being able to help and just know what I am doing. That's a positive of EM.

The police were pretty nice to me and grateful when I introduced myself. The EMS guy, on the other hand, was kind of a douche. I was just trying to explain to him what I saw, and he was totally ignoring me. He said, "We got a call for a seizure? So, it wasn't a seizure?" I tried to explain to him that the patient had myoclonic jerks, but I don't think he knew what that meant, and also he thought I was some yahoo pretending to be a doctor. Anyways, I quickly told him what I saw, and then said "well, looks like you boys have it from here, so I'll peace out." And then I peaced out.

But yeah, links back to the previous thread: it doesn't seem like EMS really wanted me there at all... even though I tried to make myself as small as possible.
It's hard to play doctor when there's a real doctor there
 

shookwell

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I can't find the EMS thread, so I'll post in here, since it's somewhat relevant. Basically, I was sitting on a bench and all of a sudden I hear a loud *womp* next to me. The girl next to me had a syncopal event and banged her head. She then had what I believe were myoclonic jerks. At the time, I thought she might be having a seizure, so I protected her airway, calmed everyone down, and told someone to call 911 for seizure-like activity.

Yeah, that was pretty cool being able to help and just know what I am doing. That's a positive of EM.

The police were pretty nice to me and grateful when I introduced myself. The EMS guy, on the other hand, was kind of a douche. I was just trying to explain to him what I saw, and he was totally ignoring me. He said, "We got a call for a seizure? So, it wasn't a seizure?" I tried to explain to him that the patient had myoclonic jerks, but I don't think he knew what that meant, and also he thought I was some yahoo pretending to be a doctor. Anyways, I quickly told him what I saw, and then said "well, looks like you boys have it from here, so I'll peace out." And then I peaced out.

But yeah, links back to the previous thread: it doesn't seem like EMS really wanted me there at all... even though I tried to make myself as small as possible.
The rules vary by state/region, but here I have an EMS counsel certification which comes with an ID card that means that I have been certified as an EMS doctor in the region, which means that I am the boss and can give orders to any EMS crews in the area.

The few times I have been on the scene of something in the field (when off-duty, not related to my actual job) the EMS crews have been very deferential after I identified myself and called me "sir" and did what I asked them to do.