How often do EM residents/attendings deal with cardiac arrests?

[spartanracer21]

Just wondering - how often do EM doctors need to deal with cardiac arrests and go through all of ACLS?

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[WilcoWorld]

I've never gone "through all of ACLS" in a single case. Because ACLS covers a broad range of pathologies.

How often do I run a full arrest code? Several times a year, but probably not every month.
How often do I have to apply principles related to ACLS? Every shift.

 

[OnlyOneZlatan]

As often as someone comes to their ED with a cardiac arrest? What kind of question is this?

 

[spartanracer21]

As often as someone comes to their ED with a cardiac arrest? What kind of question is this?

No kidding every-time they come into the ED... what a genius that's a podiatry student. I guess this is something you'll never deal with. Maybe you can treat my bunion?
I'm wondering HOW OFTEN ON AVERAGE DO THE DOCS SEE things like this - ex once a week, once a month etc?

 

[OnlyOneZlatan]

No kidding every-time they come into the ED... what a genius that's a podiatry student. I guess this is something you'll never deal with. Maybe you can treat my bunion?
I'm wondering HOW OFTEN ON AVERAGE DO THE DOCS SEE things like this - ex once a week, once a month etc?

I thought I had made a mistake about understanding your question because the previous response was towards using the entirety of ACLS, but no, you asked how often the ED residents and attendings will see cardiac arrests. Did you expect people to give anecdotes and then argue over their number?

 

[Rekt]

No kidding every-time they come into the ED... what a genius that's a podiatry student. I guess this is something you'll never deal with. Maybe you can treat my bunion?
I'm wondering HOW OFTEN ON AVERAGE DO THE DOCS SEE things like this - ex once a week, once a month etc?

Bro calm down.

It's going to hugely vary between different facilities, locations, and different shifts. Some places split docs by acuity, etc. Also, are the EM guys covering in-house codes? All the time, part of the time?

 

[spartanracer21]

Nope just argue over ignorant and naive responses from people who are not even physicians... ie podiatrists and podiatry students...

 

[gutonc]

You're really starting off on the right foot here. Keep up the good work.

 

[brk81144]

Once every 2-3 months has been my community expierience since residency but the type of facility will dictate this. We are a level 3 er with daytime cath only so we don't get codes via ems. Usually it's a family member bringing them in or they code just after arriving

 

[spartanracer21]

View attachment 214324
I thought I had made a mistake about understanding your question because the previous response was towards using the entirety of ACLS, but no, you asked how often the ED residents and attendings will see cardiac arrests. Did you expect people to give anecdotes and then argue over their number?

You're really starting off on the right foot here. Keep up the good work.

nice pun there... starting off on the right foot

 

[BoardingDoc]

Nope just argue over ignorant and naive responses from people who are not even physicians... ie podiatrists and podiatry students...

To answer your question: depends on the site entirely. My main site I run maybe 1 every other month. Some of my community sites I run 2-4 a month.
To address your short but incredibly inflammatory post history: Try to relax.

 

[da8s0859q]

To address your short but incredibly inflammatory post history: Try to relax.

Seriously. Good lord.

 

[spartanracer21]

so what would you say is the most common serious ailment seen in the ED?

 

[WilcoWorld]

I think we should cut the OP some slack. S/he didn't get angry until someone gave a sarcastic response and ridiculed (what seemed to me) a sensible question.

 

[RustedFox]

I run a code on a cardiac arrest approximately once every ten shifts - either EMS rolls in with a code in progress, or I respond to a "code blue" on the floor.

 

[deleted547339]

I think we should cut the OP some slack. S/he didn't get angry until someone gave a sarcastic response and ridiculed (what seemed to me) a sensible question.

You must be new here, lol.

 

[Tenk]

so what would you say is the most common serious ailment seen in the ED?

For most places probably cardiac, CVA, and infection. Trauma could top all those depending on where you work or it could also be very rare.

 

[TheComebacKid]

As a resident I see on average 1-2 cardiac arrests every shift when I'm working in our "high acuity" pod. There were several shifts when I saw multiple. I have yet to work a shift in that pod without a level 1 trauma activation (GSW, MVC etc).

Because I work at a very busy level 1 trauma center that has a huge catchment area that is relatively resource poor, I get to see a fair amount of this pathology. That being said, when I work in the "lower acuity" the most common diagnosis on my chart is "homelessness" and "sandwich seeker". It's also in this pod I've been burned with patients who have "chest pain" but feel "alright and ready to go" and end up having a submassive PE, a pretty important diagnosis.

I think the point is that the number of cardiac arrests/traumas gets diluted out when you take into account all the lower acuity stuff I see in the ED. That being said, the vast majority of residency training programs are probably at centers that have decent acuity and most EM residents will see more than their share. Once you go out to practice, it's very dependent on your location, how large your facility is, whether they are a STEMI center/cath lab equipped, how many other ED's are you in your area etc.

 

[alpinism]

We average about 1-2 codes per shift. Most commonly from drug overdoses.

When I was in South Africa we'd average anywhere from 6-12 codes per shift. Most commonly from gunshot wounds.

 

[shoal007]

EMS codes in the field at my site. no ROSC then they dont come to the ED unless I tell them so. I see one every couple months.

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[dchristismi]

I had 2 codes in the span of 30 minutes yesterday...

 

[carbonizedeyesockets]

Just in my time in residency, codes brought in by EMS have become rarer and med command calls to pronounce in the field have gone up.

Generally, there is no demonstrable benefit to transporting (medical) cardiac arrest patients with CPR in progress.

Anyhow, just three years ago it seemed I saw a medical arrest via EMS 1-2 times per week. Now it's about 1 per month. Medical patients coding after brought in alive is a couple times per year. Trauma arrests are hit/miss; anywhere from 2 in a shift (usually within minutes of each other) to nothing in a month.

At one community site, due to a high rate of IV drug use, we see a lot of young codes. I had 3 or 4 on the last block there.

My assumption is that in residency, your experience with working codes will be inversely proportional to how good the local EMS is. A lot of EMS' do not transport unless they get ROSC, or under very specific (and relatively rare) circumstances.

 

[engineeredout]

No kidding every-time they come into the ED... what a genius that's a podiatry student. I guess this is something you'll never deal with. Maybe you can treat my bunion?
I'm wondering HOW OFTEN ON AVERAGE DO THE DOCS SEE things like this - ex once a week, once a month etc?

 

[Old_Mil]

Just wondering - how often do EM doctors need to deal with cardiac arrests and go through all of ACLS?

It depends where you go. One of the dangers of going to a multiple hospital town is that the facilities may end up specializing. During my residency there was a shake up in the way the cards group was structured in town resulting in almost all the cardiac cases being taken by EMS to a competing facility and the number of chest pains we saw went through the floor. I don't think I saw a single arrest in the last eight months of residency. Not that it matters much - ACLS isn't hard, and the PEA/Asystole branch is almost never successful at accomplishing anything and I had already seen what I needed to see (but I wouldn't have wanted to be an intern that year...)