Pharmacist in the ER

[badxmojo]

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Have any of you guys encountered a pharmacy clinical specialist in the ER? I shadowed one at hopkins... I was wondering how common/uncommon this is. If you did encounter one.. what did you make of it? helpful? unhelpful?
thanks

 

[Seaglass]

We have an ED pharmacy and a Pharm-D on 24/7. They attend all codes, are available in the dept at all times and are very helpful.

If you (as a physician) think you know enough about all manner of meds we use in the ED you are ****ting yourself. They are IMMENSELY helpful for questions about renal dosing, substitutions, cost of meds as an outpt., abx coverage, side effects, etc. Where I went to med school we didn't really have pharmacists but after a month I wouldn't want to go without one.

Wake as an institution makes extensive use of pharmacists. We always hada pharm-d making rounds with us when I was on medicine.

 

[badxmojo]

kool thanks for reply.. very encouraging

 

[peksi]

We also have such an ED clinical pharm. in the ED at Christiana till 10 pm..a great resource from multiple standpoints. (Error reduction, education etc.). All ED medication orders are reviewed by these folks for dose, interactions etc. in addition they can help expidite infrequent treatments suich as antivenom etc. ( probably not a problem in AZ)


Paul

 

[badxmojo]

so how often do you see them making any sort of intervention?

 

[Seaglass]

Lots. They often correct doses or dosing intervals or will inform us of potential drug interactions. It is especially helpful in the ED when the consultant wants you to start something that you haven't used much before. Fortunately in the ED we have our little bag of meds that we use a lot and we're pretty comfortable with them but often we have to use something new.

 

[badxmojo]

have you ever seen them interact with the pateints?

 

[drdrtoledo]

In my former career, I rotated through the ED as a pharm.d. student. It really seemed like most of what we did was look up doses and such. Most of this information is in your PDA or dosing guide... it's probably easier to ask someone than look it up though. We interacted with patients by counselling them on their discharge meds. If someone with asthma presented, we'd investigate how efficient their current therapy was. The most fun was being involved with the OD's and consulting. During codes we'd prep the meds. I was pretty ambivalent about how useful we were. Seriously, most interactions we found were brought up by the hospital computer anyway. It's great to have an extra set of eyes but I just didn't feel like a full time pharm.d. was neccessary. A regular pharmacist filling the orders should suffice. The rounding on the medical floors felt like a different matter... I really felt useless there, but that's just me. Well, anyway, I was so into what everyone else doing that I decided to go to med school... Maxing out the loans baby 😉 !

 

[Seaglass]

Yes they interact with patients to give drug info. Not too often, and I gather they would rather not in most cases.