Questions for you

[whateverbraves2]

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Hello,
I've got some questions for y'all:
1. How many Emergency Thoracotomies have you done before?
2. About how many prisoners do you see?
3. How do you deal with gang related security in your ED?
4. What is your favorite procedure to perform?
5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
6. Do you ever have to yell at specialists?

 

[Apollyon]

Hello,
I've got some questions for y'all:
1. How many Emergency Thoracotomies have you done before?
2. About how many prisoners do you see?
3. How do you deal with gang related security in your ED?
4. What is your favorite procedure to perform?
5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
6. Do you ever have to yell at specialists?

1. Chest tube - I don't know, 20? Crack the chest - zero
2. Zero
3. Don't have an issue
4. Arterial line
5. Yes - virtually every night. Slow department
6. No. Why would I?

 

[EM_Rebuilder]

Hello,
I've got some questions for y'all:
1. How many Emergency Thoracotomies have you done before?
2. About how many prisoners do you see?
3. How do you deal with gang related security in your ED?
4. What is your favorite procedure to perform?
5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
6. Do you ever have to yell at specialists?

1. On my own, zero. I have always been at a trauma center so these are typically directed by Trauma. I have been part of probably 5 in my career...
2. Almost daily, we have the contract with the jail and prison system. I dont mind seeing them; jail people tend to just be beat up, the prison people have the same issues the general public have and tend to be super polite.
3. No issue in my current job; we do have local police department officer stationed in the ED 24/7. During residency, we had metal detectors and pat downs (it was like going on a flight). We dont have to go that far where I am now. Workers did not have to be screened; I understand some places screen everyone.
4. Intubations
5. There are other slow hours as well; its 8AM and I am on FB and SD...browsed craigslist already this AM as well...
6. Rarely.. we deal with residents from other specialties primairly, and every once in a while they need a bit of re-aligning, but all in all, its not been an issue thus far (3 mos).

 

[Tiger26]

1. How many Emergency Thoracotomies have you done before?
Zero

2. About how many prisoners do you see?
Once every few shifts--generally my favorite patients--tend to be really sick and grateful just to be out of jail for a while

3. How do you deal with gang related security in your ED?
Not much of an issue

4. What is your favorite procedure to perform?
Chest tubes, then intubations, then dental blocks

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
5-7 AM

6. Do you ever have to yell at specialists?
Not really

 

[deleted109597]

1. 0. Seen a couple.
2. Do patients brought in by the border patrol count? I guess they're technically incarcerated. So if you take that, then at my one site I probably see 3 per shift, at my other I don't see any. Also, all police blood alcohol tests are done out front and I don't have to see them (unless they got hurt in their car wreck).
3. No real gang issues here.
4. Clicking the discharge patient now button
5. More than just 3-5am.
6. No.

 

[Interpolfanclub]

I'll play.

1. How many Emergency Thoracotomies have you done before?
One, my second month as an attending in community. Did zero at my level 1 trauma center.

2. About how many prisoners do you see?
Loads, we're the only hospital in town.

3. How do you deal with gang related security in your ED?
Lots of security guards. No stationed police but easily available.

4. What is your favorite procedure to perform?
Intubations, anything ortho.

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
Never, we see 55,000 per year and we do single coverage nights. 😱

6. Do you ever have to yell at specialists?
Never ever ever, hospital admin would probably can both parties involved.

 

[jendc08]

1. How many Emergency Thoracotomies have you done before?
None. Saw one in residency.

2. About how many prisoners do you see?
Rarely.

3. How do you deal with gang related security in your ED?
Has not been an issue so far.

4. What is your favorite procedure to perform?
Intubations though not at all as fun as in residency

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
Sadly know. I think we are up to 60k visits a year and also single coverage at night...so all of my nights so far I have been more busy than the day shifts.

6. Do you ever have to yell at specialists?
Definitely not. Not an effective way to deal with people.

 

[dchristismi]

1. How many Emergency Thoracotomies have you done before?
None. Saw several in residency, but I was managing the airway.

2. About how many prisoners do you see?
I only see those in a peri-arrest situation, usually because they're allergic to the silver bracelets. We don't see any prisoners, per se.

3. How do you deal with gang related security in your ED?
Not much of a problem. Now, there was a little old man who shot his little old wife and then himself on one of the floors a couple years ago. We have code silver drills, but pitiful security.

4. What is your favorite procedure to perform?
Nursemaid's elbow reduction. Or nasal foreign body removal. I love intubations, but there is nothing better than pulling that bead out or fixing a kiddo's arm. Instant gratification, and one of the few things I get thanked for.

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
Rarely. Busy shop, and personally, some of the sickest folks I see are during those hours: the chest pain since midnight, the GI bleeder, the COPDeur, all trying to make it until their doctor's office opens, and the witching hour is when they give in. The 0430 STEMI/Code/Hypotensive GI Bleeder-on-coumadin is a running joke when I'm on nights.

6. Do you ever have to yell at specialists?
Nope.

 

[Mighty Mouse]

1. How many Emergency Thoracotomies have you done before?
TWO. WHICH IS ONE MORE THAN I NEEDED TO REALIZE I NEVER WANT TO DO ONE AGAIN

2. About how many prisoners do you see?
ZERO

3. How do you deal with gang related security in your ED?
MULTIPLE ARMED SECURITY GUARDS. METAL DETECTORS. EVEN THE CODING PATIENTS GET A METAL DETECTOR WAND ON THEM BEFORE THEY ENTER RESUS. MY ED IS LIKE FORT KNOX. WALKING TO THE PARKING LOT IS A DIFFERENT STORY

4. What is your favorite procedure to perform?
DENTAL BLOCK. INSTANT PAIN RELIEF FOR THEM, INSTANT GRATIFICATION FOR ME

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
OCCASSIONALLY, BUT I DIDN'T PUT MYSELF THROUGH ALL OF THIS TO SURF THE NET. I CAN DO THAT AT HOME

6. Do you ever have to yell at specialists?
NEVER. SPEAK THEIR LANGUAGE. LEAD WITH THE INFO THEY WANT TO HEAR. BE COURTEOUS AND YOU WON'T NEED TO.

 

[StevieStud]

1. How many Emergency Thoracotomies have you done before?

Two. It was not pretty, it was not fun, and the outcome did not change.


2. About how many prisoners do you see?

Too many. With the exception of the psychiatric patients, every one of them is well behaved and very respectful. Far more so than the general population.



3. How do you deal with gang related security in your ED?

No gangs per se, but gangs are not always the biggest issue even in the bad towns as there is always the ever so slightly drunk, weapon toting, deranged spouse to deal with.

Uncle Leo is at the front door. 1 minute response by his friends is incredble. Fire Dept even comes and brings the popcorn.

Inhouse security will never be found when you need them, but Uncle Leo knows we take care of him when he is in need so the support to us is fantastic.



4. What is your favorite procedure to perform?

well baby checks in the free clinic. I know, I know it is not an ER proceedure, but some of us get out of the ER from time to time.


5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?

😴 yes, it has been known to happen. Sometimes even during daylight hours. Sometimes even while sitting in public view in the little cubicle behind the nurses station.


6. Do you ever have to yell at specialists?

Lets be honest, we are all human. We will make mistakes. At some point you will yell at a specialist (or co-worker) for doing something stupid. Just be prepared to be yelled AT for doing something equally stupid.

If you are being yelled at on a regular basis maybe it is time to do something else. If you are yelling at others on a regular basis maybe it is time to do something else.

 

[dotcb]

1. How many Emergency Thoracotomies have you done before?

3, but I have seen 15+. We do one every 2-4 weeks at current job. Have had 2 in one shift.


2. About how many prisoners do you see?

2-5 per shift


3. How do you deal with gang related security in your ED?

We have PD in ED.


4. What is your favorite procedure to perform?

intubation


5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?

No


6. Do you ever have to yell at specialists?

Yell? No. Speak assertively to consulting residents? Yes.

 

[hothause]

I'd be interested in hear what shops people are at or at least setting/city for people who responded, especially dotcb...

 

[Apollyon]

I'd be interested in hear what shops people are at or at least setting/city for people who responded, especially dotcb...

Honolulu

 

[RustedFox]

This is kinda fun. Senior resident here.

1. How many Emergency Thoracotomies have you done before?

- Zero. Saw one from the head of the bed while I was trying to get the airway. Didn't matter much in the end, and the end was nigh.

2. About how many prisoners do you see?

- Zero, unless you count those that the police bring in. Then, maybe 1 a shift or so.

3. How do you deal with gang related security in your ED?

- Not an issue here.

4. What is your favorite procedure to perform?

- The ultrasound-guided IJ. So simple, yet so... symphonic.

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?

- No way. Single-coverage nights here, too. Senior residents are expected to "run" the show with attending supervision at a distance.

6. Do you ever have to yell at specialists?

- I never yell at anyone on the phone. Its counterproductive. If someone says something dumb, I say something like: "I'm sorry sir/madam... maybe I didn't communicate this to you clearly... but this patient either needs to be admitted now, or later when they come right back and they're worse. I'd rather avoid having to call you later." I let them be as pi$$y as they want; but I never yell.

 

[VienneseWaltz]

Hello,
I've got some questions for y'all:
1. How many Emergency Thoracotomies have you done before?
2. About how many prisoners do you see?
3. How do you deal with gang related security in your ED?
4. What is your favorite procedure to perform?
5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
6. Do you ever have to yell at specialists?

1. Personally performed on cadavers: 3. Personally performed on people: 0. Witnessed: probably 5 or 6, three of whom made it to the OR, one of whom survived the OR and then died in the SICU a few hours later.
2. I see someone from central booking every few shifts; actual inmates go to another facility in my area.
3. Not usually an issue at my hospital. We have hospital security and are getting a police officer posted out front soon.
4. Lumbar puncture
5. Slow hours are 7-9 a.m. usually. Overnight I am single coverage in a busy academic facility. I generally stay off Facebook at work unless it's a very occasional post from my phone.
6. Physicians should never yell at anybody. I occasionally have to give wayward consulting residents gentle guidance (followed up by an e-mail to my boss which eventually gets to their boss). When caught in the middle of a turf war I get both/all attendings on the recorded operator line and progress is miraculously and immediately achieved.

 

[docB]

Hello,
I've got some questions for y'all:
1. How many Emergency Thoracotomies have you done before?
2. About how many prisoners do you see?
3. How do you deal with gang related security in your ED?
4. What is your favorite procedure to perform?
5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
6. Do you ever have to yell at specialists?

Ok. Since everyone else is playing:

1. Two. I think it needs to become a lost art.
2. ~0.5/shift. We see all the county jail and state prisoners.
3. It is ignored. We hope for the best.
4. Signout
5. No. We are pretty busy 24/7.
6. Yes. It never ends well though. It's like arguing with a jackass. It won't make the jackass work harder but it will make it hard for people to tell who is who.

 

[sjdcMD]

Hello,
I've got some questions for y'all:
1. How many Emergency Thoracotomies have you done before?
2. About how many prisoners do you see?
3. How do you deal with gang related security in your ED?
4. What is your favorite procedure to perform?
5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
6. Do you ever have to yell at specialists?

1. Zero - saw one in residency
2. Hardly ever
3. Not a problem here
4. Intubations
5. usually never but sometimes between 4am to 7am
6. once but very rare

 

[Greenbbs]

1. How many Emergency Thoracotomies have you done before?

Personally, 0. Been at the head for 2. Next to a cric, it's a procedure I hope to never, ever do.

2. About how many prisoners do you see?

One every few days. I don't count the drunks or Mental Hygene Arrests though.

3. How do you deal with gang related security in your ED?

Our security guards are bad-asses. They'd bend over and die for us if need be. There's one who looks like Kimbo Slice, and he's about as big too.

4. What is your favorite procedure to perform?

Closed orthopedic reductions are a personal fav, as well as ultrasound guided peripheral IV's. I love knowing I can go in when the nurses fail (which is rarely in my shop), and get the tough IV with the US in a single swoop.

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?

No. I'm in bed. Every night. I don't do any overnights in my ED. Days and evenings only. There are no slow hours at my place.

6. Do you ever have to yell at specialists?

Never, ever, ever yell at a specialist.

(Shop info: Community based tertiary care center with 120k+ volume, Northeast USA)

 

[ALFI]

1. How many Emergency Thoracotomies have you done before?
done 0 but seen a few
2. About how many prisoners do you see?
in one night the RAH had 20 come through in 3hrs

3. How do you deal with gang related security in your ED?
call a code black (personal threat) and sedate the person, put them in hard restraints and call the cops while the rent- a - cops hold a tazer to them.

4. What is your favorite procedure to perform?
the only one i have been shown so far is internal compressions...thats cool, the heart feels like a sack of worms when it goes from empty to full.

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?
my BF has just finished his ED rotation so we used to go down the street and eat, makeout, have quality time together...surgeons hours are hideous.

6. Do you ever have to yell at specialists?
only if they're wrong and i know i'm right 😳) i've yelled at a public health specialist before...he quit his job 2 days later...most men really don't like it when a female is right.

 

[deuist]

1. How many Emergency Thoracotomies have you done before?

zero

2. About how many prisoners do you see?

Every few days we get one. The prisoners from jail are usually nice. The drunks who stop by the ED on their way to jail usually are not.

3. How do you deal with gang related security in your ED?

Never been an issue

4. What is your favorite procedure to perform?

Chest tube placement

5. I know ED slow hours are 3-5 AM. Do you ever have time to just relax, go on Facebook, chat with the others, during this time?

Usually overnight once everyone is tucked in. Never during a day shift.

6. Do you ever have to yell at specialists?

Rarely.