"Sphincter-tightening"

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cbrons

cbrons

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Is this an EM-specific saying? Only have heard it used by my EM attendings and on EM podcasts/blogs/websites.

SO far as I can tell it just means "nerve-wracking." Like a situation made them nervous/felt like the other shoe was about to drop etc.
 
cbrons said:
Is this an EM-specific saying? Only have heard it used by my EM attendings and on EM podcasts/blogs/websites.

SO far as I can tell it just means "nerve-wracking." Like a situation made them nervous/felt like the other shoe was about to drop etc.
Click to expand...

It means you didn't have time to poop before the patient came in, and the patient makes you feel like you're going to poop.

Most other specialties get to take a poop break before starting on the next sick patient.
 
cbrons said:
Is this an EM-specific saying? Only have heard it used by my EM attendings and on EM podcasts/blogs/websites.

SO far as I can tell it just means "nerve-wracking." Like a situation made them nervous/felt like the other shoe was about to drop etc.
Click to expand...
No, it's used elsewhere. But I want to recognize you for being possibly the first person in the 15y history of SDN to spell nerve wracking correctly.
 
Nerve-wracking, absolutely. Here is a typical case I would describe as such:

I had a patient the other day who was somewhat stridorous, looked like a grownup with croup. No pulmonary history, no ACE inhibitors, and gradual onset over 4 days.

But... a CT showed a 7mm airway. (Yes, he was more stable that his CT let on, and I'd already tried steroids.) But still, I'm intubating that. Having exhausted all my airway toys, I still needed to call for help from anesthesia, who still gave me the credit after somehow maneuvering the 6-0 tube past the edema "since I already had the glidescope view." The surgeon was poised to trach at a second's notice. And this sphincter-tightening moment was brought to you thanks to the foresight of not using sux. Had I gone with sux, it would have certainly ended with me cricing him.

I think that airway issues are probably the number-one sphincter-tightening events we deal with.
The phrase "pucker-factor" is similar in meaning.
 
It's not even a medicine specific term. Less "nerve-wracking" (as that term could apply to a wide range of situations) and more fear. Probably stems from taking the common experience of "tensing up" when fight-or-flight kicks in to an extreme in combination with fighting your bodies desire to poop itself.
 
cbrons said:
Is this an EM-specific saying? Only have heard it used by my EM attendings and on EM podcasts/blogs/websites.

SO far as I can tell it just means "nerve-wracking." Like a situation made them nervous/felt like the other shoe was about to drop etc.
Click to expand...
Yes. EM only

Except Colorectal has authorization to use the term for obvious reasons, if needed, but has never been known to (also, for obvious reasons).



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Lol


I'm just glad we have a thread that will ultimately devolve into the most efficient way to turn a small piece of coal into a diamond.
 
"sphincter-tightening" is what you attempt to do to avoid becoming "scared ****-less"...
 
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