Tips and Tricks we've been told by attendings

[IMG69]

I thought it would be nice to create a thread of tips and tricks we've learned from our attendings on rotations.

I'll start, my ED attending said she's been getting a lot of malingering especially with covid and they often 'present' with acute abdo pain. She said when you suspect this might be the case accidentally knock the bed a little with your hip and see if the patient has pain this is just before you officially examine them. She said it's always easy for them to fake it during an abdo exam (which is true). I thought this was so simple yet pretty effective.

Have you guys been told any tips like the above?

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[WheezyBaby]

That's only really a sign for peritonitis FYI. Plenty of legitimate abd pain presents without

 

[IMG69]

That's only really a sign for peritonitis FYI. Plenty of legitimate abd pain presents without

I know but she only does this for suspected cases of malingering which I guess after 30 years you develop an eye for.

 

[calivianya]

An attending I worked with always drops central lines in the left IJ instead of the right, especially if the patient has CKD or was hypotensive on presentation. It leaves the right IJ open for a dialysis cath, which do better in the right IJ than the left because they’re not nearly as flexible as regular central lines.

I really appreciated that since my school always focused on inserting them on the right, which is silly now that I think about it.