Emergency Department
signout | January 30, 2008Friday, Thursday, Sunday--when you're working the night shift, they're all just words. Days run into other days and their names become meaningless, signifiers only of times when the mail comes and when it doesn't.
I don't mind working nights for a couple of weeks at a time. There's a kind of camaraderie among the members of the night shift, a smirk we share when we catch each others' eyes in the elevator and the coffee line. We all know that what we are doing is not normal, and in some way prevents us from being completely normal. And, we say with that smirk, it's cool.
When I work nights,…
signout | June 18, 2007The other night, we had three trauma cases come into the pediatric emergency department, almost at the same time. The first to arrive was a boy who'd collapsed and stopped breathing after being hit in the head with a ball during his prep school's baseball practice. Then, in quick succession, came two 14-year old boys who had been shot while visiting a great-aunt. One had been hit in the arm, and one in the neck.
I was in charge of the airway of the kid who'd been shot in the arm. Trembling in his neck collar, blood oozing slowly out of the bullet wound, he eyed the IV catheter a nurse was…
signout | March 6, 2007"He's just a drug seeker." This was my signout from Dr. Dispo, an emergency medicine intern. He was going home, and I was taking over the care of any patients of his that still needed disposition, whether to the inpatient floors, a short-stay unit, the psychiatry department, or home.
This last patient on his list was a "frequent flyer" in our ED, a guy who is in all the time with abdominal pain. He'd been last hospitalized the week before with a suspected small bowel obstruction, and Dr. Dispo was sure he just wanted more painkillers because they got him high. "Just get him out of here," he…
signout | February 26, 2007For weeks, our emergency department (ED) has been "red," meaning that--theoretically, anyway--it is no longer accepting patients. Of course, sick people who come to the door are not turned away. Ambulances, however, are instructed to take patients not requiring high-level trauma services to other emergency departments in the city, and our triage staff works extra hard to redirect people who don't really need emergency care.
The other day, I walked into the main charting area of the ED and smelled pizza. This worried me, as food odors in the emergency department are, more often than not, early…