Maggot infested wounds
Subarachnoid bleeds
Popping abscesses
Renal colic or rupturing aorta?
Frequnt cannabis users who wont stop throwing up and taking cold showers.
Old people who have fallen down and split their head open.
Trauma and car accidents.
Unexplained blood loss.
And some more disturbing things.
These are some of the highlights from the first few weeks. I've enjoyed it until today when I had my first deteriorating patient, and then it became stressful. Fortunately I didn't have to make the decisions and have become reasonably good at putting biggish jelcos in in a hurry. I'm not sure why I used to have issues, I just seem to have engaged the zone now. I've only had one patient properly defeat me on the jelco front recently - and that's because they literally had no veins left after many rounds of chemo.
So what have I learned so far from ED? The teaching has after all been really good.
1. Don't think about what it probably is - rule out all the things that will kill the patient now.
2. If after doing step 1, all the bad things are ruled out. You can confirm your clinical suspicion.
3. Don't jump to conclusions or get stuck thinking about one diagnosis.
4. Don't feel bad when you fail at all three steps prior to this step.
5. ED doctors do a lot more PRs than GPs. I didn't think that was going to be the case, but i've stopped being phased at least.
6. If I had been in charge of patients I would have missed a lot of serious things. Thank goodness I'm still the student.
Although I feel like I'm progressing and my skills are improving. I just feel so amateur and I wonder if I'll ever be good enough to be a real grown-up doctor. Its a very scary prospect.
Subarachnoid bleeds
Popping abscesses
Renal colic or rupturing aorta?
Frequnt cannabis users who wont stop throwing up and taking cold showers.
Old people who have fallen down and split their head open.
Trauma and car accidents.
Unexplained blood loss.
And some more disturbing things.
These are some of the highlights from the first few weeks. I've enjoyed it until today when I had my first deteriorating patient, and then it became stressful. Fortunately I didn't have to make the decisions and have become reasonably good at putting biggish jelcos in in a hurry. I'm not sure why I used to have issues, I just seem to have engaged the zone now. I've only had one patient properly defeat me on the jelco front recently - and that's because they literally had no veins left after many rounds of chemo.
So what have I learned so far from ED? The teaching has after all been really good.
1. Don't think about what it probably is - rule out all the things that will kill the patient now.
2. If after doing step 1, all the bad things are ruled out. You can confirm your clinical suspicion.
3. Don't jump to conclusions or get stuck thinking about one diagnosis.
4. Don't feel bad when you fail at all three steps prior to this step.
5. ED doctors do a lot more PRs than GPs. I didn't think that was going to be the case, but i've stopped being phased at least.
6. If I had been in charge of patients I would have missed a lot of serious things. Thank goodness I'm still the student.
Although I feel like I'm progressing and my skills are improving. I just feel so amateur and I wonder if I'll ever be good enough to be a real grown-up doctor. Its a very scary prospect.
You will be a good doctor. I know this because you are aware of your limitations. Keep slammin' those jelcos in.
ReplyDeleteOh sorry - jinxed you...
I've developed this weird obsession where I constantly check out peoples arms and hands looking for beautiful veins I could jab. Even in normally social situations. It's very weird.
ReplyDeleteIt was nice to see you gracing the hallways of the hospital the other day. Some sagely advice at the end there.
Haha yes I know exactly what you mean. I feel much more relaxed socialising with people with big veins because I know they'll be easier to resuscitate.
ReplyDelete