tag:blogger.com,1999:blog-24021163.post1654815100027460618..comments2024-02-18T01:56:38.508-06:00Comments on M.D.O.D.: Resuscitation docs..911DOChttp://www.blogger.com/profile/06466669111561150174noreply@blogger.comBlogger35125tag:blogger.com,1999:blog-24021163.post-3726605878635210002008-06-01T20:20:00.000-05:002008-06-01T20:20:00.000-05:00Drack..I posted this a few days ago but it never s...Drack..I posted this a few days ago but it never showed..<BR/><BR/>Open chest cardiac massasge was done on every arrest in my EM residency. I got VERY good at cracking a chest..<BR/><BR/>Guess what?? They stayed dead!! Big surprise..See medic above..Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-45807544666144704952008-06-01T00:38:00.000-05:002008-06-01T00:38:00.000-05:00"Here's what the AHA videos suggest. First, you ne..."Here's what the AHA videos suggest. First, you need a denim shirt."<BR/><BR/>Ghetto Medic, you crack me up. Please guest post at my blog!!!EEhttps://www.blogger.com/profile/13697074755915208566noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-34358306295798452302008-05-29T01:48:00.000-05:002008-05-29T01:48:00.000-05:00Hmmm.. To be honest I suppose I would probably ru...Hmmm.. To be honest I suppose I would probably run the code in my ED more because I know all my people and we are used to it as a group. Were the code in the ICU for example and I happened to be up there following up on a guy I admitted I would fully expect the intesivist to take it over.<BR/><BR/>I understand your argument that this is now his patient given that she is admitted, but I wonder if it was unwillingness or not wanting to step on your toes in your turf(though that seems unlikely given my experience, but maybe he's a nice guy).Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-82680689503652557952008-05-28T19:01:00.000-05:002008-05-28T19:01:00.000-05:00I work part time nights (on the side) at a small c...I work part time nights (on the side) at a small community hospital, on the inpatient side. I run my own codes and do all my own intubations. <BR/>Irony is not dead.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-86151992870221101542008-05-28T06:25:00.000-05:002008-05-28T06:25:00.000-05:00Hey Oldfart, when did they take open chest cardiac...Hey Oldfart, when did they take open chest cardiac massage out of the ACLS protocalls? Or was it just "LS" back then? That must have been a blast.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-61672218247280484072008-05-27T20:27:00.000-05:002008-05-27T20:27:00.000-05:00911, YO MAMA!!!911, YO MAMA!!!Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-62256970433493617942008-05-27T19:35:00.000-05:002008-05-27T19:35:00.000-05:00oldfart, glass houses etc...oldfart, <BR/>glass houses etc...911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-34323610002421406892008-05-27T19:30:00.000-05:002008-05-27T19:30:00.000-05:00Anon OB, gracious statement, no problem. Keep rea...Anon OB, gracious statement, no problem. Keep reading us, we are really prety funny most of the time. Maybe we'll need an OB/GYN consultant to the blog.<BR/><BR/>911, U R such a cheap Ho'..Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-23277709331212252192008-05-27T18:36:00.000-05:002008-05-27T18:36:00.000-05:00anon, i likewise must apologize for similar reason...anon, <BR/>i likewise must apologize for similar reasons. as you may or may not know i am desperate to, i don't know, go work at a hot dog stand or something. we are in a hell of a mess in podunkville and, if nothing else, i'm trying to tell as many people as i can that we really face a crisis of immense proportions in medicine... one that, i believe, is not so hard to fix as people would imagine, but, one that, if 'fixed' by any form of centralization, will break us. thanks doc.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-37266648217966299572008-05-27T18:30:00.000-05:002008-05-27T18:30:00.000-05:00Old Fart.Like I said previously...I apologize for ...Old Fart.<BR/>Like I said previously...I apologize for my original comment...just had a few bad call nights lately and had to vent. It was a bit harsh...and did not intend for it to come across how it did. Anyways..keep up the interesting and always entertaining posting.<BR/>-Anon OBAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-40153052810664115692008-05-27T16:57:00.000-05:002008-05-27T16:57:00.000-05:00Hey, I'm just sitting here learning. Watching ya'...Hey, I'm just sitting here learning. Watching ya'll duke it out and watching the dust settle. <BR/><BR/>Rock on Oldfart. But be careful, with that personal info, you're getting easier for Debbie Peel to ID.Amelia Ameshttps://www.blogger.com/profile/17296224743117560163noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-13977699175318405322008-05-27T15:26:00.000-05:002008-05-27T15:26:00.000-05:00uh, oldfart, i didn't know! it can be arranged for...uh, oldfart, i didn't know! it can be arranged for a nominal fee.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-50463937077603904392008-05-27T15:18:00.000-05:002008-05-27T15:18:00.000-05:00Holey Shitt People!! I didn't mean for that to be...Holey Shitt People!! I didn't mean for that to be so rough! I'd rather have 911 fudge packing my ass than start another argument!!<BR/>So my comments:<BR/><BR/>Anon OB, I didn't tout myself as a "guru" of anything! And I'm talking about an INTENSIVIST walking away from a pt he'd written admitting orders on! Just asking if everyone else had the same experiences with SUPPOSEDLY competent docs NOT running codes and backing out the door when we showed up!<BR/>For your OB/Gyn comment. Do have any idea how many vag bleeders we see and dispense with that you <BR/>don't? Fuck Wad! And another "for instance" This weekend, female, bleeding/pain/palbable suprapubic mass/I do US and CT and call our guys who say thanks send her up to me I want to do my own US!!And, yes it's a teaching institution and is in the top 10 in deliveries/yr in the nation, so I think they're pretty good. I was not offended that he wanted his machine/hands/etc. It's pretty much my experience that OB's want to do their OWN US! So Fuck off and climb down from whatever mountain you're on! <BR/><BR/>Ghetto Medic: Chill, go to med school and come be one of my EM Residents.<BR/>And doctors out of the hospital are like fish out of water, we flop around alot and can't accomplish shit. We depend on you pre-hospital guys to "do that thing you do"..Rock on!<BR/><BR/>Julie: Don't ever let a doctor screw around with equipment! We generally don't know what those little lines on the green thingy mean..<BR/><BR/>Rogue: Preachin' to the choir here, Bubba<BR/><BR/>Drackman: That slays me!! Annie didn't get her pulse back!!!<BR/><BR/>To All of you: Our blog is a great coping mechanism for us 6 sick phucks! We can say all the shit we think during a shift, meeting, or lecture. We really aren't here for your education or to criticise others, altho it may seem that way at times I'm sure. We're just trying to "enlighten" a few of you as to what we deal with everyday, some sad, some tragic, some so laughable you guys don't believe us, but every event we've written about is true altho the names have been changed to protect Dr Peel.....So, HTFU!!!Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-41970971056278702472008-05-27T15:04:00.000-05:002008-05-27T15:04:00.000-05:00Anonymous,The ED doctors do not necessarily have t...Anonymous,<BR/><BR/>The ED doctors do not necessarily have to be ACLS certified. ACEP has been trying to discourage ACLS requirements. The requirements for EM board certification go beyond what comes with an ACLS completion card.<BR/><BR/>But, yes, they are supposed to be the experts.Rogue Medichttps://www.blogger.com/profile/07598646309630074992noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-58001621305424263382008-05-27T14:33:00.000-05:002008-05-27T14:33:00.000-05:00I am an ER nurse. Used to be on the "code team" to...I am an ER nurse. Used to be on the "code team" too. Whenever we got called to a code, because I worked at night, usually the only doc there was an ER physician. Now I work during the daylight hours, we have a patient come in who is coding, even id their own physician is there he usually defers to the ER doc. I mean we are the ones who HAVE to be ACLS certified. If I thought someone could do the job better I would defer to him/her too.<BR/><BR/>Now if we could just keep stupid stuff from cramming up the ER. This Memorial Day Weekend has been a killer!!! Some of the staff members lives have been threatened... don't theses folks know that it's a felony to mess with a hospital employee while they're at work?? Dumbasses!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-73028650694414435422008-05-27T12:54:00.000-05:002008-05-27T12:54:00.000-05:00During my Navy time I was tasked to grade the Dent...During my Navy time I was tasked to grade the Dental Clinics cardiac arrest drills. I walk in, throw Resussi-Annie on the waiting room floor, what do the dentists do? Call 911, cause "thats what we always do". Annie didn't get her pulse back either.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-36948893762841752482008-05-27T12:43:00.000-05:002008-05-27T12:43:00.000-05:00The funny thing about codes is that the only thing...The funny thing about codes is that the only thing that has been shown to lead to better survival - leaving the hospital with a functioning brain - is good CPR and defibrillation. <BR/><BR/>No drugs.<BR/><BR/>No tubes.<BR/><BR/>No IVs.<BR/><BR/>Almost anyone can do this well.<BR/><BR/>Part of the problem with codes, both in the hospital and out of the hospital, is too much focus on the "advanced" procedures, and not enough on the basics.<BR/><BR/>Perhaps what should be done by the ED doctors is, make sure the doctor covering the floor stays and runs the code (assuming they are there, if not that could be addressed with the hospital administration), make it clear that you are just observing and offering advice when the doctor strays from the recommended treatment. Perhaps you could hand them a card with the appropriate algorithm on it.<BR/><BR/>If they learn to punt everything to you, things will not change. If they are made to realize that they can do this, they should depend on the ED less.Rogue Medichttps://www.blogger.com/profile/07598646309630074992noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-52385681951175989082008-05-27T11:30:00.000-05:002008-05-27T11:30:00.000-05:00i have doctored on two airline flights. the kits t...i have doctored on two airline flights. the kits the airlines carry, at least 5 years ago, are shit. then the pilot asks you if he has to land. not a small thing... 40,000 to the airline for an emergency landing in the cont. us. one peanut in the nose, and one hypoxic patient who got better with O2. no macgyver'ed trachs yet.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-29007165797320434532008-05-27T11:26:00.000-05:002008-05-27T11:26:00.000-05:00don't get me wrong. i'm not saying we are the only...don't get me wrong. i'm not saying we are the only one's who CAN run codes nor am i saying we are the only ones who SHOULD, i am merely lamenting the fact that as it turns out here and at my previous facility the codes all fell the the ER doc. i think it's wrong and dangerous. <BR/><BR/>and as to the speculation re the authors here i will add this clue, four of us were medical school classmates, i then met the others. we self selected in that regard and sound a lot alike because we were also lovers.911DOChttps://www.blogger.com/profile/06466669111561150174noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-48392850619723642022008-05-27T11:02:00.000-05:002008-05-27T11:02:00.000-05:00Even scarier is seeing what happens when a major e...Even scarier is seeing what happens when a major emergency happens out in the "real world", without the back-up you have inside the hospital.<BR/><BR/>At 35,000 feet, when the flight attendant asks for a doctor and those who respond find out that an ER doctor was silly enough to stand up, the rest just melt away back into the crowd. You can't even find them to be extra hands for doing something, much less making decisions.pediemhttps://www.blogger.com/profile/18062837495328074735noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-77152808623815679692008-05-27T10:55:00.000-05:002008-05-27T10:55:00.000-05:00Well, I've watched a few interventional card's at ...Well, I've watched a few interventional card's at work. I am not sure about the shock factor an EM practitioner is accustomed to.. But most interventional folks are pretty up on their toes, especially if you get hold of a good one.<BR/><BR/>It takes balls to do EM, doc. I admit, but let's be fair here. :)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-44960553355419317562008-05-27T10:26:00.000-05:002008-05-27T10:26:00.000-05:00Holy shit, fartie, this scares the bejabbers out o...Holy shit, fartie, this scares the bejabbers out of me. Note to self: do not get sick. Ever.Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-49849562384889514912008-05-27T10:24:00.000-05:002008-05-27T10:24:00.000-05:00Just wanted to chime in about oxygen gripes, Anony...Just wanted to chime in about oxygen gripes, Anonymous Ghetto Medic. I'm a RN in the ER & the other day I am caring for a patient with COPD and pneumonia on a VM. The admitting resident wants to lower the 02 flow (even though I had already clearly charted that I had tried it and the patient wasn't able to support it). Instead of finding me to do it or reading my nursing note (which of course I just write for my own entertainment), he turns just it down to 4L. So Mr. COPD, how does it feel to have a 40% VM on with 4L of 02 flowing rather than 8L? With sats dropping steadily, the family freaks out and comes to find me while I'm hanging meds for a non-STEMI getting ready for the ICU. I pause for a moment to not-so-kindly remind him that if you are trying to lower the O2 on a VM you have to change the appliance with it...So generally, the rule of thumb is...if you don't know what the hell you're doing, don't pretend you do and make my life more difficult. Stick to writing the orders and communicating with the nurses, Dumb Ass.Juliehttps://www.blogger.com/profile/12392485503763965509noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-27575373245391204882008-05-27T06:45:00.000-05:002008-05-27T06:45:00.000-05:00At our facility, The ED docs respond to all codes....At our facility, The ED docs respond to all codes. In the 19 years at this hospital, first as an RRT and now as an RN, I have seen non-ED docs run maybe 2% of codes. Most recently, it was a Cardiologist...but he showed up after the ED doc intubated.Texhttps://www.blogger.com/profile/12308655409776337095noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-9368577576518651092008-05-27T06:43:00.000-05:002008-05-27T06:43:00.000-05:00Got called to a code as an anesthesia resident, so...Got called to a code as an anesthesia resident, someone had already tried intubating, unsuccessfully, didn't really matter as you said, since his BP was "0"("Planes, Trains, and Automobiles" reference) ICU fellow told me to go get a fiberoptic scope. Kept sticking tubes down the patients throat till one went in. Patient looked like a sword swallower. And the end tidal CO2 indicator often will be negative in a code patient, since you need to have a cardiac output to have end tidal CO2.Anonymousnoreply@blogger.com