Random thoughts

Saturday, October 13, 2007

Random thoughts from the ER on a Saturday morning.

Friday night football can make for busy times in the ER. By the time the adrenalin wears off after the game and the aches and pains of major collisions make their presence felt, parents need to make a decision; is it time to see the doc or can we wait it out? Technology exists today which allows physicians to examine patients or to help supervise operations from remote sites. Imagine sitting at home and having a virtually house call. Not quite ready for prime time and for now, the patient and the doctor need to be in the same room and that’s usually in the office or hospital.

People who may have partied too much and are left over from the night shift start to wake up, perhaps a little more sober and wonder where their friends might be. I try to remind them that if they were abandoned, that perhaps their friends weren’t really. The latest campus ad for responsible drinking suggests keeping track of your friends is as important as keeping track of your cell phone.

Surge capacity talks about how many patients a hospital can handle in a major emergency or disaster. Imagine how the doctors and nurses felt when the temperature and humidity skyrocketed in Chicago last weekend. Aside from the “regular” emergency load, the calls came in for potentially hundreds of heat exhausted runners. While controversy abounds as to whether the race organizers were prepared for the worst, the race medical team met the challenge of 300 runners needing significant care. The treatment for most heat related illness requires time to cool the patient and time to rehydrate them with fluids, often using IVs. Major waits occur in ERs when two resources are in short supply: rooms and nurses. When the beds can’t be turned over and when nurses can’t safely add another patient to their load, the waiting room starts to fill up. Nobody is happy in that situation, not the nurses, not the doctor and especially not the patients.

Two long suspensions were handed out by the NHL to Philadelphia Flyer players because of deliberate attempts to injure an opponent. Most recently, Jesse Boulerice took a home run swing with his stick and connected with an unsuspecting Vancouver Canuck. The league’s suspension seems appropriately harsh, but if victims of similar violence arrive in the ER, they are often quickly followed by the police.

With apologies to Abraham Lincoln: you cannot please all of the people, all of the time. I’m thrilled when a patient arrives with potential serious medical problems and I find no disaster. But this thrill is short lived, since some patients are less than satisfied when the good news comes. I’m not certain why. I would think that they would be pleased when I tell them that they don’t need an operation. I guess President Lincoln was right.

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