r/emergencymedicine

Im an ed attending that gets accosted by every hallway patient when going from my desk to my next task. The requests for pillow/blanket, food, results, bathroom from hordes of stretcher zombies Im currently not taking care of take like 15 minutes out of an 8 hour shift. Please share tips and tricks to get people to let me walk to my actual patients in peace.

Young man, recently immigrated from West Africa, brought by siblings for AMS after trying weed gummy for first time (given to him by his American friend).

Patient a bit tachy and hypertensive; obviously anxious, but oriented and without any neuro deficits. Complaining of chest pain, so figure i'd get an EKG and labs incase his "friend" was lying to him about the ingested substance. Give him some oral ativan and turn off the lights; reassure the family.

RN: Doc you want the urine?

Me: Nah, i'm good. He said it was weed gummy. Worst case scenario, he was slipped some meth or cocaine. If EKG/labs are fine, he can go once he's a bit more calm."

*A few minutes later*

RN: Hey doc, you sure you don't want the urine?

Me: ...N...no? No, i'm good. A UDS won't really change anything and i doubt this healthy, young man has a UTI...

*A few minutes later*

RN: Doc, you wanna look at the urine?

Me: ...Sorry, i'm not really into that kind'f stuff....

RN: Doc, i really think you should look at his urine.

Me: [This man better have porphyria or something]. *Sees urine* Oh....well....you know, RN....if you'd just lead with "Hey, Doc, this man just peed out a worm", i'd've been a lot more interested from the get go.

Honestly...i never really expected to have to prescribe praziquantel here in the US... Honestly, i don't even know if our local pharmacies carry it or can get it.

What the hell does this even mean?!?

Like seriously if your paediatrician is ok with it then they are a shitty paediatrician!

I obviously give the usual little spiel about why it matters but there is no point pushing these patients too hard because then they out the child at risk by taking them home too early or not re-attending!

I'm 20M if it's relevant but otherwise, yesterday during a 911 shift, I bought 4 5 hour energies. One for the shift and 3 because I'm a premed college student and need energy to remember the 10 fucking steps of glycolysis and their enzymes. Yeesh.

Yesterday I threw it back like a shot glass and pretty quickly, it felt like someone started an IV on me and pushed propofol through the line. Super quick sleepy feeling, but I chalked it up to getting 6 hours instead of 8. This last night I got 8, did the same thing and threw the bottle back like a shot, and now I am literally fighting to stay awake to write this post.

My heart rate is high, interestingly enough, but I feel sleepy.

Does this happen to anyone else?

I'm going to be as vague as possible.

Comes to the ED for cough, cold, congestion for more than a week. Charge decides to have him treated through the lobby after a clean CXR and COVID swab. Then, phone rings off the hook. Apparently, they are on the board of a famous CA health system and insurance company (I am not in CA). IMS attending, the unit manager, and another provider all ask "why aren't they in a room?! Don't you know who they are?!"

1. No we don't.

2. That doesn't matter. They have simple complaint.

Our charge (bless her) put them in fast track hall bed just to be dispo'd with robitussin-DM. I come with their packet. They are on the phone with the pharmacy, papers still warm from the printer mind you, to be greeted with something a lot of their customers/consumers/ patients deal with with a blind eye and a shrug from the c-suite end, "you have xx insurance? We don't contract with them. Usually you have to go to their pharmacy."

Their reply, "well is it ready?"

"No, and it is over the counter."

"Well, I can pay cash. Can you make it for me?" He takes his packet and all but runs out.

The sweet schadefreude of him seeing what their customers that aren't in the usual network deal with made me giddy. We contract with this company to be an admitting hospital for them, but not a designated center. It causes so much confusion for their patients and many fall through the cracks since they don't have a dedicated hospital.

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The little reading I’ve done on why it failed is the access was hard and the iv infiltrated. If it really was that bad why wouldn’t they just do a central line/IO. The goal is to execute her anyway why does it matter? Also if she goes to the ED is she DNR because of her execution status or is she to be resuscitated and they try again later?

Almost 2 months of constant eye pain and I’m losing hope
Hello everyone. I’m desperate and I really don’t know what to do anymore.

It’s been almost 2 months that my life has felt like a nightmare because of a constant, severe sensation/pain in my right eye. It is there all day, every day, without a single real break. I wake up with it and go to sleep with it. It has completely taken over my life.

The strange thing is that my eye isn’t red, my vision is normal, and doctors haven’t been able to find an obvious cause. I’ve seen 3 different ophthalmologists, and none of them can really explain what is happening.

They haven’t found a foreign body, obvious conjunctivitis, or any clear injury that would explain how severe and constant the symptoms are. I’ve tried so many treatments and eye drops, including STERDEX, LACRYADEX, artificial tears and other medications, but nothing has given me any meaningful relief.

The sensation is extremely intense and constant. I’m struggling to function normally because I can’t escape it for even a few minutes. It’s not just “a little discomfort” — it feels unbearable and it’s exhausting me mentally every single day.
What scares me the most is that nobody seems to know what is causing it. I keep thinking: What if this is permanent? What if I have to live with this for the rest of my life?

I’m honestly terrified and completely exhausted by this situation.

Has anyone here experienced severe constant eye pain/discomfort with a relatively normal eye exam, and eventually found out what was causing it?
I would really appreciate hearing from anyone who has been through something similar and eventually found an explanation or something that actually helped.

Today, I received the last few interview invites needed to hit the number that predicts over a 90% chance of matching.

Now, I fully recognize that nothing is guaranteed (although I am basing this off the previous Match Data), but I’m just so excited to be so close to the finish line.

All the uncertainty of pushing myself to the limit to study and take endless exams throughout the past few years has finally paid off.
I haven’t been this happy in so long and I just need to share it with someone 😭

MS3 here trying to make arguably the biggest life decision yet: specialty choice. I have always liked EM and always pictured EM…. but after hanging out on this sub for awhile, starting to have doubts.

So my biggest question mainly for anyone who has been through residency and practiced as an attending: do you regret your career choice? I know the circadian rhythm sucks. I know the adrenaline wears off. Residency is ass no matter what. But all in all, if you had a chance to do it again…. Would you?

just really want to know if yall are simply venting on Reddit or actually hate this line of work 😭

Hiii! I’m going from outpatient GI surgery (pre/intra/postop) to a Trauma 1 ED with no ED experience and barely any hospital experience (less than a year). To say I’m excited and nervous is an understatement. I’m a quick learner and very determined; I know once I get my footing I’ll thrive. I also know I will start off feeling dumb & that will ultimately help me push myself to my potential. Yet, I can’t help but feel nervous about going from being one of the best where I’m at now to the newest/least experienced at this new place. I want to prepare, but idk how! Any advice? Things I should know or study? Any helpful tips you learned in the ED that you wish you knew sooner? I will greatly appreciate any advice at all!! ❤️ thanks for reading.

What are medicines you prescribe for patient satisfaction bc you have lost the will to live (sarcasm)?

Case: 40M no hx of lung disease presents with URI symptoms x 3 days. Go over negative CXR, clear lung sounds, COVID + swab

Pt asks for an inhaler prescription

I explain why it is not clinically indicated

He accepts the explanation without further fuss

Soon after discharge we get multiple phone calls from family members harassing staff that he didn't get an inhaler

😑

the hills I am willing to die on are sparse and I have grown tired of trying to explain things when really ppl are just looking for quick fixes, it's not worth wasting my time. BUT I'm curious to others approach to these silly expectations. For me, if it has minimal probability of causing harm then fuck it, I'll prescribe anyone tesslon perles, naproxen, Zyrtec, tamiflu, whatever. Considering prescribing primatene inhalers for these non-asthmatics that NEED an inhaler 🤔

ETA: I should clarify, it's not abt stewardship or inhalers, this is spite medicine.

EM resident and absolutely hate consultants at my facility/program. I had a patient with odontogenc deep space infection concerning for ludwigs present some time after extraction with sublingual and submental swelling. Airway intact. Immediately started Unasyn, abx, gave decadron, CT soft tissue neck with IV contrast. I called the ENT service a PA answered and said they don’t deal with that and to contact OMFS. My attending called and asking to speak to the ENT attending who accepted seeing the patient but wanted OMFS for source control. I continue calling OMFS who first weren’t happy with only soft tissue neck even though it got basically head to upper chest without seeing the scans requesting CT max/face then asking if it was a glandular pathology again not looking at the scan and not appreciating the recent dental work. They both work remotely and aren’t on site. She then calls me back saying “oh yeah I see what you’re talking about. Is ENT draining?” I mentioned to her, the fellow, that I wasn’t sure yet as ENTs evaluation was pending because they are also remote but he wanted her on for source control. She then has the hubris to say “I wish I had better communication” … okay dude like me too???? Then she said let me know what their plans are and hung up. I put them in a group chat together and left.

It’s so exhausting, I did my job; Airway assessment, medications, diagnosis, IMU admit for airway monitoring. I’m sorry you’re working remote and that you also have a high census but this is what it is. I spoke to my attending who basically kept it real saying anyone know has to drive to the facility will find anyway to not by punting it to someone else.

I’m partly mad at my naivety for first believing the PA, not getting more information from ENT, and letting the fellow give me an extremely passive aggressive attitude and hanging up in my face. This feels perpetual even with surgical consults that are in house. Appendicitis or SBOs prior to attending evaluation getting punted to medicine only for me to get yelled at.

My feedback today was be more strict with consultants but I always feel like the service I’m contacting are the experts and know best and that they would always do best for the patient. This isn’t universal btw because I’ve gotten to see some really excellent attendings at work from all types of services but find that it’s typically surgical sub specialties that do this. Sorry for the rant??

Hey guys I need help. I am a student in the DFW area currently enrolled in an EMT program and as part of a class project, I need to interview professionals who earned their EMT certification and later advanced to higher-level careers using the knowledge and experience gained from that certification. I was wondering if anyone would be willing to participate in a interview for my project. The interview will be on a Zoom and should be a minimum of 15 minutes. I need someone in the DFW area, someone in Texas but outside of DFW, and someone internationally. Please if you’re willing to do the interview you can comment, message, or email me my email is:

hayleevenado1813@gmail.com