Psychiatry presentations comprise about 5-6% of total presentations,1,2 but account for way more work. It’s a common mis-perception that psych patients require a one-hour intensive interview in order to ascertain what they need. Not true. We got an inservice from one of our psychiatry faculty today. He allowed me to share his pearls on evaluating psych patients with the most important parts of a history that can be done in 15 minutes: The …
Elusive OMSS The Definitive Medical Explanation
After having seen several cases I thought that this was important enough to share. [Can’t believe that this hasn’t been published in a major journal]. Below I describe the pathophysiology and teleology and then finish up with two cases from recent memory. Introduction: “did you see grandpa pick up that keg of beer?” …”Yeah he has sick old man strength” Ever heard of an Old Timer displaying an inordinate amount of strength for …
Acknowledging Death in the ER
Picture the following: A resuscitation is in progress for an elderly gentleman. Health care providers try frantically to restore signs of life. Chest compressions are ongoing, a breathing tube is placed, large intravenous line inserted, electrical shocks and medications given. Eventually the team realizes that they have exhausted all possibilities. To do more would be futile. The team leader “calls the code”. People mill away … one resident chides another about stealing her …
Uphill both ways … in my dad’s pyjamas!
Imagine being at a conference where 1 in 3 attendees are depressed and 1 in 5 wish they were somewhere else … fun conference? I was reflecting on my residency when I wished that an attending would have stuck up for me just once when I was getting abused – three particular nurses, two residents and one physician stand out. I made a promise never to let that happen in front of me. …
This Just in! BIBEMS suppositorium stat! [LOL]
My good friend and colleague Mark Wahba [read his brilliant ideas here]gave a talk at half day … he referred to a patient as a “BIBEM“. … I am thinking ” what’s a BIBEM? [as in Justin Bieber]” – NO! … turns out that this stands for Brought In By EMS. Later that night I was charting “No ROS; Note S/S Infxn and RTER; Scar teaching √” These are what we call “Acronyms” …
… — … LWBS …—… ER inpatients …—… EMS park …—… Overcapacity
We had our inaugural residency retreat last month! Our guest speaker was Dr Paul Parks – a humble affable family man and Emergency Physician who was unwittingly thrust into the public eye after Emails were leaked documenting failures in the Alberta Health Care system resulting in ER “suboptimal outcomes”. Dr Parks and colleagues documented what they felt were deleterious outcomes in patients in the waiting room of the University of Alberta Hospital …