29 September 2009
19 September 2009
13 September 2009
I am training to be an Emergency Medicine physician, but sometimes I wonder how I would do in an actual emergency. I mean, I can run a trauma or cardiac arrest code without much problem on my own turf. But, how would I hand a situation at 36,000 feet?
Obviously, most of us won’t be faced with a situation like Wallace who relieved a tension pneumothorax with a wire hanger, a catheter and a bottle of brandy. However, I would like to think I could handle something reasonably simple. A bump on the head from a piece of falling luggage?
The British Medical Journal in 2000 ran an article listing the top 10 medical emergencies as: chest pain, collapse, asthma, head injury, psychiatric problems, abdominal problems, diabetes, allergic reactions, and OB-Gyn emergencies. Since 1986, most airlines carry an AED, and most also carry oxygen and some basic medical supplies. A study in 2008 by USA Today stated that three overseas airlines and only one US airline seem to do more than carry the minimum medical equipment.
Of course, I didn’t think about what could potential be in this particular aircraft’s safety kit as I sat watching the other passengers start to board the airplane: the morbidly obese person who was wiping sweat off their face as they hurried aboard, the obviously pregnant woman who was pacing around the waiting area, the barrel-chested passenger who looked as if they couldn’t wait to land to be able to pull out their cigarette pack and take their next drag, the laughing out loud been-at-the-airport-bar-during-their-layover pair, and the other 50 or so ticking time bombs of potentially unknown medical problems.
Armed with my medical knowledge and last year’s ACEP presentation “101 Uses for a Safety Pin and Duct Tape” I boarded, thinking in my head, “Surely you can’t be serious?” “I am serious, and don’t call me Shirley.”
05 September 2009
They make lots of noise.
And the firemen inside are always nice.
I probably wrote a poem similar to this when I was in first grade, and our class visited the fire house located right next door to our grade school. I thought it was cool that the firemen got to live in a big house and had a pole to slide down. Plus, they helped people, and I thought that was the best thing of all; helping people. Because that's what it's all about!
Today myself and a group of residents spent the day with the gentlemen of BNIA (Buffalo Niagara International Airport) Fire and Rescue. Along with learning about their day to day operations, it was nice to become familiar with some of the people we work with. As part of our EMS and SMART responsibilities, we respond to airport alerts. These get sent out whenever a plane is having a problem, mechanical usually. Code 1 is for less than 5 passengers. Code 2 is for more than 5 passengers, Code 3 is plane down. We had one Code 3 last year which everyone has heard about. No more of those please.
Here are some pics from the day, enjoy! And wave at your local firemen when they go by!
04 September 2009
One of the thoughts that came to me last night as I was walking the empty hallways of the hospital is how eerie a familiar place can suddenly seem. We occasionally have to leave the E.D. which is located in the basement of the hospital and go up to the second floor to inject a patient who is getting a CT scan with IV contrast. We do this because there is a small possibility that the IV line will infiltrate, or spill its contents into the surrounding skin, during the injection phase of the scan. This is bad. You can get a very nasty skin necrosis with this.
During the day, there are plenty of radiologists around to do the injection, but in the middle of the night, there's only a radiology tech running the scanner, so we get called up. As I walked the empty hallway heading toward the back of the radiology department, I started wondering about all those scenes in horror movies. You know, the one where the unsuspecting person is casually walking along when the scary music starts playing. There might be a sudden soft squeak. Or the sound of a breath. The person stops and looks around. Then walks a little more quickly. The music begins to rise. The person starts to walk faster. That kind of a thing.
I guess I was thinking of scary stuff because we'd had a patient come in with their own little stuff of horror movies. Seems the patient had been sleeping when they felt something near their ear. In their sleep they reached out and felt something warm and furry. They suddenly woke and grabbed it with two hands and ran to the bathroom.
They called out to their father sleeping in the next room. When he turned the light on, the patient realized they were holding a live bat in their hands! The father shot the bat with a BB gun, and they came into the E.D. with the bat in a baggie. The patient needed to start on rabies vaccinations because the bat had actually scratched their ear.
The bat was placed on ice in a container for the Health Department to come and pick up. One of the clerks called it her "pet" since it spent the majority of the morning sitting on her desk, and she had to keep renewing the ice supply. We had quite a laugh at sign out, and everyone had to go look at the bat.
I tell you, we can't make this stuff up...
p.s. a shout-out to one of our attendings, Dr. Jehle (yay-lah) who made the local media following a multi-car pile-up. I was at the General that night so my buddies at the County and Children's suffered through the multiple traumas.