EMEDPA

I was an acls and phthls instructor years ago. I stopped teaching acls in 2001 when they told us we couldn't fail people anymore and they could remediate forever. Nope. Some folks need to fail acls. when you keep defibing folks who are talking to you, you should fail.

Did my ATLS recert yesterday (my 7th) and was asked if I want to be an instructor. I think I am going to do it. If you teach one class/yr for 4 years you get your card recerted automatically and you get paid to teach. The local level 1 trauma ctr is 5 min from my house, so it is very convenient and would save me essentially 200/yr( a 4 yr cert course costs around $800). This is the first year they are allowing PAs/NPs to take the instructor course and teach.

Einstein is solid as well.

yes, you will get more money with a fellowship, but the more important factor is that you will be able to get jobs not generally open to folks with less than a decade of experience. One high quality job in upstate NY posts their infrequent job openings as "residency grad OR 10 years of progressive EM experience, including solo coverage positions with ACLS, ATLS, PALS, and a difficult airway course". I work a really good solo job now and had to go the ten year route and get all the alphabet soup certs. .

Any further info on the off-service rotations? You mentioned trauma. How about anesthesia, ICU, etc?

OR, UT, and ND all have passed significant PA legislation in the last year. Physicians do not have to sign charts and are not responsible for the errors of PAs. Individual hospitals or practices may still require any level of supervision of PAs(or NPs) that they want, but it will no longer be required. HB 3036 removes supervision requirements and chart review for all PAs with 2000 hours of post graduate clinical practice. It also allows PAs to apply for a telehealth license which previously only docs could apply. Lastly PAs will no longer be required to apply for dispensing privileges in Or

they pay the FM docs way less(as they should).

ditto. The FM docs at my shop make $20/hr more than me and the EM docs make double. If it came down to it, I would work for 1/2 my current rate and no physician will work for that.

I assume you tried glucagon at some point for its inotropic potential. Guessing you tried that before epi, etc next option is dialysis, right?

I thought mag gluconate had the best bioavailability with 250 mg equivalent to 400 mg of oxide, but as always I could be wrong about this.

I precept everywhere I work, both at rural and community facilities. The sweet spot seems to be departments of 15-20 beds. You see and do a lot as there are no students, but the volume is reasonable as well. At my rural jobs, some students have great experiences with multiple codes, airway disasters, procedures, etc, while some do very few procedures or see very few critical pts. It just depends on the month. My last student got to participate in both adult and peds codes, but the one before that basically did an urgent care rotation with a few chest pains and chf pts thrown in.

the beauty of single coverage is that they can't drop providers when you only have enough to cover the department to start with. I actually worked more in 2020 than ever before, covering for sick docs and PA partners and when one facility decided not to expose residents to covid.

really? Last time I looked there were almost no jobs in SLO. I love it there. The hot springs there are awesome and the restaurant scene for a small town is top notch. Local vineyards and wineries too....mmmmmm

Y'all are welcome to secede.

alcohol, caffeine, poor diet, diuretics, PPIs, GI issues like gastric bypass/Crohns, etc..... lowest I saw a while ago was a lady with all of these and an undetectable mag level (<0.4 by our lab). She had muscle spasm to the point of involuntary painful contractions at random intervals, fatigue, and aloc. repleted and admitted. was a different person the next day.