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Everything posted by medic25

  1. CT here; our volume has been way down. Main ED typically had 95-110 patients on the board all winter long during the day; lately it’s been been 30-40. COVID numbers definitely growing, but everyone else has been staying away. Sent from my iPhone using Tapatalk
  2. Got my P100 respirator today; fallback in case we get to the point of needing bags of leaves in the ED...
  3. Holding out until the last minute before my next shift, but I'll be saying goodbye to my beard this week as well; wish I could just sell them on giving me a PAPR instead...
  4. Must be nice to have testing readily available. We still can't test anyone who isn't being admitted, and need to jump through a host of hoops with public health to even try and make this happen. I've had colleagues in the ED with high-risk patients who were denied testing by the health department. We should have been prepared for this is a nation well before now, but instead we are scrambling to catch-up.
  5. Yes, they had agreed to refunding anyone who had to cancel due to a travel ban. Now that the conference is cancelled it’s a moot point; everyone is getting refunded. Sent from my iPhone using Tapatalk
  6. Yes for us; I had to cancel attending the SEMPA Conference next week, along with a group of our other PAs.
  7. Can't speak to it personally, but I know that they are out there. My health system has two PAs who serve as Medical Informatics Officers
  8. Always the big question I've heard; then what? Even if you clamp the aorta and stop the loss, are you putting them on a chopper with an open chest and no perfusion below the clamp? I could see an argument for it in a stab wound, tamponade on echo and lost pulses in front of you... maybe you get lucky and have a single puncture in the heart you can close. Besides the cost of equipment, I think it's also important to consider the risk of bloodborne pathogen exposure and the impact on the rest of the department if the odds of a successful resuscitation are close to zero.
  9. Off-topic, but wondering your thoughts on the risk/benefit of a thoracotomy in a resource-limited setting? Unless you have surgical backup arriving extremely quickly (I'm guessing a challenge in a solo provider rural ER), what are you gaining that can't be done with an ultrasound probe on the heart and a couple of chest tubes?
  10. Agreed; between the two organizations, AAEM has always been the more anti-PA or NP organization. The recently updated their position statement on APPs, and at the same time dissolved their "allied health" membership category that had allowed for APPs to join, feeling that it was against their philosophy to allow non-physicians to be a part of the organization.
  11. Another Nebraska alum here; overall had a very good experience with them. Mine was over a decade ago so I'm sure the process had changed significantly now but it wasn't a terrible workload; for comparison I completed my MBA last year and found it to be much more rigorous in terms of coursework and assignments.
  12. It's a pretty famous children's hospital here on the East Coast; have to say I didn't give it a second thought when I heard CHOP! No worse than saying UCLA Medical Center instead of University of California, Los Angeles Medical Center...
  13. Agree with Kargiver; we served on the board together and there were certainly ups and downs in terms of amount of time needed. Get a sense of how much of the time can be done remotely through email and conference calls vs. meeting in person; the travel commitment can be a big one depending on the organization, and your responsibilities at home.
  14. The thought is that we can reduce the need for patients physically returning for things like wound checks and hopefully cut down on bounce backs and re-admissions if we can check in on some higher-risk patients. Not sure how the billing will work; above my pay grade I'm afraid...
  15. Anyone who has experience with seeing patients virtually in a telemedicine setting have tips or advice? Our ED is running a pilot project doing follow-up visits with ED patients using video visits. I can definitely see challenges to the loss of hands on examination, access to vital signs, etc.; love to get some advice on how to get the most benefit from the trial.
  16. I've had to do the same education with topical lidocaine jelly for NG tubes with our nurses. They'll use it as the lubricant for inserting the tube and think that the local is ineffective; once I told them to have the patient snort the jelly then wait 20 minutes, all of a sudden NG tubes are amazingly much more comfortable!
  17. The article did mention he was enrolled in the ZMapp trial, but was randomized to the control arm so didn't receive the medication.
  18. We had a physician from Liberia present grand rounds for us a couple of years ago who shared his story of surviving Ebola. He credited the PA who cared for him as the one who saved him; Liberia has a large number of PAs in their health system, and several died during the last large outbreak. Sent from my iPhone using Tapatalk
  19. The 1998 Aviation Medical Assistance Act is supposed to provide coverage that is even stronger than most Good Samaritan laws. Here's a quote from the law: An individual shall not be liable for damages in any action brought in a Federal or State court arising out of the acts or omissions of the individual in providing or attempting to provide assistance in the case of an in-flight medical emergency unless the individual, while rendering such assistance, is guilty of gross negligence or willful misconduct.
  20. No, went old school and whipped him over to CT right away. Sent from my iPhone using Tapatalk
  21. Recently had an elderly patient with "abdominal bloating" after eating a burger, triaged as an ESI Level 4. Markedly hypertensive at triage, past surgical hx of a AAA repair. I'll let you guess what his diagnosis was....
  22. Nah, it always matters what you think I definitely don't want to downplay the importance of serial exams, especially in abdominal complaints; just saying that they may not always change much of the care plan. In the patient with appendicitis on CT, they'll be getting antibiotics and a surgical consult regardless of what my repeat exam shows, then the surgeon will again push on their abdomen when they see them. If I don't have a specific clinical question to address, it's not unreasonable to defer the repeat exam at times and spare the patient some additional discomfort.
  23. Pretty common in our department as well. We all carry hospital-issued iPhone's, so if the consultant is quick with their callback you are often in the room with the patient giving them an update. I don't think it's always a guaranteed that at patient will need another abdominal exam 90 minutes after the initial exam. If the patient the patient had RLQ tenderness and has CT-documented appendicitis, they will still need to see the surgeon regardless of the repeat exam; in some situations it's just more likely to inflict more discomfort without adding much to the clinical management.
  24. Is it a possibility to stay on as a casual employee while in PA school? We've have several ER techs go back to school and come back to be hired as PAs; by staying with the hospital while in school they maintained their seniority within the health system.
  25. Paramedic practitioners have already been a part of the health system of other countries for several years, including the UK and Australia. They are to the best of my knowledge prepared at the Masters level, and primarily work in ED's, EMS and some primary care settings. Here in the US we have no structure set up yet for educational requirements, and importantly billing reimbursement (not really an issue in the NHS). It is an uphill battle nationally getting American EMS agencies to pay traditional paramedics a living wage; without a mechanism to improve reimbursement for paramedic practitioners I wouldn't anticipate a huge rush to adopt this level of training if the medic will get a Masters degree and still be lucky to make $20/hour. I don't know if community paramedicine is driving the Missouri efforts or if there is someone else leading it; just sharing some info about how other countries are structured. Here's a video highlighting a paramedic practitioner in the UK: https://www.emsworld.com/video/12106357/u-k-reporter-spends-24-hours-with-nhs-paramedic-practitioner
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