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  1. Thanks for the response. I'm going to shadow the department head who will also be my SP and the one training me, so that should give me a pretty good idea of what it will be like. It's an area of medicine I'm really interested in, so I'm hopeful it will be a good fit.
  2. Basically just curious what the the biggest challenges were from your experience. I don't have experience in sleep medicine, so would be interested in hearing what it was like for you starting off and what the learning curve was like.
  3. I'm interviewing for a position in sleep medicine, and I'm wondering if anyone who has worked in or is currenlty working in sleep medicine could tell me a little bit about what you do and what your experience has been like.
  4. I don't work in EM, but thought that EM PAs would probably be best at answering this. Is IM Toradol contraindicated for patients who take baby aspirin? The interaction checks I have done show that these are contraindicated, but I've seen providers give it to patients on aspirin. And what about warfarin and other anticoagulants? Do you ever give toradol to patients on these drugs? I've seen this done as well. I've never had to actually administer it, but there may come a time when I need to.
  5. I also work in Washington and read this part of the newsletter. It seems that most of the disciplinary actions taken on doctors are related to narcotics and most of the actions taken against PAs are due to personal health issues (probably mental health issues) that make it unsafe for them to practice. I did see a recent disciplinary action taken against a PA for missing testicular torsion in a child. I would think there would be more to the story than just a misdiagnosis, but I guess if the outcome is bad enough from a misdiagnosis then it very well could affect your license.
  6. Thanks, but the National Provider Database doesn't give info to the general public correct? I thought only healthcare facilities had access to that information. I could be wrong.
  7. Other than checking with a state medical board, I'm curious what others here recommend doing to check the records of physicians and other providers they will be working with. Things like disciplinary actions, malpractice claims, etc... Also is there a way to find out all of the states a provider has practiced in other than just asking them directly?
  8. Thanks for the helpful replies.
  9. beattie228 can you point me in the direction of those studies? I have read that irrigating under pressure can force foreign material deeper into the wound. Some sources advocate making an incision to widen the wound and gently irrigating it. I have also read some sources that say not to routinely get x-rays while others do. Every source I've read or listened to says the only evidence for treating puncture wounds is anecdotal and there is no agreed upon method for managing them, so that is why I'm curious what others do.
  10. Can those of you who work in the ER share some of your advice on the management of puncture wounds? There doesn't seem to be any clear consensus on how these wounds are to be managed. Obviously the wounds need to be cleaned and any foreign bodies removed as well as having tetanus updated, but how far do you go with exploring a wound if you are not sure if a foreign body is present? For example, if someone has a puncture wound through the sole of the shoe, and no foreign body is visible and the patient doesn't know how deep the puncture went or if there is any foreign material, what would you do in this scenario? I have heard some people core the wound, and others widen the wound until they are able to see the full length of the puncture. These methods also carry their own risks so I am just curious what those who have experience with this would do. And does anyone ever routinely use ultrasound for searching for foreign bodies in these types of scenarios? Thank you for the help.
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