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About fuma102

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  1. I've seen that annual PA turnover is about 10% (as of 2011), but this accounts for all PAs. I vaguely recall that "back when I was in PA school" I was told that within two years from graduation, 70% of us will switch jobs. I can not find a link on this. Does anyone have any links / data showing that new PAs change jobs more frequently? Thanks! Patrick
  2. Since we're on the topic of treatments not quite ready for prime time (vaso / steroids...) http://www.ncbi.nlm.nih.gov/pubmed/23743237 1700 pts with VF / VT arrest: prophylacic lidocaine recipients and non-recipients were comparable, except for shorter time to first ROSC and higher systolic blood pressure at ROSC in those receiving lidocaine. After initial ROSC, arrest from VF/VT recurred in 16.7% and from non-shockable arrhythmias in 3.2% of prophylactic lidocaine recipients, 93.5% of whom were admitted to hospital and 62.4% discharged alive, as compared with 37.4%, 7.8%, 84.9% a
  3. No surprise on the poor outcome. in your case, you say medics found pt in asystole and had an unwitnessed arrest. Pt's technically not a candidate for hypothermia based on current ACEP guidelines. http://www.acep.org/News-/Publications/ACEP-News/Focus-On--Therapeutic-Hypothermia-After-Cardiac-Arrest/ "To be eligible for therapeutic hypothermia, patients must meet all of the following criteria: Be an adult successfully resuscitated from witnessed arrest from presumed cardiac cause. Be comatose and intubated. Have an initial rhythm of ventricular fibrillation or nonperfusing ventricu
  4. "surgical and invasive procedures require physician level training. However, technical aspects of certain invasive procedures may be performed by appropriately trained, licensed or certified, credentialed non-physicians under direct and/or personal supervision of a physician who possesses appropriate training and privileges in the performance of the procedure being supervised, and in compliance with local, state, and federal regulations. Invasive procedures employing radiologic imaging are within the practice of medicine and should be performed only by physicians with appropriate training
  5. ortho - learn to splint / reduce / suture cards - learn ekgs and, if youre lucky, bedside sono Geri- depends on location. if inpatient, you can probably see / absorb alot and see "the hard discussions" Derm / Neuro - derm for the steroid classes & suturing & I&Ds (you have to get the cyst OUT for the sebaceous cyst to not grow back!) Neuro for subtle exam findings that may be helpful in the ED.
  6. Not true! If youre lazy and want to be in 1199 or in HHC and get great benefits for doing nothing, its a great place to be!
  7. eventually, the ED is going to be discharging PEs that have no strain on bedside sono, is not hypoxic and not making trops. others will go to IR for thrombolytics --> obs for a day or two --> discharged. For us, most DVTs go home unless theyre large enough clots to be fetched or a candidate for thrombolytics or someone with no PMD who needs a bridge in house.
  8. typically youre not a net positive for the group until after 2 years. Asking for a cut up front in your first year is silly - you have no leverage and no experience. Ask for escalating increases, and get it in writing. Friend got a derm job about 8 years ago. **VERY** busy office- we're talking she clocks 80 patients in an 8 hour day, if not more. The doc routinely hits 120. First year, 75K. Second year 80K. Third year, 80K + 10% over 300K. fourth yr 80k + 20% fifth year 80k+ 30%. max of 40%. She hits 300k in collections within 3-4 months. I dont know about the rest of
  9. its part of our offering for sexual assault. I'd be surprised if an ED didnt offer it. Then again, many of our clients that "request" Plan B - not as part of a sexual assault - are a bit off the rocker.
  10. When does the chart cloning issue begin affecting repayments (or has it already?) What exactly is considered a cloned chart? For our bread & butter (sore throat, ankle sprain, HA, vag bleed, kidney stones...), the ROS / PE is quite similar. Any word on exactly what the thresholds are, and if this affects RVU based compensation?
  11. Its good to have a sepsis discussion based on this (extremely out of the ordinary & unfortunate) case. We here in NYC are more than a bit upset the physician's name was published in the original article. Thankfully it wasnt a PA that this happened to for our sake. In sepsis though, its lactate, lactate, IVC sono, lactate. wbc elevation doesnt bother us, and normal vitals dont mean much if they present with a lactate >4 - they go to a unit. Im more scared of a lactate of 8 than a wbc of 38. we have been housing our ICU patients for HOURS and if theyre in the ED, its ED managem
  12. still, the question is- if youre staying late, are you asking your boss for extra cash? Why or why not? If youre in fast track, macro's are your friend (though Im hearing macros are going to be dissolved on many systems to not raise a red flag for billing?). For a twisted ankle, sore throat... its pretty mindless charting, no? the rule outs are slim, litigation low, I dont really bother myself too much with these charts. I know that patient flow is endless, but why are you killing yourself and staying late if youre not getting paid? Now the septic gome on the other hand.... in
  13. EmedPA brings up a good point, one I see way too often in our ED. Folks commonly stay late to review scribe notes, sign charts, review documentation, whatever. Do you charge for this? There is absolutely no reason to not document as you go along, write in reassessments in real time for medico-legal issues (ahem, abd reassessments, pt c/o CP radiating to back - so repeat ekg ordered / sent for uberSTAT CT / lipase added, etc). Its a system dependent thing, some EMRs are tortuous to deal with. But if you stay late to document and you've been in fast track- you have no excuse for not
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