|
Its Halloween season, so pull out your scary mask and Grim Reaper outfit. It's time to take the kids out to trick-or-treat and restock that cupboard with candy. I always liked Halloween, partly because it starts the holiday season, but also because it's a free for all on the candy hoarding. It's the one day when my kids can get candy and – since I take them out – I get the "finders' fee" (AKA some of their candy). A win-win situation for everyone!
 As an ode to Halloween, let's talk about our scariest medical moments. Post your responses on the PRESENT eTalk and let's compare scary moments.
Hopefully for most of us in the podiatric profession, the very scariest moments are experienced by others. For example, most of us have heard the statement about anesthesia: its 99% boredom and 1% pure terror. Personally, I'm not wild about those odds. Think about the stories trauma surgeons and vascular surgeons must have. One can only imagine the rating on the "scary scale" of a patient with a ruptured abdominal aortic aneurysm.
Luckily for me, I've not had any terribly scary moments on the operating table – knock on a giant tree of wood. I have had two nerve-wracking moments in the ER, both of which occurred during my ER rotation as a very green resident.
It was a Sunday morning, and it was a bit slower than normal (my hospital's ER was usually quite busy). I happened to be standing around without a patient when the doors of the ambulance bay burst open and a bunch of people surrounding a gurney came rushing in to one of the trauma bays.
My attending ER physician that day – an absolutely fabulous doctor and excellent teacher – looked my way
"Come over here and help us run this code."
I looked behind me – no one there. "Uh oh. He means me!", I thought, just before he yelled again for me to come over.
An elderly lady was having an MI and went into asystole just as the ambulance was arriving at the hospital.
I ran over – my own heart pounding like mad – and, at his command, started chest compressions. I was trained on basic life support, like all other healthcare workers, so was reasonably comfortable with this (as comfortable as one could be in this novel situation). Today, our podiatric students and residents are trained in both basic life support and advanced cardiac life support. This just goes to show the improvements in our training.
Our code team worked on the patient for some time, but, sadly, she expired. It was with a heavy heart that I stopped compressions, and the attending called the patient's time of death. It was a very sad end to a scary and exhilarating moment in my training.
My second situation was less serious, though was just as nerve wracking in its own way.
As a trainee, I made it my ER rotation motto to take any case that came in – podiatric or not. At the time, my alma mater's ER was set up with a clipboard system. After patients completed their initial triage and intake, they were roomed, and the clipboard was placed on a standing file near the charge nurse's desk. Some residents would try to pick and choose their cases, disappearing somewhere until the next interesting case up. I took a slightly different tact. I went in a rigid order, taking whatever was the next patient clipboard, regardless of the chief complaint.
That turned out to be my undoing...
At this particular moment, the next case happened to be a young lady with pelvic pain. Up to this point in my training, I had done exactly ZERO pelvic examinations. Now, my students at Western University are trained in their Essentials of Clinical Medicine class to do these types of exams, so at least they are prepared. Yes, I'm telling you my podiatry students are trained to do pelvic exams. That's the kind of quality education modern podiatric trainees get.
Ok, back to me...
Pelvic exam. Uh oh. Heart rate starts picking up a bit. I felt that, before going in to meet my new patient, it would be ethical to let my resident know that I hadn't done this type of procedure before.
"That's OK," he said. "Go for it. You'll be fine. Come and get me when you're done."
Not being especially comfortable with that attitude, I dutifully went in to my patient's room, introduced myself, and gathered a history. I spent some extra time, allowing her to get to know me, and make her comfortable. When it came time for the physical exam, I let my patient know that hers was the first pelvic examination I will have done up to that point. Honesty is always the best policy.
Amazingly, she let me do the exam!
Oh boy...Tachycardia!
Luckily, because I was worried just this sort of thing might happen, I had previously read up on pelvic exams (no You Tube at the time). Did it prepare me? No. Did it help me stay calm? Not a chance. I prepared all of my instruments to the best of my ability, secretly took a deep breath, and got started. Things went reasonably well, though to this day, I don't think my exam was adequate to diagnose anything other than the fact that she was, indeed, female.
As it turns out, my resident was just outside the curtain and – I found out later – came in a couple of times to make sure everything was ok. Welcome to medicine Dr. Wet Behind the Ears!
Happy Halloween to all. Write in with your scariest medical moments. Let's see if we can find a winner of the scariest moment contest.
Best wishes,
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]
Get a steady stream of all the NEW PRESENT Podiatry
eLearning by becoming our Facebook Fan.
Effective eLearning and a Colleague Network await you. |
 |
This ezine was made possible through the support of our sponsors: |
|
Ode To Halloween:
.jpg)
