Podcast: Play in new window | Download (Duration: 21:58 — 25.3MB)
Subscribe: RSS
(21:58) Ron goes through his final final and some skills testing. No more lectures, no more teacher’s dirty looks.
What I Did This Week
Clinicals
Paper work. What a pain.
Mentions:
Listener Questions
Hey Kelly, I know that you’ve blogged on this topic many times and I’ve got a quick question for you. Since you’re apt to transport some rather sick (yet not entirely time sensitive) patients without lights, sirens, and guns a blazin’, do you sometimes still describe your transport as “emergent” when giving radio report to ensure the receiving staff understands that the patient is sick? It would sure be nice to trust that painting a clinical picture would be enough to alert the nurses that they should plan on placing the patient a corner or hallway, but having spent a lot of time working in the department, I fear the staff would sometimes be too busy and distracted to pick up on less overt signals. Even with a fairly obvious description, our nurses are often multi-tasking while taking radio report, and it would be very easy to assume: “The patient can’t be that sick, I didn’t hear any sirens and they’re non-emergent.” As always, thanks for the podcast,
– Vince
Warm regards from a cold england
Jamie
Subscribe or review on iTunes.
Thanks for the response; it looks like regional variability strikes again! I kinda like your setup, but in my area there’s pretty much two arrival notifications we can use: emergent vs. non-emergent. It doesn’t allow much for shades of gray, but upon reflection I still think it’s a sound concept since so much of what we do is based on the doorway diagnosis of “sick vs. not-sick.”
Pertaining to Jamie’s question, I was rather shocked that Kelly hadn’t done a whole lecture entitled “The Lethal Triad” at some point, let alone had encountered the topic. I’m sure it’s something he’s taught but just never described as such. Speaking for our English colleague, I’ll note that in addition to listing the three factors Ron mentioned (hypothermia, hypovolemia, and coagulopathy), the concept of the lethal triad really focuses on how each piece affects the other two. Hypovolemia begets hypothermia and coagulopathy; hypothermia worsens coagulopathy and blood loss; coagulpathy leads to hemorrhage and more hypothermia. I, for one, really like how it emphasizes a multi-faceted approach to folks losing blood and the need to correct all three problems, not just the obvious loss of red cells into the street (or, as is usually the case at my community hospital, the toilet bowl). Enjoy your Christmases gentlemen.