Things I have yet to see

17 Sep

I’ve been training in EM/ICU full time for 5 years with a smattering of other things for another 3 years. Despite this length of time there’s a whole host of things that I’ve never seen and managed. A lot of them are core competencies for EM docs and like a lot of stuff we need to know how to manage it whether or not we have experience or not with it. Below is a list of some of the big things that come to mind:

  • major burns/escharotomy
  • cyanide toxicity
  • spontaneous aortic dissection (I suspect I’ve seen it and missed it)
  • compartment syndrome
  • emergency thoracotomy (though in retrospect I’ve been present when it should have been done)
  • emergency cricothyroidotomy (again I think it should have been done…)
  • toxic alcohols
  • pregnant cardiac arrest
  • priapism

What’s on your list?

 

14 thoughts on “Things I have yet to see

  1. Oh man. I hope you’re not working tomorrow. In fact, having shared this today, you might want to take the rest of the week off.

  2. Sadly, over the last 16 years, I have seen and done all of those, except of course, being thanked for an admission! I have never picked up a new inborn error of metabolism though. I suspect that I have missed a few.

    • i’ve suspected the inborn error thing a number of times but have never had one confirmed. Heterotropic pregnancy is the other one that springs to mind and i’ve seen that twice which seems weird when i haven’t had a dissection yet!

  3. Hey Andy
    Seen some of those but some other “uncommon ED” stuff not seen

    major burns/escharotomy pt when to theatre for same but not in department.

    cyanide toxicity nope

    spontaneous aortic dissection (I suspect I’ve seen it and missed it)yeah, didnt survive the transfer.

    compartment syndrome yup, got to take few to theatre with ortho boss (small hosp life)

    emergency thoracotomy (though in retrospect I’ve been present when it should have been done) Pretty rare in NZ

    emergency cricothyroidotomy (again I think it should have been done…)Never seen it.

    toxic alcohols, yeah saw bad home distillery..

    pregnant cardiac arrest nope thank God

    priapism yup got to insert cannula *CrossesLegs*

    Aint seen Carbon Monoxide poisoning.

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