Here’s the thing.
There’s a quite simply colossal divide between what goes on in the published EM literature and, the interwebs and what happens in the real world. At least for me. I imagine the interwebs (led by the Aussies and North Americans) are more representative of practice in the countries… err… represented. I imagine this reflects the degree of advancement of the specialty in those countries.
If you were to analyse the content discussed in EM journals and on the blogosphere you might get the impression that we spend all day in the resus room, clawing young, previously healthy people back from the brink, using the most up to date, recent and evidence based interventions we have to offer.
Instead it seems that I spend most of my time is spent dealing with non-specific abdo pain, viral syndromes low back pain and elderly people with exacerbations of chronic diseases.
This isn’t a post to complain about non-emergent pathology in the ED; I’m happy to see whatever comes in the door. It’s the patients we serve, not our own fragile egos as to what we think our jobs should look like.
It is also not a post to complain about the ubiquitous nature of trauma, airway and resuscitation in the literature and the blogosphere. In terms of technical skills these are some of the most important things we do. I don’t want to read lots of posts on viral syndromes and low back pain because most of the time from a technical, medical point of view it doesn’t matter a damn what we do with those conditions as they all get better without us doing much of anything. (there’s a majorly important aspect to how we treat them as human beings but that’s a whole different story)
It is simply an acnknoledgement that there’s a little bit of a disconnect there. There are no practical suggestions that follow from this.