So it has been a couple of weeks since I started in the Emergency Room. During that time, I have had the pleasure of seeing all kinds of things. Of course, the complaint that I have seen the most is Abdominal Pain, which is what has always been the highest complaint in the ED.
I have also seen a couple of traumas. One was a man who was shot by his wife and the other was a little girl who was hit by a car. I learned a lot from those 2 situations. First of all, the main role that the emergency room has in those situations is to stabilize. The man who was shot, the most important thing to check is to ensure that his airway is stable, he can breath without any problems, and that his circulation is intact and is able to maintain a blood pressure. The whole thing took about 1 hour and he was completely stable and sent home with the bullets still in him. We do not take bullets out because it causes more problems than if you left them in.
The little girl had a broken leg and was transferred to a children's hospital.
Most of the other issues were medically related. I was able to drain a few infections and start numerous IVs. However, I did not do some other things such as central lines or arterial blood gasses.
I did learn several things so far. First and foremost, I need to be more confident. This is where I am lacking. I know my material and I do a decent job getting a good history, I just need to be more confident and with years of leadership experience, I should be able to do this more easily. However, this being my first EM rotation I think it just takes a little bit of time. Second, I need to realize that I am only to focus on the cause of the patient being here and if that is going to threaten their lives. If I happen to notice something else and it is not imminent they can follow up with their regular doctor.
Now after 3 days off and a recharge I am going back into the trenches tomorrow and show what I am really able to do. This rotation also exposed me to the inner city emergency room. Next week I start at the community hospital. Let's see what happens next.
I think it would be difficult to only focus on the chief complaint, I can see where you would want to treat any other issues that you found, especially since a large portion of people never follow up with their PCP. I am sure it gets easier to focus on only what brought them that day after awhile.
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