Recent content by gro2001

I don't think that this is either naive or dumb. The most useful thing you can do in life that will help you make decisions big and small is figuring out your core values. Once you figure those out, everything else becomes fairly simple. There are a number of coaching methodologies, including...

Yes, I agree on all counts.

That and also because of the age related brain atrophy the exam may be normal for longer after an injury.

In the scenarios you described above, the patient in scenario 2 was put in jeopardy and possibly harmed. Patients in scenario 2 usually get repeat imaging months later because someone has noticed a gradual cognitive (or motor) decline. Sometimes that is (mostly) reversed by draining the subdural...

I very often look at a patient in atrial fibrillation and think thank God for blood thinners. They prevent so many strokes!

I am both an emergency physician and a neurointensivist, and this is one way that my fellowship has changed my EM practice. I scan a lot more now. I fairly often see patients with chronic subdurals that were almost certainly due that fall a couple of months ago that was missed. Sometimes the...

When a similar event happened in my hospital that led to our charge RN being arrested, the police officer was demanding the nurse draw the blood for him so he could take it into evidence. They actually would not be able to use the blood we send to the lab. Or at the very least that evidence...

Do you have any training in forensic medicine? I do not, and so would not be comfortable making any speculation on how long somebody has been dead. Particularly in any official capacity. And any conversation with a police officer is always in an official capacity, regardless if they are kind...

Almost the exact same thing happened at an ER I worked at. Except in our case it was the charge nurse who was arrested. Handcuffed and everything.

And conversely I am not arguing that the majority of HEMS flights are high yield (or at all helpful really). And while some of it is geographic (it will never make sense to fly someone in NYC, it will often make sense to fly someone in Alaska) another big component is the quality of the transfer...

Working in both the ER and inpatient side of things I now realize that while there is some additional EM specific grief these consultants dish out, mostly it's just how they are. By far the biggest factor is the pay incentive though. Our hospital is a little weird in that for a lot of...

I think all of you routinely encounter patients in whom a few minutes makes a difference. A dominant hemisphere M1 occlusion loses about a week of life expectancy per minute that recannalization is delayed. https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.026735 Although there is not...

I think you can relax a bit in terms of your concerns about getting sued in this situation. So far there has never been a lawsuit against a doctor assisting on an inflight emergency. Considering that the denominator must be huge (just about every doctor has some sort of story), those are pretty...

No.

I think this is an under appreciated aspect of the problem. The front of office and answering service employees seem to be like 95% idiots, nation wide. Our answering service for example can't tell the difference between neurologic specialties or physicians who work for our group vs outsiders...