Why the Comedy Writer Chose Emergency Medicine

Author: Jacob Lentz

After we met in a hospital in Cape Town and he laudably showed me both how to start IV lines (something nurses do in the States, so much appreciated) and how not to contract TB (also appreciated), Robbie asked me to write an entry for Pondering EM on the topic of why a comedy writer would choose emergency medicine as a specialty.

Briefly, before I went to medical school I wrote for Jimmy Kimmel Live for eight and a half years. Having been involved in well over a thousand episodes of television and with a quite comfortable professional life where I worked with hilarious, interesting people while getting eight weeks of paid vacation a year, I then had a brief psychotic episode in which I applied to medical school.

Hunting the Culprit: (Properly) Understanding ECG Leads

Recently I was lucky enough to have attended the ‘EMECG’ course in Cape Town, SA. It was a 2-day event that took place at the beautiful V&A waterfront. 

Not a bad backdrop to learn about ECGs #emecg pic.twitter.com/aOVqfwJLht

— Robert Lloyd (@PonderingEM) April 11, 2015

The faculty delivered high yield, EM-centric ECG education in a hugely entertaining way, and I'm champing at the bit to demonstrate my improved interpretation skills at work!

Pondering Paeds: Buckle In!

Author: Dr. Katie Knight
I believe that anything we do in the paediatric emergency department should aim for the most streamlined care pathway and least hassle for the child, parent and whole family. Quality improvement projects that change something to achieve the above are right up my street.

I was involved in introducing a new buckle fracture guideline in a department I worked in a while ago, which totally changed the way we dealt with the injury (splinting rather than casting) – kids and parents much preferred the new approach, and the department saved money as well – an all-round win. More information on the project can be found here.

Case 4: Precordial Stab

I am currently on a 3-month elective in Cape Town, South Africa. I'm experiencing an awesome city, sampling a new flavour of emergency medicine, and getting exposed to some regular major trauma (an area of EM I am interested in, but have had minimal experience with so far). On day 3, I was involved in an amazing case…

‘If you want to see major trauma, get yourself to resus!’ shouted the consultant on the floor that day. A 16 year-old boy had been brought in by ambulance. He had been assaulted on the way to school, and his most obvious injury was a stab wound to the left anterior chest.

Pondering Paeds: Bloods, Sweat and Tears

...or, how to do a) more successfully with less of b) and c)…

Author: Dr. Katie Knight (see bio below)

We've just had the big 6-monthly changeover in junior doctors across London, cue many nervous looking F2s, GP trainees and EM trainees setting foot in paediatric A&E for the first time.

Aside from the dreaded paediatric trauma call, the thing that really freaks a lot of junior doctors out is sticking sharp pointy objects into tiny humans – we paediatricians don’t exactly enjoy this part of our job but we definitely have a few ways of making it less stressful for both parties.

I thought I'd put together some practical tips for making procedures go smoothly for both you and the child. Some of them are from my own experience as a paediatric trainee, some have been passed on to me by wise play therapists (if one exists in your department, befriend them immediately, they are totally invaluable).

Pondering EM Journal Club: ‘Changes in Medical Errors after Implementation of a Handoff (Handover) Program’

The Emergency Department is usually the only part of the hospital that has multiple doctors and nurses working at full speed 24 hours/day. A night shift as an ED registrar rarely allows for a wink of sleep, and we are constantly chopping and changing between day and evening shifts when not on night duty, punishing our bodies. Finishing work on time is essential to maintain any routine (and sanity!) in your life as an ED doctor. 

Therefore, we buy into the shiftwork mentality – it is the clock that dictates when we leave work, not how long our list of patients is.

Despite the transiency of patients in the ED, (most go home, and those that are admitted usually get rushed upstairs so that the ‘4-hour target’ is adhered to -certainly in the UK, increasingly so in Australia) a consequence of shiftwork culture in the ED is that an undeniably large part of our job is ‘handover’.

Case 3: Demon in a Bottle

About the Author
Dr. Brendan Morrissey (@unsarcasticone) is an Emergency Medicine Advanced Trainee currently working at St. Vincent's Hospital Melbourne ED - one of Austalia's leading hospitals in dealing with drug and alcohol affected patients (see here for recent article in 'The Age'). He studied at University College Dublin, and has been working in Emergency Medicine across Australia and New Zealand for the last 8 years. His interests are Public Health and Medical Education.










The Case:

A 51-year-old man self-presents to your inner city ED one Friday evening; he’s complaining of mild abdominal pain and shortness of breath. A quick scan of his old notes at triage shows a background of Chronic Liver Disease secondary to alcohol. He does not appear in distress and is haemodynamically normal, so is placed in the long line for an empty cubicle.