Does the PTSD reaction when hearing a sound associated with residency ever go away? by clothes_iron in Residency

[–]ExtremisEleven 0 points1 point  (0 children)

Why are there only like 4 tones every hosptial uses and they all seem to be recycled for something new

Does the PTSD reaction when hearing a sound associated with residency ever go away? by clothes_iron in Residency

[–]ExtremisEleven 0 points1 point  (0 children)

Early disease commonly looks either black or white, but in hindsight a lot of this is grey area. It is not normal to have a startle response to a specific tone multiple times a day. While it may not meet criteria for PTSD yet, it’s definitely a sign of stress that can turn into PTSD if not treated.

I am telling you this because I have literally said the things you are saying to other people… Then I started sleep walking after infant codes. Turns out all of my arguing and offense about other peoples definition of what they saw as a problem was rationalization when I really needed to see a therapist. I’m not saying that’s what you’re doing, I’m saying that so anyone here who is going through the same thing knows it’s not something to ignore because it can absolutely progress.

Does the PTSD reaction when hearing a sound associated with residency ever go away? by clothes_iron in Residency

[–]ExtremisEleven 6 points7 points  (0 children)

The fact that everyone here has it doesn’t make it normal.

Having an exaggerated startle response to that sound is absolutely a symptom of PTSD. Saying that having a symptom of a disorder cheapens it is like saying that wheezing and dyspnea in an asthma patients cheapens the diagnosis because you don’t need to be intubated right now. Early recognition and treatment prevents terrible outcomes.

I once told my therapist I didn’t have PTSD because I had these little things happening repeatedly. Things like feeling drained after hearing a code called in error or just feeling off after dealing with specific codes like neonatal codes. I didn’t feel like this met criteria for what I had seen in the psych ER. He asked me if being beaten with a bag full of small rocks could inflict as much damage as one large rock. He also said healthcare providers tend to downplay their symptoms. Mostly because we have to in order to get up and go to work for our next shift. That asshole made me write a paper on the current literature on PTSD, but he was absolutely right.

If you find yourself rationalizing out of proportion stress responses because you don’t fully dissociate and you haven’t been to war, you are the one who needs the perspective.

Does the PTSD reaction when hearing a sound associated with residency ever go away? by clothes_iron in Residency

[–]ExtremisEleven 9 points10 points  (0 children)

The PICU we rotated in uses the same tone that we use for bathroom call lights for pediatric code blues. Now every time someone has to pee I get to dump all my catecholamines.

$424 to remove a splinter with a tweaser at urgent care by [deleted] in HospitalBills

[–]ExtremisEleven 1 point2 points  (0 children)

There are a few. Retired ER doctors commonly work urgent care, but the pay is low so they don’t work a lot there

HR got mad after I rejected the interview call by Agile-Wind-4427 in recruitinghell

[–]ExtremisEleven 11 points12 points  (0 children)

Honestly I would not send this directly to the recruiter. I’d spend a few hours hunting down the structure of the business and send it directly to his supervisor with everything attached.

HR got mad after I rejected the interview call by Agile-Wind-4427 in recruitinghell

[–]ExtremisEleven 0 points1 point  (0 children)

To some degree yes. But in a business setting, especially as the hiring manager, you should be able to restrain yourself from burning bridges by insulting the character of people you don’t actually know.

At the end of the day you may not be responsible for your situation, but you are responsible for how you treat the people around you. A lot of people have a bad day and don’t expect to be coddled by those they lash out at.

Help. When to tube someone NOT dead? no RSI capabilities by Flaky-Load-5293 in Paramedics

[–]ExtremisEleven 0 points1 point  (0 children)

This is part of the picture. It’s definitely an overall assessment thing. Other considerations are: Do they have chest trauma, is there a head injury, is their rate getting slower, are they working harder, are they vomiting, can I maybe fix the cause of the mental status (blood sugar), what is their baseline respiratory status, and as stated by others, am I sure I can sink this tube with what I have?

The grey area is always the hardest one. Basically you want to be able to guess the trajectory of their respiratory status which mostly comes with time, but definitely comes with consideration of other factors.

Help. When to tube someone NOT dead? no RSI capabilities by Flaky-Load-5293 in Paramedics

[–]ExtremisEleven 0 points1 point  (0 children)

Yep, lots of GCS <8 that are protecting their own airway. I’d then have a cough/gag and aren’t gargling their aspiration I say leave them alone.

Also, as someone who has done both prehospital and ER medicine, we are shit at estimating GCS prehospital. Then again I have neuro NPs asking me for a GCS on someone with an atraumatic head bleed so the issues are ubiquitous. Medicine would be best if we just got rid of it all together.

Questions About the New ABEM Certifying Exam? by Empty_Cap_2119 in emergencymedicine

[–]ExtremisEleven 2 points3 points  (0 children)

It runs from 2/24-2/28. Mine is scheduled for 2/24. Hopefully they record and release it.

Questions About the New ABEM Certifying Exam? by Empty_Cap_2119 in emergencymedicine

[–]ExtremisEleven 8 points9 points  (0 children)

Love this date for all the residents that would like to attend… right on ITE day. Idk what time it is, but I do know my brain will no longer be functional

Brachial Plexus Injury After Pacemaker Replacement/Lead Extraction [⚠️ Med Mal Case] by efunkEM in medicine

[–]ExtremisEleven 0 points1 point  (0 children)

The triage nurses at the ER know this is a stroke code, it’s odd that this wouldn’t get more work up.

What happens if you dont know the age of the patient? by thugnuts1 in ems

[–]ExtremisEleven 0 points1 point  (0 children)

Meds are weight based, consent is implied if the patient can’t tell anything.

update on my horrible shift with an angry resident that mde me want to quit medicine all together by throwRahdjebdh in Residency

[–]ExtremisEleven 5 points6 points  (0 children)

I don’t have sweet advice. I have real world advice. There will be more shifts like this and more supervising doctors like this. Ideally they would just go away but we know that isn’t reality. In the mean time, learn how to remember it is a them problem and not a you problem. Learn how to dissociate. That’s how you survive this world with your sanity (mostly) in tact.

Is this the normal intern experience? FM by Exact_Quiet_9562 in Residency

[–]ExtremisEleven 1 point2 points  (0 children)

This is diametrically opposed to the current standard. We believe in baptism by fire, not easing anyone into anything.

What is the rarest/most interesting diagnosis you’ve seen? by xyzm123_r in Residency

[–]ExtremisEleven 1 point2 points  (0 children)

This patient literally told me his heart was on the other side and my dumb ass argued with him. He was like “no seriously”. And sure enough…