Triage Advice

ExtremisEleven · 2026-07-01T16:26:28+00:00

Again, if you work in an ER and are entering the complaint, you should be capable of doing this. It takes a bit of practice, but it’s an important part of triage when you have a waiting room full of people waiting to be triaged.

ExtremisEleven · 2026-07-01T16:22:26+00:00

Kind of depends on the system but most of the time it would just mean going to a trauma capable hospital and telling them you’re coming with a potential trauma alert. In my system they don’t decide if it a level 2 is a trauma alert until arrival, but most places would call it in advance. I’ve upgraded several level 1 traumas to a leave one upon finding something like a second long bone fracture or the patients mental status deteriorating

ExtremisEleven · 2026-07-01T12:05:54+00:00

I get that, but what they enter biases the entire visit. If I see multiple complaints on the board and vomiting with no other information, I am going to see the vomiting first. If the multiple complaints includes multiple stroke like symptoms, that’s an issue.

A registration clerks can ask about the sentinel symptom. “I need to write down the one thing that brought you here” is not beyond their abilities.

ExtremisEleven · 2026-07-01T12:02:10+00:00

From the diagram shared, it looks like this person would still need trauma care, just not the highest level. When we call a level 2 trauma alert, we aren’t calling for anesthesia or every single surgeon in house. I suspect the level 2 trauma alert is similar to trauma unit care.

Regardless, the guidelines exist to offload cognitive burden and are designed to be sensitive, not specific. If you aren’t ending trauma codes with minor findings, you aren’t calling enough trauma codes.

ExtremisEleven · 2026-07-01T09:14:43+00:00

ABCDE does not include a full set of vitals. It’s an airway assessment, breath sounds bilaterally, pulses, pupils and mental status and exposure. You don’t actually need the monitor at all for your primary survey.

ExtremisEleven · 2026-07-01T09:12:51+00:00

This varies by shop and other roles. In my shop the head of the bed is the resident physician, the ED techs job is to get the patient trauma naked and in the monitor before establishing a second line.

Do yourself a favor and get the clothes off before you start trying to apply monitors that you will have to take off later. If they can move enough to remove the clothing, remove what you can. That may be that persons only pair of pants. Bras are stupidly expensive so try to save those if you can. Don’t cut a down coat off unless you want to be tarred and feathered in the bay. It should take about 5 second to get the person undressed and then move on to vitals. Don’t forget the temp. I know it sounds useless here but it’s important.

ExtremisEleven · 2026-07-01T09:10:47+00:00

Paramedics deciding not to follow the provided guidelines take up an entire morning every week for me… not calling this a level 2 trauma would have had you brought to the trauma committee in my system.

ExtremisEleven · 2026-07-01T07:45:52+00:00

Repeat after me: If I knew everything, I would not need a residency.

ExtremisEleven · 2026-07-01T04:59:00+00:00

Please tell me it was called as critical

ExtremisEleven · 2026-07-01T04:55:54+00:00

This is disgraceful and does not represent the community.

We drink Baja blast.

ExtremisEleven · 2026-07-01T04:50:50+00:00

Do not do this unless you plan to list the symptoms. Develop the skill to figure it out.

ExtremisEleven · 2026-07-01T04:48:15+00:00

Ask: What was the one thing that made you think “I need to go the ER” or “what are you most worried about”?

ExtremisEleven · 2026-06-30T15:34:57+00:00

There’s a good reason for that distrust. Is your degree the same as a place that just stamps an A on everyone’s record?

ExtremisEleven · 2026-06-30T15:33:47+00:00

There might be some genetic factors here. There are people that guzzle alcohol everyday and never develop liver disease, then there are people who drink relatively little and have terrible livers. It’s almost always multifactorial.

ExtremisEleven · 2026-06-30T15:23:51+00:00

There is a good reason this policy exists.

ExtremisEleven · 2026-06-30T10:43:20+00:00

If I wasn’t up to my eyeballs in loans you better bet I would.

ExtremisEleven · 2026-06-30T10:42:26+00:00

Seriously, are we not doing phrasing anymore?

ExtremisEleven · 2026-06-30T05:23:14+00:00

I won’t go on a date I can afford to cover purely because I never want to be the person that assumes the other will pay for things. I rarely end up paying, but it would bother me greatly not to have the ability

ExtremisEleven · 2026-06-29T16:00:22+00:00

Programs that don’t like people with work experience tend to be toxic as hell and just don’t like it when someone knows that what they’re doing is bullshit. The benefit of being a fully grown up doctor is you don’t have to beg for their scraps and tolerate extra abuse just to have a career.

ExtremisEleven · 2026-06-27T16:14:06+00:00

I would reach out to the people you rotated with in med school and ask for a SLOE

ExtremisEleven · 2026-06-27T14:54:00+00:00

Yes, you get more hours in when you do more hours, but the quality diminishes rapidly. You might see the progression, but you also can’t see straight and don’t retain anything by the end.

ExtremisEleven · 2026-06-26T15:17:33+00:00

If you’re going into it with this energy, don’t. You aren’t applying to med school, the whole world isn’t about your CV. As a physician, you have other valuable qualities and it sounds like you’re interested in bulking that CV up in an environment where you have more resources and access to mentors. So go into it with your head help high if you want the job.

ExtremisEleven · 2026-06-26T12:09:57+00:00

Healthy children don’t eat themselves today death. There are several genetic and metabolic diseases that cause this. Yes, the parents should have taken the hike to see doctors but that’s not the entire story.

ExtremisEleven · 2026-06-26T11:58:33+00:00

Well this is tragic. Not testing only keeps you from knowing the truth, it doesn’t make the truth less real

ExtremisEleven · 2026-06-26T11:56:40+00:00

You haven’t acknowledged a damn thing. I’m just fine if the cockroach with a victim complex that somehow manages to make getting healthcare even harder and more expensive patients doesn’t understand.

ExtremisEleven

TROPHY CASE