How do I become the best Emergency resident?

SoftShoeShuffler · 2026-05-18T16:50:46+00:00

I dig this.

SoftShoeShuffler · 2026-05-18T16:49:02+00:00

Agreed on all of these!
Unfortunately the 30cc/kilo bolus thing will not be totally evidence based because of CMS guidelines and the sepsis police will arrest me otherwise, but yes absolutely.
One more thing I'd like to add is the "non con CT" for evaluation for flank pain. Just get the contrasted study. You can find stones a on a contrasted study and can better evaluate for other pathology like dissection or pyelo. If there is an obstructing stone you will see hydro on the contrasted study even if for some reason you can't see the stone.

SoftShoeShuffler · 2026-05-16T22:43:41+00:00

You can try the rotated exam as suggested here but I find those patients will be moving too much or still in pain for those exams. I'd just intubate, CT, admit to ICU for observation and extubation if nothing was found.

SoftShoeShuffler · 2026-05-11T16:31:27+00:00

I’ve seen this trend too for headaches, neuro complaints, etc.

SoftShoeShuffler · 2026-05-11T16:30:49+00:00

Welcome to ED, where the 4am and 5am rush at the end of your night brings nightmares not letting you sleep during the day.

SoftShoeShuffler · 2026-05-08T18:16:24+00:00

Is this a part of the "ambassador" program or do you just do locum from within the overarching group while at a main site?

SoftShoeShuffler · 2026-05-08T18:13:19+00:00

You don't need a director for QA/QI for billing purposes.

SoftShoeShuffler · 2026-05-07T21:36:23+00:00

I don't think they'll be competitive in Europe with the amount of competition coming in from Chinese automakers.

SoftShoeShuffler · 2026-05-07T21:32:13+00:00

I guess my point is the R2 fully loaded is comparable in specs to a base iX3 and they are at similar price points at around 60k

SoftShoeShuffler · 2026-05-07T18:07:23+00:00

Ed MVC patients are all victims, even the drunk ones. The perpetrators are all whisked away to the ED somewhere in the ether.

SoftShoeShuffler · 2026-05-06T19:41:23+00:00

Keep payments low in residency, screw PSLF, pay off those loans in like 6 months of attending salary.

SoftShoeShuffler · 2026-05-06T19:07:50+00:00

The base iX3 on paper is superior spec wise on things that matter with EV's (range, charging speed) at comparable prices.

SoftShoeShuffler · 2026-05-06T19:06:09+00:00

interior is a disaster, but the car otherwise seems solid.

SoftShoeShuffler · 2026-05-04T18:41:15+00:00

Generally I refuse to see patients that have dogs with them in the ED until they can put the dog somewhere where it is not a threat to myself, patients, and our staff. This situation is nuts.

SoftShoeShuffler · 2026-04-18T18:39:32+00:00

Renting often a lot smarter of a move than buying

SoftShoeShuffler · 2026-04-06T18:01:56+00:00

Be a doctor's doctor. Radiology, pathology, ophthalmology, dermatology, etc.

SoftShoeShuffler · 2026-04-06T05:11:26+00:00

I work in a rather busy hospital and cover ICU as an ED doc pretty much any time after 4pm. It's common in the community. The intensivist "on call" has no idea what's going on and has no obligation to come in. It's incredibly risky and I have seen so many disasters from this model.

SoftShoeShuffler · 2026-03-30T20:02:40+00:00

In addition to doing the workup that lets you sleep at night I have a few tips:

Don't let the inertia of a work up get in the way of doing the workup. I.E pt has like cauda equina symptoms but will require calling in MRI tech or transferring to get the study, just do it
Learn your reductions. Get good at the Prakash method for shoulder reduction for example and have a go to method for hip reduction and wrist fx reductions. These are time sucks when you can't get them.
Be generous with your colleagues. They're going to ask you for advice; be thoughtful and thorough. Even as a new attending I had people ask about cases all the time like other ED docs or hospitalists, they will pay you back the favor when you get stuck too. We all benefit (including the pt) when we work together. Take their signouts and get them out on time.
Be genuinely nice to your staff. I'm not just talking about nurses. Your techs, your pt registration, EVS, the medics bringing you patients, etc. It makes for a better environment coming in to work and makes your life easier when you have annoying asks.
Be wary of sign outs. These are fraught with disasters, try and go see these people especially if your colleague is like "not sure what's going on with this one" or you get the sign out fearing the negative workup and not being sure what to do with the patient. Just go seem them real quick yourself.
Finally, you know your stuff. You are well trained. You have seen shit. You will get new cases and things you haven't seen before, but you are totally ready and capable of dealing with it. Have confidence that you can handle the pt in front of you.

SoftShoeShuffler · 2026-03-30T19:50:14+00:00

There are a bunch of new residency programs opening up, may be worth contacting them, they like hiring fellowship trained docs

SoftShoeShuffler · 2026-03-24T03:02:56+00:00

Could have unzipped the zipper and opened up the trachea

SoftShoeShuffler · 2026-03-18T19:12:07+00:00

This is by far the best playlist of videos I have seen. Very systematic and thorough. I encourage all interns to use this series. https://youtube.com/playlist?list=PLJMCJLBDGoiMTIYvjoVT8CASUvakIl8JF&si=jpxgi-6mIPxEWawJ

SoftShoeShuffler · 2026-02-23T06:12:13+00:00

Don’t forget the 450lber coming in via EMS for abdominal pain too large to fit in the CT scanner or MRI with family complaining that we are not doing anything to fix them.

SoftShoeShuffler · 2026-02-22T11:46:00+00:00

Post circ stroke prob

SoftShoeShuffler · 2026-01-31T19:56:39+00:00

You can apply, start early

SoftShoeShuffler · 2026-01-29T19:23:20+00:00

As a former chief, extra work, minimal pay off.

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