Tuesday, April 26, 2011

Cant you see I'm Charting

One of my biggest pet peeves is when more attention is paid to the chart than to the patient. Boy, today I got peeved. I was seeing a patient in one of the units when their asymtomatic tachycardia became very symptomatic with the sudden accumulation of a large amount of blood with froth in the chest tube. At first I thought it was something even more worse than it appeared but I managed to press down on the chest and twist off the chest tube hoping the bleeding would tamponade the lung. While all this is going on I am yelling for help. After four or five yells and trying to use my foot to hit the code alarm I finally heard the nurse yell, "can somebody get that, Im charting!" The RT popped in when the vent alarms went off and helped me. Finally the nurse showed up. After the patient was taken care of, I though about what had happened. If I hadnt been there, the chart would be perfect but the patient would have been dead.

Friday, April 22, 2011

Federal Reserve Blood Bank

I know it is a scary thought, but what if the Federal Reserve ran the blood banks? At present, one unit of packed red cells is 220 ccs and intended to raise the hemoglobin by one point and the hematocrit by three. To make it look like there is more blood available,the Federal Reserve would increase the number of unit bags that the blood comes in, so each new Federal Reserve Unit would be diluted and maybe only contain 110 ccs of blood and the rest of the bag would be filled with saline. Sure, there are now more units available, but now each unit only raises the hematocrit 0.5. So, in each transfusion you need twice as many units. The real amount of blood available is the same, all you did is make each "unit" less effective.

I guess it is a good thing that the Federal Reserve does not manage blood banks, too bad they manage our nations life blood.

Wednesday, April 6, 2011

Non-essential functions

I saw on the news all these different governmental administrators explaining that a government shut down would only affect non-essential functions and that they were working on plans to operate in this way. They also said 800,000 people would be placed on furlough with the shut down. Doesn't this mean that we have 800,000 people who are government workers doing nothing important and therefore why do we have them anyway? For that matter, why do we have things in the government that are not essential anyway?

Saturday, April 2, 2011

What's good for the goose killed the gander

I was just sent an email from a friend. A senior National Health Service Administrator in the UK passed away from gastric cancer. It was diagnosed earlier but she had to wait 9 months before her surgery. The surgery was even done at a hospital that she was in charge off. Of course it was way to late. I then thought what if it was over here in the US? You come in to the ED with stomach pain or nausea. They will get a ct regardless of your ability to pay. If UT shows a mass the surgeon on call then has to see you as well as the gastroenterologist. Before you know it you have the egd done, biopsy read and most likely surgery and the first round of chemotherapy before you even left the hospital. Sure you may get bills but if you don't have insurance the hospital writes most of it off and the doctorsa have to suck it up.

So, who has the better system if you are the patient?