4.8 • 1.4K Ratings
🗓️ 6 July 2023
⏱️ 23 minutes
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0:00.0 | Behind the Night, the surgery podcast, relevant and engaging content designed to help you dominate the day. |
0:13.0 | Hey BTK listeners, the weather is getting warmer, the days are getting longer, and that can only need one thing. |
0:27.0 | It's time for new interns to hit the hospital. Don't worry though, we've got your back. I'm Eden Clark, and I'm Shnatsu Sen, and this series will give you some practical tips and tricks for dominating your intern year. |
0:37.0 | In this episode, we're going to have some fun with a rapid fire review of the common scary pages you're very likely to get this year. |
0:44.0 | First, Nina, what's your general approach to addressing pages from the floor? |
0:50.0 | I think whenever I get an urgent or an emergent page that makes me a little scared, the first step is just to breathe. |
0:56.0 | I've noticed talking to interns and junior residents that often in these situations the initial move is to panic. It really doesn't help anyone to panic yourself included. |
1:05.0 | 99.9% of the time you have a little time to figure things out, get a lay of the land and make a plan. |
1:11.0 | So before you answer that stat page or walk into the coding patient's room, just take a deep breath, clear your mind, and then go. |
1:17.0 | You know a lot more about these patients than you think you do, even these early days of residency. |
1:22.0 | The next tip I have is to always err on the side of seeing the patient. It gets really easy in residency to become attached to your computer screen and your page. |
1:30.0 | If you're getting paged over and over again, if you're concerned at all, or if you just aren't even really sure what's going on, just go see your patients. |
1:37.0 | I promise you'll get more information from looking at them, talking to them, and chatting with the nurse than you ever will from back and forth chart checking and phone calls. |
1:45.0 | Third is knowing your toolbox. There are a lot of people who can help and studies that can give you a lot of information about an unstable patient very quickly. |
1:53.0 | From a person's standpoint, you have your senior residents and attendings, but you also have people on other teams, the bedside and charge nurses, the rapid response or stat team, and a handful of ICUs with people who can help you if you need them. |
2:05.0 | More on this when we get to the next part, but you also have a handful of labs and imaging studies that can give you a lot of information if you know how and when to apply them. |
2:13.0 | In general, a CDC, BMP, VBG or ABG with lactate, a chest x-ray, and an ultrasound machine can give very rapid and pretty comprehensive information. Finally, load the boat. |
2:24.0 | All of these people I listed before are here and have almost certainly got years of experience with hospitalized patients that you just don't have when you're at the stage. |
2:32.0 | Don't let a patient decompensate alone. As a senior resident, I'm never mad when somebody tells me that they're worried about a patient and they're actually okay, but times when patients are decompensating and I don't know about it, keep me up at night. |
2:44.0 | We all know that this is part of the learning curve for the job we do, and a great way to get better managing sick patients is to loot people in who know more about it than you do and watch how they do it. |
2:53.0 | That was a really great overview and how to approach needed while keeping your pool and not panicking. Now that we got the framework, let's get into some of the most common pages that will make your stomach turn over as an intra. |
3:05.0 | The pages we talk about today should generally all be reasons to call your seniors as soon as possible, especially during your first few months, and as you're developing your own judgment for sick versus not sick. |
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