If you think that practicing emergency medicine in a community ED is all runny noses and soccer injuries, think again. I have seen more patients per shift since I started at my current job than probably any shift during my residency. And my acuity rate is on average, at least 30-40% admissions. Some days even more. Tonight, it seemed like everyone. In the past week, I’ve put in 2 central lines. Most of my patients are sick, for real. It’s pretty amazing.
Tonight I felt like superwoman as I stayed late for my shift to help a colleague get central access on a patient. As I methodically proceeded through the memorized physical actions of anesthetizing, finding the vein, aspirating blood, feeding the guidewire, dilating the tissues and finally threading a triple lumen catheter into the patient’s femoral vein, I experienced an out of body reaction. I saw myself standing at the patient’s bedside, saw the patient laying with his eyes closed, waiting for the IV access that would bring him the pain medicine he needed. I did what no one else had been able to do for that man. While it was no big deal to me, I saw it in a different perspective, almost meditatively. I’m sure it’s the same feeling that many surgeons must get after performing hundreds of proceedures…the ability to detach yourself from the immediate distractions of blood, needles and drugs. Pretty cool.