TSR Med Students' Society (TSR Meds) Watch

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Renal
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#7701
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#7701
(Original post by j00ni)
I had a post-op patient yesterday who was pretty much unresponsively drowsy after a couple of doses of morphine, pinpoint unequal pupils and RR of 7/min. Rang the SHO on call (the SHO of the team is on nights and the other SHO on one of my other teams was at a different hospital), explained the situation, and he was like "Why are you bleeping me, I'm the SHO on call, can't you contact your own team"
Had something similar happen with a sick punter on my ward the other day, only a pair of F1s and three finalists around, no SHOs or StRs in. In the end, one of the F1s had to go down to clinic and hunt out the only cardiologist on site (he didn't answer his bleep). The consultants first question; was it to ask for the history? Was it to ask for the obs? No, it was to ask if the patient was his. The answer being no, we have a CCF punter on the ward who's now in renal failure. :mad:
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Touche
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#7702
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#7702
I feel sorry for F1s a lot of the time... got fast bleeped to a septic sickie last night and the poor F1 looked like she was about to burst into tears when I got there. Not much she could have done, and other than basic resus and a neck line there wasn't much I did either... didn't stop me calling the non on-call colorectal surgical consultant at 4am and telling him about his sickie. I think as time goes on I've started to get more comfortable with the fact I don't have magic healing hands that can fix everything, and that most of the time seniors *want* (even if they don't always *like*) to be involved in their patients... If you're really stuck getting a consultant on his mobile is a sensible move... I call em up regularly now.

(hating general surgery on-calls :P)
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Philosoraptor
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#7703
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#7703
Oh dear - you guys are ever so slightly scaring me. I'm soo going to have no idea what's going on in the future.
General anaesthetic is fun by the way, apart from the hangover. :eek:
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Touche
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#7704
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#7704
(Original post by belis)
Scary stuff Jooni, but I am not even that suprised. Cardiac arrest-clearly medical. Not worthy orthopods attention. Around here most of the time we don't even bother bleeping them and let crash team/critical care outreach sort the patient out. Out of curiosity, when you put out 2222 call who comes to the bedsite in your trust?
Would you honestly want an orthopaedic consultant at your arrest? It's not that they don't care... it's just that they don't have a clue cos it's been so long since they had to deal with that stuff regularly. I've been on an ortho round and had a patient start fitting while being examined... was hilarious to see the ortho consultant try and deal with it. In the end I suggested he carry on the round with the reg while a couple of us stayed and sorted it. Of course he cared, he just didn't have the practised skills or knowledge to deal with fits.
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Ataloss
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#7705
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#7705
(Original post by Touche)
Would you honestly want an orthopaedic consultant at your arrest? It's not that they don't care... it's just that they don't have a clue cos it's been so long since they had to deal with that stuff regularly. I've been on an ortho round and had a patient start fitting while being examined... was hilarious to see the ortho consultant try and deal with it. In the end I suggested he carry on the round with the reg while a couple of us stayed and sorted it. Of course he cared, he just didn't have the practised skills or knowledge to deal with fits.
If the patient was under his/her care - yes the Orthopaedic Consultant should be there - maybe not to actively participate in the resuscitation - but to be involved in the decision as to whether the patient is a candidate for critical care, liaise with the family, support his/her team etc...

The Orthopods are generally ATLS trained so I often find it odd they are unable to put an airway into a fitting patient for example, deliver some oxygen, place them in recovery position and administer IV or PR anti-convulsant medication.

It is akin to a medic not putting pressure on a wound when the patient is exsanguinating and establishing fluid resuscitation. First principles are first principles and if a first aider in the community could deal with it - any hospital Consultant or GP should be able to deal with it.

As for the lack of exposure to arrests - in one hospital where I worked there were more cardiac arrests on the Orthopaedic wards than any other except CCU and MAU.

Rant over. Sorry. :o:
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belis
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#7706
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#7706
Would you honestly want an orthopaedic consultant at your arrest? It's not that they don't care... it's just that they don't have a clue cos it's been so long since they had to deal with that stuff regularly.
Taking that our ortho consultants are ATLS trained and seem to be pretty much on the ball regarding resus when attending major trauma I do not really buy it that they don't have a clue as to how to deal with cardiac arrest. Personaly I think it is one big conspiracy. Orhopods are working hard on maing everyone believe that they can't deal with medical side of things so that they don't have to get involved.

I do not think that they precense is required though as it seems to work well when critical care team runs the show. They are quite well placed to make decision as to who is suitable for ITU and liasing with the family. As long as patients notes are up to date and consultants are contactable with regards to further management I think they are of more use elsewhere.
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Touche
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#7707
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#7707
(Original post by belis)
Taking that our ortho consultants are ATLS trained and seem to be pretty much on the ball regarding resus when attending major trauma I do not really buy it that they don't have a clue as to how to deal with cardiac arrest. Personaly I think it is one big conspiracy. Orhopods are working hard on maing everyone believe that they can't deal with medical side of things so that they don't have to get involved.

I do not think that they precense is required though as it seems to work well when critical care team runs the show. They are quite well placed to make decision as to who is suitable for ITU and liasing with the family. As long as patients notes are up to date and consultants are contactable with regards to further management I think they are of more use elsewhere.
You're prolly not too far from the truth on some occasions... :p: Everyone having such low expectations of you can really take the pressure off
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visesh
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#7708
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#7708
Eak, 4th year starts tomorrow. :scared:
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Fluffy
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#7709
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#7709
(Original post by visesh)
Eak, 4th year starts tomorrow. :scared:
Good luck!
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fairy spangles
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#7710
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#7710
I dont think my appeal is gonna go through.
No one will speak to me from the uni.
I have no idea what to write ive been e-mailing people for weeks on end.
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Fluffy
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#7711
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#7711
Also, if you're appealing, Uni's almost never actively engage with the appealee... The process is akin to a legal procedure at the end of the day, and they have to play things by the book. Don't take that as them not giving a crap though. They're just doing their job.
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fairy spangles
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#7712
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#7712
Guys thanks for everything.
My department got back to me and have been fantastic they are submitting an appeal on my behalf.
They have told me not to worry and all should be well.
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Touche
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#7713
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#7713
G'luck again spangles. When do you finally find out?
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Helenia
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#7714
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#7714
I just got my quartile ranking.
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ThisLittlePiggy
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#7715
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#7715
Judging by that smiley face I assume the news wasn't good?

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Ataloss
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#7716
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#7716
(Original post by Helenia)
I just got my quartile ranking.
Congratulations.

Top quartile as expected I presume. :yep:
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AEH
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#7717
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#7717
Good show Helenia, good show.
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Helenia
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#7718
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#7718
(Original post by Ataloss)
Congratulations.

Top quartile as expected I presume. :yep:
I was expecting/hoping for 2nd, to be honest, so this was a pleasant surprise. Now I've just got the other 60% of my application to worry about... (though in reality it's more than 60% as there's only 6 points variability between top and bottom quartile).
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Ataloss
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#7719
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#7719
(Original post by Helenia)
I was expecting/hoping for 2nd, to be honest, so this was a pleasant surprise. Now I've just got the other 60% of my application to worry about... (though in reality it's more than 60% as there's only 6 points variability between top and bottom quartile).

Sure you will have an excellent application and get one of your top choices.

Good luck.
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visesh
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#7720
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#7720
Woo well done Helen
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