Practical EMS
My mission is to use the stories we all have in emergency medicine to encourage and uplift you where you are. EMT, Paramedic, nurse, PA, NP or physician. Emergency medicine is a very difficult specialty with unique challenges, and it calls us all to be better than the average person in order to stay healthy for our patients, our families and own mental wellness. I want to connect with EMS crews, fire crews, ER RN's, ER techs and new ER advanced practice providers to better understand their current struggles. I also want to bridge the gap between prehospital medicine and the emergency department and to encourage those seeking to become an advanced practice provider. Disclaimer: All Practical EMS content is opinion only. It is unaffiliated with any company or organization and does not represent any company or organization that Aaron currently works for or has worked for in the past. No content should be taken as medical advice.
Practical EMS
97 | Drs. Sean and Adam | Difficult admissions | What admissions do and do not accomplish | Group culture | Obs vs in-patient status | How we can help the hospitalist from the ED
The difficult admissions are the generally weak, unable to walk with no acute findings. They typically do not uncover any acute findings while in the hospital
In the ED, we can probably do a better job of involving some of our resources like social work to really give the patient and their family a better understanding of what admission will and won’t accomplish for them
Part of the America culture does put us in unique situations as the elderly often do not live with their children anymore. Family live far apart and often cannot help each other when in need
No one blames the patient for the situation they are in, but we want to find the best solution to serve them
IM deals with the limitations of insurance much more than we do in the ED
Ultimately, each hospital group needs to establish a culture. What would you want done for your Grandma?
A little more work now on these difficult cases in the ED can have the downstream benefit of keeping admission beds open for your next shift
Dementia patients with progression of their disease process can be tricky to disposition as well
We don’t do the best job in our society of talking about the normal aging process and how to preserve our patient’s dignity and sense of self in that process
We are scared to death of death
What is the difference between Observation admission and Inpatient admission?
The care is the same regardless of the admission type
An observation admission is best thought of as a problem that could likely be handled in the outpatient setting if the patient had unfettered access to follow up to PCP and specialists
In-patient implies that they need resources only found in the hospital
In-patient vs obs can change over time, if nothing new is found, these statuses can change
Sean recommends the book Same As Ever by Morgan Housel
He talks about the changes in medicine being so gradual that they don’t make headlines, but they are dramatic over time none the less
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.