Yesterday was my first shift in toxicology and quite disappointing.
Despite my expectations and hopes; there were an over crowded emergency without any educational benefit for me. Most of my patients were ingested benzodiazepines or intoxicated with ethanol and a smaller group were intoxicated with amphetamines, opioids etc. Since 10pm till 1am I had 22 patients, 3 of them comatose enough to be intubated. I just saw my patients, take a very brief history (Material? Amount? Time Taken? Emesis? Reason?) and a more brief Physical examinations (ABC + V/S + pupils + rarely neurologic examination) and write my orders rapidly. Not enough time to think, consult or even concentrate at my cases.
What make the shift harder was the act of EMS and other hospitals that send any addict patient with any presentation (mostly decreased LOC) to our ED.
My resume in this shift:
about 30-40 patients admitted
2 CPRs both with ROSC
5 Intubations
The educational note of my shif:
My compatriots are mostly addict or at least have someone addict in their family; interestingly Pour Methadon syroup or liqufied opium in refrigerator.
P.S. Tonight I'll be in my favorite ED again.
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