Thursday, December 22, 2005

From the comments on this post at GruntDoc (doesn't his blog look great?):
My wife, a fellow emergency physician here at Landstuhl Regional Medical Center (Germany), had a 30yo male with classic signs for appendicitis (i.e. RLQ pain, RLQ ttp, rebound, guarding) a few nights ago. After completing her Hx and PE she called the SOD (surgeon of the day) for a consult stating that she believed her patient had an acute appendicitis that required surgical intervention. The surgeon, of course, asked her what the CBC and UA results were... She stated that they were still pending.

The SOD went off on her questioning her reasoning for a surgical consult without the benefit of laboratory results... Taking the high road she calmly stated that the labs were pending and would be resulted shortly after his arrival to the ED. Upon his arrival he berated her in front of the entire ED staff for a premature consult. Again, taking the high road, she thanked him for arriving in the ED so quickly and directed him to the patient's bedside. Moments after examining the patient he filled out a buck slip and took the patient to the OR for his appendectomy -- the labs were still pending as he wheeled the patient to the OR...
Unfortunately, our surgeons sometimes ask for the CT results and castigate us if we haven't done one. I can't keep track of who wants one and who doesn't. What bothers me the most is that we (the ER docs) can predict, based on the time of day, whether a particular surgeon will ask for a CT. If it is almost time for the doc we call to go off call, the chances are high we will be asked to order a CT. If it is 5am, we will be asked for a CT. If we get a CT in the evening and end up delaying the call to the surgeon until, say, midnight, we will be asked why we got the CT.

Follow the link to find out the results of the surgery.