Comments on: Clipboard Conundrum http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/ A blog from inside the emergency department Wed, 08 Feb 2012 14:07:09 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Inthebiz http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15952 Inthebiz Thu, 31 Dec 2009 16:59:52 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15952 Highlarious! Highlarious!

]]> By: FlyingERDoc83 http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15944 FlyingERDoc83 Thu, 31 Dec 2009 10:37:56 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15944 Of course it leaves out all of my good formulas I spent time typing. Of course it leaves out all of my good formulas I spent time typing.

]]> By: FlyingERDoc83 http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15943 FlyingERDoc83 Thu, 31 Dec 2009 10:37:09 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15943 What about e (2.71828...)? Pain > 0 and = e and = (e ^ 3)/4 and = (e ^ 2) and 10, call funeral director for patient to test-fit casket It's very simple to type that into a computer, and MS Excel can do the calculations in no time. Seriously, the 0-10 scale as frequently used is only useful in a small minority of patients in the ED and likely a similar proportion of patients in the hospital as inpatients. It is useless for the patient with daily back pain visits who is allergic to everything but that medication that starts with a "D", "di"-something, given rapidly by IV bolus with a chaser of Benadryl. Oh, and a few Xanny bars to go, please, because they are having a panic attack from all these ED visit bills and the pharmacies are all closed at this time of night around a holiday weekend when their family doctor is on vacation and won't be back for 2 weeks. Board Certification in Emergency Medicine does NOT equal legalized drug dealer, and accreditation of hospitals should be inversely related to the amount of CDS-listed medications prescribed for the recreational use of the patient. What about e (2.71828…)?

Pain > 0 and = e and = (e ^ 3)/4 and = (e ^ 2) and 10, call funeral director for patient to test-fit casket

It’s very simple to type that into a computer, and MS Excel can do the calculations in no time.

Seriously, the 0-10 scale as frequently used is only useful in a small minority of patients in the ED and likely a similar proportion of patients in the hospital as inpatients. It is useless for the patient with daily back pain visits who is allergic to everything but that medication that starts with a “D”, “di”-something, given rapidly by IV bolus with a chaser of Benadryl. Oh, and a few Xanny bars to go, please, because they are having a panic attack from all these ED visit bills and the pharmacies are all closed at this time of night around a holiday weekend when their family doctor is on vacation and won’t be back for 2 weeks.

Board Certification in Emergency Medicine does NOT equal legalized drug dealer, and accreditation of hospitals should be inversely related to the amount of CDS-listed medications prescribed for the recreational use of the patient.

]]> By: SeaSpray http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15939 SeaSpray Thu, 31 Dec 2009 05:58:33 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15939 Hilarious WC!! :) I used that method of reporting pain to the ED nurse this summer just to tease a bit but she just said we I couldn't do that and its 1-2, 3-4, 5-6 pain, etc. I think I said a 5.something. I told her I was joking. And I did that because I think it's funny how some med people get all squirrelly if a patient says 20 or whatever. :) Love the 3.1415 and the Pi/61. Hilarious WC!! :)

I used that method of reporting pain to the ED nurse this summer just to tease a bit but she just said we I couldn’t do that and its 1-2, 3-4, 5-6 pain, etc. I think I said a 5.something. I told her I was joking. And I did that because I think it’s funny how some med people get all squirrelly if a patient says 20 or whatever. :)

Love the 3.1415 and the Pi/61.

]]> By: ERP http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15931 ERP Thu, 31 Dec 2009 00:17:58 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15931 I absolutely refuse to use the pain scale execpt with cardiac patients. I call it pain "mild", "moderate" or "severe" and that is it. Either that or I just order a pain med for "PRN pain". Luckily no one has complained. I absolutely refuse to use the pain scale execpt with cardiac patients. I call it pain “mild”, “moderate” or “severe” and that is it. Either that or I just order a pain med for “PRN pain”. Luckily no one has complained.

]]> By: igloodoc http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15909 igloodoc Wed, 30 Dec 2009 16:34:39 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15909 Hey WC You missed the part of the JCAHO directive where you get Nurse K to hand the order to the patient and have the patient fill in the part “Administer [chosen pain medication] [chosen dosage] intramuscularly/intravenously every ___ hours for pain rated as _______.” Silly WC. You thought you had to fill that in... Hey WC
You missed the part of the JCAHO directive where you get Nurse K to hand the order to the patient and have the patient fill in the part “Administer [chosen pain medication] [chosen dosage] intramuscularly/intravenously every ___ hours for pain rated as _______.”

Silly WC. You thought you had to fill that in…

]]> By: JC http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15907 JC Wed, 30 Dec 2009 15:58:08 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15907 I had a patient that once described pain as 5.5, 4.0, 6.75 etc. She just wanted to be accurate, I guess. I do like the pi idea. How many numbers after the point will your system accept? :) I had a patient that once described pain as 5.5, 4.0, 6.75 etc. She just wanted to be accurate, I guess. I do like the pi idea. How many numbers after the point will your system accept? :)

]]> By: midwest woman http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15906 midwest woman Wed, 30 Dec 2009 14:49:39 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15906 on a scale of 1 to 10 I rate this post as a 10.361. Hilarious. Working with the old folks, I'm a maverick. When you're 99.9999 y/o the pain scale is ridiculous. I still just go with a lot or a little. When a patient thinks he's at the bank and you're the teller, trying to figure out a number on pain is low on the totem pole. And frustating for everyone involved. Happy New Year, wc. on a scale of 1 to 10 I rate this post as a 10.361. Hilarious. Working with the old folks, I’m a maverick. When you’re 99.9999 y/o the pain scale is ridiculous. I still just go with a lot or a little. When a patient thinks he’s at the bank and you’re the teller, trying to figure out a number on pain is low on the totem pole. And frustating for everyone involved.
Happy New Year, wc.

]]> By: StorytellERdoc http://www.epmonthly.com/whitecoat/2009/12/clipboard-conundrum/#comment-15905 StorytellERdoc Wed, 30 Dec 2009 14:37:28 +0000 http://www.epmonthly.com/whitecoat/?p=4069#comment-15905 This post is hysterical! 2.17? Isn't that like a hangnail? I do have to say, though, your new hospital protocol might favor a lot of seekers who come in with a pain scale of ten...bad, bad dental pain again! LOL Happy New Years to you and yours. Great post. This post is hysterical! 2.17? Isn’t that like a hangnail? I do have to say, though, your new hospital protocol might favor a lot of seekers who come in with a pain scale of ten…bad, bad dental pain again! LOL

Happy New Years to you and yours. Great post.

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