3009.....i mean....2009
this is how the year has felt so far. a bit confused and slightly off kilter. now as an anesthesiology resident----aka CA-1----aka clinical anesthesia-1----aka typically a second year resident and a first year anesthesia resident----PGY-2, etc as the acronyms could go on and on.
i am training at a county institution in a large urban center----basically this translates into what is better known as the 'knife and gun club' for the ER and trauma services. county has their own terminology for what is known to many in the medical world as a 'trauma'----an 'RB' or 'Red Blanket'. Now i am not well versed in history of county or our armed services medical terms but i do believe this term comes from that in so much as throwing a red blanket on someone who was a trauma victim and required emergent care to survive. so as we go through our days and nights of training that the RB becomes part of our vocabulary.
the interesting thing is the abuse of such a system----see when someone calls an RB to the OR---we treat it as a life-threatening situation that requires immediate surgery----we prepare for starting the surgery in seconds to minutes from the time we hear the call. this is critical for cases where someone is bleeding from a stab wound or GSW----possibly coming up from the ER with their chest already opened and the surgeon performing internal compressions, sometimes the pt still breathing and somewhat stable....for now....but in all of these situations team work is critical and we all have our roles. now back to the abuse story....see when a surgeon puts an urgent case into the scheduling genies as i call them----they turn in a 279----or 479---the paper with the patient info/surgery planned/surgeons/equipment needed----and from the golden paper the nurse manager who is running the or board places them on the board and prioritizes cases based on urgency of case and staff available at any given time. from the anesthesiologist's standpoint we must always have at least one if not two people available for an RB b/c we are a level 1 trauma center and could get hit at anytime....but this sometimes translates into fewer 'urgent' cases going during certain times of the day----and the surgery residents get annoyed with this----'why are you only running two rooms?; why can't we do our surgery first? blah blah blah.....and what often ends up happening is if they get really fed up with waiting they end up calling a case an RB and bring the pt to the OR immediately----basically putting us into a situation where we have to take the case but is kind of b/s b/c they will often take a long time to get the patient to the or---i am talking 30 or more minutes----or even better----oh well we are going to call this one in as an RB in about an hour....just fyi-----that goes completely against what the idea of an RB is in the first place man!!!! yes neurosurgery i am talking to you! just b/c it is now convenient for you to bring the pt to the OR doesn't give you the right to call it an RB!
so we now tend to call such cases pink blankets....or fake RB's-----so when we get an RB call now we ask 'is it a real RB?'......
that is just pathetic.
i am training at a county institution in a large urban center----basically this translates into what is better known as the 'knife and gun club' for the ER and trauma services. county has their own terminology for what is known to many in the medical world as a 'trauma'----an 'RB' or 'Red Blanket'. Now i am not well versed in history of county or our armed services medical terms but i do believe this term comes from that in so much as throwing a red blanket on someone who was a trauma victim and required emergent care to survive. so as we go through our days and nights of training that the RB becomes part of our vocabulary.
the interesting thing is the abuse of such a system----see when someone calls an RB to the OR---we treat it as a life-threatening situation that requires immediate surgery----we prepare for starting the surgery in seconds to minutes from the time we hear the call. this is critical for cases where someone is bleeding from a stab wound or GSW----possibly coming up from the ER with their chest already opened and the surgeon performing internal compressions, sometimes the pt still breathing and somewhat stable....for now....but in all of these situations team work is critical and we all have our roles. now back to the abuse story....see when a surgeon puts an urgent case into the scheduling genies as i call them----they turn in a 279----or 479---the paper with the patient info/surgery planned/surgeons/equipment needed----and from the golden paper the nurse manager who is running the or board places them on the board and prioritizes cases based on urgency of case and staff available at any given time. from the anesthesiologist's standpoint we must always have at least one if not two people available for an RB b/c we are a level 1 trauma center and could get hit at anytime....but this sometimes translates into fewer 'urgent' cases going during certain times of the day----and the surgery residents get annoyed with this----'why are you only running two rooms?; why can't we do our surgery first? blah blah blah.....and what often ends up happening is if they get really fed up with waiting they end up calling a case an RB and bring the pt to the OR immediately----basically putting us into a situation where we have to take the case but is kind of b/s b/c they will often take a long time to get the patient to the or---i am talking 30 or more minutes----or even better----oh well we are going to call this one in as an RB in about an hour....just fyi-----that goes completely against what the idea of an RB is in the first place man!!!! yes neurosurgery i am talking to you! just b/c it is now convenient for you to bring the pt to the OR doesn't give you the right to call it an RB!
so we now tend to call such cases pink blankets....or fake RB's-----so when we get an RB call now we ask 'is it a real RB?'......
that is just pathetic.
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