yeah, which i now have coursing thru my veins. we were one patient away from capping last night. thirty mins before morning report i had a H&P to dictate, got called for a fall, and got a lactate that was 7 on a not even very sick patient. im hoping that it was lab error. i went to go see her and make sure she wasnt writhing in pain from her ischemic bowel or something. she was a soft admit for COPD in the first place! she was sitting there happy as a clam, her only complaint being the EKG stickers were itchy. i cant get a BMP drawn on my DKA for anything, but by got they had that crazy lactate to me ASAP. fffffffffff. </vent>

yeah man, it's SCARY what the ER focuses on and what they miss. i remember starting as an intern and assuming they knew what they were doing - my upper level corrected my of the misconception quickly and frequently. a healthy skepticism makes a good md, also lots of caffeine

wow, yeah they f'd that up. though i will say i've given our er a pass for the next month cuz one of them jammed the only blakemore tube in the 2 connecting hospitals down the gullet of a massive variceal bleeder that i was about to admit with a mild cough.

and also - mudpiles - love it, this still goes through my head, frickin medschool mnemonics.

hell, we had three tylenol ppl in two days. no real mystery, tho, came in all suicidal and crazy. dont know how the antifreeze thing got missed by the ED, tho. dude had a bicarb of 12 and a gap. i mean, there are only so many things in mudpiles, amirite? they sent him to the floor. by the time we got to him and rechecked a BMP his bicarb was 9. they didnt even do an ABG. his pH was 7.1 when we checked it. i mean, damn.

DAMN! nice catch, and the wood's lamp is gravy. our ER was full of toxicology wannabes so we were never so lucky. though at the peds hospital we'd catch 1 or 2 tylenol poisonings a year. sounds like you're having too much fun in the middle of the night lol

have to brag. ER totally missed an ethylene glycol poisoning. Had admitted the guy to the floor without even any telemetry, btw with a bicarb of 12. Not sure what they were thinking. We caught it and got him to the ICU and emergent dialysis. Since we had some free time, we even got a Wood's lamp and the urine fluoresced. awesome!!! nothing like making pee glow at 4am.

yeah, ive resigned myself that ill basically be hanging out with my team, and the patients. good thing my cointern is cool. he is a transitional optho guy. totally sarcastic. we get along great. the resident switches on the 4th of the month, so i havent met her yet, but she is sposed to be cool, as well.

thats awesome! sounds like a good way to end the year. man trust me, july and vacation is going to feel amazing. haha. yeah the vampire thing is a bit strange though - hard to hang out with normal people that month lol

nightfloat, actually. its really doing a number on my circadian rhythms. nice to have weekends off, weird to be a vampire. next month is hard, but then a consult month and a pretty chill VA ward. and that is it! doing research and having some vacation in july. i cant wait!!!

good to see you around the forums, you must be surviving this year just fine - and possibly on a chill month - homestretch!