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The medical director of my paramedic program used to work for a hospital that provided medical control for a number of major airlines (generally speaking, even
by JshWright 14y ago
The medical director of my paramedic program used to work for a hospital that provided medical control for a number of major airlines (generally speaking, even when they ask for a physician on a plane, they're also calling the airline's 'on call' doctor as well).
His scariest stories weren't due to the criticality of the patient, but rather the incompetence of the provider on board the plane (to the point that he, on several different occasions, had to instruct the flight crew to 'please keep him away from the patient for the rest of the flight'). Just because someone is a 'doctor' doesn't necessarily mean they're well equipped to handle a medical emergency (note: the physician interviewed here managed the patient perfectly appropriately).
It's possible he was just pandering to the room of soon-to-be paramedics at the time, but he said he generally instructed the flight crew to ask for a paramedic before a physician, simply because they're generally more comfortable working in the 'austere' medical setting found on a plane.
- btilly 14y agoMy wife told me about a famous dermatologist who flies in dread of getting that call and there being no other doctor available. When med school was 40 years ago, you're not necessarily going to be comfortable handling, say, a heart attack.
- supwiggles 14y agoOne of my paramedic instructors told me a pretty funny story. Apparently they were on shift one Saturday afternoon, when a call came through for a Code 2 (Cardiac Arrest) at a local racecourse. Anyway, it was about 15 minutes away so they took off in a hurry, all the while receiving notes on their terminal regarding the job. Apparently it went along the lines of this: Initial: Unknown Age, Cardiac Arrest, Racecourse etc Update: CPR in Progress Update: Doctor has self accounced at scene. Update: Doctor has called patient as deceased. CPR ceased. It took another 5 minutes for the paramedics to get to the racecourse, and they still unloaded their gear and made their way to the patient. When asking for the doctor, they found that it was actually the racecourse veterinarian who had made the call.
- pyre 14y agoAre you implying that the emergency call was for a horse/dog in cardiac arrest, or just that the racecourse vet was the 'doctor' performing on the human?
- supwiggles 14y agoSorry, I should have clarified. It's late here, and I am tired. The call was for a human, the 'doctor' who called it was a vet at the racecourse.
- JshWright 14y agoI'm assuming the patient wasn't a racehorse? If I had a dollar for every time a dermatologist or podiatrist tried to be 'helpful' on an emergency scene... I could probably buy a coffee at Starbucks... The same goes for 'nurses.' If an ER nurse wants to help out, that's great. Invariably though, it's a nurse at a nursing home or dialysis center... I don't mean to imply these folks aren't skilled professionals, but prehospital medical emergencies are generally well outside their experience, and the confusion that arises from that can be dangerous.
- stephencanon 14y agoUnlike a podiatrist, a dermatologist went to medical school. If they're young, there's actually a good chance that they were among the very best medical students -- in the past few years, dermatology has become one of the more competitive fields in medicine because of the lifestyle (short predictable hours, high pay, minimal insurance hassles). There are daft people in every field, but I would be delighted to have most of the derm residents and attendings I've met in an emergency (in fairness, I should note that this is a small sample, drawn from a couple top-tier hospitals, and biased towards people who do volunteer backcountry search and rescue).
- JshWright 14y agoYeah, the podiatrist comment was a bit tongue-in-cheek. Like I said, I'm not try to discredit these folks as skilled (and in many cases, extremely smart) individuals. However, a couple weeks of a rotation through an ER during med school isn't really going to prepare you well for prehospital emergencies (SAR, on the other hand, can be great training for that). Making an assessment and clinical decisions based on fairly limited information isn't something I've found most physicians to be comfortable with, especially in an emergency setting. My list of 'glad to see you' docs is pretty much: ER, OB, and Anesthesia.
- FireBeyond 14y agoOne of my EMS instructors: "On scene, any person claiming to be a physician should be assumed to be a dermatologist or proctologist until proven otherwise."
- philwelch 14y agoIt could be worse--psychiatrists are also physicians.
- deleted 14y ago[deleted]