Tuesday, August 4, 2009

KDR in the ER

by: Amir Arsalan

It is currently 8:24 AM. I just got off an intense 10 hour night shift from work. Last night, the Emergency Room was completely inundated with patients. I was hounded by nurses, patients, and staff the entire night. I barely even had time for food or bathroom breaks. Oddly, I’m not even slightly exhausted, rather I feel energetic and lively. You might be wondering why. Two hours ago, an average, middle-aged, slightly overweight man came in with a chief complaint of ‘dyspnea’ – difficulty breathing. Other than the fact that he was on a ventilator, the situation seemed somewhat mundane…at first.

Within an hour, his condition worsened into a life-threatening state. There were 4 nurses and 2 radiology technicians by his bed-side and an intensivist on-call. Without warning, his heart rate climbed to ventricular tachycardia, his breathing rate increased, and his blood oxygen saturation level decreased significantly. The nurses alternated in performing rotations of CPR as multiple doses of epinephrine were pumped into his body. Needless to say, Room 17 was in a frantic state, while I calmly stood in a corner, jotting down event notes. Minutes later, the attending ER doctor called the time of death. The patient expired. The culprit: pulmonary embolism.

I have been working at Sentara Williamsburg as an Emergency Room scribe this summer. It would be a great exaggeration to say that all my shifts have been as interesting as the one I described above. However, my experiences so far have been incredible. I have learned a great deal about emergency medicine and the world of health-care in general.

The purpose of an Emergency Room scribe is to facilitate patient flow by working closely with a doctor as his or her assistant. Documentation is a major aspect of the job. We record patient histories, physical exams, diagnostic procedures, lab results, and other activities in which the doctor may engage. There are currently around 18 of us in total, and the ER is always staffed with at least 1-3 scribes. The coolest part about working as a scribe is the real-world application. You are actually able to experience all those ‘meaningless’ topics covered in basic chemistry or biology courses. It is a great opportunity for those thinking about medical school. I would highly recommend it to any premeds. You probably make as much as an average sweat-shop worker, but it’s the experience that counts, right?

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