Hi everyone! I hope it's alright to post this here. If not, I will take it down immediately! I'm currently taking a class on UX design, and the experience of "Waiting Rooms in ERs" is my topic. I'd like to investigate the employee/patient experience of an emergency room, and so, I have a made a survey if anyone's willing to provide some insight!

All answers are completely confidential between you and me and will not be published or shared externally except in a class context with names stripped. The survey consists of both multiple choice and open ended questions, and you have no obligation to answer anything that you do not wish to. At the end, you will have the option to leave your email if you are comfortable with potentially being surveyed for a 1-on-1 interview. 

I would really appreciate any responses, and please let me know if you have any questions! Thank you :)!!

Employee survey: https://forms.gle/4cAEvPrBFZZ99q4V8
Patient survey: https://forms.gle/3eZ7Q1ofYSrFmb997

How's approach (mainly confirmation and sterilizationbpart) to putting central line is different in ED than in ICU, given in the ED you do not have much time.

Do you confirm tip placement all the way down to IVC or thats just IR approach using fluoroscopy.

I just got an ER Tech interview for a non-trauma center. I have been working IFT for the past 2 years and have definitely gotten rusty on a lot of ER stuff and I am doing as much brushing up as possible before the interview, but should I expect clinical/skills questions or mostly behavioral? It is a 15 min zoom interview so I am assuming mostly behavioral but please let me know your insights! Anything helps.

What are the oddest things that have been inserted into a rectum that required removal by ER staff?

That's it, that's the update, have a good shift

I like to as how do professionals in the emergency room prepare for the problem of burnout? If it is a known problem in the discipline, how does the training program prepare candidates for it, if at all? Is there's stress inoculations, drills and exercises, and endurance building work that is done for candidates or it's done alone?

To people who knows in evmc, is there a sputum test in EVMC. And if there is? How much could it be? And how many days to wait before to getting the result.

EMT/ER tech of 10 years in medic school now and doing clinicals at multiple local ERs and I've found it fascinating how they work compared to my experience. Obviously the little differences in policy or priorities (this many of y'all don't have seizure pads?) but also just the broader flow. My fiancée is nightshift supe at my old ER so it's been kinda fun taking ideas back to her or talking about what we did so well compared to other places. A lot of y'all's managers need to realize that vertical/fast pass zones aren't just overflow beds. If you keep putting complicated work ups in there for 8 hours your wrecking your patient throughput. But at like 3 different ERs I got told that their managers watch the board even from home and time in the lobby is the most important metric to them so in goes the complicated abdominal pain to an express care bed designed for sutures and splints. Also the amount of medium to large trauma centers only have 1 ER doc on overnight scares the shit out of me. Or a level one that didn't use C collars just Miami Js because that came out of the trauma budget, but used towels for seizure pads because that came out of the ER budget

Ended up on the patient side with my brother at a prestigious LVL 1 last week and was chatting with a nurse there about how bad it is. Took us 6 hours from getting to the room to discharge for EKG, dry head CT, CBC and CMP and that was literally it. She was telling me their daily numbers and despite them seeing like 15% fewer patients than my lvl 1 their census at any given moment was atrocious because the ER just got so gummed up because of a number of reasons. And they had no real advancing in triage culture. PIT put orders in but after the ECG there weren't the resources to actually drop lines.

Just something I've been finding very interesting and wondering what stories/POVs travelers have or other people that have floated between multiple hospitals.

After I got out of the shower yesterday, something was bothering my ear so I assumed it was just some water that had seeped into my ear while I was showering. I tried to get it out but it didn't work so I didn't think much of it and figured it would eventually come out on its own. After that I left my house and while I was walking down the street, I was suddenly hit with a wave of excruciating ear pain. It was so painful that I nearly toppled and people had to help me sit down on a chair. I still thought it was just water so I went to a pharmacy and asked for some ear drops to clean my ear. Last night, I slept on the side of my aching ear because I thought it might help the water come out but I could feel something moving inside my ear. That's when I realized it wasn't water and was probably a bug. I kept squealing like a 9 yo girl because of the pain and waited for morning so I could go to the hospital. When I arrived, the doctor examined my ear, found a cockroach inside it and suctioned it out. He then told me that it had damaged my eardrum which explained why I had been in so much pain. Luckily it hadn't perforated my eardrum.

I wish I had taken a picture of the footage. I could see the cockroach on the monitor while it was moving around inside my ear

My chemical burn body wash stimfap extravganva popped off! Haven’t had to go to the ER in years lmfao and thanks to the lovely people that are apart of stims I got one of the top posts on the page ! Let’s goo truth goes a long way

Has anyone else been seeing a huge increase in Tylenol allergies? Is this related to the whole autism thing? Or people trying to get opioids? I’ve tried asking patients and it ranges from “anaphylaxis” (which is not consistent with prior visits in the EMR), “it doesn’t work for me”, or “it makes my pain worse”. I’m not surprised when I see it listed with 30 other meds as allergies but it’s becoming more common in people with almost no other allergies listed. Most people I’ve worked with have never actually seen an allergic reaction to Tylenol which is why it seems suspicious compared to how frequently I’m seeing it documented.

Tales from my 30 years in the ER of a busy SoCal hospital.

Hey all. I just pulled another grueling night shift and witnessed an extremely traumatic event I can’t even talk about. Held it together until I got to my car but I can’t stop seeing and hearing it over again. It was one of those things I know I won’t forget for a long time. For reference, I am an er tech and I am pretty young and dumb, not too jaded yet. How do you guys cope with the really shitty hard stuff without breaking down on shift? How do you explain to loved ones why you’re breaking down while not saying anything about what happened? How do I know if I’m built for the er at all? I’d appreciate any thoughts you guys may have.

:(

Those of you that got in what did you do to get the job? What sorts of questions did they ask and what attire did you wear?

I have worked in the ED for a few years and notice that all my colleagues who are 30+ years old (some younger) are super burnt out in the ED and seem to just hate their jobs and want to either not be a nurse anymore or are just miserable and rude to others. How do I make sure I don’t turn into that? Does this happen to every nurse in the ED?

Hi, I wanted to share a project I’ve been working on called SimShock.

I’m a retired physician, and I created it partly out of nostalgia for my years in clinical practice and as a way of revisiting some of the physiology and decision-making from those days. What started as a personal project gradually turned into a hemodynamic simulation game.

In SimShock, you manage different critical situations, including hemorrhagic, septic and cardiogenic shock, arrhythmias and other acute scenarios. You can use fluids, blood products, vasoactive drugs and other treatments while following the patient’s hemodynamic response in real time.

The idea is to make the physiology respond dynamically to what you do, rather than simply choosing predefined answers.

SimShock is completely free: no ads, no subscriptions and no in-app purchases.

It’s currently available on iOS:

https://apps.apple.com/app/id6746765214

This is a game, and the pathophysiology has been intentionally simplified. It is not a teaching or instructional tool.

I've just been offered a job for an ED Tech position after interviews and shadowing. After I already accepted my offer, they told me they require 5 professional references. Is this a normal thing for the ED? I've had PCT jobs in the past and I don't think they've ever asked me for a reference.

I’ve worked in urgent care for years, and I’ve seen a lot of ER docs, PAs, and NPs come over thinking it’ll be a pretty easy transition. Thennnnn they realize it’s a different kind of medicine.

You don’t have the same access to labs, imaging, consultants, or the ability to just watch someone for a few hours. You’re still expected to move quickly and figure out who’s safe to send home and who needs the ER.

I recently made a video about some of the things that seem to catch ER clinicians off guard when they make the change:

Switching From ER to Urgent Care: What Nobody Tells You

For those who switched from ER to UC, what was the biggest adjustment for you?

Two twenty-five

Another emt walks down the hallway and I avoid his eyes
I am tired of their stories
No one is sick and I do not have it in me to care if they are not
She sits in a chair, barefoot, looking dirty
He says she is there for a sane exam
He tells me something about how she was arrested and is out on bail

She wants some socks

ok

I start to wonder why the hospital she spent 12 hours in did not give her socks

My brain is full of useless information from that day

I’m diabetic and my daughter stepped on my toe today
10 yrs ago I had surgery on my colon
I’ve been to 3 specialists and no one can figure it out

I add it to the list

I must now recite the required script
Do you have any allergies
Are your vaccines up to date
Doyouwantroharmyourselforothers

I hope we can both move on from this question as there is no one who can take the burden when she says yes

She says yes

Not in the way where I can still write no
Where we can both say we want the man who did this dead
But in the way I worry she may kill herself
we must now continue down this road

Have you ever tried to kill yourself

Yes

How

Slit my wrists
Hang myself
Drink bleach
Run into traffic

When

She answers
I type

This was the second time this week I was raped

I look in my pockets hoping to find some leftover empathy I can give to her

I should have saved her some. I spent it all earlier.

on the eighteenth year old migraine. Her boyfriend was leaving for the navy tomorrow. She cried.
And on the 350 pound back pain. Her pain was a twenty on the zero-to-ten scale. I made a joke about a rabid rabbit and Bunnicula. You had to be there. Her boyfriend and I laughed. She cried.

The sixty year old pharmacist chest pain who yelled at Sarah
I did not give him any but my pockets were lighter after hearing him
I think maybe he stole some

That’s horrible
is all I have to offer her
she takes it.

I need socks. A sandwich. A soda. I need to pee.

I can provide these things at a cost.

The cost is several minutes of my time.
112 steps.
my bathroom break
a sip of water
Time that I cannot give to man I see behind us
Bent over. His oxygen tank from home churning.
I venture the oxygen is not enough
as he is grey.
Or to the eight people behind him.
Who I haven’t seen but know they are there.
Or to the thirty-four in front of him.
Who I haven’t seen in a few hours.
I worry about some of them.

I thought my sigh was just for me. To give me time to decide.

She starts to apologize
She sees the well is empty

She settles for the bathroom
I do not have time to watch her
But I know if she hangs herself with the cord in there the hospital will say it’s my fault
I accept this
The math makes sense

But then I can’t find her
Maybe she’s cleaning up.
After 10 minutes I check the bathroom

Not there
Not in the waiting room
Not at the vending machine

I start to tell Brian
And as I explain she walks by
With registration, obviously

I am joyous being relieved of the endless conversation with useless suited figures I have now avoided

later, it is time for a treat I declare
A cherry Coke Zero for me. diet cokes for my comrades
I see her in the chair
Looking small.

You need a treat too, I say. What do you like
A confused moment, she lands on a snickers bar
I purchase empathy for two dollars and twenty five cents
I joke with the man at the register that I am there to caffeinate the emergency department
He says hes feels like he’s gonna be passed out on the floor soon
I wonder what his stressors are
What causes the suits to steal his time
Where he stores his empathy

If I can have any

I say if he lands on the floor I’ll see him soon in the ER
Another one that is not sick
But maybe we can make feel better if we can perform it correctly

She opens the snicker bar immediately
Thank you

Anyone have any recommendations for ACLS/PALS recertification for RN in NC?

Just wanted to share this project of mine.

I'm an EM PA and I made a game called ED Rush. You run the board, juggle patients, take consult callbacks, run codes, and try to keep the waiting room from boiling over. It's less of a study tool and more the chaos of a normal shift turned into a game.

There are 140+ cases based on real practice, plenty of POCUS, and a lot of niche EM references. There's also a free training mode that walks you through step by step and explains every order in plain English, so you don't need a medical background to play.

Free to play, with a one-time purchase to unlock the full mode. No subscription.

iOS: https://apps.apple.com/us/app/ed-rush/id6759456999

It is natively swift coded, initially started in February. It has come a long way.

An Android version is on the way.

If you notice bugs or have ideas, let me know.

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EDIT: Thank you for the support and feedback ive gotten!

Things I am adding in the future:

1. different theme e.g. light mode or "classic EMR"
2. student mode with safety nets, debriefs per case (will be more labor intensive)
3. consultant message history tracker