LAS VEGAS, NV – Last Friday was the conclusion of the 18th annual meeting of the High-rolling Emergency Medicine Physicians (HEMP) association. Aside from several heaters at the craps table, HEMP President Dr. Cray Rudnick said the meeting also produced a document that will change ER practice across the country.
“We basically hammered out key catchphrases that will get consultants to come take a pain in the ass patient off your board, even if that means getting some dirty looks and ‘stretching’ or completely ‘falsifying’ the truth at times.” Dr. Rudnick shared in a tone that could be called almost giddy.
Gomerblog was able to obtain a partial list of these magic phrases:
Anesthesia: “Mallampati 4, GCS of 4, I’m gonna try a King LT.” Anesthesia will be in the ER before you even hang up the phone.
Cardiology: “ST Elevation, new from EKG last year!” The ST elevation may be unchanged from 6 months ago, but its definitely new from the EKG 12 months ago.
ENT: “Kid with difficulty breathing last seen holding a quarter.” Could be a kid you saw cough while holding some change when you walked past his bed, but let them experts figure that one out.
Dermatology: We’re clueless here. Please contact HEMP if you’ve got any ideas!
Gastroenterology: “Upper GI Bleed, Dropping H&H.” Could be that the patient coughed up blood after flossing and their H&H is now 14/42 down from 15/45 at a checkup 2 years ago but better safe that sorry!
General Surgery: “Young healthy male, less than 24hrs of umbilical becoming RLQ pain with peritoneal signs, classic appy.” Could also be that he has the same pain he gets everytime he subsists on Chipotle and Busch Light for a whole weekend.
Hospital Administration: “Plummeting Press-Ganey scores and a bad Yelp Review!” Maybe they’ll come in but I wouldn’t count on it.
Infectious Diseases: “Patient with a rash and aids.” Hearing aids aren’t really relevant, but you can’t tell lowercase aids from uppercase AIDS on the phone!
Internal Medicine: None needed. They’ll pretty much see anything and have accepted their role as the dumping grounds for the ER and Ortho.
Nephrology: Your guess is as good as ours, maybe claim the dialysis unit has free pizza and it’s in the ER?
Neurosurgery: “Cauda Equina!” They can’t tell over the phone that its just an obese patient with back pain, normal bowel/bladder function and normal saddle feelings!
Occupational Med: “Acute worker’s comp”? We’ve never seen anyone who does Occ Med at work, like ever.
OB/GYN: “Ectopic Pregnancy by our Ultrasound” Everyone knows an ER ultrasound is like a North Korean military threat, useless and inaccurate, but they now have to prove it wrong on their own. Bed 4, now open!
Ophthalmology: “60yr old Eskimo female with severe eye pain and profuse tearing.” You should get props from the Lookingball Doctors for just knowing that Eskimo women have high rates of Acute Angle Closure Glaucoma.
Oral Surgery: “Severe Dental Abscess.” Even if its 4 weeks of tooth pain, they’ll handle the patient.
Orthopaedic Surgery: “I’m concerned for Flexor Tenosynovitis.” There may be 4 days of pain and a small dorsal finger scratch, but by the time they know it, the patient is off your board!
Pathology: Yeah right.
Pediatrics: “Former premie with lethargy.” Could be a girl born at 39 weeks instead of 40 who stayed up a bit last night at Bat Mitzvah party.
Plastic Surgery: “Infected breast implant, draining pus and cash.” Maybe this will work, maybe.
Psychiatry: “Depressed young male considering ending it all.” Entirely accurate representation of a recent breakup victim thinking about deleting his Tinder account.
Rheumatology: Good luck.
Urology: “Testicular Torsion.” Maybe its that or maybe the guy hurts because he racked his family jewels on a railing while skateboarding an hour ago. Let the expert figure it out.