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Uh, the flu vaccine? It doesn't fully prevent infection, transmission, or death, and is likely far less effective than the Pfizer/Moderna vaccines at each of those things.

I'll start. Let me get my zebra in: Takutsubo's cardiomyopathy (even though the pt. doesn't really meet the epidemiological risk factors). Any workup 5.5 years ago to figure out what caused the PEs? Is he on anticoagulation?

Right, but then OP mentions pushing etomidate...

What do you mean by this? You have sedatives but no paralytics?

I agree. However, for the engineering controls to work as designed, they must not be intentionally ignored. I would be a lot more sympathetic if this were an emergent situation, with verbal orders and a time-sensitive need for the medication. This was not. A couple of things here. The override...

This should probably be kept in the domain of licensure and civil damages. However, I do find many in the healthcare community are trying to shift all blame onto the “system”. I find that a very troubling trend; where is the personal accountability and responsibility? People keep saying this is...

I am unsure how this relates to the points I've raised in this thread, but against my better judgement, I'll take the bait. Good. That is exactly how I wish to come across. I interpret your description of my posting as a complement. I try to learn and practice based on the best science and...

No, I did not (nor do I currently) work for you. I do like the word peri-arrest. I keep using it here because it nicely encapsulates the precise clinical scenario that I am referring to and that is at the crux of this scenario.

Again, where did I say that "nurses shouldn't do anything before the doc sees the patient"? I have been very clear and very particular with the claims I have made in this thread. Your "oversimplification" is wrong. I never commented on anything beyond what should happen with a critically...

Ah, so the story unravels. Those three patients are not the same level of "critical". The principle I will again espouse is that the physician must attend to the sickest patient in the department first, at least until stabilization has begun. Let me remind you, that this all started when I said...

Where did I say this?

It's ironic that you think my personal experiences are worth less than yours, but ignoring that. Let's approach this from a different perspective. National data shows that there are between 300,000 and 400,000 out of hospital cardiac arrests annually in the U.S. I chose cardiac arrest because...

You are completely correct that I am unconvinced the situation that you describe is happening regularly. I am not saying that it cannot happen; of course it can, but that is the unusual exception to the rule, not routine. Fundamentally, the question I propose you ask is: who is the sickest...

You're missing a little nuance that makes a world of difference. My stance is that a doctor should evaluate a critically ill (ergo, time sensitive) patient when available. The key distinction is that in an ER, a doctor is always (I guess technically almost always) available. Prehospitally, a...

1. C’mon. Not even close to the same thing. 2. I never said that. My implication was, however, and something that I stand behind fully is that medical school and residency training in emergency medicine prepares you for independent assessment, diagnosis, and decision making better than nursing...

Yes, I work in the US. I made a point of emphasizing provider because: 1. Many physicians don’t like being called providers (just like many PAs/NPs don’t like being called mid levels), so I don’t use (either) word and 2. I’m trying to get at the concept of what were the educational...

I am aware that there is high acuity across ERs in America, with no beds to admit to (ICU or floor) and no hospitals available to transfer patients out to, compounded/caused by critical staff shortages, leading to prolonged boarding of patients in the ED, causing all of the associated delays...

What are you even saying? Your practice environment is apparently exceptional if you consistently have multiple peri-arrest patients at the same time in a 9 bed FSER.