Navigating Doctors Idiosyncrasies - page 2
by whitecat5000 1,237 Views | 12 Comments
So back story. . . I had a 32 yr old female patient that was a direct admit around 2300 for hematuria. We call the doctor and get orders for a CT abd/pelvis w + w/o contrast, insert three-way and irrigate PRN, and CBC. So CT... Read More
- 0Mar 22, '13 by psu_213Quote from AltraThe only issue would be the 3 way. If they have CBI, they would be admitted. Most of the pt's in the ED who have Foleys placed for urinary retention are sent home with f/u with urology. However, hematuria pt's are occasionally admitted if the doc is concerned if the foley will just get clotted. I can go either way, in my experience. Anyway...OT but ... admission for this? Unless there was intractable pain / nausea, this sounds like an outpatient workup.
As for the original scenario, there is basically no way I would have called the doc back for orders for an HCG and a BMP (I would say that a CMP is not really necessary just for kidney function--although I'm a bit surprised the doc didn't order either a CMP or BMP to being with). As JBudd mentioned, in the ER, we are fully expected to just order these if a CT with contrast is ordered.
I also find little (to nothing) wrong with this scenario.
- 0Mar 24, '13 by whitecat5000Quote from AltraYeah, she was admitted because there was pain with urination and she kept passing quarter sized clots with much difficulty.I don't see this as a physician's "idiosyncrasy" ... I just see it as learning to recognize protocols and requirements for diagnostic testing and so forth.
OT but ... admission for this? Unless there was intractable pain / nausea, this sounds like an outpatient workup.
Thanks for all the feedback everyone!