I just wanted to share my recent experience with you guys and I welcome comments, criticism or feedback. Ok so I work in a small, rural critical acces hospital emergency room. My background includes general medical floor, orthopedics and 2 years in a much larger super fast paced ED. Most of the docs where I work now are either residents or family medicine physicians. None are board certified for emergency medicine.
So anyway I was working one night and received a 92 y/o female c/o chest pain. I also noticed, once she was on the monitor that her heart rhythm was A-Fib with RVR (ventricular rate of 103, not horrible but still). I called the physician to let him know we had patient and gave him a little info as to what was going on with her. After he assessed her and walked out of the room I asked job if I needed to give her cardizem to which he responded "why would you do that?". I told him that she might need some because this is a new onset of afib and technically she had RVR and her vent was was in the 130-150s now. I was always taught that if the vent rate is over 100bpm and in afib it qualifies as RVR. He goes on to explain to me what afib is and insisted she didn't have RVR. I then asked him, politely, to explain why I'm wrong because I legit wanted to be corrected if I truly dont understand something. He mumbled under his breath and had no further comments. That ticked me off already but the best part was what he ordered next for this lady... Yep, you guessed it: cardizem 20mg IVP. This happened only 5 min after our debate.
So help me out here to understand what he was trying to say! Am I even correct? Should I have questioned him like I did? How would you handle this situation? Thanks so much!
