Finish your assessments

Please complete your assessments before making any hasty treatment decisions so you don’t look like an idiot.

For example, first of all, don’t forget to ask your patient what hurts and what happened. Don’t assume all old people are senile and unable to answer questions. This 90-year-old man turned out to be the funniest patient I’ve seen in a long time, even if he was very hard of hearing.

Then, just because someone is complaining of thigh pain doesn’t automatically mean he has a mid-shaft femur fracture. If it doesn’t look like there’s obvious deformity, perhaps you should consider touching his leg, for starters. He was later found to have a hip fracture, and the traction splint you wanted to use would surely have been very bad for him indeed.

Also, if he doesn’t even seem to be in any noticeable pain, don’t get so fixated on starting an IV and giving him narcotics that you forget to actually ask the patient what happened. His femur wasn’t fractured; I have no idea what you saw (or assumed). The fall likely wasn’t purely mechanical either. And you failed both otherwise easy IV attempts, unaided by him supine on the ground holding up his arms for gravity to drain all his blood downwards. Details, people. Details.

(Let’s not even get started with the whole “audible rales across the room” thing that inevitably ends up being upper airway mucus/phlegm/respiratory infection. What the hell do you think a stethoscope is used for?)

Take a minute to save a minute. Do things properly the first time around.

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