Swine Flu

I've been working the 6pm-4am shift for the past four nights at the County. The patient wait times are getting longer and we are hitting record numbers of patients seen. I attribute it to fears of Swine Flu.

The symptoms of swine flu aka H1N1 virus are:

Fever, cough, sore throat, rhinorrhea, body aches, headaches, and sometimes nausea/vomiting/diarrhea. (Essentially, your normal flu symptoms)

We get especially concerned if the patient has come from Mexico, San Diego, or the Imperial County in the past week or if the patient has been in contact with some from these areas in the past 7 days.

If the person has exhibited symptoms for less than 48 hours, I prescribe an antiviral. Turns out the cost is $92.99 bucks for Tamiflu (oseltamivir) or $63.99 for Relenza (zanamivir). *Epocrates

But here's the rub: a lot of my patients don't have insurance or have federally funded/state funded health insurance.

How the hell are they going to pay for it?

What I like about Emergency Medicine

1. Variety - Every day is different. Some days there are trends. It can be pediatric patients with fevers one day, then women with vag bleeding another. I lose attention easily sometimes so it helps to see different types of patients.

2. Ultrasound - I'm really enjoying portable ultrasound to make diagnoses. I've used the PROBE to find retinal detachment, gallstones, AAAs, vascular access, pneumothorax, and free fluid in the abdomen after traumas. My favorite u/s exam is the eye because it so clear. The hardest exam for me is cardiac. Here's an excellent website on ultrasound.

3. Progressiveness - Since EM is the newest specialty, I believe our specialty has the ability to flex and bend to changes. For example, Ketamine and Propofol in combination for Keto-Fol! There's a lot of room for growth and debate on what should be done in the ED.

4. Shift work -I don't mind the transition between mornings, nights, and days. It's cool to stay awake after an overnight shift and hang out at Starbucks seeing morning people when it's nearly bedtime for me.

5. The smells - Just kidding;)